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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02369653
Registration number
NCT02369653
Ethics application status
Date submitted
21/01/2015
Date registered
24/02/2015
Date last updated
8/03/2022
Titles & IDs
Public title
A Study of the Safety and Effectiveness of Apixaban in Preventing Blood Clots in Children With Leukemia Who Have a Central Venous Catheter and Are Treated With Asparaginase
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Scientific title
A Phase III Randomized, Open Label, Multi-center Study of the Safety and Efficacy of Apixaban for Thromboembolism Prevention Versus No Systemic Anticoagulant Prophylaxis During Induction Chemotherapy in Children With Newly Diagnosed Acute Lymphoblastic Leukemia (ALL) or Lymphoma (T or B Cell) Treated With Asparaginase
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Secondary ID [1]
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2014-000328-47
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Secondary ID [2]
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CV185-155
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Lymphoma
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Acute Lymphoblastic Leukemia
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Condition category
Condition code
Cancer
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Lymphoma (non Hodgkin's lymphoma) - High grade lymphoma
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Cancer
0
0
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Lymphoma (non Hodgkin's lymphoma) - Low grade lymphoma
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Cancer
0
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Leukaemia - Acute leukaemia
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Cancer
0
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Leukaemia - Chronic leukaemia
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Cancer
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Children's - Leukaemia & Lymphoma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Experimental: Apixaban - Children aged 1 to \<18 years weighing 6 to \<35 kg randomized to apixaban will receive a fixed dose apixaban based on body weight tier twice a day for approximately 28 days.
Children aged 1 to \<18 years weighing = 35 kg will receive 2.5 mg of apixaban twice a day for approximately 28 days. Subjects = 5 years may be administered either 2.5-mg, 0.5-mg tablets or oral solution apixaban. Subjects \< 5years and \< 35 kg may be administered 0.5-mg tablets only
Placebo comparator: No systemic anticoagulant prophylaxis - No systemic anticoagulant prophylaxis
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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The Number of Participants With Non-Fatal DVT, PE, and CVST, and VTE-Related-Death
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Assessment method [1]
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The number of participants with non-fatal deep vein thromboses (DVT) (including asymptomatic and symptomatic), pulmonary embolism (PE), cerebral venous sinus thrombosis (CVST); and venous thromboembolism (VTE) related-death objectively confirmed by a blinded, independent adjudication committee.
Symptomatic events are included during the intended treatment period. Asymptomatic events are included from scans up to Day 40.
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Timepoint [1]
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From first dose up to approximately 40 days after first dose
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Primary outcome [2]
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The Number of Participants With Adjudicated Major Bleeding
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Assessment method [2]
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The number of participants with major bleeding adjudicated by a blinded, independent adjudication committee. Adjudicated major bleeding is defined as bleeding that satisfies one or more of the following criteria:
1. fatal bleeding
2. clinically overt bleeding associated with a decrease in hemoglobin of at least 20g/L (ie, 2g/dL) in a 24-hour period
3. bleeding that is retroperitoneal, pulmonary, intracranial, or otherwise involves the CNS; and/or
4. bleeding that requires surgical intervention in an operating suite, including interventional radiology.
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Timepoint [2]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [1]
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The Number of Participants With Non-fatal Asymptomatic Deep Vein Thromboses (DVT)
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Assessment method [1]
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The number of participants with non-fatal asymptomatic deep vein thromboses (DVT) adjudicated by a blinded, independent adjudication committee
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Timepoint [1]
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From first dose up to approximately 40 days after first dose
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Secondary outcome [2]
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The Number of Participants With Non-fatal Symptomatic Deep Vein Thromboses (DVT)
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Assessment method [2]
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The number of participants with non-fatal symptomatic deep vein thromboses (DVT) adjudicated by a blinded, independent adjudication committee
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Timepoint [2]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [3]
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The Number of Participants With Non-fatal Pulmonary Embolism (PE)
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Assessment method [3]
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The number of participants with non-fatal pulmonary embolism (PE) adjudicated by a blinded, independent adjudication committee
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Timepoint [3]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [4]
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The Number of Participants With Cerebral Venous Sinus Thrombosis (CVST)
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Assessment method [4]
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The number of participants with cerebral venous sinus thrombosis (CVST) adjudicated by a blinded, independent adjudication committee
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Timepoint [4]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [5]
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The Number of Participants With Venous Thromboembolism (VTE)-Related-death
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Assessment method [5]
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The number of participants with venous thromboembolism (VTE)-related-death adjudicated by a blinded, independent adjudication committee
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Timepoint [5]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [6]
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The Number of Participants With Major and Clinically Relevant Non-Major Bleeding (CRNMB)
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Assessment method [6]
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The number of participants with major and clinically relevant non-major bleeding (CRNMB) adjudicated by a blinded, independent adjudication committee
CRNM bleeding is defined as bleeding that satisfies one or both of the following:
1. overt bleeding for which blood product is administered and not directly attributable to the subject's underlying medical condition and
2. bleeding that requires medical or surgical intervention to restore hemostasis, other than in an operating room
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Timepoint [6]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [7]
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The Number of Participant Deaths
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Assessment method [7]
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The number of participant deaths adjudicated by a blinded, independent adjudication committee
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Timepoint [7]
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From first dose date until the end of the treatment period + 30 days (Up to approximately 59 days)
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Secondary outcome [8]
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The Number of Participants With an Arterial Thromboembolic Event
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Assessment method [8]
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The number of participants with an arterial thromboembolic event including paradoxical embolism and stroke adjudicated by a blinded, independent adjudication committee
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Timepoint [8]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [9]
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The Number of Participants With a CVAD-Related Infection
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Assessment method [9]
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The number of participants with a central venous access device (CVAD)-related infection adjudicated by a blinded, independent adjudication committee
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Timepoint [9]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [10]
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The Number of Participants Needing Catheter Replacements During the Study
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Assessment method [10]
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The number of participants needing catheter replacements during the study
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Timepoint [10]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [11]
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The Number of Participants With CVAD Patency Restoration Events After Thrombolytic Therapy Use
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Assessment method [11]
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The number of participants with central venous access device (CVAD) patency restoration events after thrombolytic therapy use
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Timepoint [11]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [12]
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The Number Participants Experiencing Superficial Vein Thrombosis Events
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Assessment method [12]
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The number participants experiencing superficial vein thrombosis events.
Clots that occur in a superficial vein ie, cephalic vein, basilic vein (upper extremity) or saphenous vein (lower extremity) confirmed by radiographic imaging.
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Timepoint [12]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [13]
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The Number of Participants With Clinically Relevant Non-Major Bleeding Events (CRNMB)
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Assessment method [13]
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The number of participants with clinically relevant non-major bleeding events (CRNMB) adjudicated by a blinded, independent adjudication committee.
CRNM bleeding is defined as bleeding that satisfies one or both of the following:
1. overt bleeding for which blood product is administered and not directly attributable to the subject's underlying medical condition and
2. bleeding that requires medical or surgical intervention to restore hemostasis, other than in an operating room
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Timepoint [13]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [14]
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The Number of Participants With Minor Bleeding Events
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Assessment method [14]
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The number of participants with minor bleeding events adjudicated by a blinded, independent adjudication committee.
Minor bleeding defined as any overt or macroscopic evidence of bleeding that does not fulfill the criteria for either major bleeding or CRNMB
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Timepoint [14]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [15]
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The Number of Platelet Transfusions Needed During the Study
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Assessment method [15]
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The number of platelet transfusions needed during the study.
The events are not adjudicated. A subject could have more than one platelet transfusion.
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Timepoint [15]
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From first dose up to approximately 34 days after first dose
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Secondary outcome [16]
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Maximum Observed Concentration (Cmax)
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Assessment method [16]
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The maximum observed concentration (Cmax) was measured to assess the pharmacokinetics of oral or enteric apixaban in pediatric subjects receiving induction chemotherapy.
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Timepoint [16]
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pre-dose, 1-4 hours post dose
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Secondary outcome [17]
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Trough Observed Concentration (Cmin)
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Assessment method [17]
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The trough observed concentration (Cmin) was measured to assess the pharmacokinetics of oral or enteric apixaban in pediatric subjects receiving induction chemotherapy.
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Timepoint [17]
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pre-dose, 1-4 hours post dose
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Secondary outcome [18]
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Area Under the Concentration-Time Curve [AUC(TAU)]
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Assessment method [18]
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The area under the concentration-time curve \[AUC(TAU)\] was measured to assess the pharmacokinetics of oral or enteric apixaban in pediatric subjects receiving induction chemotherapy.
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Timepoint [18]
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pre-dose, 1-4 hours post dose
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Secondary outcome [19]
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Anti-FXa Activity
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Assessment method [19]
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Anti-FXa Activity was measured to characterize the relationship between apixaban plasma concentration and anti-FXa activity in pediatric subjects receiving induction chemotherapy
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Timepoint [19]
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pre-dose and 2.5 hours after dosing on day 7. Day 8 and day 15.
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Eligibility
Key inclusion criteria
For more information regarding BMS clinical trial participation, please visit www.BMSStudyConnect.com
* New diagnosis of de novo ALL, lymphomas (T or B cell), or mixed-phenotype acute leukemia
* Planned 3-4 drug systemic induction chemotherapy with a corticosteroid, vincristine and a single dose or multiple doses of asparaginase, with or without daunorubicin
* Functioning Central Venous Access Device
* Must be able to tolerate oral medication or have it administered via an Nasogastric tube (NGT) or GT tube
* Males and females,age 1 year(365 days) to < 18 (17 years and 364 days) years.
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Minimum age
1
Year
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Maximum age
17
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Subjects scheduled to have > 3 Lumbar Punctures over the course of the study treatment period
* Prior history of documented DVT or PE in the past 3 months
* Known inherited bleeding disorder or coagulopathy
* Major surgery [excluding Central Venous Access Device (CVAD) replacement and bone marrow aspiration and non-open biopsy] within the last 7 days prior to enrollment that may be associated with a risk of bleeding. Open biopsy is considered a major surgery.
* Uncontrolled severe hypertension at enrollment. Severe hypertension is defined as a systolic or diastolic blood pressure (BP) > 5 mm Hg above the 95th percentile as defined by the National High Blood Pressure Education Program Working Group (NHBPEP) established guidelines for the definition of normal and elevated blood pressure in children
* Extreme hyperleukocytosis, white blood cell (WBC) counts over 200 x 109/L (200,000/microL) at the time of enrollment
* Liver dysfunction manifested by SGTP (ALT) > 5X Upper limit of normal (ULN) and/or Aspartate aminotransferase (AST) >5 X ULN and/or direct (conjugated) bilirubin > 2X ULN
* Renal function < 30% of normal for age and size as determined by the Schwartz formula
* International normalized ratio (INR) > 1.4 and activated partial thromboplastin time (aPTT) > 3 seconds above the upper limit of normal for age, within 1 week prior to enrollment.
* History of allergy to apixaban or Factor Xa inhibitors
* History of significant adverse reaction or major bleeding related adverse reaction to other anticoagulant or antiplatelet agents
* History of any significant drug allergy (such as anaphylaxis or hepatotoxicity
* Any investigational drug being administered during the study
Other protocol inclusion/exclusion criteria may apply
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Study design
Purpose of the study
Prevention
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
22/10/2015
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
7/07/2021
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Sample size
Target
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Accrual to date
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Final
512
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,VIC
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Recruitment hospital [1]
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Local Institution - New Lambton Heights
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Recruitment hospital [2]
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Queensland Children's Hospital - Sth Brisbane
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Recruitment hospital [3]
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Monash Medical Centre Clayton - Clayton
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Recruitment hospital [4]
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Local Institution - Parkville
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Recruitment postcode(s) [1]
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2305 - New Lambton Heights
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Recruitment postcode(s) [2]
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4101 - Sth Brisbane
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Recruitment postcode(s) [3]
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3168 - Clayton
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Recruitment postcode(s) [4]
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3052 - Parkville
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Arizona
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Country [2]
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United States of America
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State/province [2]
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California
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Country [3]
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United States of America
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State/province [3]
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Connecticut
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Country [4]
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United States of America
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State/province [4]
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Delaware
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Country [5]
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United States of America
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State/province [5]
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Florida
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Country [6]
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United States of America
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State/province [6]
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Georgia
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Country [7]
0
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United States of America
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State/province [7]
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Idaho
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Country [8]
0
0
United States of America
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State/province [8]
0
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Indiana
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Country [9]
0
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United States of America
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State/province [9]
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Iowa
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Country [10]
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United States of America
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State/province [10]
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Kentucky
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United States of America
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State/province [11]
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Louisiana
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United States of America
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Maryland
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Country [13]
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United States of America
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State/province [13]
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Michigan
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United States of America
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State/province [14]
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Minnesota
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Country [15]
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United States of America
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State/province [15]
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Mississippi
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Country [16]
0
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United States of America
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New Jersey
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Country [17]
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United States of America
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State/province [17]
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New York
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Country [18]
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United States of America
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State/province [18]
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North Carolina
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Country [19]
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United States of America
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State/province [19]
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Ohio
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Country [20]
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United States of America
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Pennsylvania
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Country [21]
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United States of America
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Tennessee
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Country [22]
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United States of America
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Texas
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United States of America
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Washington
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Country [24]
0
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United States of America
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State/province [24]
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Wisconsin
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Country [25]
0
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Belgium
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State/province [25]
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Bruxelles
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Country [26]
0
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Belgium
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State/province [26]
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Edegem
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Country [27]
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Belgium
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State/province [27]
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Gent
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0
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Belgium
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State/province [28]
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Leuven
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0
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Canada
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State/province [29]
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Alberta
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Country [30]
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Canada
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State/province [30]
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Newfoundland and Labrador
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Country [31]
0
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Canada
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State/province [31]
0
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Ontario
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Country [32]
0
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Czechia
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State/province [32]
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Brno
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Country [33]
0
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Hungary
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State/province [33]
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Budapest
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Country [34]
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Hungary
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State/province [34]
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Debrecen
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Country [35]
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Hungary
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State/province [35]
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Pecs
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Country [36]
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Korea, Republic of
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State/province [36]
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Seoul
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Mexico
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Distrito Federal
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Mexico
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Jalisco
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0
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Mexico
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Nuevo Leon
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0
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New Zealand
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Christchurch
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Country [41]
0
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Poland
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State/province [41]
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Wroclaw
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Poland
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State/province [42]
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Zabrze
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0
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Puerto Rico
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0
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Caguas
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0
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Russian Federation
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Kirov
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0
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Russian Federation
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Moscow
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Russian Federation
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0
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Saint Petersburg
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Country [47]
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Russian Federation
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State/province [47]
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St.petersburg
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Bristol-Myers Squibb
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Address
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Country
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Other collaborator category [1]
0
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Commercial sector/industry
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Name [1]
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Pfizer
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Address [1]
0
0
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
The purpose of this study is to compare the effect of a blood thinning drug called Apixaban versus no administration of a blood thinning drug, in preventing blood clots in children with leukemia or lymphoma. Patients must be receiving chemotherapy, including asparaginase, and have a central line (a catheter inserted for administration of medications and blood sampling)
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Trial website
https://clinicaltrials.gov/study/NCT02369653
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Bristol-Myers Squibb
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Address
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Bristol-Myers Squibb
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Country
0
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Phone
0
0
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Fax
0
0
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Email
0
0
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Contact person for public queries
Name
0
0
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Address
0
0
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Country
0
0
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Phone
0
0
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Fax
0
0
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Email
0
0
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Contact person for scientific queries
No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/53/NCT02369653/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/53/NCT02369653/SAP_001.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT02369653
Download to PDF