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Phase 4 N=676 Randomized Treatment

Uninterrupted Dabigatran Etexilate in Comparison to Uninterrupted Warfarin in Pulmonary Vein Ablation (RE-CIRCUIT)

Atrial Fibrillation

Enrolled (actual)
676
Serious AEs
20.4%
Results posted
Nov 2017
Primary outcome: Primary: Incidence of Major Bleeding Events (MBEs), as Defined by the International Society on Thrombosis and Haemostasis (ISTH) — 1.6; 6.9 percentage of participants — p=0.0009

Study Design & Population

Study type
Interventional
Phase
Phase 4
Interventions
Warfarin (Drug); Dabigatran Etexilate 150mg (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Boehringer Ingelheim
Primary completion
Nov 2016

Outcome Measures

OutcomeResultp-value
PRIMARY
Incidence of Major Bleeding Events (MBEs), as Defined by the International Society on Thrombosis and Haemostasis (ISTH)
1.6; 6.9 0.0009 sig
SECONDARY
Incidence of the Composite of Stroke, Systemic Embolism, or Transient Ischemic Attack (TIA)
0.0; 0.3
SECONDARY
Incidence of Minor Bleeding Events
18.6; 17.0
SECONDARY
Incidence of ISTH MBE, Stroke, Systemic Embolism, or TIA (Composite Endpoint Combining Safety and Efficacy
1.6; 7.2

Summary

The primary objective of this trial is to assess the safety of an uninterrupted dabigatran etexilate periprocedural anticoagulant regimen compared to an uninterrupted warfarin regimen in Non-Valvular Atrial Fibrillation (NVAF) patients undergoing Atrial Fibrillation (AF) ablation in a PROBE (Prospective, randomized, open label, blinded end point) active controlled study. Secondary objectives are to assess additional safety endpoints and efficacy in this clinical setting. It is not intended to assess confirmatory hypothesis, this is an exploratory study.

Eligibility Criteria

Inclusion criteria

  • Male or female patients aged >= 18 years.
  • Patients eligible for treatment with dabigatran etexilate 150 mg b.i.d. according to local label.
  • Treatment naïve patients or patients on oral anticoagulant treatment with a Vitamin K Antagonist (VKA), dabigatran etexilate, rivaroxaban, apixaban or edoxaban.
  • Patient with paroxysmal or persistent NVAF with a planned catheter ablation for AF unless it is performed an investigational ablation technique.
  • AF must have been documented at least once either by ECG, Holter monitoring, loop recorder, telemetry, trans-telephonic monitoring, pacemaker or cardiac defibrillator read outs within 24 months prior to screening (Visit 1).
  • The patient must be able to give informed consent in accordance with International Conference on Harmonisation (ICH) Good Clinical Practice (GCP) guidelines and local legislation and/or regulations.

Exclusion criteria

  • Patients with permanent AF.
  • Patients with AF felt to be secondary to an obvious reversible cause such as, but not limited to, an acute myocardial infarction, pulmonary embolism, recent surgery, pericarditis or thyrotoxicosis.
  • Patients with Left Atrium (LA) size >= 60 mm
  • Patients with contraindications to systemic anticoagulation with heparin, warfarin or dabigatran etexilate
  • Patients with a known allergy to warfarin tablets and it excipients or to dabigatran etexilate or its excipients
  • Mechanical or biological heart valve prosthesis
  • Severe renal impairment (estimated Creatinine Clearance (CrCl) calculated by Cockcroft-Gault equation) 3x upper limit of normal and/or -- Known active hepatitis C and/or -- Known active hepatitis B and/or -- Known active hepatitis A
  • Need for continued treatment with systemic ketoconazole, itraconazole, posaconazole, cyclosporine, tacrolimus, dronedarone, rifampicin, phenytoin, carbamazepine, St. John's Wort or any cytotoxic/myelosuppressive therapy.
  • Pre-menopausal (last menstruation <=1 year prior to screening) who:
  • Are pregnant or breast-feeding or plan to become pregnant during study or
  • Are not surgically sterile or
  • Are of child bearing potential and not practising two acceptable method of birth control, or do not plan to continue practising an acceptable method of birth control throughout the trial
  • Patients who have participated in another trial with an investigational drug or device within the past 30 days preceding the screening visit or are participating in another trial (patients participating in an observational study only will not be excluded)
  • Patients not willing or able to comply with the protocol requirements or considered unreliable by the Investigator concerning the requirements for follow-up during the study and/or compliance with study drug administration, who have a life expectancy less than the expected duration of the trial due to concomitant disease and/or subjects who are institutionalised due to official or court orders and/or vulnerable subjects who are dependent on the Sponsor or the Investigator or the site, or patients who have any condition which in the opinion of the Investigator, would not allow safe participation in the study (e.g. drug addiction, alcohol abuse).
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT02348723). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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