Anfibatide Phase Ib-IIa Clinical Trial

Overview

Investigate the safety and efficacy of Anfibatide in non-ST segment myocardial infarction patients

Full Title of Study: “A Multi-center, Randomized, Double-blind, Multi-dose Group, Parallel Group and Placebo Controlled Phase Ib-IIa Clinical Study to Evaluate the Safety and Efficacy of Antiplatelet Thrombolysin for Injection for the Treatment of Patients With Non-ST Segment Elevation Myocardial Infarction (NSTEMI).”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Double (Investigator, Outcomes Assessor)
  • Study Primary Completion Date: December 2014

Detailed Description

1. This study is a phase Ib-IIa exploratory study to observe the safety of Antiplatelet Thrombolysin for Injection for the treatment of non-ST segment myocardial infarction (NSTEMI) patients and preliminarily evaluate the efficacy of different doses, providing the theoretical basis of the phase II and III clinical study protocol. 2. To investigate the pharmacokinetics of different doses.

Interventions

  • Drug: Anfibatide
    • Snake venom
  • Drug: Placebo
    • Saline

Arms, Groups and Cohorts

  • Active Comparator: Anfibatide
    • Bolus injection will be finished in 5 minutes immediately when the guidewire passes through the first stenosed vessel; bolus injection of different doses+0.002IU/kg/h intravenous infusion for 48h
  • Placebo Comparator: Placebo
    • Bolus injection will be finished in 5 minutes immediately when the guidewire passes through the first stenosed vessel; bolus injection of different doses+0.002IU/kg/h intravenous infusion for 48h

Clinical Trial Outcome Measures

Primary Measures

  • Platelet aggregation
    • Time Frame: up to 48 hours
    • The inhibition of ristocetin-induced platelet aggregation as measured by whole blood impedance aggregometr in vitro.
  • Bleeding events
    • Time Frame: Day 0 to day 30
    • Bleeding events classified according to the Bleeding Academic Research Consortium (BARC) .

Secondary Measures

  • Mortality
    • Time Frame: 30 days after treatment
    • all-cause mortality, relapse of nonfatal myocardial infarction, nonfatal stroke, second target vascular reconstructio.
  • Safety Endpoints
    • Time Frame: Day 0 to day 30
    • Degree of thrombocytopenia; Moderate (<100,000 platelets/mm3); Severe (<50,000 platelets/mm3); Extremely severe (<20,000 platelets/mm3)
  • Thrombosis formation
    • Time Frame: 48 hours after infusion during operation
    • Thrombosis formation after stent implantation:
  • Thrombolysis in myocardial infraction (TIMI)
    • Time Frame: day 0
    • The proportion of TIMI from grade 0 to 3 Pre -and post-PCI was evaluated.
  • Corrected TIMI frame count(CTFC)
    • Time Frame: day 0
    • The values of CTFC were evaluated and compared between groups.
  • TIMI myocardial perfusion grade (TMBG)
    • Time Frame: day 0
    • The proportion of TMPG from grade 0 to 3 Pre -and post-PCI was evaluated.

Participating in This Clinical Trial

Inclusion Criteria

1. Aged 18-70 years; 2. Laboratory tests show increase of the markers of myocardial damage (CK-MB,CTnI), or reduction after increase, with at least one values exceeding the 99th percentile of the upper limit of the reference value; 3. Ischemia symptoms (ischemic chest pain lasts for over 15 minutes, little release after taking nitroglycerin sublingually) or a new myocardial ischemia on electrocardiogram(ECG), i.e. a new ST-T variation (a new or transient depression of ST segment by over 0.1mV, or T-wave inversion≥0.2mV); 4. Patients receive PCI after coronary angiography; 5. Patients, or their family or guardian give signed informed consent forms. Exclusion Criteria:

1. Patients with severe unstable hemodynamics who should receive urgent PCI; 2. Patients with untreated hypertension (SBP>180 mmHg or DBP >110mmHg) and hypotension shock (SBP<90mmHg/80mmHg for over 30min); 3. Investigator considers patients need to use GPIIb/IIIa receptor antagonists during the study period; 4. After coronary angiography, the number of stenosed vessels >2;lesions in left main branch, severe calcification and artery graft lesions; 5. Patients with heart function in decompensatory phase (Killip grade 3-4) or cardiac shock; 6. Patients with malignant arrhythmia, e.g. the third-degree atrioventricular block, ventricular tachycardia or fibrillation ventricular; 7. Patients with severe hepatic or renal dysfunction, with serum aspartate transaminase(AST) and alanine transaminase (ALT) exceeding 1.5 times the upper limit of reference values, creatinine clearance <30ml/min or serum creatinine ≥200μmol/L or 2.5mg/dl; 8. Patients who have received PCI in the past six months; 9. Patients who have received coronary artery bypass grafting (CABG) previously; 10. Patients who have received invasive operation in the past 3 months; 11. Patients who have suffered from ischemic stroke or transient ischemic attack (TIA) in the past 6 months, or patients with past history of hemorrhagic stroke; 12. Patients who need a long-term treatment of oral anticoagulants (such as warfarin); 13. Patients with active peptic ulcer, or other diseases of hemorrhagic tendency; 14. Patients with disease of coagulation disorder; 15. Hematology test shows platelet count <100,000mm3,or hemoglobin<100g/L; 16. Women in pregnant or lactation period, or women of child-bearing age do not take efficient contraception measures; 17. Patients with an allergic constitution; 18. Patients who is participating in other clinical trials; 19. Patients who do not give a signed informed consent forms; 20. Patients who are not suitable to enroll in the trial according to the investigator's judgement.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: 70 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Lee’s Pharmaceutical Limited
  • Provider of Information About this Clinical Study
    • Sponsor

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