Clopidogrel and the Optimization of Gastrointestinal Events (COGENT-1)

Stopped early · Phase 3 · Has a placebo group

Conditions studied: Acute Coronary Syndrome, Myocardial Infarction, Coronary Artery Disease, Percutaneous Coronary Intervention

In brief

The purpose of the COGENT-1 clinical trial is to determine whether CGT-2168 (clopidogrel and omeprazole) compared to clopidogrel is safe and effective in reducing the incidence of gastrointestinal bleeding and symptomatic ulcer disease, in the setting of concomitant aspirin therapy. Antiplatelet therapy is an essential element of care for patients with atherothrombotic disease. Bleeding is a fundamental adverse effect of all antiplatelet drugs including aspirin, clopidogrel and dual antiplatelet regimens. The gastrointestinal tract is the most common site of bleeding related to antiplatelet therapy, typically in connection with peptic ulcer disease. Recently published studies suggest the use of clopidogrel carries a gastrointestinal bleeding risk similar to that of aspirin or non-aspirin non-steroidal anti-inflammatory drugs. Patients taking any two of these drugs (clopidogrel, aspirin and/or non-aspirin NSAIDs) are exposed to an even higher risk of bleeding and ulcer disease. Cogentus Pharmaceuticals is launching phase 3 trials of a novel combination product, CGT-2168, which has the potential to significantly reduce this problem and increase patient safety. CGT-2168 combines a standard dosage of clopidogrel and a gastroprotectant (omeprazole) in a once-daily pill that may reduce the likelihood of adverse gastrointestinal events.

Key facts

Study ID

NCT00557921

Run by

Cogentus Pharmaceuticals

People needed

5000

Starts

2007-12-01

Expected to finish

2009-11-01

Last updated by the study team

2009-01-28

Who can join

Age: 21 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Patients in whom a requirement for clopidogrel therapy with concomitant aspirin is anticipated for at least the next 12 months. Specific conditions that may confer a need for long-term clopidogrel + aspirin therapy may include non-ST segment elevation acute coronary syndrome (unstable angina/non-Q-wave MI), ST segment elevation acute MI), or new placement of a coronary artery stent.
• For women of childbearing potential, negative pregnancy test prior to randomization and agreement to use effective method of birth control during the study.
• Able to provide written informed consent based on competent mental status.

You may not qualify if…

• Patients currently hospitalized for whom discharge is not anticipated within 48 hours of randomization.
• Requirement for current or chronic use of a proton pump inhibitor, H2 receptor blocker, sucralfate or misoprostol.
• Erosive esophagitis, esophageal or gastric variceal disease, or non-endoscopic gastric surgery. Patients with a history of GERD/erosive esophagitis or dyspepsia who do not currently require proton pump blockers will be eligible.
• Receipt of > 21 days of clopidogrel or another thienopyridine prior to randomization.
• Oral anticoagulation that cannot be safely discontinued for duration of study.
• Recent fibrinolytic therapy.
• Scheduled percutaneous coronary intervention (PCI). Patients may be enrolled upon completion of PCI.
• Recent (< 30 days prior to randomization) or scheduled coronary artery bypass graft (CABG) surgery.
• Cardiogenic shock at time of randomization, refractory ventricular arrhythmias, or congestive heart failure (NY Heart Association class IV).
• Active pathological bleeding or a history of hereditary or acquired hemostatic disorder.
• History of hemorrhagic stroke, intracranial neoplasm, arteriovenous malformation or aneurysm.
• Systemic corticosteroids except low-dose oral corticosteroids equivalent to prednisone < or equal to 5 mg/day.
• Allergy or contraindication to clopidogrel or other thienopyridine drugs, omeprazole or other proton pump inhibitor drugs, aspirin or salicylate derivatives, or other study drug ingredients.
• Treatment within 30 days prior to randomization with any investigational drug or device including investigational coronary artery stents or currently enrolled in another interventional drug or device study.
• Women who are pregnant or breastfeeding.
• Life expectancy less than 12 months.
• Laboratory abnormality at screening that is clinically significant or outside protocol-allowed limits, or any other condition that precludes participation in the study in the opinion of the Investigator.

Where it is running

• Alabama Clinical Therapeutics, LLC — Birmingham, Alabama, United States
• Cardio-Thoracic Surgeons P.C. — Birmingham, Alabama, United States
• Birmingham Heart Clinic, PC — Birmingham, Alabama, United States
• John F Simmons , MD PC — Geneva, Alabama, United States
• Clinical Research Consultants, Inc. — Hoover, Alabama, United States
• The Heart Center, PC — Huntsville, Alabama, United States
• Mobile Heart Specialists, PC — Mobile, Alabama, United States
• Advanced Cardiac Specialists — Mesa, Arizona, United States
• Redpoint Research — Phoenix, Arizona, United States
• Cardiovascular Consultants, Ltd. — Phoenix, Arizona, United States
• Cochise Clinical Research — Sierra Vista, Arizona, United States
• Paradigm Clinical Research, Inc. — Tucson, Arizona, United States
• Tri-Lakes Research — Hot Springs, Arkansas, United States
• Michael A. Frais, Cardiologist, P.A. — Hot Springs, Arkansas, United States
• NEA-Clinic Cardiology — Jonesboro, Arkansas, United States
• Searcy Medical Center — Searcy, Arkansas, United States
• Cardiology Consultants of Orange County — Anaheim, California, United States
• Chest and Critical Care Consultants, A Medical Group — Anaheim, California, United States
• Clinical Solutions Advantage — Buena Park, California, United States
• Turns Institute for Clinical Research — Castro Valley, California, United States
• Escondido Cardiology Associates — Escondido, California, United States
• Accurate Clinical Trials, Inc. — Laguna Hills, California, United States
• Therapeutic Research Institute of Orange County — Laguna Hills, California, United States
• Kirtik Thaker MD — Lakewood, California, United States
• Alabama Clinical Research Institute, Inc. (ACRI) — Alexander City, Alabama, United States

Full record on ClinicalTrials.gov

Trial information comes from ClinicalTrials.gov and is refreshed daily. TrialsForMe does not provide medical care and does not run the studies it lists.