PROACT Xa - A Trial to Determine if Participants With an On-X Aortic Valve Can be Maintained Safely on Apixaban

Stopped early · Phase 3

Conditions studied: Aortic Valve Disease, Aortic Valve Stenosis, Aortic Valve Failure

In brief

Currently, warfarin is the only approved anticoagulation for patients with mechanical valves. The purpose of this study is to determine if participants with an On-X Prosthetic Heart Valve / On-X aortic valve can be maintained safely and effectively on apixaban. Both the On-X aortic valve and apixaban have been approved for use by the US Food and Drug Administration (FDA) but they have not been approved to be used together.

Key facts

Study ID

NCT04142658

Run by

Artivion Inc.

People needed

863

Starts

2020-05-01

Expected to finish

2022-12-12

Last updated by the study team

2024-03-20

Who can join

Age: 18 and older. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Male or female at least 18 years of age at the time of giving informed consent.
• Participants currently receiving warfarin anticoagulation and who are able to receive warfarin with a target INR 2.0 to 3.0.
• Participants are able to take low-dose aspirin at a dose of 75 -100 mg daily or have a documented contraindication to aspirin use.
• Implantation of an On-X mechanical valve in the aortic position at least 3 months (90 days) ago.
• Female participants of childbearing potential, including those who are less than 2 years post-menopausal, must agree to, and comply with using a highly effective method of birth control (eg, barrier contraceptives [condom or diaphragm with a spermicidal gel], hormonal contraceptives [implants, injectables, combination oral contraceptives, transdermal patches, or contraceptive rings], intrauterine devices or sexual abstinence) while partaking in this study. In addition, all women of childbearing potential must agree to continue to use birth control throughout the study until last study visit.
• Informed of the full nature and purpose of the study, including possible risks and side effects, given ample time and opportunity to read and understand this information, and sign and date the written informed consent before inclusion in the study.

You may not qualify if…

• Mechanical valve in any position other than aortic valve.
• Any cardiac surgery in the three months (90 days) prior to enrollment.
• Need to be on aspirin >100 mg daily or a P2Y12 inhibitor (clopidogrel, ticagrelor, prasugrel, or ticlopidine).
• Known hypersensitivity or other contraindication to apixaban.
• On dialysis or a creatinine clearance < 25 mL/min.
• Ischemic stroke or intracranial hemorrhage within 3 months.
• Active pathological bleeding at the time of screening for enrollment.
• Active endocarditis at the time of screening for enrollment.
• Pregnant, plan to become pregnant, or are breast feeding.
• On concomitant combined strong P-gp and CYP3A4 inducers or inhibitors.
• History of non-compliance with recommended monthly INR testing.

Where it is running

• CHI St. Vincent Heart Institute — Little Rock, Arkansas, United States
• Loma Linda University Medical Center — Loma Linda, California, United States
• Stanford University Medical Center — Palo Alto, California, United States
• Sharp Memorial — San Diego, California, United States
• Hartford Hospital — Hartford, Connecticut, United States
• Yale- New Haven Hospital — New Haven, Connecticut, United States
• Baycare Health / Morton Plant Hospital — Clearwater, Florida, United States
• Shands Hospital (University of Florida Health) — Gainesville, Florida, United States
• AdventHealth Orlando — Orlando, Florida, United States
• Tallahassee Research Institute — Tallahassee, Florida, United States
• University of South Florida — Tampa, Florida, United States
• Piedmont Atlanta Hospital — Atlanta, Georgia, United States
• Emory University Hospital — Atlanta, Georgia, United States
• Northeast Georgia Medical Center — Gainesville, Georgia, United States
• Wellstar Kennestone Hospital — Marietta, Georgia, United States
• Northwestern Memorial Hospital — Chicago, Illinois, United States
• OSF Cardiovascular Institute — Rockford, Illinois, United States
• Indiana University Health Methodist Hospital — Indianapolis, Indiana, United States
• Franciscan Health Indianapolis — Indianapolis, Indiana, United States
• University of Iowa — Iowa City, Iowa, United States
• Maine Medical Center — Portland, Maine, United States
• John's Hopkins University — Baltimore, Maryland, United States
• Brigham and Women's Hospital — Boston, Massachusetts, United States
• Beth Israel Deaconess Medical Center — Boston, Massachusetts, United States
• Tucson Heart Center — Tucson, Arizona, United States

Full record on ClinicalTrials.gov

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