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The purpose of this study is to determine if it is feasible and safe to use the REG1 Anticoagulation System instead of unfractionated heparin during percutaneous coronary intervention (PCI) in subjects with coronary artery disease (CAD).
The study drug, REG1, is the first specific, direct-acting, antidote-controlled anticoagulant ever described. Regado is developing REG1 for use in patients suffering from acute coronary syndrome who undergo coronary revascularization procedures. These procedures, which include coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), put patients at high risk for therapy-related bleeding complications. REG1 is being developed initially to increase therapeutic flexibility and improve patient outcomes in coronary revascularization procedures.
REG1 is a two-component system, consisting of an aptamer-based anticoagulant and its matched antidote. The REG1 anticoagulant component (RB006) is a single-stranded, nucleic acid aptamer. RB006 selectively and potently binds to and inhibits Factor IXa, a protein critical to blood coagulation. The antidote component, RB007, is a complementary nucleic acid that binds to and neutralizes RB006. The binding of RB007 to RB006 causes the predictable and rapid reversal of the RB006 effect and allows the patient's blood to return to normal.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Unfractionated Heparin | Active Comparator | Unfractionated Heparin |
|
| REG1 Partial Rev. | Experimental | REG1 with partial reversal |
|
| REG1 Total Rev. | Experimental | REG1 with total reversal |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| REG1 | Drug | ii. The REG1 anticoagulation system consists of a drug (RB006) and antidote (RB007). The drug (RB006) is administered via IV bolus to achieve anticoagulation. The antidote (RB007) is administered as an IV bolus dose at approximately 10% the total reversal dose followed by the remaining dose several hours later to counteract RB006 induced anticoagulation. |
| Measure | Description | Time Frame |
|---|---|---|
| Major bleeding using the ACUITY bleeding criteria | until hospital discharge or 48 hours whichever occurs first | |
| Composite of death, nonfatal myocardial infarct (MI), and urgent target vessel revascularization (TVR) | through Day 14 (+/- 3 days) |
| Measure | Description | Time Frame |
|---|---|---|
| Angiographic complications | through Day 14 (+/- 3 days) | |
| Femoral Sheath Complications | until the sheath is pulled |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| The Care Group, LLC | Indianapolis | Indiana | 46290 | United States | ||
| Henry Ford |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20660806 | Result | Cohen MG, Purdy DA, Rossi JS, Grinfeld LR, Myles SK, Aberle LH, Greenbaum AB, Fry E, Chan MY, Tonkens RM, Zelenkofske S, Alexander JH, Harrington RA, Rusconi CP, Becker RC. First clinical application of an actively reversible direct factor IXa inhibitor as an anticoagulation strategy in patients undergoing percutaneous coronary intervention. Circulation. 2010 Aug 10;122(6):614-22. doi: 10.1161/CIRCULATIONAHA.109.927756. Epub 2010 Jul 26. | |
| 30957581 |
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|
| REG1 | Drug | ii. The REG1 anticoagulation system consists of a drug (RB006) and antidote (RB007). The drug (RB006) is administered via IV bolus to achieve anticoagulation. The antidote (RB007) is administered as an IV bolus dose at 100% of the total reversal dose to counteract RB006 induced anticoagulation. |
|
| Unfractionated Heparin | Drug | Heparin will be administered per standard of care at sites |
|
|
| Detroit |
| Michigan |
| 48202 |
| United States |
| UNC | Chapel Hill | North Carolina | 27599 | United States |
| Geisinger | Danville | Pennsylvania | 17822 | United States |
| Black Hills Clinical Research Center | Rapid City | South Dakota | 57701 | United States |
| H. Italiano | Buenos Aires | Argentina |
| Derived |
| Park EJ, Choi J, Lee KC, Na DH. Emerging PEGylated non-biologic drugs. Expert Opin Emerg Drugs. 2019 Jun;24(2):107-119. doi: 10.1080/14728214.2019.1604684. Epub 2019 Apr 19. |
| ID | Term |
|---|---|
| D003324 | Coronary Artery Disease |
| ID | Term |
|---|---|
| D003327 | Coronary Disease |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D014652 | Vascular Diseases |
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| ID | Term |
|---|---|
| D006493 | Heparin |
| ID | Term |
|---|---|
| D006025 | Glycosaminoglycans |
| D011134 | Polysaccharides |
| D002241 | Carbohydrates |
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