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| ID | Type | Description | Link |
|---|---|---|---|
| 2011-002685-20 | EudraCT Number |
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The purpose of this study is to demonstrate that Fibrinogen Concentrate (Human)(FCH) can reduce the amount of donor blood products needed during complex cardiovascular surgery, and that it is safe and well tolerated. Subjects in this study will get either a FCH or placebo infusion during surgery. This will be in addition to the standard treatment, which is donor blood or blood products. Placebo does not contain any effective medicine.
The study is randomised. This means that the likelihood that subjects will get FCH or placebo is 50%. To make the comparison between FCH and placebo as fair as possible, the study is "double blind". This means that neither the subjects nor the study doctor will know if FCH or placebo is administered. If necessary, the study doctor can find out which treatment the subjects are receiving.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Fibrinogen Concentrate (Human) | Experimental |
| |
| Placebo | Placebo Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Fibrinogen Concentrate (Human) (FCH) | Biological | Single dose infused intravenously within 5 minutes of the completion of the measurement of the 5-minute bleeding mass; the dose is determined individually based on the measured maximum clot firmness (MCF) and subject body weight |
| Measure | Description | Time Frame |
|---|---|---|
| Total units of allogeneic blood products | Number of units administered of all allogeneic blood products combined (fresh frozen plasma, platelets, and red blood cells) | Up to 24 hours after investigational medicinal product (IMP) administration |
| Measure | Description | Time Frame |
|---|---|---|
| Total avoidance of allogeneic blood transfusions | Number of subjects who are alive and do not have any administration of platelets, fresh frozen plasma (FFP), and red blood cells (RBCs) during the first 24 hours after administration of IMP | 24 hours after IMP administration |
| Quantity of blood loss (6 hours) |
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Inclusion Criteria:
At Screening:
Intraoperative (at the 1st 5-minute bleeding mass):
Exclusion Criteria:
At Screening and/or baseline:
Intraoperative (at the 1st 5-minute bleeding mass):
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| Name | Affiliation | Role |
|---|---|---|
| Niels Rahe-Meyer, MD, PhD | Hannover Medical School | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Allgemeines Krankenhaus der Stadt Wien - Universitätskliniken | Vienna | A-1090 | Austria | |||
| Fundacao Universitaria de Cardiologia - Instituto de Cardiol |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30462259 | Derived | Rahe-Meyer N, Levy JH, Mazer CD, Schramko A, Klein AA, Brat R, Okita Y, Ueda Y, Schmidt DS, Gill R. Randomized evaluation of fibrinogen versus placebo in complex cardiovascular surgery: post hoc analysis and interpretation of phase III results. Interact Cardiovasc Thorac Surg. 2019 Apr 1;28(4):566-574. doi: 10.1093/icvts/ivy302. | |
| 27317703 |
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|
| Placebo | Biological | Single dose of sodium chloride solution infused intravenously within 5 minutes at a volume equivalent to that needed for FCH |
|
Blood drainage volume from the chest |
| 6 hours after skin closure |
| Quantity of blood loss (12 hours) | Blood drainage volume from the chest | 12 hours after skin closure |
| Quantity of blood loss (24 hours) | Blood drainage volume from the chest | 24 hours after skin closure |
| Change in bleeding mass | The 5-minute bleeding mass is measured as the difference in weight of surgical swabs after 5 minutes of surgical packing of the aortic surgical site. | Immediately before and 5 minutes after completion of IMP administration |
| Mortality (Day 10) | Mortality with adjudicated cause of death up to 10 days after surgery | Up to 10 days after surgery |
| Mortality (Day 30) | Mortality with adjudicated cause of death up to 30 days after surgery | Up to 30 days after surgery |
| FFP consumption (24 hours) | 24 hours after IMP administration |
| FFP consumption (10 days) | 10 days after IMP administration |
| Platelet consumption (24 hours) | 24 hours after IMP administration |
| Platelet consumption (10 days) | 10 days after IMP administration |
| Red blood cells (RBC) consumption (24 hours) | 24 hours after IMP administration |
| RBC consumption (10 days) | 10 days after IMP administration |
| Total units of all allogeneic blood products (6 hours) | Number of units of all allogeneic blood products combined (FFP, platelets, and/or RBCs) administered during the first 6 hours after administration of IMP | 6 hours after IMP administration |
| Total units of all allogeneic blood products (12 hours) | Number of units of all allogeneic blood products combined (FFP, platelets, and/or RBCs) administered during the first 12 hours after administration of IMP | 12 hours after IMP administration |
| Volume of all allogeneic blood products (6 hours) | Volume of all allogeneic blood products combined (FFP, platelets, and/or RBCs) administered during the first 6 hours after administration of IMP | 6 hours after IMP administration |
| Volume of all allogeneic blood products (12 hours) | Volume of all allogeneic blood products combined (FFP, platelets, and/or RBCs) administered during the first 12 hours after administration of IMP | 12 hours after IMP administration |
| Volume of all allogeneic blood products (24 hours) | Volume of all allogeneic blood products combined (FFP, platelets, and/or RBCs) administered during the first 24 hours after administration of IMP | 24 hours after IMP administration |
| Time from administration of study drug to completion of skin closure | Average 2 hours |
| Mortality (24 hours) | Mortality with adjudicated cause of death during the first 24 hours after administration of IMP | WIthin 24 hours after IMP administration |
| Peak plasma concentration of fibrinogen (Cmax) | At up to 10 time points from baseline and up to Day 11 after surgery. |
| Maximum clot firmness | At baseline; on the day of surgery at: 30 min before CPB, the 1st 5 min bleeding mass, the end of IMP infusion, the 2nd 5-min bleeding mass, and closure; and on Day 2, 3, 4 and at the end of the study (discharge/Day 11 or at discontinuation if earlier). |
| Porto Alegre |
| Rio Grande do Sul |
| 90620001 |
| Brazil |
| InCor | São Paulo | São Paulo | 05403-000 | Brazil |
| Providence Health-St Paul's Hospital | Vancouver | British Columbia | V6Z 1Y6 | Canada |
| Hamilton Health Science | Hamilton | Ontario | L8L 2X2 | Canada |
| Ottawa General Hospital | Ottawa | Ontario | K1H 8L6 | Canada |
| University of Toronto - St. Michael's Hospital | Toronto | Ontario | M5B 1W8 | Canada |
| Toronto General Hospital | Toronto | Ontario | M5G 2C4 | Canada |
| Universite Laval - Cardiologie et de Pneumologie de Quebec | Sainte-Foy | Quebec | G1V 4G5 | Canada |
| University Hospital St. Anna Brno | Brno | 65691 | Czechia |
| Fakultni nemocnice Ostrava | Ostrava - Poruba | 708 52 | Czechia |
| Kobenhavns Universitet-Det Sundhedsvidenskabelige Fakultet | Copenhagen | 2200 | Denmark |
| HUCH Anaestesia and Surgery | Helsinki | FI-00290 | Finland |
| Klinikum der Universität München | Munich | Bavaria | 81377 | Germany |
| Klinikum der J.-W.-Goethe-Universität | Frankfurt am Main | Hesse | 60590 | Germany |
| Study Site | Bielefeld/Hannover | Germany |
| Policlinico S. Orsola Malpighi | Bologna | Italy |
| Fondazione Centro San Raffaele | Milan | 20132 | Italy |
| Azienda Ospedaliera di Udine | Udine | 33100 | Italy |
| Nagoya University Hospital | Nagoya | Aichi-ken | 466-8560 | Japan |
| Kurume University Hospital | Kurume | Fukuoka | 830-0011 | Japan |
| Hamamatsu University Hospital | Hamamatsu | Higashi-ku | 431-3192 | Japan |
| Kobe University Hospital | Kobe | Hyōgo | 650-0017 | Japan |
| Kyoto University Hospital | Kyoto | Kamigyo-ku | 602-8566 | Japan |
| Tohoku University Hospital | Sendai | Miyagi | 980-8574 | Japan |
| Tenri Hospital | Tenri | Nara | 632-8552 | Japan |
| National Cerebral and Cardiovascular Center | Suita, Osaka | Osaka | 565-8565 | Japan |
| Keio University Hospital | Shinjuku | 160-8582 | Japan |
| Inst. Kardiologii im. Prymasa Tysiaclecia Kard. S. Wyszynskiego | Warszawa - Anin | Masovian Voivodeship | 04-628 | Poland |
| Krakowski Szpital Specjalistyczny im. Jana Pawla II | Krakow | 31-202 | Poland |
| Samodzielny Publiczny Szpital Kliniczny nr 2 | Szczecin | 70-111 | Poland |
| Papworth Hospital | Cambridge | CB23 3RE | United Kingdom |
| University Hospital of Leicester | Leicester | LE3 9QT | United Kingdom |
| Liverpool Heart and Chest Hospital | Liverpool | L14 3PE | United Kingdom |
| Southampton General Hospital | Southampton | SO16 6YD | United Kingdom |
| Rahe-Meyer N, Levy JH, Mazer CD, Schramko A, Klein AA, Brat R, Okita Y, Ueda Y, Schmidt DS, Ranganath R, Gill R. Randomized evaluation of fibrinogen vs placebo in complex cardiovascular surgery (REPLACE): a double-blind phase III study of haemostatic therapy. Br J Anaesth. 2016 Jul;117(1):41-51. doi: 10.1093/bja/aew169. |
| ID | Term |
|---|---|
| D016063 | Blood Loss, Surgical |
| D019106 | Postoperative Hemorrhage |
| ID | Term |
|---|---|
| D006470 | Hemorrhage |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D007431 | Intraoperative Complications |
| D011183 | Postoperative Complications |
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| ID | Term |
|---|---|
| D005340 | Fibrinogen |
| ID | Term |
|---|---|
| D000209 | Acute-Phase Proteins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D001779 | Blood Coagulation Factors |
| D011498 | Protein Precursors |
| D001685 | Biological Factors |
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