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It is general that there are many factors for individual differences of drugs in clinical application, of which genetic factors accounted for more than 20%. Novel oral anticoagulants-NOACs (include rivaroxaban, apixaban, dabigatran and so on) have advantages of convenient use and no need of monitoring, compared with the traditional vitamin K antagonist. With lack of predicted biomarkers, especially the research data of Chinese, it has the important significance in studying individual differences of NOACs in the anticoagulant efficacy and safety, through the pharmacogenomics research.
The aim of this study is to determine the polymorphism of drug metabolizing enzymes, drug transporters and drug target genes in Chinese population. By detecting the gene polymorphism, we intend to study the pharmacokinetic/ pharmacodynamics/ pharmacogenomics (PK-PD-PG) correlation of NOACs and provide scientific basis for accurate medication guide for people to use NOACs.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| wild genotype | Through next generation sequencing, distinguish wild genotype of NOACs |
| |
| mutant genotype | Through next generation sequencing, distinguish mutant genotype of NOACs |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| detection of genotype | Genetic | detection of genotype by next generation sequencing |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of stroke or systemic embolic events (including TIA) | During the observation time, record the incidence of stroke or systemic embolic events (including TIA) after NOACs(rivaroxaban, apixaban, dabigatran) administration by telephone or out-patient clinic. | At 1 year |
| Incidence of bleeding events | During the observation time, record the incidence of bleeding events after NOACs(rivaroxaban, apixaban, dabigatran) administration by telephone and out-patient clinic, including subcutaneous bleeding, gingival bleeding, gastrointestinal bleeding, intracranial hemorrhage, etc. | At 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Genotype detected by next generation sequencing | Collect blood specimen before NOACs administration, then detect genotype of NOACs by next generation sequencing. | pre-dose of NOACs (rivaroxaban, apixaban, dabigatran) |
| Level of anticoagulant activity assessed by anti-factor Xa activity |
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Inclusion Criteria:
(I)Chinese Healthy Volunteers
(II)Chinese Patients
Exclusion Criteria:
(I)Chinese Healthy Volunteers
(II)Chinese Patients
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(I)Chinese Healthy Volunteers:In accordance with the criteria of each bioequivalence trial of NOACs;150-200 cases for each drug (II)Chinese Patients:In accordance with anticoagulation indications of NOACs,never received NOACs in a month and intend to take NOACs or have received NOACs for more than one week continuously;200 cases for each drug
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Qian Xiang, Ph.D | Contact | +86 010 66110802 | xiangqz@126.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Anhui Provincial Hospital(The First Affiliated Hospital Of USTC) | Recruiting | Hefei | Anhui | 230001 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37203300 | Derived | Xiang Q, Wang Z, Mu G, Xie Q, Liu Z, Zhou S, Zhang H, Wang Z, Jiang J, Hu K, Zhang Y, Zhao Z, Yuan D, Guo L, Wu T, Zhang J, Wang N, Xiang J, Gu Z, Sun J, Cui Y. Genetic variants influenced the risk of bleeding and pharmacodynamics of rivaroxaban in patients with nonvalvular atrial fibrillation: A multicentre prospective cohort study. Clin Transl Med. 2023 May;13(5):e1263. doi: 10.1002/ctm2.1263. | |
| 36578040 |
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Before and after rivaroxaban and apixaban administration, record anti-factor Xa activity detected by blood coagulation tests. |
| At baseline; at 3 hours, at 8 or 9 hours, at 12 hours for Chinese healthy volunteers, at 48 or 72 hours for Chinese patients |
| Level of anticoagulant activity assessed by anti-factor IIa activity | Before and after dabigatran administration, record anti-factor IIa activity detected by blood coagulation tests. | At baseline; at 2 hours, at 4 hours, at 8 hours, at 12 hours for Chinese healthy volunteers, at 72 hours for Chinese patients |
| Expression level of miRNA | Before and after NOACs administration, detect the expression level of miRNA about pharmacodynamics. | At baseline; at 2 or 3 hours, at 4 hours (only for dabigatran), at 8 or 9 hours, at 12 hours for Chinese healthy volunteers, at 48 or 72 hours for Chinese patients. |
| Expression level of LncRNA | Before and after NOACs administration, detect the expression level of LncRNA about pharmacodynamics. | At baseline; at 2 or 3 hours, at 4 hours (only for dabigatran), at 8 or 9 hours, at 12 hours for Chinese healthy volunteers, at 48 or 72 hours for Chinese patients. |
| Incidence of stroke or systemic embolic events in the other observation times | During the other observation time, record the incidence of stroke or systemic embolic events (including TIA) after NOACs(rivaroxaban, apixaban, dabigatran) administration by telephone or out-patient clinic. | At 1 month, 6 months and 2 years (according the actual duration of NOACs taken in patiens) |
| Incidence of bleeding events in the other observation times | During the other observation time, record the incidence of bleeding events after NOACs(rivaroxaban, apixaban, dabigatran) administration by telephone and out-patient clinic, including subcutaneous bleeding, gingival bleeding, gastrointestinal bleeding, intracranial hemorrhage, etc. | At 1 month, 6 months and 2 years (according the actual duration of NOACs taken in patiens) |
| Peking University First Hospital | Recruiting | Beijing | Beijing Municipality | 100034 | China |
|
| Beijing Hospital | Recruiting | Beijing | Beijing Municipality | 100730 | China |
|
| Beijing HuiLongGuan Hospital | Active, not recruiting | Beijing | Beijing Municipality | China |
| The Second Affiliated Hospital Of Chongqing Medical University | Recruiting | Chongqing | Chongqing Municipality | 400010 | China |
|
| Fujian Medical University Union Hospital | Active, not recruiting | Fuzhou | Fujian | 350000 | China |
| 900 Hospital of the Joint Logistics Team (Original name: Fuzhou General Hospital of Nanjing Militray Command) | Recruiting | Fuzhou | Fujian | China |
|
| The 7th People's Hospital of Zhengzhou | Recruiting | Zhengzhou | Henan | China |
|
| The Third Hospital of Changsha | Active, not recruiting | Changsha | Hunan | China |
| Wuxi People's Hospital | Withdrawn | Wuxi | Jiangsu | 214023 | China |
| The Affiliated Hospital of Jiangnan University, or called Original Wuxi Third Hospital | Active, not recruiting | Wuxi | Jiangsu | China |
| The First Affiliated Hospital of Nanchang University | Active, not recruiting | Nanchang | Jiangxi | 330006 | China |
| the First Affiliated Hospital of Liaoning University of Traditional Chinese Medicine | Active, not recruiting | Shenyang | Liaoning | 110032 | China |
| The affiliated hospital of Inner Mongolia medical university | Recruiting | Hohhot | Neimenggu | China |
|
| The Affiliated Hospital of Qingdao University | Active, not recruiting | Qingdao | Shandong | China |
| Shanghai Public Health Clinical Center | Active, not recruiting | Shanghai | Shanghai Municipality | 201508 | China |
| Renji Hospital, School of Medicine, Shanghai Jiao Tong University | Recruiting | Shanghai | Shanghai Municipality | China |
|
| Derived |
| Zhang H, Zhang Z, Liu Z, Mu G, Xie Q, Zhou S, Wang Z, Cao Y, Tan Y, Wei X, Yuan D, Xiang Q, Cui Y. Circulating miR-320a-3p and miR-483-5p level associated with pharmacokinetic-pharmacodynamic profiles of rivaroxaban. Hum Genomics. 2022 Dec 28;16(1):72. doi: 10.1186/s40246-022-00445-5. |
| 35935625 | Derived | Liu Z, Mu G, Xie Q, Zhang H, Jiang J, Xiang Q, Cui Y. Hemoclot Thrombin Inhibitor Assay and Expected Peak-Trough Levels of Dabigatran: A Multicenter Study. Front Cardiovasc Med. 2022 Jul 22;9:894888. doi: 10.3389/fcvm.2022.894888. eCollection 2022. |