The primary objective of this study is to establish the dose-response relationship with regard to efficacy and safety of BIBR 1048 (50 mg bis in die(b.i.d), 150 mg b.i.d, 225 mg b.i.d. and 300 mg quaque die(q.d) ) in preventing venous thromboembolism(VTE) in patients undergoing primary elective total hip and knee replacement.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
DOUBLE
Enrollment
1,973
Enoxaparin 40 mg s.c once a day for 5-10 days of treatment period
50 mg b.i.d BIBR 1048 capsule twice a day for 5-10 days of treatment period
150 mg b.i.d BIBR 1048 capsule twice a day for 5-10 treatment period
Number of Participants With Venous Thromboembolic (VTE) Events
Deep vein thrombosis (DVT) (proximal and distal) as detected by routine bilateral venography on day 8 +/- 2, plus symptomatic DVT confirmed by venography during the treatment period or PE confirmed by objective testing
Time frame: Treatment period (up to day 8+/-2 days visit)
Number of Participants With Major Bleeding Events (MBE)
Time frame: From approximately 14 days prior to surgery to 4-6 weeks post surgery
Number of Participants With VTE Events and All Cause Mortality
Deep venous thrombosis (DVT) (proximal and distal) as detected by routine bilateral venography on day 8 +/- 2, plus symptomatic DVT confirmed by venography during the treatment period or Pulmonary Embolism (PE) confirmed by objective testing and all deaths.
Time frame: Treatment period (up to day 8+/-2 days visit)
Number of Participants With Proximal DVT, PE (Pulmonary Embolism) and VTE Related Mortality
Deep venous thrombosis (DVT) (proximal) as detected by routine bilateral venography on day 8 +/- 2, plus symptomatic proximal DVT confirmed by venography during the treatment period or PE confirmed by objective testing plus VTE related mortality
Time frame: Treatment period (up to day 10)
Number of Participants With Proximal DVT
Deep venous thrombosis (DVT) (proximal) as detected by routine bilateral venography on day 8 +/- 2, plus symptomatic proximal DVT confirmed by venography during the treatment period
Time frame: Treatment period (up to day 8+/-2 days visit)
Volume of Blood Loss
Volume of blood loss was to be analysed using an analysis of variance (ANOVA), which included treatment and centre.
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225 mg b.i.d BIBR 1048 capsule twice a day for 5-10 treatment period
300 mg q.d BIBR 1048 capsule for 5-10 treatment period
1160.19.43004 Krankenhaus der Barmherzigen Schwestern Linz
Linz, Austria
1160.19.43002 Orthopädisches Spital Speising
Vienna, Austria
1160.19.43001 A.ö. Krankenhaus d. Statutarstadt Wiener Neustadt
Wiener Neustadt, Austria
1160.19.32002 V.U.B. Jette
Brussels, Belgium
1160.19.32004 UZ Gent
Ghent, Belgium
1160.19.32005 Virga Jesseziekenhuis
Ghent, Belgium
1160.19.32006 Boehringer Ingelheim Investigational Site
Huy, Belgium
1160.19.32007 C.H.U. de Tivoli
La Louvière, Belgium
1160.19.42004 University Hospital Brno
Brno-Bohunice, Czechia
1160.19.42001 Hospital Kladno
Kladno, Czechia
...and 49 more locations
Time frame: Day 1 (Day of surgery)
Rate of Transfusions Due to Bleedings
Percentage of patients requiring transfusions due to bleeding .Rate of need of transfusion were to be analysed using a logistic regression with treatment and centre.
Time frame: Day 1 (Day of surgery)
Number of Participants With Clinically Significant, Minor or Any Bleeding Events
Number of participants with Clinically Significant, minor or any bleeding events. Clinically significant bleeding events are defined as * Spontaneous skin haematoma larger than \>25 cm² * Wound haematoma \>100 cm² * Spontaneous nose bleed \>5 minutes * Macroscopic haematurea, either spontaneous or lasting more than 24 hours if associated with an intervention * Spontaneous rectal bleeding (more than spot on toilet paper) * Gingival bleeding \>5 minutes * Any other bleeding event considered as clinically significant by the investigator All other bleeding events that did not fulfil the criteria of MBE or clinically significant bleeding event were classified as minor bleeding events.
Time frame: Treatment period (up to day 8+/-2 days visit)
Laboratory Analyses
Number of patients with possible clinically significant abnormalities, i.e. with values out of normal range. Normal ranges are defined as: Haematocrit \[%\]: (0.35-0.45) for women and (0.39-0.51) for men Haemoglobin \[g/dL\]: (11.6-15.4) for women and (13.2-17.3) for men White Blood Cell count \[10\^9/L\]: (4-10.3) for women and (3.9-10.3) for men Platelets \[10\^9/L\]: (145-420) for women and men Sodium \[mmol/L\]: (135-146) for women and men Potassium \[mmol/L\]: (3.5-5) for women and men Aspartate aminotransferase (AST) \[U/L\]: (11-37) for women and (11-39) for men Alanine aminotransferase (ALT) \[U/L\]: (8-43) for women and (8-45) for men Alkaline Phosphatase \[U/L\]: (36-118) for women and (35-123) for men Creatinine \[mg/dL\]: (0.57-1.06)for women and (0.72-1.3) for men Bilirubin, total \[mg/dL\]: (0.22-1.28) for women and men Uric acid \[mg/dL\]: (2.4-6.47) for women and men
Time frame: Screening to end of treatment
Plasma Concentration (Cmax) of Dabigatran
Maximum plasma concentration of Dabigatran (at steady-state) and Pre-dose plasma concentrations at steady state. Cmax represents the maximum concentration of Dabigatran in plasma. Cmax,ss represents the maximum concentration of Dabigatran in plasma at steady state. Cpre,ss represents pre-dose concentration of Dabigatran in plasma at steady state
Time frame: Day 1 to end of treatment
Area Under the Plasma Concentration-time Curve During a Dosing Interval
Area under the plasma concentration-time curve during a dosing interval (at steady-state). The AUC0-12h (for b.i.d. treatment regimens) and AUC0-24h (300 mg q.d.) after the first dose on day of surgery calculated by extrapolation using the elimination rate constant, reported only if the extrapolated fraction of AUC was less than 30 % of the total AUC.
Time frame: up to day 8+/-2 days visit