The purpose of this study is to assess the independent effects of both a 4-Factor prothrombin complex concentrate (PCC) - (Kcentra) and Tranexamic acid (TXA) on the bleeding parameters (bleeding duration and blood volume) following a punch biopsy, in addition to assessing their effects on the anticoagulant/pharmacodynamic (prothrombin time and endogenous thrombin potential) changes induced by rivaroxaban at steady state, to better understand their potential role in bleeding reversal.
This is a 2 part, single center study to be conducted in healthy men and women. Part 1 (open-label) consists of Screening Phase (within 28 days before admission into the study center on Day -1), followed by a 3 day treatment period and a follow-up visit on Day 8. A single oral 20 milligram (mg) dose of rivaroxaban will be administered on Day 1. Pharmacokinetic (PK), pharmacodynamics (PD), and punch biopsy parameters will be assessed. Part 2 (double-blind) consists of Screening Phase (within 28 days before admission into the study center on Day -1), followed by a 8 day treatment period (Day -1 to Day 7) and a follow-up visit on Day 11. Rivaroxaban (20 mg every 12 hrs) will be administered on Days 1 through 3 and single 20 mg dose will be given on the morning of Day 4. A single dose of either 4-factor PCC, TXA or saline (Placebo) will be administered in a randomized, blinded fashion on Day 4. PK, PD, Exploratory Bio-markers and punch biopsy parameters will be assessed. Participants' safety will be monitored throughout the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
158
A single dose of 20 milligram (mg) of rivaroxaban orally will be administered to participants on Day 1 in part 1 and through day 1 and 3 with a final 20 mg dose administered on the morning of Day 4 in part 2.
1.0 g single dose of tranexamic acid (TXA), intravenously administered (over 10 mins) on Day 4.
Kcentra, a 4-factor PCC, 50 IU/kg, single dose, intravenously administered (maximum rate of 210 \[international units\] IU/min) on Day 4.
Saline \[Kcentra saline control or TXA saline control\] on Day 4.
Unnamed facility
Overland Park, Kansas, United States
Change From Baseline in Blood Volume in Part 1
Volume of blood (BV) collected after a punch biopsy is performed.
Time frame: Day-1 (Baseline) and 4 hour (hr) postdose on Day 1
Change From Baseline in Bleeding Duration in Part 1
Bleeding duration (BD) after a punch biopsy is performed.
Time frame: Day-1 (Baseline) and 4 hr postdose on Day 1
Mean Change in Thrombin Generation Assay (TGA) - Endogenous Thrombin Potential (ETP) Lag-time in Part 2
The thrombin generation assay (TGA) is based on the premise that measurements of thrombin generation are indicative of the overall coagulating capacity of the individual. The data derived from the thrombography can be used to determine the ETP, which in turn provides a functional assessment of the overall clotting cascade. Change in lag time (time required until thrombin is generated) will be observed.
Time frame: Predose (Baseline) and up to 72 hrs postdose on Day 4
Mean Change in Thrombin Generation Assay (TGA) - Endogenous Thrombin Potential (ETP) Peak in Part 2
The thrombin generation assay (TGA) is based on the premise that measurements of thrombin generation are indicative of the overall coagulating capacity of the individual. The data derived from the thrombography can be used to determine the ETP, which in turn provides a functional assessment of the overall clotting cascade. Change in peak (the maximal effect on thrombin generation) will be observed.
Time frame: Predose (Baseline) and 72 hours postdose on Day 4
Mean Change in Thrombin Generation Assay (TGA) - Endogenous Thrombin Potential (ETP) Time to Peak in Part 2
The thrombin generation assay (TGA) is based on the premise that measurements of thrombin generation are indicative of the overall coagulating capacity of the individual. The data derived from the thrombography can be used to determine the ETP, which in turn provides a functional assessment of the overall clotting cascade. Change in time-to-peak (time required to reach maximal effect on thrombin generation) will be observed.
Time frame: Predose (Baseline) and 72 hours postdose on Day 4
Mean Change in Thrombin Generation Assay (TGA) - Endogenous Thrombin Potential (ETP) Area Under Curve (AUC) in Part 2
The thrombin generation assay (TGA) is based on the premise that measurements of thrombin generation are indicative of the overall coagulating capacity of the individual. The data derived from the thrombography can be used to determine the ETP, which in turn provides a functional assessment of the overall clotting cascade. Change in AUC (the overall effect on thrombin generation) will be observed.
Time frame: Predose (Baseline) up to 72 hours on Day 4
Mean Change in Prothrombin Time (PT) in Part 2
Prothrombin Time is a global clotting test that is used for the assessment of the extrinsic pathway of the blood coagulation cascade.
Time frame: Predose (Baseline) up to 72 hours on Day 4
Change From Baseline in Blood Volume in Part 2
Time frame: Predose (Baseline) and 72 hours on Day 4
Change From Baseline in Bleeding Duration in Part 2
Time frame: Predose (Baseline) and 72 hours on Day 4
Maximum Observed Plasma Concentration (Cmax) in Part 1
Time frame: Predose and up to 24 hrs postdose on Day 1
Time to Maximum Observed Plasma Concentration in Part 1 (Tmax)
Time frame: Predose and up to 24 hrs post-dose
Area under Plasma Concentration Time Curve From Time 0 to 24 in Part 1 (AUC [0 TO 24]
Time frame: Predose and up to 24 hrs postdose on Day 1
Maximum Observed Plasma Concentration (Cmax) in Part 2
Time frame: Predose and up to 72 hrs postdose on Day 4
Minimum Observed Plasma Concentration (Cmin) in Part 2
Time frame: Predose Days 1 to 4
Time to Maximum Observed Plasma Concentration (Tmax) in Part 2
Time frame: Predose and up to 72 hrs postdose on Day 4
Area under plasma concentration time curve during the dosing interval (AUCtau) in Part 2
Time frame: Predose and up to 24 hours
Mean Change in Thrombin Generation Assay (TGA) Endogenous Thrombin Potential (ETP) Lag-time in Part 1
The thrombin generation assay (TGA) is based on the premise that measurements of thrombin generation are indicative of the overall coagulating capacity of the individual. The data derived from the thrombography can be used to determine the ETP, which in turn provides a functional assessment of the overall clotting cascade. Change in lag time (time required until thrombin is generated) will be observed.
Time frame: Predose (Baseline) up to 24 hours on Day 1
Mean Change in Thrombin Generation Assay (TGA) Endogenous Thrombin Potential (ETP) Peak in Part 1
The thrombin generation assay (TGA) is based on the premise that measurements of thrombin generation are indicative of the overall coagulating capacity of the individual. The data derived from the thrombography can be used to determine the ETP, which in turn provides a functional assessment of the overall clotting cascade. Change in peak (the maximal effect on thrombin generation) will be observed.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Predose (Baseline) up to 24 hours on Day 1
Mean Change in Thrombin Generation Assay (TGA) Endogenous Thrombin Potential (ETP) Time to Peak in Part 1
The thrombin generation assay (TGA) is based on the premise that measurements of thrombin generation are indicative of the overall coagulating capacity of the individual. The data derived from the thrombography can be used to determine the ETP, which in turn provides a functional assessment of the overall clotting cascade. Change in time-to-peak (time required to reach maximal effect on thrombin generation) will be observed.
Time frame: Predose (Baseline) up to 24 hours on Day 1
Mean Change in Thrombin Generation Assay (TGA) Endogenous Thrombin Potential (ETP) Area Under Curve (AUC) in Part 1
The thrombin generation assay (TGA) is based on the premise that measurements of thrombin generation are indicative of the overall coagulating capacity of the individual. The data derived from the thrombography can be used to determine the ETP, which in turn provides a functional assessment of the overall clotting cascade. Change in AUC (the overall effect on thrombin generation) will be observed.
Time frame: Predose (Baseline) up to 24 hours on Day 1
Mean Change in Prothrombin Time (PT) in Part 1
Prothrombin Time is a global clotting test that is used for the assessment of the extrinsic pathway of the blood coagulation cascade.
Time frame: Predose (Baseline) up to 24 hours on Day 1
Trough Plasma Concentration (Ctrough) in Part 2
Ctrough is the trough plasma concentration before dosing or at the end of the dosing interval of any dose other than the first dose.
Time frame: Predose and up to 72 hrs postdose on Day 4
Number of Participants With Adverse Events as a Measure of Safety and Tolerability
An adverse event is any untoward medical event that occurs in a participant administered an investigational product, and it does not necessarily indicate only events with clear causal relationship with the relevant investigational product.
Time frame: Up to 37 Days (Part 1) and Up to 40 Days (Part 2)