Impact of Biomarkers on Pharmacokinetics and Pharmacodynamics of Ticagrelor

Cui Yimin400 enrolled

Overview

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%. Ticagrelor is a new-type receptor antagonist of P2Y12 and it is not affected by the influence of CYP2C19 polymorphism. With lack of predicted biomarkers, especially the research data of Chinese, it has the important significance in studying individual differences of ticagrelor in the antiplatelet 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 ticagrelor and provide scientific basis for accurate medication guide for people to use ticagrelor.

Study Type

OBSERVATIONAL

Enrollment

400

Conditions

Ticagrelor Pharmacokinetics Pharmacodynamics Pharmacogenomics Accurate Medication

Interventions

Eligibility

Sex: ALLMin age: 18 YearsHealthy volunteers:

Medical Language ↔ Plain English

Inclusion Criteria: (I)Chinese Healthy Volunteers * In accordance with the inclusion criteria for each bioequivalence trial of ticagrelor; * Sign informed consent of the research; * Complete to collect indexes of pharmacodynamics and pharmacogenomics in the cycle with control drug. (II)Chinese Patients * With diagnosis of acute coronary syndrome (ACS), included unstable angina, non ST segment elevation myocardial infarction and ST segment elevation myocardial infarction; * More than 18 years of age, male or female; * Never received ticagrelor in a month and intend to take ticagrelor or have received ticagrelor for more than one week continuously； * sign informed consent. Exclusion Criteria: (I)Chinese Healthy Volunteers * In accordance with the exclusion criteria for each bioequivalence trial of ticagrelor; (II)Chinese Patients * With history of immunodeficiency disease, including positive HIV index; * Positive Hepatitis B surface antigen (HBsAg) and HCV index; * Combined therapy of CYP3A potent inhibitors (e.g., ketoconazole, itraconazole, voriconazole, telithromycin, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, Atazanavir, etc.), CYP3A substrate of narrow therapy window (e.g., cyclosporine, quinidine, etc.) and potent inducers of CYP3A (e.g., rifampin, phenytoin, carbamazepine, etc.) in 14 days before treatment with ticagrelor; * Severe liver dysfunction and abnormal renal function; * Uncontrolled hypertension, or systolic blood pressure \> 180mmHg or diastolic pressure \> 110mmHg during screening; * Include contraindications of ticagrelor, such as hypersensitivity, active bleeding, moderate or severe liver disease, previous history of intracranial hemorrhage, gastrointestinal hemorrhage in the past 6 months and major operation within 30 days.

Locations (7)

Anhui Provincial Hospital（The First Affiliated Hospital Of USTC）

Hefei, Anhui, China

RECRUITING

The First Affiliated Hospital of Anhui Medical University

Hefei, Anhui, China

RECRUITING

Peking University First Hospital

Beijing, Beijing Municipality, China

RECRUITING

900 Hospital of the Joint Logistics Team (Original name: Fuzhou General Hospital of Nanjing Militray Command)

Fuzhou, Fujian, China

RECRUITING

The 7th People's Hospital Of Zhengzhou

Zhengzhou, Henan, China

ACTIVE_NOT_RECRUITING

The Third Xiangya Hospital of Central South University

Changsha, Hunan, China

ACTIVE_NOT_RECRUITING

The Second Affiliated Hospital Of Nanchang University

Nanchang, Jiangxi, China

ACTIVE_NOT_RECRUITING

Outcomes

Primary Outcomes

Incidence of major adverse cardiac events (MACE)

During the observation time, record the incidence of MACE after ticagrelor administration by telephone or outpatient clinic , including myocardial infarction, cardiac death, stent stenosis, stent thrombosis, ect.

Time frame: At 1 year

Incidence of bleeding events

During the observation time, record the incidence of bleeding events after ticagrelor administration by telephone or outpatient clinic, including subcutaneous bleeding, gingival bleeding, gastrointestinal bleeding, intracranial hemorrhage, etc.

Time frame: At 1 year

Secondary Outcomes

genotype detected by next generation sequencing

Collect blood specimen before ticagrelor administration, then detect genotype of Ticagrelor by next generation sequencing.

Time frame: pre-dose of Ticagrelor

Level of platelet reactivity assessed by ADP aggregation rate

Before and after ticagrelor administration, record the ADP aggregation rate detected by Light Transmittance Aggregometry(LTA).

Time frame: At baseline, at 12 hours for Chinese healthy volunteers or at 48 hours for Chinese patients.

Level of platelet reactivity assessed by PRI

Before and after ticagrelor administration, record PRI detected by VerifyNow System.

Time frame: At baseline, at 12 hours for Chinese healthy volunteers or at 48 hours for Chinese patients.

Expression level of miRNA

Before and after ticagrelor administration, detect the expression level of miRNA about pharmacodynamics.

Time frame: At baseline, at 12 hours for Chinese healthy volunteers or at 48 hours for Chinese patients.

Expression level of proteomics

Before and after ticagrelor administration, detect the expression level of proteomics about pharmacodynamics

Time frame: At baseline, at 12 hours for Chinese healthy volunteers or at 48 hours for Chinese patients

Expression level of LncRNA

Before and after ticagrelor administration, detect the expression level of LncRNA about pharmacodynamics.

Time frame: At baseline, at 12 hours for Chinese healthy volunteers；at 48 hours for Chinese patients.

Incidence of MACEs in the other observation times

During the other observation time, record the incidence of MACE after ticagrelor administration by telephone or outpatient clinic , including myocardial infarction, cardiac death, stent stenosis, stent thrombosis, ect.

Time frame: At 1 month, 6 months and 2 years (according the actual duration of ticagrelor taken in patiens)

Incidence of bleeding events in the other observation times

During the other observation time, record the incidence of bleeding events after ticagrelor administration by telephone or outpatient clinic, including subcutaneous bleeding, gingival bleeding, gastrointestinal bleeding, intracranial hemorrhage, etc.

Time frame: At 1 month, 6 months and 2 years (according the actual duration of ticagrelor taken in patiens)

Impact of Biomarkers on Pharmacokinetics and Pharmacodynamics of Ticagrelor

Overview

Conditions

Interventions

Eligibility

Locations (7)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts