The goal of this clinical trial is to test if the study drug, BXP154B works to stop bleeding from a minor wound in patients that are on apixaban for anticoagulant therapy. The main questions it aims to answer are: * How long does it take to stop bleeding after BXP154B is applied to a wound? * How many people require the use of a rescue treatment to stop bleeding? * Does BXP154B reduce instances of re-bleeding after the bleeding has stopped initially? * Is BXP154B safe and well-tolerated?
Oral anticoagulant-related clinically relevant nonmajor bleeding (CRNMB; i.e., non-major bleeding that requires medical intervention, increased level of care, or face-to-face evaluation) and minor bleeding, often referred to as 'nuisance' bleeding, carries a high burden in terms of patient discomfort, anxiety, temporary disability, and reduced quality of life, and strain on medical and socioeconomic resources. Prolonged bleeding following minor injuries (falls, scrapes, cuts) can be life-interrupting and frequently leads patients to seek medical care, often times in an urgent care or emergency department (ED) setting. Prolonged bleeding from minor injuries is a significant challenge to daily life for people on anticoagulants, and is anything but 'minor' to the patient. Bio 54, LLC, is developing BXP154B, a topical agent intended for self-administration (in or outside the home) to treat external bleeding from minor wounds in patients on anticoagulants. The development of BXP154B will offer patients on anticoagulants a much-needed treatment for self-management of external bleeding from minor wounds at home. BXP154-201 is a randomized, double-blind, placebo-controlled, 2-way crossover-design study to evaluate the efficacy and safety of BXP154B (6 mL) compared with volume-matched placebo in the treatment of bleeding following punch biopsy in subjects on apixaban. Subjects will be enrolled in this clinical trial for a total of seven days, following a screening period of up to 28 days. The study commences on Day 1 with a skin punch biopsy and administration of the investigational drug or placebo. Subsequently, follow-up assessments will be conducted on Days 2, 3, and 4. A second skin punch biopsy will be performed on Day 4, followed by additional follow-up assessments on Days 5, 6, and 7. Upon completion of the Day 7 assessments, subjects will have fulfilled their involvement in the study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
24
BXP154B will be self-administered topically following wound induction
Placebo will be self-administered topically following wound induction
Punch biopsy to leg
Accel Research Sites Network - DeLand
DeLand, Florida, United States
Time to achieve hemostasis (in minutes) following start of treatment
Time to achieve hemostasis (in minutes) will be compared between active treatment and control.
Time frame: 60 minutes following start of treatment
Proportion of subjects who achieve hemostasis within 4mins, 8mins, 12mins, 16mins, 20mins, 25mins, 30mins, 40 mins, 50mins, 60mins
Summarized as the proportion of subjects that met criteria and compared between active treatment and control.
Time frame: 60 minutes following start of treatment
Proportion of subjects who require rescue treatment intervention to achieve hemostasis following biopsy
Summarized as the proportion of subjects that met criteria and compared between active treatment and control.
Time frame: 60 minutes following start of treatment
Time to achieve hemostasis (in minutes) with no rebleeding requiring self-managed or medical intervention within 72 hours after the start of treatment
Time (in minutes) to achieve hemostasis will be compared between active treatment and control.
Time frame: 72 hours following start of treatment
Proportion of subjects who experience rebleeding following initial hemostasis that requires self-managed or medical intervention to re-achieve hemostasis within 24, 48, and 72 hours after the start of treatment
Summarized as the proportion of subjects that met criteria and compared between active treatment and control.
Time frame: 72 hours following start of treatment
Proportion of subjects who experience rebleeding following initial hemostasis that requires subsequent self-managed intervention to re-achieve hemostasis within 24, 48, and 72 hours after the start of treatment
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Summarized as the proportion of subjects that met criteria and compared between active treatment and control.
Time frame: 72 hours following start of treatment
Proportion of subjects who experience rebleeding following initial hemostasis that requires subsequent medical intervention to re-achieve hemostasis within 24, 48, and 72 hours after the start of treatment
Summarized as the proportion of subjects that met criteria and compared between active treatment and control.
Time frame: 72 hours following start of treatment
Number of rebleeding episodes following initial hemostasis that require subsequent medical intervention to re-achieve hemostasis within 24, 48, and 72 hours after the start of treatment
Summarized as the number of episodes per subject compared between active treatment and control.
Time frame: 72 hours following start of treatment
Time to achieve hemostasis (in minutes) following the start of treatment in subjects with a bleed time of at least 10 minutes in either treatment period
Time (in minutes) to achieve hemostasis will be compared between active treatment and control.
Time frame: 72 hours following start of treatment
Proportion of subjects who experience adverse events including adverse skin reactions and other clinically significant findings on physical exam; clinically significant lab values; and clinically significant changes in vital signs.
Summarized as the proportion of subjects reporting adverse events compared between active treatment and control.
Time frame: 9 days
Systolic blood pressure
Summarized as observed values and change from baseline compared between active treatment and control.
Time frame: 7 days
Diastolic blood pressure
Summarized as observed values and change from baseline compared between active treatment and control.
Time frame: 7 days