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A Randomized, Open-Label, Parallel-Group, Multi-Center Study for the Evaluation of Efficacy and Safety of Edoxaban Monotherapy Versus Low Molecular Weight (LMW) Heparin/Warfarin in Subjects With Symptomatic Deep-Vein Thrombosis (eTRIS)

This study has been completed.
Information provided by (Responsible Party):
Daiichi Sankyo Inc. Identifier:
First received: August 2, 2012
Last updated: March 26, 2015
Last verified: March 2015
Assess the relative change in thrombus volume as determined by two assessments (Baseline and Day 14-21) with magnetic resonance imaging (MRI) in subjects with deep-vein thrombosis (DVT) treated with either an edoxaban monotherapy regimen or a low molecular weight (LMW) heparin/warfarin regimen.

Condition Intervention Phase
Deep Vein Thrombosis
Venous Thrombosis
Drug: edoxaban tosylate
Drug: enoxaparin/unfractionated heparin
Drug: warfarin
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Randomized, Open-Label, Parallel-Group, Multi-Center Study for the Evaluation of Efficacy and Safety of Edoxaban Monotherapy Versus (LMW) Heparin/Warfarin in Subjects With Symptomatic Deep-Vein Thrombosis - Edoxaban Thrombus Reduction Imaging Study

Resource links provided by NLM:

Further study details as provided by Daiichi Sankyo Inc.:

Primary Outcome Measures:
  • Relative change from baseline in thrombus volume assessed by MRI [ Time Frame: 14 - 21 days from time of randomization ]

Secondary Outcome Measures:
  • Clinically relevant bleeding (i.e., major or clinically relevant non-major bleeding) [ Time Frame: From Day 1 Visit to Day 10 Visit, and during treatment up to 3 days after interrupting or stopping study drug ]
  • Recurrence of VTE [ Time Frame: 90 days from time of randomization ]
  • Major adverse cardiovascular events (MACE) defined as a composite of non-fatal myocardial infarction (MI), non-fatal stroke, non-fatal systemic embolic event (SEE) and cardiovascular death. [ Time Frame: 90 days from time of randomization ]
  • Change from baseline in the presence or absence of thrombus by vessel [ Time Frame: 14 - 21 days from time of randomization ]

Estimated Enrollment: 90
Study Start Date: August 2012
Study Completion Date: March 2014
Primary Completion Date: January 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: edoxaban tosylate Drug: edoxaban tosylate
edoxaban tosylate (DU-176b), film-coated for oral use, 90 mg QD for 10 days (±2 days) followed by 60 mg QD for a total of approximately 90 days of edoxaban treatment
Active Comparator: heparin/warfarin Drug: enoxaparin/unfractionated heparin
enoxaparin - administered by subcutaneous injection;1 mg/kg/ twice daily or 1.5 mg/kg once daily unfractionated heparin - started with 5000 IU bolus intravenous administration, 1300 IU/h continuous infusion, minimum of 5 days of treatment and stopped when target INR (2.0 - 3.0) is achieved.
Drug: warfarin
tablet for oral use; daily dosage, adjusted to maintain international normalized ratio (INR) between 2.0 and 3.0; 90 days treatment.

Detailed Description:
The classical management of patients with venous thromboembolism (VTE) consists of an initial treatment of at least five days of a (LMW) heparin followed by long-term treatment with a vitamin K antagonist (VKA), such as warfarin. The eTRIS study will address the clinically important question of whether edoxaban monotherapy, without concomitant (LMW) heparin at the time of treatment initiation is comparable to or better than standard treatment with (LMW) heparin/warfarin therapy in subjects with acute symptomatic DVT as assessed by the relative change from baseline in thrombus volume (measured by MRI) at Day 14-21.

Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Male or female subjects older than the minimum legal adult age (country specific)
  • Acute symptomatic proximal DVT involving the popliteal, femoral or iliac veins confirmed by compression ultrasonography (CUS) or other appropriate imaging techniques (such as venography or spiral/contrast CT) with symptom onset < or = 1week prior to randomization
  • Able to provide signed informed consent

Exclusion Criteria:

  • Concomitant pulmonary embolism known to the investigator at the time of randomization
  • Thrombectomy, insertion of a caval filter, or use of a fibrinolytic agent to treat the current episode of DVT
  • Indication for warfarin other than DVT
  • More than 48 hours pre-treatment with therapeutic dosages of anti-coagulant treatment (LMWH, UFH, fondaparinux, VKA, factor Xa inhibitor or other anti coagulant per local labeling) prior to randomization to treat the current episode
  • Treatment with any investigational drug within 30 days prior to randomization
  • Calculated CrCL < 30 mL/min
  • Significant liver disease (e.g., acute hepatitis, chronic active hepatitis, cirrhosis) or ALT > or = 2 times the upper limit of normal (ULN), or total bilirubin (TBL) > or = to 1.5 times the ULN (however subjects whose elevated TBL is due to known Gilbert's syndrome may be included in the study)
  • Subjects with active cancer for whom long term treatment with (LMW) heparin is anticipated
  • Life expectancy < 3 months
  • Active bleeding or high risk for bleeding contraindicating treatment with (LMW) heparin or warfarin
  • Uncontrolled hypertension as judged by the Investigator (e.g., systolic blood pressure > 170 mmHg or diastolic blood pressure > 100 mmHg despite antihypertensive medications confirmed by repeat measurement)
  • Women of childbearing potential without proper contraceptive measures (i.e., a method of contraception with a failure rate < 1 % during the course of the study including the observational period) and women who are pregnant or breast feeding
  • Any contraindication listed in the local labeling of LMWH, UFH, or warfarin
  • Chronic treatment with non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs) including both cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX- 2) inhibitors for > or = 4 days/week anticipated to continue during the study.
  • Treatment with aspirin in a dosage of more than 100 mg/per day or dual antiplatelet therapy (any two antiplatelet agents including aspirin plus any other oral or intravenous [IV] antiplatelet drug) anticipated to continue during the study
  • Treatment with P-gp inhibitors is not permitted at the time of randomization; subsequent use is permitted, with a dose reduction in the edoxaban monotherapy treatment arm.
  • Known history of positive Hepatitis B antigen or Hepatitis C antibody
  • Subjects with any condition that, as judged by the investigator, would put the subject at increased risk of harm if he/she participated in the study; including, but not limited to, subjects at increased risk of harm if given a gadolinium-based contrast agent such as gadofosveset trisodium (Ablavar®)
  • Subjects for whom MRI would be contraindicated (e.g., subjects with metal implants) or for whom the use of a gadolinium-based contrast agent such as gadofosveset trisodium (Ablavar®) would be contraindicated
  • Subject has previously entered this study or another edoxaban study
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Please refer to this study by its identifier: NCT01662908

  Show 34 Study Locations
Sponsors and Collaborators
Daiichi Sankyo Inc.
Principal Investigator: Samuel Z Goldhaber, MD Brigham and Women's Hospital
  More Information

Publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Daiichi Sankyo Inc. Identifier: NCT01662908     History of Changes
Other Study ID Numbers: DU176b-D-U211
Study First Received: August 2, 2012
Last Updated: March 26, 2015

Additional relevant MeSH terms:
Venous Thrombosis
Embolism and Thrombosis
Vascular Diseases
Cardiovascular Diseases
Calcium heparin
Fibrinolytic Agents
Fibrin Modulating Agents
Molecular Mechanisms of Pharmacological Action
Factor Xa Inhibitors
Serine Proteinase Inhibitors
Protease Inhibitors
Enzyme Inhibitors processed this record on April 28, 2017