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BLeeding Events and Maintenance DoSe of PraSugrel (BLESS)

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ClinicalTrials.gov Identifier: NCT01790854
Recruitment Status : Terminated (Low events rate. Scarce economical resources)
First Posted : February 13, 2013
Last Update Posted : July 29, 2016
Sponsor:
Collaborator:
A.R. CARD Onlus Foundation
Information provided by (Responsible Party):
David Antoniucci, Careggi Hospital

Brief Summary:
Aim: to verify if after the acute phase of ACS acute coronary syndrome (1-months), from 1 to 12 months the reduction of maintenance dose of prasugrel from 10 mg to 5 mg/day may reduce the bleeding events (5 mg vs 10 mg). All patients will be treated with 325 mg of aspirin followed by a maintenance dosage of 100 mg of aspirin for at least 1 year. At baseline (after 60 mg loading dose of prasugrel) and after 1 month (7 days after the randomization at 10 or 5 mg of prasugrel) all patients will undergo light transmittance aggregometry (LTA) test to evaluate residual platelet reactivity (pharmacodynamic effects).

Condition or disease Intervention/treatment Phase
Adverse Reaction to Antiplatelet Agent Acute Coronary Syndrome Drug: Prasugrel dose 5 mg/day Drug: Prasugrel dose 10 mg/day Phase 4

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 195 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Bless Study (BLeeding Events and Maintenance DoSe of PraSugrel)
Study Start Date : November 2012
Primary Completion Date : October 2014
Study Completion Date : October 2014

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Bleeding
Drug Information available for: Prasugrel
U.S. FDA Resources

Arm Intervention/treatment
Experimental: Prasugrel dose 5 mg/day
225 patients will be treated with 325 mg of aspirin (followed by a maintenance dosage of 100 mg of aspirin for at least 1 year and with 60 mg loading dose of prasugrel followed by a maintenance dosage of 5 mg/day of prasugrel for 12 months
Drug: Prasugrel dose 5 mg/day
Active Comparator: Prasugrel dose 10 mg/day
225 patients will be treated with 325 mg of aspirin (followed by a maintenance dosage of 100 mg of aspirin for at least 1 year and with 60 mg loading dose of prasugrel followed by a maintenance dosage of 10 mg/day of prasugrel for 12 months
Drug: Prasugrel dose 10 mg/day



Primary Outcome Measures :
  1. bleeding [ Time Frame: 12 months ]
    major, minor and minimal bleeding defined according BARC (Bleeding Academic Research Consortium criteria (11), occurring from 1 month to the end of the study.


Secondary Outcome Measures :
  1. MACE [ Time Frame: 12 months ]
    MACE (cardiac death, Myocardial Infarction, stroke) occurring from 1 month to the end of the study; late stent thrombosis.


Other Outcome Measures:
  1. pharmacodynamic effects [ Time Frame: 12 months ]
    pharmacodynamic effects of shifting prasugrel maintenance dose from 10 mg to 5 mg after ACS

  2. residual platelet reactivity (LTA) [ Time Frame: baseline - 1 month ]
    correlation between residual platelet reactivity (LTA), both at baseline and at 1-month, with bleeding and ischemic events



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Ages Eligible for Study:   18 Years to 74 Years   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • all ACS patients treated with PCI (percutaneous coronary intervention) and dual antiplatelet therapy (DAPT: aspirin plus prasugrel).
  • Informed written consent

Exclusion Criteria:

  • Age < 18 years
  • Active bleeding; bleeding diathesis; coagulopathy
  • History of gastrointestinal or genitourinary bleeding <2 months
  • Major surgery in the last 6 weeks
  • History of intracranial bleeding or structural abnormalities
  • Suspected aortic dissection
  • Any previous TIA (transient ischemic attack)/stroke
  • Administration in the week before the index event of clopidogrel, ticlopidine, prasugrel, ticagrelor, thrombolytics, bivalirudin, low-molecular weight heparin or fondaparinux .
  • Known relevant hematological deviations: Hb <10 g/dl, Thrombocytopenia. <100x10^9/l
  • Use of coumadin derivatives within the last 7 days
  • Chronic therapy with prasugrel or ticagrelor
  • Known malignancies or other comorbid conditions with life expectancy <1 year
  • Known severe liver disease, severe renal failure
  • Known allergy to the study medications
  • Pregnancy

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01790854


Locations
Italy
Careggi Hospital
Florence, Italy
Sponsors and Collaborators
David Antoniucci
A.R. CARD Onlus Foundation
Investigators
Principal Investigator: David Antoniucci, MD Careggi Hospital, division of Invasive Cardiology

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: David Antoniucci, Head Division of Invasive Cardiology, Careggi Hospital
ClinicalTrials.gov Identifier: NCT01790854     History of Changes
Other Study ID Numbers: BLESS Study
First Posted: February 13, 2013    Key Record Dates
Last Update Posted: July 29, 2016
Last Verified: July 2016

Keywords provided by David Antoniucci, Careggi Hospital:
prasugrel
antiplatelet
Acute Coronary Syndrome

Additional relevant MeSH terms:
Acute Coronary Syndrome
Myocardial Ischemia
Heart Diseases
Cardiovascular Diseases
Vascular Diseases
Prasugrel Hydrochloride
Platelet Aggregation Inhibitors