Status:

NOT_YET_RECRUITING

Safety and Efficacy of Apixaban Versus Warfarin in Peritoneal Dialysis Patients With Non Valvular Atrial Fibrillation: a Prospective, Randomised, Open-label, Blinded End-point Trial (APIDP2)

Lead Sponsor:

University Hospital, Caen

Conditions:

Atrial Fibrillation

Peritoneal Dialysis Complication

Eligibility:

All Genders

18+ years

Phase:

PHASE3

Brief Summary

Introduction: Several randomised controlled trials have demonstrated that novel oral anticoagulants (NOACs) are safer compared to vitamin K antagonists for the management of non valvular atrial fibri...

Detailed Description

The prevalence of AF in the general population is estimated to range around 1% depending on age, reaching 8% in patients over 80 years old. This prevalence is of 20% and 14% in patients on hemodialysi...

Eligibility Criteria

Inclusion

  • Inclusion criteria
  • Males and females, age at least 18 years, in ESRD treated with peritoneal dialysis for ≥ 3 months
  • Patients with a history of non valvular AF treated by oral anticoagulation or patients initiating oral anticoagulation for a diagnosis of non valvular AF
  • CHA2DS2-VASc score of ≥ 2.
  • For women of childbearing age who are sexually active, use of an effective method of contraception for up to 10 days after the end of treatment and a negative blood pregnancy test at enrollment.
  • Signature of informed consent
  • Exclusion criteria
  • Not considered by the treating physician(s) to be candidates for oral anticoagulation (for example, hemoglobin \<8.5g/dL, history of intracranial hemorrhage, active bleeding, recent gastrointestinal bleed or retroperitoneal bleed, severe hepatic impairment, or anaphylactic reaction to apixaban)
  • Moderate or severe mitral stenosis
  • Patients with a history of transient ischemic attack or stroke in the 3 months prior to inclusion
  • Patient treated with haemodyalisis
  • Conditions other than non valvular AF that require anticoagulation such as mechanical prosthetic valve, deep venous thrombosis, or pulmonary embolism
  • Life expectancy \< 3 months
  • Anticipated kidney transplant within the next 3 months
  • Individuals covered by Articles L1121-5 to L1121-8 of the French Public Health Code (corresponding to all protected persons: pregnant women, postpartum women, breastfeeding mothers, individuals deprived of their liberty by judicial or administrative decision, minors, individuals under legal protection such as guardianship or trusteeship).
  • Women of childbearing age not using a highly effective contraceptive method during the study and up to 10 days after the end of treatment.
  • Use of potent inducers of CYP3A4 (particularly rifampicin, phenytoin, carbamazepine, phenobarbital, or St. John's wort (Hypericum perforatum)).
  • Use of CYP3A4 and P-gp inhibitors, particularly azole antifungals (ketoconazole, itraconazole, voriconazole, posaconazole, fluconazole), HIV protease inhibitors, clarithromycin, and erythromycin.
  • Contraindication to anticoagulant treatment, such as antiphospholipid syndrome.

Exclusion

    Key Trial Info

    Start Date :

    October 30 2024

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ESTIMATED

    End Date :

    October 30 2027

    Estimated Enrollment :

    178 Patients enrolled

    Trial Details

    Trial ID

    NCT06045858

    Start Date

    October 30 2024

    End Date

    October 30 2027

    Last Update

    August 9 2024

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