UMIN-CTR Clinical Trial

Unique ID issued by UMIN UMIN000032829
Receipt number R000037238
Scientific Title Japanese Anti-Coagulation Regimen Exploration in AF Catheter Ablation Registry - Rivaroxaban cohort Extension
Date of disclosure of the study information 2018/06/01
Last modified on 2020/11/25 22:45:13

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Basic information

Public title

Japanese Anti-Coagulation Regimen Exploration in AF Catheter Ablation Registry
- Rivaroxaban cohort Extension

Acronym

JACRE-REx

Scientific Title

Japanese Anti-Coagulation Regimen Exploration in AF Catheter Ablation Registry
- Rivaroxaban cohort Extension

Scientific Title:Acronym

JACRE-REx

Region

Japan


Condition

Condition

Patients enrolled in [the previous study] who have not declared refusal to participation in this study according to an opt-out policy.
[The previous study]
Patients with nonvalvular atrial fibrillation [NVAF] who undergo catheter ablation.

Classification by specialty

Cardiology

Classification by malignancy

Others

Genomic information

NO


Objectives

Narrative objectives1

To evaluate the efficacy and safety of rivaroxaban, an oral factor Xa inhibitor, in patients with NVAF during the perioperative period of catheter ablation by retrospectively following up patients until the late postoperative period.

Basic objectives2

Safety,Efficacy

Basic objectives -Others


Trial characteristics_1


Trial characteristics_2


Developmental phase



Assessment

Primary outcomes

The combination of thromboembolism and serious bleeding during the late postoperative period after one month from catheter ablation.
- Thromboembolism: including transient ischemic attack, cerebral infarction, and other kinds of systemic embolism.
- Serious bleeding

Key secondary outcomes

Occurrence (recurrence) of atrial fibrillation during the late postoperative period after one month from catheter ablation
Presence or absence of repeated ablation during the late postoperative period after one month from catheter ablation and its details
Stroke (ischemic)/TIA during the late postoperative period after one month from catheter ablation
Stroke (hemorrhagic) during the late postoperative period after one month from catheter ablation
Cardiovascular events during the late postoperative period after one month from catheter ablation
Serious bleeding during the late postoperative period after one month from catheter ablation
Not serious but clinically significant bleeding during the late postoperative period after one month from catheter ablation
Presence or absence of discontinuation of anticoagulant therapy during the late postoperative period after one month from catheter ablation


Base

Study type

Observational


Study design

Basic design


Randomization


Randomization unit


Blinding


Control


Stratification


Dynamic allocation


Institution consideration


Blocking


Concealment



Intervention

No. of arms


Purpose of intervention


Type of intervention


Interventions/Control_1


Interventions/Control_2


Interventions/Control_3


Interventions/Control_4


Interventions/Control_5


Interventions/Control_6


Interventions/Control_7


Interventions/Control_8


Interventions/Control_9


Interventions/Control_10



Eligibility

Age-lower limit

20 years-old <=

Age-upper limit


Not applicable

Gender

Male and Female

Key inclusion criteria

Patients must meet all of the following conditions to be eligible for the study.
1] Diagnosis of nonvalvular atrial fibrillation [NVAF].
NVAF refers to atrial fibrillation without history of rheumatic mitral valve disease, prosthetic valve, or mitral valve repair.
2] Undergoing ablation therapy [radiofrequency ablation only] for the treatment of atrial fibrillation.
3] Receiving rivaroxaban for at least 3 weeks by the time of hospitalization for catheter ablation.
4] Age 20years and older at providing consent.
5] Written informed consent must be obtained from the patient, unless the following condition does not apply. If, upon approval by the Ethics Review Committee, information on the study has been properly disclosed to the target patients through means such as poster presentations in the study site, obtaining written informed consent can be exempted so that the patient will be excluded from the study only when she/he declares refusal to enrollment in the study.

Key exclusion criteria

Patients will be excluded from the study if any of the following conditions apply.
1] Contraindication to ablation therapy for the treatment of atrial fibrillation [e.g., due to a preoperative transesophageal echocardiography, CT, or MRI finding of a thrombus in the left atrium/left atrial appendage].
2] Development of thromboembolism or myocardial infarction within 2 months before enrollment.
3] Contraindication to Rivaroxaban.
4] For a study site that is allowed to omit the procedure of obtaining written informed consent, a patient who declares refusal to enrollment in the study will be excluded.
5] Current participation in another interventional clinical study.
6] The investigator's judgement that the patient will be inappropriate for participation in the study.

Target sample size

1118


Research contact person

Name of lead principal investigator

1st name Ken
Middle name
Last name Okumra

Organization

Saiseikai Kumamoto Hospital

Division name

Cardiovascular medicine, Division of Arrhythmia treatment category

Zip code

861-4193

Address

5-3-1,Chikami Minami-Ku Kumamoto-City Kumamoto,Japan

TEL

096-351-8000

Email

okumura@hirosaki-u.ac.jp


Public contact

Name of contact person

1st name Akiko
Middle name
Last name Fujihiro

Organization

A2 Healthcare Corporation

Division name

Clinical Development Promotion Dept.

Zip code

112

Address

1-4-1,Koishikawa,Bunkyo-Ku, Tokyo, JAPAN

TEL

03-3830-1075

Homepage URL


Email

JACRE_Ex@a2healthcare.com


Sponsor or person

Institute

Reimeikyo

Institute

Department

Personal name



Funding Source

Organization

Bayer Yakuhin,Ltd.

Organization

Division

Category of Funding Organization

Profit organization

Nationality of Funding Organization

Japan


Other related organizations

Co-sponsor


Name of secondary funder(s)



IRB Contact (For public release)

Organization

Saiseikai Kumamoto Hospital

Address

5-3-1,Chikami Minami-Ku Kumamoto-City Kumamoto,Japan

Tel

096-351-8000

Email

JACRE_Ex@a2healthcare.com


Secondary IDs

Secondary IDs

NO

Study ID_1


Org. issuing International ID_1


Study ID_2


Org. issuing International ID_2


IND to MHLW



Institutions

Institutions



Other administrative information

Date of disclosure of the study information

2018 Year 06 Month 01 Day


Related information

URL releasing protocol

https://www.sciencedirect.com/science/article/abs/pii/S0914508720302999

Publication of results

Published


Result

URL related to results and publications

https://www.sciencedirect.com/science/article/abs/pii/S0914508720302999

Number of participants that the trial has enrolled

823

Results

Long-term incidence of thromboembolism was extremely low in patients with AF treated with CA, while that of major bleeding was not necessarily low.

Results date posted

2020 Year 11 Month 17 Day

Results Delayed


Results Delay Reason


Date of the first journal publication of results


Baseline Characteristics

Data of 975 patients(rivaroxaban,n=823;warfarin,n=152)were collected from 27 institutes.Patient population had mean age 63.7+-10.3 years,710(72.8%)males,mean CHA2DS2-VASc score 1.9+-1.5,and mean follow-up period 28.7+-12.7 months after the index procedure.Anticoagulants were continued in 496(50.9%)patients during the follow-up.

Participant flow

We established a prospective registry, called the JACRE registry, for patients on rivaroxaban or warfarin administration who received CA for AF. The outcomes up to 30 days following the procedure were reported previously. The present study involved a longer follow-up of patients enrolled in this registry to evaluate long-term anticoagulation strategies and clinical outcomes.

Adverse events

Thromboembolism occurred in 3 patients, hemorrhagic stroke in 5, and major bleeding events in 9 (annualized event rate, 0.13%, 0.22%, and 0.40% per patient-year, respectively).

Outcome measures

Composite of thromboembolism and severe bleeding events after 1 month of catheter ablation treatment.
Thromboembolism; transient ischemic attack, stroke, and other systemic embolism
Serious bleeding

Plan to share IPD


IPD sharing Plan description



Progress

Recruitment status

Completed

Date of protocol fixation

2018 Year 04 Month 19 Day

Date of IRB

2018 Year 05 Month 30 Day

Anticipated trial start date

2018 Year 06 Month 15 Day

Last follow-up date

2019 Year 03 Month 31 Day

Date of closure to data entry

2019 Year 03 Month 31 Day

Date trial data considered complete

2019 Year 04 Month 30 Day

Date analysis concluded

2019 Year 06 Month 26 Day


Other

Other related information

In VENTURE-AF study, post-ablation incidences of thromboembolism and bleeding events in patients treated with rivaroxaban were reported not to differ from those treated with warfarin. In a double-blind study ROCKET-AF, rivaroxaban, an oral factor Xa inhibitor, was shown to be non-inferior to warfarin for prophylactic effects against NVAF-related <stroke and systemic embolism>.


Management information

Registered date

2018 Year 06 Month 01 Day

Last modified on

2020 Year 11 Month 25 Day



Link to view the page

Value
https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000037238


Research Plan
Registered date File name

Research case data specifications
Registered date File name

Research case data
Registered date File name