Early Gastric Cancer Clinical Trial
Official title:
Does Early Re-administration of Aspirin/Clopidogrel Increase the Risk of Bleeding From Artificial Ulcer After EMR or ESD?
Verified date | November 2012 |
Source | Asan Medical Center |
Contact | n/a |
Is FDA regulated | No |
Health authority | Korea: Food and Drug Administration |
Study type | Interventional |
Aspirin and/or clopidogrel users are increasing due to increased prevalence of
cardiovascular or cerebrovascular disease with an aging society in Korea. Also, the patients
having endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) for
early gastric cancer or gastric premalignant lesions including adenoma and dysplasia are
increasing among aspirin and/or clopidogrel users. Practically, aspirin or clopidogrel is
recommended to be stopped for 5~14 days before EMR or ESD because bleeding risk during or
after procedure. And it is recommended to restart of aspirin and/or clopidogrel as soon as
possible if immediate bleeding during or after the procedure is not occurred in
consideration of thromboembolic risk. However, early restarting of aspirin and/or
clopidogrel raise the risk of delayed bleeding and the risk of complications associated with
delayed ulcer healing. Although it is important to determine the timing of restarting
aspirin and/or clopidogrel in consideration of complications of post-EMR/ESD ulcer and
thromboembolic risk, there is no definite guideline about the timing of restarting aspirin
and/or clopidogrel.
This study is aimed to determine the timing of restarting aspirin and/or clopidogrel for the
patients having EMR or ESD among aspirin and/or clopidogrel users. The investigators planned
to compare the delayed bleeding rate and ulcer healing rate in patients with post-EMR/ESD
ulcer when take proton pump inhibitor (pantoprazole 40 mg per day) between the patients
restarting aspirin and/or clopidogrel within 3~4 days after the procedure and the patients
restarting aspirin and/or clopidogrel 2 weeks after the procedure during 4 weeks. The
primary endpoint is delayed ulcer bleeding rate at 4 weeks after EMR/ESD. The secondary end
point is ulcer healing rate within 4 weeks.
Status | Enrolling by invitation |
Enrollment | 400 |
Est. completion date | June 2014 |
Est. primary completion date | May 2014 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years to 80 Years |
Eligibility |
Inclusion Criteria: - Patients who have taken aspirin and/or clopidogrel for cardiovascular and/or cerebrovascular disease and are found to have early gastric cancer or premalignant lesions including adenoma and dysplasia by upper endoscopy. Exclusion Criteria: - Patients with known coagulopathy or abnormal coagulation tests (prothrombin time, partial thromboplastin time and platelet count) - Patients receiving other antithrombotic, anticoagulant drugs - Patients needing continuation of nonsteroidal anti-inflammatory drugs, cyclooxygenase-2 (COX-2) inhibitors, or steroid after EMR/ESD - Patient with recent percutaneous coronary intervention (placement of drug eluting coronary artery stent within 12 months, bare metal coronary artery stents within 1 month) - Patient's age > 80 year-old or < 18 year-old - Patient with severe cardiovascular, pulmonary, hepatic, or renal disease |
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
Korea, Republic of | Asan Medical Center | Seoul |
Lead Sponsor | Collaborator |
---|---|
Asan Medical Center | Takeda |
Korea, Republic of,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | delayed ulcer bleeding | 4 weeks | Yes | |
Secondary | ulcer healing rate | 4 weeks | Yes |
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