Trial Outcomes & Findings for Study of Ciraparantag for Reversal of Anticoagulation Induced by Edoxaban, Apixaban or Rivaroxaban in Healthy Adults (NCT NCT04593784)

NCT ID: NCT04593784

Last Updated: 2026-04-20

Results Overview

The primary efficacy endpoint is achieving a WBCT (measured by PoC coagulometer) ≤ 120% of baseline within 1 hour after administration of ciraparantag/PBO, which is subsequently sustained after 1 hour through at least 6 hours after ciraparantag/PBO dosing (Responder).

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

41 participants

Primary outcome timeframe

Within 1 hour and sustained through 6 hours

Results posted on

2026-04-20

Participant Flow

Screening occurred between Oct 2021 and Aug 2023 at 3 phase 1 clinics. Subjects were enrolled into the cohorts listed below (i.e., no participants were enrolled in Cohort 2, Apixaban 10mg).

41 subjects were enrolled; 40 subjects were assigned to a cohort (1 subject discontinued due to cohort being full). Of the 40 subjects assigned to a cohort and dosed with anticoagulant, 37 subjects were randomized and 3 subjects were not randomized and discontinued the study early, prior to treatment with ciraparantag/placebo, due to not meeting study WBCT threshold for sufficient anticoagulation.

Participant milestones

Participant milestones
Measure
Cohort 1 (Edox) PBO
Subjects received 60 mg edoxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last edoxaban dose, a single IV dose of placebo was administered.
Cohort 1 (Edox) Cira 180 mg
Subjects received 60 mg edoxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last edoxaban dose, a single IV dose of 180 mg ciraparantag was administered.
Cohort 3 (Riva) Cira 180 mg
Subjects receive 20 mg rivaroxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last rivaroxaban dose, a single IV dose of 180 mg ciraparantag was administered.
Cohort 3 (Riva) PBO
Subjects receive 20 mg rivaroxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last rivaroxaban dose, a single IV dose of placebo was administered.
Overall Study
STARTED
6
12
13
6
Overall Study
COMPLETED
6
12
12
6
Overall Study
NOT COMPLETED
0
0
1
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Cohort 1 (Edox) PBO
Subjects received 60 mg edoxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last edoxaban dose, a single IV dose of placebo was administered.
Cohort 1 (Edox) Cira 180 mg
Subjects received 60 mg edoxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last edoxaban dose, a single IV dose of 180 mg ciraparantag was administered.
Cohort 3 (Riva) Cira 180 mg
Subjects receive 20 mg rivaroxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last rivaroxaban dose, a single IV dose of 180 mg ciraparantag was administered.
Cohort 3 (Riva) PBO
Subjects receive 20 mg rivaroxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last rivaroxaban dose, a single IV dose of placebo was administered.
Overall Study
Randomized, not dosed w ciraparantag, due to not meeting threshold for sufficient anticoagulation
0
0
1
0

Baseline Characteristics

Study of Ciraparantag for Reversal of Anticoagulation Induced by Edoxaban, Apixaban or Rivaroxaban in Healthy Adults

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Cohort 1 (Edox) PBO
n=6 Participants
Subjects received 60 mg edoxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last edoxaban dose, a single IV dose of placebo was administered.
Cohort 1 (Edox) Cira 180 mg
n=12 Participants
Subjects received 60 mg edoxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last edoxaban dose, a single IV dose of 180 mg ciraparantag was administered.
Cohort 3 (Riva) PBO
n=6 Participants
Subjects receive 20 mg rivaroxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last rivaroxaban dose, a single IV dose of placebo was administered.
Cohort 3 (Riva) Cira 180 mg
n=12 Participants
Subjects receive 20 mg rivaroxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last rivaroxaban dose, a single IV dose of 180 mg ciraparantag was administered.
Total
n=36 Participants
Total of all reporting groups
Age, Continuous
44.7 Years
STANDARD_DEVIATION 15.38 • n=129 Participants
45.3 Years
STANDARD_DEVIATION 14.46 • n=22 Participants
43.5 Years
STANDARD_DEVIATION 15.6 • n=151 Participants
47.0 Years
STANDARD_DEVIATION 14.76 • n=94 Participants
45.4 Years
STANDARD_DEVIATION 14.30 • n=25 Participants
Sex: Female, Male
Female
1 Participants
n=129 Participants
7 Participants
n=22 Participants
1 Participants
n=151 Participants
4 Participants
n=94 Participants
13 Participants
n=25 Participants
Sex: Female, Male
Male
5 Participants
n=129 Participants
5 Participants
n=22 Participants
5 Participants
n=151 Participants
8 Participants
n=94 Participants
23 Participants
n=25 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=129 Participants
7 Participants
n=22 Participants
1 Participants
n=151 Participants
6 Participants
n=94 Participants
17 Participants
n=25 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
3 Participants
n=129 Participants
5 Participants
n=22 Participants
5 Participants
n=151 Participants
6 Participants
n=94 Participants
19 Participants
n=25 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=129 Participants
0 Participants
n=22 Participants
0 Participants
n=151 Participants
0 Participants
n=94 Participants
0 Participants
n=25 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=129 Participants
0 Participants
n=22 Participants
0 Participants
n=151 Participants
0 Participants
n=94 Participants
0 Participants
n=25 Participants
Race (NIH/OMB)
Asian
0 Participants
n=129 Participants
1 Participants
n=22 Participants
0 Participants
n=151 Participants
0 Participants
n=94 Participants
1 Participants
n=25 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=129 Participants
0 Participants
n=22 Participants
0 Participants
n=151 Participants
0 Participants
n=94 Participants
0 Participants
n=25 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=129 Participants
2 Participants
n=22 Participants
4 Participants
n=151 Participants
1 Participants
n=94 Participants
8 Participants
n=25 Participants
Race (NIH/OMB)
White
5 Participants
n=129 Participants
9 Participants
n=22 Participants
2 Participants
n=151 Participants
11 Participants
n=94 Participants
27 Participants
n=25 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=129 Participants
0 Participants
n=22 Participants
0 Participants
n=151 Participants
0 Participants
n=94 Participants
0 Participants
n=25 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=129 Participants
0 Participants
n=22 Participants
0 Participants
n=151 Participants
0 Participants
n=94 Participants
0 Participants
n=25 Participants
Baseline Whole Blood Clotting Time (WBCT) as measured by PoC Coagulometer
235.2 seconds
STANDARD_DEVIATION 37.69 • n=129 Participants
239.0 seconds
STANDARD_DEVIATION 35.76 • n=22 Participants
213.7 seconds
STANDARD_DEVIATION 30.85 • n=151 Participants
235.4 seconds
STANDARD_DEVIATION 28.52 • n=94 Participants
232.9 seconds
STANDARD_DEVIATION 32.80 • n=25 Participants

PRIMARY outcome

Timeframe: Within 1 hour and sustained through 6 hours

Population: The Efficacy Population included those randomized subjects who received the planned single dose of ciraparantag/PBO and had at least one subsequent WBCT (as measured by PoC coagulometer) measurement. Subjects were analyzed based on their randomized treatment assignment.

The primary efficacy endpoint is achieving a WBCT (measured by PoC coagulometer) ≤ 120% of baseline within 1 hour after administration of ciraparantag/PBO, which is subsequently sustained after 1 hour through at least 6 hours after ciraparantag/PBO dosing (Responder).

Outcome measures

Outcome measures
Measure
Cohort 1 (Edox) Cira 180 mg
n=12 Participants
Subjects received 60 mg edoxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last edoxaban dose, a single IV dose of 180 mg ciraparantag was administered.
Cohort 1 (Edox) PBO
n=6 Participants
Subjects received 60 mg edoxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last edoxaban dose, a single IV dose of placebo was administered.
Cohort 3 (Riva) Cira 180 mg
n=12 Participants
Subjects receive 20 mg rivaroxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last rivaroxaban dose, a single IV dose of 180 mg ciraparantag was administered.
Cohort 3 (Riva) PBO
n=6 Participants
Subjects receive 20 mg rivaroxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last rivaroxaban dose, a single IV dose of placebo was administered.
Subjects Achieving WBCT ≤120% of Baseline
0 Participants
1 Participants
0 Participants
0 Participants

Adverse Events

Cohort 1 (Edox) PBO

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Cohort 3 (Riva) PBO

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Cohort 1 (Edox) Cira 180 mg

Serious events: 0 serious events
Other events: 7 other events
Deaths: 0 deaths

Cohort 3 (Riva) Cira 180 mg

Serious events: 0 serious events
Other events: 3 other events
Deaths: 0 deaths

Enrolled Not Treated

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Cohort 1 (Edox) PBO
n=6 participants at risk
Subjects received 60 mg edoxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last edoxaban dose, a single IV dose of placebo was administered.
Cohort 3 (Riva) PBO
n=6 participants at risk
Subjects receive 20 mg rivaroxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last rivaroxaban dose, a single IV dose of placebo was administered.
Cohort 1 (Edox) Cira 180 mg
n=12 participants at risk
Subjects received 60 mg edoxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last edoxaban dose, a single IV dose of 180 mg ciraparantag was administered.
Cohort 3 (Riva) Cira 180 mg
n=12 participants at risk
Subjects receive 20 mg rivaroxaban orally once daily in the morning from Day 1 to Day 3 or Day 4. On Day 3 / 4, approximately 3 hours after the last rivaroxaban dose, a single IV dose of 180 mg ciraparantag was administered.
Enrolled Not Treated
n=4 participants at risk
Subjects received 60 mg edoxaban or 20 mg rivaroxaban orally once daily in the morning from Day 1 up to Day 3 or Day 4. Subjects discontinued the study early (prior to treatment with ciraparantag/placebo) due to not meeting study WBCT threshold for sufficient anticoagulation.
General disorders
Feeling Hot
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
16.7%
2/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
25.0%
3/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/4 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
General disorders
Infusion site erythema
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
8.3%
1/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/4 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
Gastrointestinal disorders
Constipation
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
8.3%
1/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/4 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
Injury, poisoning and procedural complications
Arthropod bite
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
8.3%
1/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/4 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
Musculoskeletal and connective tissue disorders
Back pain
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
8.3%
1/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/4 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
Musculoskeletal and connective tissue disorders
Musculoskeletal pain
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
8.3%
1/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/4 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
Musculoskeletal and connective tissue disorders
Pain in extremity
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
8.3%
1/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/4 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
Vascular disorders
Phlebitis
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
8.3%
1/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/4 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
Gastrointestinal disorders
Paraesthesia oral
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
8.3%
1/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/4 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
Gastrointestinal disorders
Abdominal tenderness
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/6 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
8.3%
1/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/12 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.
0.00%
0/4 • Adverse events were monitored from the time the informed consent was signed through the last study visit / study completion which occurred five days after IP-dosing. Serious Adverse Events were reported through 30 days after the last dose of ciraparantag/placebo.

Additional Information

Scientific Advisor

Apollo Investment Management

Phone: +352 2088 1301

Results disclosure agreements

  • Principal investigator is a sponsor employee Any publication based on the results obtained at the Site shall not be made before the first multi-centre publication. The INVESTIGATOR shall have publication or presentation privileges provided manuscript/abstract is submitted to SPONSOR for review/comment sixty (60) days prior to submission; INSTITUTION agrees to delete information identified by CRO/SPONSOR as Confidential Information.
  • Publication restrictions are in place

Restriction type: OTHER