Evidence map›Paper›PMID 23379785›Full record

Trial reportJournal of interventional cardiology2013

Would tirofiban have been shown non-inferior to abciximab had the TENACITY trial not been terminated for financial reasons?

Peter B Berger, Judson B Williams, Vic Hasselblad, Karen Chiswell, Karen S Pieper, Robert M Califf

Abstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of interventional cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
2.3field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 2 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Peter B BergerGeisinger Clinic, Danville, Pennsylvania, USA. pbberger@geisinger.edu
Judson B Williams
Vic Hasselblad
Karen Chiswell
Karen S Pieper
Robert M Califf
Duke University · USClinical Research Institute · USGeisinger Medical Center · US

Funding

Postdoctoral Training in Cardiovascular Clinical ResearchT32HL069749 · NHLBI · DUKE UNIVERSITY · PI MARK, DANIEL B · 2003 to 2023
$6.7M
Cardiothoracic Surgical Network Clinical CenterU01HL088953 · NHLBI · DUKE UNIVERSITY · PI SMITH, PETER K · 2007 to 2013
$2.6M
NHLBI NIH HHS T32 HL069749NHLBI NIH HHS T32‐HL069749NHLBI NIH HHS U01 HL088953
6 · The paper itself

Abstract

objectivesTo investigate whether tirofiban would have been non-inferior to abciximab had the trial completed enrollment and place the termination of this trial in a broader research ethics context.

backgroundTENACITY was terminated by the sponsor for financial reasons. At the time, event rates for the 2 treatment arms were unknown.

methodsTENACITY was designed to compare tirofiban with abciximab in approximately 8,000 patients; however, enrollment was terminated after 383 (4.8%) patients. The primary end-point was a composite of 30-day death, myocardial infarction, and urgent target vessel revascularization. Non-inferiority was defined as the likelihood that tirofiban would preserve at least 50% of the ability of abciximab to reduce the primary end-point at 30 days, based on abciximab's demonstrated ability to reduce such events by 43% (relative risk, 0.573; 95% confidence interval [CI], 0.507-0.648; P < 0.001). To determine the probability of non-inferiority given the patients already enrolled, a Bayesian approach was used.

resultsThe primary composite end-point occurred in 8.8% of patients randomized to abciximab versus 6.9% receiving high-bolus-dose tirofiban (odds ratio, 0.77; 95% CI, 0.37-1.64). The estimated conditional power for the test that tirofiban would be non-inferior to abciximab if all patients been enrolled is 93.7%. Using the estimated predictive power method, the likelihood was 84.8%.

conclusionsTENACITY was well powered to identify non-inferiority with tirofiban versus abciximab, and the patients enrolled strengthened the probability that this would have been the outcome had the trial been completed. When a clinical trial is terminated solely for financial reasons, it is incumbent upon the sponsor to provide proper patient follow-up and publication of the findings.

Indexed as

AbciximabAcute Coronary SyndromeAgedAntibodies, MonoclonalEarly Termination of Clinical TrialsFemaleHumansImmunoglobulin Fab FragmentsMaleMiddle AgedMyocardial InfarctionPlatelet Aggregation InhibitorsStentsSurvival RateTirofibanTreatment OutcomeAbciximabAntibodies, MonoclonalImmunoglobulin Fab FragmentsPlatelet Aggregation InhibitorsTirofibanTyrosine

Identifiers

PMID23379785
PMCPMC4156852
OpenAlexW1484071242

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.