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NCT03891524: AXIOMATIC-TKR

A Study of JNJ-70033093 (BMS-986177) Versus Subcutaneous Enoxaparin in Participants Undergoing Elective Total Knee Replacement Surgery

Completed Phase 2 Results posted Last updated 30 March 2025
What this trial tests

Phase 2 trial testing JNJ-70033093 25 mg in Arthroplasty, Replacement, Knee in 1,242 participants. Completed in 6 April 2021.

Timeline
17 June 2019
Primary endpoint
6 April 2021
6 April 2021

Quick facts

Lead sponsorJanssen Research & Development, LLC
PhasePhase 2
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingsingle
Primary purposeprevention
Enrollment1,242
Start date17 June 2019
Primary completion6 April 2021
Estimated completion6 April 2021
Sites117 locations across Italy, South Africa, Japan, Russia, Greece, Ukraine, Belgium, Israel

Drugs / interventions tested

Conditions studied

Sponsor

Janssen Research & Development, LLC — full company profile →

Who can join

50 and older, any sex, with Arthroplasty, Replacement, Knee. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Number of Participants With Total Venous Thromboembolism (VTE) (CEC-adjudicated) Primary · Up to Day 14

Total VTE was defined as the composite of clinical events committee (CEC)-adjudicated proximal and/or distal Deep Vein Thrombosis (DVT) (asymptomatic confirmed by venography assessment of the operated leg or objectively confirmed symptomatic), nonfatal pulmonary embolism (PE), or any death.

GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo7
JNJ-70033093 50 mg Once Daily + Placebo30
JNJ-70033093 25 mg + Placebo Twice Daily (BID)27
JNJ-70033093 50 mg BID14
JNJ-70033093 200 mg Once Daily + Placebo8
JNJ-70033093 100 mg + Placebo BID12
JNJ-70033093 200 mg BID10
Enoxaparin 40 mg Once Daily54
Number of Participants With Any Bleeding Event (CEC-adjudicated) Secondary · Up to Day 14; Up to Day 52

Any bleeding was defined as the composite of major bleeding according to the International Society on Thrombosis and Haemostasis (ISTH) criteria modified for the surgical setting, clinically relevant nonmajor bleeding events, or minimal bleeding events as assessed by the CEC.

Up to Day 14
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo8
JNJ-70033093 25 mg + Placebo Twice Daily (BID)2
JNJ-70033093 50 mg BID7
JNJ-70033093 200 mg Once Daily + Placebo11
JNJ-70033093 100 mg + Placebo BID7
JNJ-70033093 200 mg BID6
Enoxaparin 40 mg Once Daily12
Up to Day 52
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo8
JNJ-70033093 25 mg + Placebo Twice Daily (BID)2
JNJ-70033093 50 mg BID7
JNJ-70033093 200 mg Once Daily + Placebo11
JNJ-70033093 100 mg + Placebo BID7
JNJ-70033093 200 mg BID6
Enoxaparin 40 mg Once Daily12
Number of Participants With Total VTE (CEC-adjudicated) Secondary · Up to Day 52

Total VTE was defined as the composite of (CEC-adjudicated) proximal and/or DVT (asymptomatic confirmed by venography assessment of the operated leg or objectively confirmed symptomatic), nonfatal PE, or any death.

GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo7
JNJ-70033093 50 mg Once Daily + Placebo30
JNJ-70033093 25 mg + Placebo Twice Daily (BID)27
JNJ-70033093 50 mg BID14
JNJ-70033093 200 mg Once Daily + Placebo8
JNJ-70033093 100 mg + Placebo BID12
JNJ-70033093 200 mg BID10
Enoxaparin 40 mg Once Daily54
Number of Participants With Composite of Major and Clinically Relevant Nonmajor Bleeding (CRNM) Events (CEC-adjudicated) Secondary · Up to Day 14, Up to Day 52

Composite of Major bleeding event (BE): Fatal bleeding; bleeding that is symptomatic and occurs in critical area/organ and/or; extrasurgical site bleeding causing fall in Hemoglobin (Hb) level of 20 grams per liter (g/L) or more, or leading to transfusion of 2 or more units of whole blood or red cells with temporal association within 24-48 hours to bleeding, and/or; surgical site bleeding that requires second intervention open, arthroscopic, endovascular,or hemarthrosis resulting in prolonged hospitalization, deep wound infection and/or either unexpected and prolonged and/or sufficiently large

Up to Day 14
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo2
JNJ-70033093 25 mg + Placebo Twice Daily (BID)0
JNJ-70033093 50 mg BID2
JNJ-70033093 200 mg Once Daily + Placebo1
JNJ-70033093 100 mg + Placebo BID1
JNJ-70033093 200 mg BID1
Enoxaparin 40 mg Once Daily5
Up to Day 52
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo2
JNJ-70033093 25 mg + Placebo Twice Daily (BID)0
JNJ-70033093 50 mg BID2
JNJ-70033093 200 mg Once Daily + Placebo2
JNJ-70033093 100 mg + Placebo BID1
JNJ-70033093 200 mg BID1
Enoxaparin 40 mg Once Daily5
Number of Participants With Major Bleeding Events (CEC-adjudicated) Secondary · Up to Day 14; Up to Day 52

Number of participants with major BE (adjudicated by CEC) were reported. Major Bleeding events were defined as: fatal bleeding; bleeding that is symptomatic and occurs in critical area/organ and/or; extrasurgical site bleeding causing fall in Hb level of 20 g/L or more, or leading to transfusion of 2 or more units of whole blood or red cells with temporal association within 24-48 hours to bleeding, and/or; requires second intervention open, arthroscopic, endovascular, or hemarthrosis resulting in prolonged hospitalization or a deep wound infection and/or; either unexpected and prolonged and/or

Up to Day 14
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo0
JNJ-70033093 25 mg + Placebo Twice Daily (BID)0
JNJ-70033093 50 mg BID0
JNJ-70033093 200 mg Once Daily + Placebo0
JNJ-70033093 100 mg + Placebo BID0
JNJ-70033093 200 mg BID0
Enoxaparin 40 mg Once Daily1
Up to Day 52
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo0
JNJ-70033093 25 mg + Placebo Twice Daily (BID)0
JNJ-70033093 50 mg BID0
JNJ-70033093 200 mg Once Daily + Placebo0
JNJ-70033093 100 mg + Placebo BID0
JNJ-70033093 200 mg BID0
Enoxaparin 40 mg Once Daily1
Number of Participants With CRNM Bleeding Events (CEC-adjudicated) Secondary · Up to Day 14; Up to Day 52

Number of participants with CRNM bleeding events (adjudicated by CEC) were reported. CRNM bleeding: acute clinically overt bleeding that does not satisfy additional criteria required for bleeding event to be defined as major BE is still considered clinically relevant for example: epistaxis, gastrointestinal bleed, hematuria, bruising/ecchymosis, hemoptysis, hematoma.

Up to Day 14
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo2
JNJ-70033093 25 mg + Placebo Twice Daily (BID)0
JNJ-70033093 50 mg BID2
JNJ-70033093 200 mg Once Daily + Placebo1
JNJ-70033093 100 mg + Placebo BID1
JNJ-70033093 200 mg BID1
Enoxaparin 40 mg Once Daily4
Up to Day 52
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo2
JNJ-70033093 25 mg + Placebo Twice Daily (BID)0
JNJ-70033093 50 mg BID2
JNJ-70033093 200 mg Once Daily + Placebo2
JNJ-70033093 100 mg + Placebo BID1
JNJ-70033093 200 mg BID1
Enoxaparin 40 mg Once Daily4
Number of Participants With Minimal Bleeding Events (CEC-adjudicated) Secondary · Up to Day 14; Up to Day 52

Number of participants with minimal bleeding events (adjudicated by CEC) were reported. Minimal bleeding event was defined as any bleeding event not met major or CRNM criteria. CRNM bleeding: acute clinically overt bleeding that does not satisfy additional criteria required for bleeding event to be defined as major BE is still considered clinically relevant for example: epistaxis, gastrointestinal bleed, hematuria, bruising/ecchymosis, hemoptysis, hematoma.

Up to Day 14
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo6
JNJ-70033093 25 mg + Placebo Twice Daily (BID)2
JNJ-70033093 50 mg BID5
JNJ-70033093 200 mg Once Daily + Placebo8
JNJ-70033093 100 mg + Placebo BID7
JNJ-70033093 200 mg BID4
Enoxaparin 40 mg Once Daily8
Up to Day 52
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo6
JNJ-70033093 25 mg + Placebo Twice Daily (BID)2
JNJ-70033093 50 mg BID5
JNJ-70033093 200 mg Once Daily + Placebo9
JNJ-70033093 100 mg + Placebo BID7
JNJ-70033093 200 mg BID5
Enoxaparin 40 mg Once Daily8
Number of Participants With Major or CRNM Bleeding Events (CEC-adjudicated) Secondary · Up to Day 14; Up to Day 52

Major Bleeding events were defined as: fatal bleeding; bleeding that is symptomatic and occurs in critical area/organ and/or; extrasurgical site bleeding causing fall in Hb level of 20 g/L or more, or leading to transfusion of 2 or more units of whole blood or red cells with temporal association within 24-48 hours to bleeding, and/or; requires second intervention open, arthroscopic, endovascular, or hemarthrosis resulting in prolonged hospitalization or a deep wound infection and/or; either unexpected and prolonged and/or sufficiently large to cause hemodynamic instability. CRNM bleeding: acut

Up to Day 14
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo2
JNJ-70033093 25 mg + Placebo Twice Daily (BID)0
JNJ-70033093 50 mg BID2
JNJ-70033093 200 mg Once Daily + Placebo1
JNJ-70033093 100 mg + Placebo BID1
JNJ-70033093 200 mg BID1
Enoxaparin 40 mg Once Daily5
Up to Day 52
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo2
JNJ-70033093 25 mg + Placebo Twice Daily (BID)0
JNJ-70033093 50 mg BID2
JNJ-70033093 200 mg Once Daily + Placebo2
JNJ-70033093 100 mg + Placebo BID1
JNJ-70033093 200 mg BID1
Enoxaparin 40 mg Once Daily5
Number of Participants With Major VTE (CEC-adjudicated) Secondary · Up to Day 52

Number of participants with major VTE (adjudicated by CEC) were reported. Major VTE was defined as a composite of proximal DVT (asymptomatic confirmed by venography or objectively confirmed symptomatic), nonfatal PE, or any death.

GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo2
JNJ-70033093 25 mg + Placebo Twice Daily (BID)1
JNJ-70033093 50 mg BID1
JNJ-70033093 200 mg Once Daily + Placebo0
JNJ-70033093 100 mg + Placebo BID2
JNJ-70033093 200 mg BID0
Enoxaparin 40 mg Once Daily4
Number of Participants With Major VTE (CEC-adjudicated) Secondary · Up to Day 14

Number of participants with major VTE (adjudicated by CEC) were reported. Major VTE was defined as a composite of proximal DVT (asymptomatic confirmed by venography or objectively confirmed symptomatic), nonfatal PE, or any death.

GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo2
JNJ-70033093 25 mg + Placebo Twice Daily (BID)1
JNJ-70033093 50 mg BID1
JNJ-70033093 200 mg Once Daily + Placebo0
JNJ-70033093 100 mg + Placebo BID2
JNJ-70033093 200 mg BID0
Enoxaparin 40 mg Once Daily4
Number of Participants With Proximal Deep Vein Thrombosis (DVT) (CEC-adjudicated) Secondary · Up to Day 14

Number of participants with proximal DVT (adjudicated by CEC) were reported. DVT asymptomatic confirmed by venography assessment of the operated leg or objectively confirmed symptomatic.

Asymptomatic
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo0
JNJ-70033093 25 mg + Placebo Twice Daily (BID)0
JNJ-70033093 50 mg BID0
JNJ-70033093 200 mg Once Daily + Placebo0
JNJ-70033093 100 mg + Placebo BID0
JNJ-70033093 200 mg BID0
Enoxaparin 40 mg Once Daily1
Symptomatic
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo0
JNJ-70033093 25 mg + Placebo Twice Daily (BID)0
JNJ-70033093 50 mg BID0
JNJ-70033093 200 mg Once Daily + Placebo0
JNJ-70033093 100 mg + Placebo BID0
JNJ-70033093 200 mg BID0
Enoxaparin 40 mg Once Daily0
Number of Participants With Proximal DVT (CEC-adjudicated) Secondary · Up to Day 52

Number of participants with proximal DVT (CEC-adjudicated) were reported. DVT asymptomatic confirmed by venography assessment of the operated leg or objectively confirmed symptomatic.

Asymptomatic
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo0
JNJ-70033093 25 mg + Placebo Twice Daily (BID)0
JNJ-70033093 50 mg BID0
JNJ-70033093 200 mg Once Daily + Placebo0
JNJ-70033093 100 mg + Placebo BID0
JNJ-70033093 200 mg BID0
Enoxaparin 40 mg Once Daily1
Symptomatic
GroupValue95% CI
JNJ-70033093 25 mg Once Daily + Placebo0
JNJ-70033093 50 mg Once Daily + Placebo0
JNJ-70033093 25 mg + Placebo Twice Daily (BID)0
JNJ-70033093 50 mg BID0
JNJ-70033093 200 mg Once Daily + Placebo0
JNJ-70033093 100 mg + Placebo BID0
JNJ-70033093 200 mg BID0
Enoxaparin 40 mg Once Daily0

Adverse events — posted to ClinicalTrials.gov

Time frame: Up to 6 weeks. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

JNJ-70033093 25 mg Once Daily + Placebo
Serious: 1/33 (3%)
Deaths: 0/33
JNJ-70033093 50 mg Once Daily + Placebo
Serious: 2/150 (1%)
Deaths: 0/150
JNJ-70033093 25 mg + Placebo Twice Daily (BID)
Serious: 5/148 (3%)
Deaths: 0/148
JNJ-70033093 50 mg BID
Serious: 5/148 (3%)
Deaths: 0/148
JNJ-70033093 200 mg Once Daily + Placebo
Serious: 2/147 (1%)
Deaths: 0/147
JNJ-70033093 100 mg + Placebo BID
Serious: 5/149 (3%)
Deaths: 0/149
JNJ-70033093 200 mg BID
Serious: 2/148 (1%)
Deaths: 0/148
Enoxaparin 40 mg Once Daily
Serious: 11/296 (4%)
Deaths: 1/296

Serious adverse events (29 terms)

ReactionSystemJNJ-70033093 25 mg Once Da…JNJ-70033093 50 mg Once Da…JNJ-70033093 25 mg + Place…JNJ-70033093 50 mg BIDJNJ-70033093 200 mg Once D…JNJ-70033093 100 mg + Plac…JNJ-70033093 200 mg BIDEnoxaparin 40 mg Once Daily
Deep Vein ThrombosisVascular disorders
Atrial FibrillationCardiac disorders
DiarrhoeaGastrointestinal disorders
VomitingGastrointestinal disorders
Non-Cardiac Chest PainGeneral disorders
Covid-19Infections and infestations
Device Related InfectionInfections and infestations
UrosepsisInfections and infestations
Wound InfectionInfections and infestations
ContusionInjury, poisoning and procedural complications
Craniocerebral InjuryInjury, poisoning and procedural complications
Periprosthetic FractureInjury, poisoning and procedural complications
Subdural HaemorrhageInjury, poisoning and procedural complications
Cardiovascular EvaluationInvestigations
Full Blood Count DecreasedInvestigations
Haemoglobin DecreasedInvestigations
Electrolyte ImbalanceMetabolism and nutrition disorders
HyponatraemiaMetabolism and nutrition disorders
ArthralgiaMusculoskeletal and connective tissue disorders
Compartment SyndromeMusculoskeletal and connective tissue disorders
RhabdomyolysisMusculoskeletal and connective tissue disorders
Ischaemic StrokeNervous system disorders
DyspnoeaRespiratory, thoracic and mediastinal disorders
HypoxiaRespiratory, thoracic and mediastinal disorders
Pulmonary EmbolismRespiratory, thoracic and mediastinal disorders
Other adverse events (1 terms — click to expand)

ReactionSystemJNJ-70033093 25 mg Once Da…JNJ-70033093 50 mg Once Da…JNJ-70033093 25 mg + Place…JNJ-70033093 50 mg BIDJNJ-70033093 200 mg Once D…JNJ-70033093 100 mg + Plac…JNJ-70033093 200 mg BIDEnoxaparin 40 mg Once Daily
ConstipationGastrointestinal disorders

Most-reported serious reactions: Deep Vein Thrombosis, Atrial Fibrillation, Diarrhoea, Vomiting, Non-Cardiac Chest Pain, Covid-19, Device Related Infection, Urosepsis.

Data from ClinicalTrials.gov NCT03891524 adverse events section.

Sponsor's own description

The purpose of this study is to determine the efficacy of JNJ-70033093 in preventing total venous thromboembolism (VTE) events (proximal and/or distal deep vein thrombosis \[DVT\] \[asymptomatic confirmed by venography assessment or objectively confirmed symptomatic\], nonfatal pulmonary embolism \[PE\], or any death) during the treatment period.

Publications & conference data

8 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Milvexian for the Prevention of Venous Thromboembolism.
    Weitz JI, Strony J, Ageno W, Gailani D, et al · · 2021 · cited 193× · PMID 34780683 · DOI 10.1056/nejmoa2113194
  2. Factor XI Inhibitors for Prevention and Treatment of Venous Thromboembolism: A Review on the Rationale and Update on Current Evidence.
    Nopp S, Kraemmer D, Ay C. · · 2022 · cited 61× · PMID 35647061 · DOI 10.3389/fcvm.2022.903029
  3. Factor XI(a) inhibitors for thrombosis: an updated patent review (2016-present).
    Al-Horani RA. · · 2020 · cited 40× · PMID 31847619 · DOI 10.1080/13543776.2020.1705783
  4. The rebirth of the contact pathway: a new therapeutic target.
    Srivastava P, Gailani D. · · 2020 · cited 34× · PMID 32740037 · DOI 10.1097/moh.0000000000000603
  5. Factor XI Inhibition for the Prevention of Venous Thromboembolism: An Update on Current Evidence and Future perspectives.
    Poenou G, Dumitru Dumitru T, Lafaie L, Mismetti V, et al · · 2022 · cited 26× · PMID 35707632 · DOI 10.2147/vhrm.s331614
  6. New pharmacological agents and novel cardiovascular pharmacotherapy strategies in 2022.
    Tamargo J, Agewall S, Borghi C, Ceconi C, et al · · 2023 · cited 25× · PMID 37169875 · DOI 10.1093/ehjcvp/pvad034
  7. Factor XI Inhibitors: A New Horizon in Anticoagulation Therapy.
    Presume J, Ferreira J, Ribeiras R. · · 2024 · cited 13× · PMID 38306010 · DOI 10.1007/s40119-024-00352-x
  8. Factor XIa Inhibitors as a Novel Anticoagulation Target: Recent Clinical Research Advances.
    Xia Y, Hu Y, Tang L. · · 2023 · cited 12× · PMID 37375813 · DOI 10.3390/ph16060866

Verify or expand the search:

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Data sources for this page

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Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing