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RecruitingNCT07288489EQUILIBRIX-SUpdated Aug 21, 2026

Phase 3 Trial of VMX-C001 vs Usual Pharmacological Care in Patients Taking a FXa Direct Oral Anticoagulant Who Require Urgent Surgery With or Without Heparin.

A Phase 3 interventional study of VMX-C001 and Usual Pharmacological Care in Blood Loss, Surgical and Coagulation Disorder, sponsored by VarmX B.V.. Recruiting at 37 sites in 7 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-08-21.

Sponsored by VarmX B.V. · Phase 3, Interventional, and Treatment

Phase
Phase 3
Study type
Interventional
Enrollment
800
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The goal of this clinical trial is to learn if VMX-C001 works to to allow blood clotting control in participants who take FXa Direct Oral Anticoagulants (DOACs) during surgery or other invasive procedures that carry a high risk of bleeding. The main question it aims to answer is:

● What is the proportion of participants in whom the stopping of bleeding was classed as good or excellent during the procedure, as judged by a group of experts who did not know which treatment was given?

Researchers will compare a fixed dose of VMX-C001 to the usual treatment that would be given for the required procedure.

Participants will:

  • Be given either a fixed dose of VMX-C001 or usual treatment before they undergo the required procedure in theatre
  • Have regular clinical assessments, including laboratory tests, during their hospital stay following the procedure
  • Return to the clinic for a check-up and tests approximately 28 days after the procedure was conducted.
02

Conditions studied

  • Blood Loss, Surgical
  • Coagulation Disorder

Keywords

  • Direct oral anticoagulant (DOAC)
  • Human coagulation factor
  • Surgery
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  1. Male or female patient aged ≥18 years.
  2. The patient or legally authorised representative (LAR) has given written informed consent.
  3. The patient requires urgent surgery/procedure for which the risk of bleeding is considered high and for which haemostasis is considered necessary.
  4. The patient has a significant FXa DOAC level at the time of procedure.
  5. The patient would require treatment (usual pharmacological care) to restore coagulation for the required procedure.
  6. The patient must be willing to use appropriate contraception.

Exclusion criteria

Exclusion Criteria:

  1. The patient is known for any reason, other than administration of a FXa DOAC, to have an increased risk of bleeding compared to a patient in a similar clinical situation.
  2. The patient has received any non FXa DOAC anticoagulants within 7 days of Screening or has received heparin (UFH or LMWH) within 3 days of Screening.
  3. The patient has received any of the prespecified medications not allowed in the 7 days prior to Randomisation.
  4. The patient was treated with an investigational drug \<30 days or 5 half-lives, whichever is longer, prior to Screening.
  5. Expected survival, in the Investigator's judgement, is \<3 months due to comorbidity.
  6. Patients in whom the Investigator considers it is not possible to estimate the expected blood loss.
  7. Known "Do Not Resuscitate" order or similar advanced directive.
  8. Cardiogenic shock at the time of screening unless related to the need for the required procedure.
  9. The patient has sepsis (including severe sepsis or septic shock) at the time of screening.
  10. The patient is pregnant or a lactating female.
  11. Known hypersensitivity to any component of VMX-C001 or hamster proteins.
  12. Patients who, in the opinion of the Investigator, should not participate in the study for any other reason, or inability to comply with the protocol.
  13. Prior exposure to VMX-C001.
04

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
800 participants (estimated)

Study arms

  • Experimental
    VMX-C001

    Participants will be administered a fixed dose of VMX-C001 before undergoing the required procedure.

    Drug: VMX-C001

  • Active comparator
    Usual Pharmacological Care

    Participants will be given the usual treatment used by the site for patients receiving FXa DOACs when undergoing the required procedure.

    Drug: Usual Pharmacological Care

Interventions

  • DrugVMX-C001

    A fixed dose of VMX-C001 will be administered prior to commencement of procedure.

  • DrugUsual Pharmacological Care

    Usual pharmacological care should be treatment planned to restore coagulation or support haemostasis for the required procedure.

05

What researchers measure

Primary outcomes

  1. Effect of VMX-C001 versus usual pharmacological care on haemostasis

    Proportion of participants with good or excellent haemostatic efficacy during the required procedure.

    Time frame: From start to end of required procedure (Day 1).

Secondary outcomes

  1. Effect of VMX-C001 versus usual pharmacological care on FXa DOAC induced anticoagulation measured by dilute prothrombin time (dPT).

    Change in dPT.

    Time frame: From Pre-procedure assessment compared to baseline (Randomisation) (Day 1).

  2. Effect of VMX-C001 versus usual pharmacological care on FXa DOAC induced anticoagulation as measured by dilute Russell Viper Venom Time (dRVVT).

    Change in dRVVT.

    Time frame: From Pre-procedure assessment compared to baseline (Randomisation) (Day 1).

  3. Effect of VMX-C001 versus usual pharmacological care on the extent of actual blood loss compared to expected blood loss during procedure.

    Percentage of expected blood loss.

    Time frame: From start to end of required procedure (Day 1).

  4. Effect of VMX-C001 versus usual pharmacological care on bleeding severity.

    Bleeding severity at the Start of procedure using a 5 point scale (grades 0 \[no bleeding\] to 4 \[life threatening\])

    Time frame: Start of procedure (Day 1).

  5. Effect of VMX-C001 versus usual pharmacological care on bleeding severity prior to procedure.

    Bleeding severity measured by blood loss.

    Time frame: Between Randomisation and Pre-procedure timepoint (Day 1).

06

Study locations

19 of 37 sites recruiting
  • Chandler Regional Medical Center (CRMC)
    Chandler, Arizona 85224, United States
    Not yet recruiting
  • St. Joseph's Hospital and Medical Center
    Phoenix, Arizona 85013, United States
    Not yet recruiting
  • HonorHealth John C Lincoln Medical Center
    Phoenix, Arizona 85020, United States
    Recruiting
  • Stanford Hospital and Clinics
    Stanford, California 94305, United States
    Not yet recruiting
  • Denver Metro Orthopedics, P.C. - Englewood Location
    Englewood, Colorado 80113, United States
    Not yet recruiting
  • Medical Center of the Rockies
    Fort Collins, Colorado 80523, United States
    Not yet recruiting
  • Christiana Care
    Newark, Delaware 19718, United States
    Not yet recruiting
  • University of South Florida
    Tampa, Florida 33606, United States
    Recruiting
  • University of Iowa Health Care
    Iowa City, Iowa 52242, United States
    Not yet recruiting
  • Massachusetts General Hospital
    Boston, Massachusetts 02114, United States
    Not yet recruiting
  • Beaumont Hospital, Royal Oak
    Royal Oak, Michigan 48073, United States
    Not yet recruiting
  • William Beaumont Hospital - Troy Campus
    Troy, Michigan 48085, United States
    Not yet recruiting
  • Duke University Medical Center
    Durham, North Carolina 27710, United States
    Not yet recruiting
  • The University of Oklahoma Health Sciences Center
    Oklahoma City, Oklahoma 73126, United States
    Not yet recruiting
  • Texas Tech University Health Sciences Center - El Paso
    El Paso, Texas 79905, United States
    Not yet recruiting
  • Memorial Hermann Hospital-TMC Investigational Drugs Services Pharmacy
    Houston, Texas 77030, United States
    Recruiting
  • The University of Texas McGovern Medical School at Houston
    Houston, Texas 77030, United States
    Not yet recruiting
  • Royal Brisbane and Women's Hospital (RBWH)
    Herston, Queensland 4006, Australia
    Not yet recruiting
  • Mater Private Hospital
    South Brisbane, Queensland 4101, Australia
    Recruiting
  • Gold Coast University Hospital
    Southport, Queensland 4215, Australia
    Recruiting
  • St Vincent Hospital, Melbourne
    Fitzroy, Victoria 3065, Australia
    Not yet recruiting
  • Alfred Health, Melbourne
    Melbourne, Victoria 3004, Australia
    Recruiting
  • Fiona Stanley Hospital
    Murdoch, Western Australia 6150, Australia
    Not yet recruiting
  • Multiprofile Hospital for Active Treatment Heart and Brain EAD
    Pleven, Pleven 5800, Bulgaria
    Recruiting
  • Multiprofile Hospital for Active Treatment AD Haskovo
    Haskovo, 6304, Bulgaria
    Recruiting
  • UMBAL Kanev AD
    Rousse, 7002, Bulgaria
    Recruiting
  • Multiprofile Hospital for Active Treatment Hristo Botev
    Vratsa, 3000, Bulgaria
    Recruiting
  • CHU de Saint-Etienne - Hopital Bellevue
    Saint Priest En Jarez, Pays de la Loire Region 42270, France
    Recruiting
  • Fukuoka Neurosurgical Hospital
    Fukuoka-Shi, Fukuoka, 811-1313, Japan
    Recruiting
  • Japanese Red Cross Kumamoto Hospital
    Kumamoto-shi, Kumamoto, 861-8520, Japan
    Recruiting
  • Auckland City Hospital
    Grafton, Auckand 1023, New Zealand
    Recruiting
  • Aotearoa Clinical Trials - Middlemore (ACTT) Middlemore Hospital
    Papatoetoe, Auckland 2025, New Zealand
    Recruiting
  • Waikato Hospital
    Hamilton, Waikato Region 3204, New Zealand
    Recruiting
  • Wellington Hospital
    Newtown, Wellington Region 6021, New Zealand
    Not yet recruiting
  • Gloucestershire Hospitals NHS Foundation Trust - Gloucestershire Royal Hospital
    Gloucester, Gloucestershire GL1 3NN, United Kingdom
    Recruiting
  • Guys and St Thomas NHS Foundation Trust - St Thomas Hospital
    London, London SE1 7EH, United Kingdom
    Recruiting
  • Kings College Hospital NHS Foundation Trust
    London, SE5 9RS, United Kingdom
    Recruiting
07

References and documents

Individual participant data

Plan to share: Yes — VarmX will consider on a case-by-case basis requests to share Individual Patient Data (IPD) with external, verified, qualified scientific and medical researchers. Information on the process and requirements for submitting a voluntary data sharing request for IPD can be obtained from info@varmx.com

Supporting information: Study protocol

No publications or documents are linked to this record.

08

Registry details

Key details

Study ID
NCT07288489
Lead sponsor
VarmX B.V.
Responsible party
Sponsor
First posted
Dec 17, 2025
Start date
Aug 18, 2026
Primary completion
Jan 2029 (estimated)
Completion
Jan 2031 (estimated)
Last update
Aug 21, 2026

Study contacts

Head of Clinical Operations
Contact
m.zorer@VarmX.com
+43 664 88375193

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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