Retrospective Study of Patients Who Were Treated With Fondaparinux Pre-, Peri- and/or Postpartum for Prophylaxis or Treatment of Venous Thromboembolism (FondaPPP)

July 28, 2011 updated by: GlaxoSmithKline

Retrospektive Studie zu Patientinnen, Die pränatal, Perinatal Oder Postnatal Prophylaktisch Oder Therapeutisch Mit Fondaparinux Behandelt Wurden

The objective of this retrospective study is to gather information about how fondaparinux is used pre-, peri- and/or postpartum for both the prophylaxis and treatment of venous thromboembolism (VTE) in order to fill an information gap concerning the off-label use of fondaparinux during pregnancy.

Study Overview

Status

Completed

Intervention / Treatment

Detailed Description

During pregnancy there is a generally enhanced risk to develop venous thromboembolism (VTE). Although such events are rare they may lead to serious risks for the mothers´ and children´s health. Compared with non-pregnant women, pregnant women have an about five-fold risk to develop VTE.

Due to their characteristic spectrum of side effects and the generally long duration of exposure in pregnancy the preferred anticoagulants may produce potentially dangerous side effects, as bleedings, heparin-induced thrombocytopenia (HIT), allergic reactions, osteoporosis, or congenital anomalies.

Today, low-molecular weight heparins (LMWH) are the preferred agents for anticoagulation in pregnancy. Compared with unfractioned heparins (UFH) LMWHs have the advantages of a lower bleeding risk, a lower rate of allergic reactions and HIT, a more predictable response and a longer half-life that makes dosing more convenient (od or bid).

Still, there is a considerable proportion of pregnancies where heparin intolerance (allergic reactions or HIT) that make it inevitable to change to another anticoagulant.

On the one hand, fondaparinux has repeatedly been reported successful in the VTE prophylaxis of pregnancies where allergic reactions on heparins, or heparinoids, had occurred. Additionally, a considerable amount of oral reports have reached GSK about an additional number of successful cases in the past.

On the other hand, we have no systematic and overall view about how many pregnancies have already been treated for which reasons, and how successful they were. Due to an increase of certain risk factors, as obesity or the growing age of mothers at childbirth with the associated need for anticoagulation, we expect an increased number of cases where alternative anticoagulation to heparins may be needed.

There are a number of potential advantages of fondaparinux over heparins, such as a once daily application, no dose adjustment needed to body weight and no monitoring of thrombocytes, a lower potential for causing intolerance reactions and no risk for HIT.

The objective of this retrospective study is to gather information about how fondaparinux is used pre-, peri- and/or postpartum for both the prophylaxis and treatment of VTE in order to fill an information gap concerning the off-label use of fondaparinux during pregnancy.

Study Type

Observational

Enrollment (Actual)

120

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Berlin, Germany, 13353
        • GSK Investigational Site
    • Baden-Wuerttemberg
      • Mannheim, Baden-Wuerttemberg, Germany, 68167
        • GSK Investigational Site
    • Hessen
      • Frankfurt, Hessen, Germany, 60590
        • GSK Investigational Site
    • Nordrhein-Westfalen
      • Duisburg, Nordrhein-Westfalen, Germany, 47051
        • GSK Investigational Site
      • Muenster, Nordrhein-Westfalen, Germany, 48143
        • GSK Investigational Site
    • Rheinland-Pfalz
      • Bonn, Rheinland-Pfalz, Germany, 53115
        • GSK Investigational Site
    • Sachsen
      • Leipzig, Sachsen, Germany, 04289
        • GSK Investigational Site

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child
  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Sampling Method

Probability Sample

Study Population

Pregnant women who received a prophylaxis against venous thromboembolism because of an elevated thromboembolic risk and who were therefore treated in a haemostaseological centre.

Description

Inclusion Criteria:

  • Patients who were treated with fondaparinux pre-, peri- and/or postpartum for more than 7 days for VTE prophylaxis or treatment, especially those with a history of abortion, and/or stillbirth, VTE, severe fetal and maternal complications during pregnancy, severe inherited or acquired thrombophilias, long-term anticoagulation (e. g. patients with mechanical heart valves) and/or intolerance to heparins or heparinoids or heparin-induced thrombocytopenia (HIT)

Exclusion Criteria:

  • Patients who were treated with fondaparinux for less than 7 days
  • Patient who were treated with fondaparinux only postpartum

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort
  • Time Perspectives: Retrospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
fondaparinux prescribed subjects
fondaparinux prescribed subjets
fondaparinux

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants Receiving Fondaparinux in the Indicated Therapy Intervals
Time Frame: 4 months (all cases occurred between 2004 and 2010)
The prenatal interval is defined as the interval of time until 3 days before birth. The perinatal interval is defined as the interval of time from 2 days before birth to one day after birth. The postnatal interval is defined as the interval of time beginning 2 days after birth.
4 months (all cases occurred between 2004 and 2010)
Number of Participants With the Indicated Reason for Change to Fondaparinux
Time Frame: 4 months (all cases occurred between 2004 and 2010)
It was possible for a participant to have changed to fondaparinux for multiple reasons.
4 months (all cases occurred between 2004 and 2010)
Number of Participants Administered the Indicated Dose of Fondaparinux Per Day
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Duration of Fondaparinux Administration
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Duration of Prenatal Fondaparinux Administration
Time Frame: 4 months (all cases occurred between 2004 and 2010)
The prenatal interval is defined as the interval of time until 3 days before birth.
4 months (all cases occurred between 2004 and 2010)
Duration of Postnatal Fondaparinux Administration
Time Frame: 4 months (all cases occurred between 2004 and 2010)
The postnatal interval is defined as the interval of time beginning 2 days after birth.
4 months (all cases occurred between 2004 and 2010)
Number of Participants for Whom Fondaparinux Administration Was Interrupted for Birth
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Number of Hours Before Birth That the Last Fondaparinux Dose Was Administered
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Number of Hours After Birth at Which Fondaparinux Administration Was Restarted
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Number of Participants With the Indicated Reason for the End of Fondaparinux Administration
Time Frame: 4 months (all cases occurred between 2004 and 2010)
It is possible that a participant stopped receiving Fondaparinux for multiple reasons.
4 months (all cases occurred between 2004 and 2010)
Number of Participants With the Indicated Outcome of Pregnancy by Type of Birth
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Number of Participants With the Indicated Type of Conception/Fertilization
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Number of Participants Who Delivered a Single Child Versus Twins
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Mean Weight of Newborn
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Mean Height of Newborn
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Mean Head Circumference of Newborn
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Mean APGAR Score at 1, 5, and 10 Minutes After Birth
Time Frame: 4 months (all cases occurred between 2004 and 2010)
APGAR is a test performed by a doctor, midwife, or nurse at 1 and 5 minutes after birth. The 1-minute score determines how well the baby tolerated the birthing process; the 5-minute score assesses how well the newborn is adapting to the new environment. The health care provider examines the baby's breathing effort, heart rate, muscle tone, reflexes, and skin color. Each category is scored with 0 (worst score), 1, or 2 (best score), depending on the observed condition. The rating is based on a total score of 1-10, with 10 suggesting the healthiest infant.
4 months (all cases occurred between 2004 and 2010)
Number of Newborns Who Had a "Healthy" Postnatal Classification
Time Frame: 4 months (all cases occurred between 2004 and 2010)
A "healthy" documentation was based on the investigators' individual assessment.
4 months (all cases occurred between 2004 and 2010)
Number of Newborns With Abnormalities
Time Frame: 4 months (all cases occurred between 2004 and 2010)
No formal definition for abnormalities was predetermined; documentation was based on the investigators' individual assessment.
4 months (all cases occurred between 2004 and 2010)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants Hospitalized Because of Thromboembolic Treatment
Time Frame: 4 months (all cases occurred between 2004 and 2010)
Thromboembolic treatment is a defined as prophylaxis for an elevated thromboembolic risk or therapeutic treatment of acute thromboembolism.
4 months (all cases occurred between 2004 and 2010)
Duration of All Hospitalizations Under UFH, LMWH, and Fondaparinux Administration
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Duration of Hospitalizations Before, During, and After Fondaparinux Administration
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Number of Participants With Complications Under UFH/LMWH Therapy
Time Frame: 4 months (all cases occurred between 2004 and 2010)
A complication is defined as any thromoemolism, bleeding, skin change, HIT, amputation, or other complication (as indicated by investigator).
4 months (all cases occurred between 2004 and 2010)
Number of Participants With Thromboembolisms Under UFH/LMWH Therapy
Time Frame: 4 months (all cases occurred between 2004 and 2010)
Any sign of thromboembolism as indicated by investigator was measured.
4 months (all cases occurred between 2004 and 2010)
Number of Participants With Bleedings Under UFH/LMWH Therapy
Time Frame: 4 months (all cases occurred between 2004 and 2010)
No formal definition for bleeding was predetermined; documentation was based on the investigators' individual assessment.
4 months (all cases occurred between 2004 and 2010)
Number of Participants With Skin Changes Under UFH/LMWH Therapy
Time Frame: 4 months (all cases occurred between 2004 and 2010)
No formal definition for skin change was predetermined; documentation was based on the investigators' individual assessment.
4 months (all cases occurred between 2004 and 2010)
Duration From Start of UFH/LMWH Therapy to Skin Change
Time Frame: 4 months (all cases occurred between 2004 and 2010)
No formal definition for skin change was predetermined; documentation was based on the investigators' individual assessment.
4 months (all cases occurred between 2004 and 2010)
Number of Participants Who Exhibited Observed Skin Changes and Also Had Erythema Associated With the Skin Changes Under UFH/LMWH Therapy
Time Frame: 4 months (all cases occurred between 2004 and 2010)
Erythema is defined as inflammation of the skin, associated with reddening, and is a frequent side effect of heparins.
4 months (all cases occurred between 2004 and 2010)
Number of Participants Who Exhibited Observed Skin Changes and Also Had Skin Necrosis Associated With the Skin Changes Under UFH/LMWH Therapy
Time Frame: 4 months (all cases occurred between 2004 and 2010)
Skin necrosis is defined as the dying off of skin area because of allergic reaction. Skin necrosis is a severe side effect of heparins.
4 months (all cases occurred between 2004 and 2010)
Number of Participants With Heparin-induced Thrombocytopenia (HIT II) Under UFH/LMWH Therapy
Time Frame: 4 months (all cases occurred between 2004 and 2010)
HIT II is characterized as a sudden decrease of thrombocyte count because of allergic response on heparin/platelet factor 4 (PF-4) complexes and is a severe and potentially fatal side effect of heparins. Usually, HIT occurs between Day 5 and Day 14 of exposure to UFH or LMWH.
4 months (all cases occurred between 2004 and 2010)
Duration From Start of UFH/LMWH Therapy to HIT
Time Frame: 4 months (all cases occurred between 2004 and 2010)
4 months (all cases occurred between 2004 and 2010)
Number of Participants With and Without Complications Under Fondaparinux Therapy
Time Frame: 4 months (all cases occurred between 2004 and 2010)
A complication is defined as any thromoemolism, bleeding, skin change, HIT, amputation, death, or other complication (as indicated by investigator).
4 months (all cases occurred between 2004 and 2010)
Number of Participants With Thromboembolisms Under Fondaparinux Therapy
Time Frame: 4 months (all cases occurred between 2004 and 2010)
Any sign of thromboembolism as indicated by investigator was measured.
4 months (all cases occurred between 2004 and 2010)
Number of Participants With Bleedings Under Fondaparinux Therapy
Time Frame: 4 months (all cases occurred between 2004 and 2010)
No formal definition for bleeding was predetermined; documentation was based on the investigators' individual assessment.
4 months (all cases occurred between 2004 and 2010)
Number of Participants With Skin Changes Under Fondaparinux Therapy
Time Frame: 4 months (all cases occurred between 2004 and 2010)
No formal definition for skin change was predetermined; documentation was based on the investigators' individual assessment.
4 months (all cases occurred between 2004 and 2010)
Number of Participants With Heparin-induced Thrombocytopenia (HIT II) Under Fondaparinux Therapy
Time Frame: 4 months (all cases occurred between 2004 and 2010)
The participant with HIT II was pretreated with LMWH; however, the serious adverse event of HIT II was documented after the participant switched to Fondaparinux treatment.
4 months (all cases occurred between 2004 and 2010)
Duration From Start of Fondaparinux Therapy to HIT
Time Frame: 4 months (all cases occurred between 2004 and 2010)
For the 1 participant who developed HIT after receiving Fondaparinux, the number of days from start of therapy to HIT is presented.
4 months (all cases occurred between 2004 and 2010)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

March 1, 2010

Primary Completion (Actual)

July 1, 2010

Study Completion (Actual)

July 1, 2010

Study Registration Dates

First Submitted

October 1, 2009

First Submitted That Met QC Criteria

October 29, 2009

First Posted (Estimate)

October 30, 2009

Study Record Updates

Last Update Posted (Estimate)

August 26, 2011

Last Update Submitted That Met QC Criteria

July 28, 2011

Last Verified

July 1, 2011

More Information

Terms related to this study

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

Clinical Trials on Thromboembolism

Clinical Trials on fondaparinux

3
Subscribe