- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03404635
Monotherapy Anticoagulation To Expedite Home Treatment of Venous Thromboembolism (MATHVTE)
Monotherapy Anticoagulation To Expedite Home Treatment of Venous
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Contacts and Locations
Study Locations
-
-
Indiana
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Indianapolis, Indiana, United States, 46202
- Indiana University Health Methodist Hospital
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Indianapolis, Indiana, United States, 46202
- Eskenazi Health System
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
Patients must be low risk, as defined by either A or B below:
A. The modified Hestia criteria:
- Systolic blood pressure > 100 mm Hg
- No thrombolysis needed
- No active bleeding
- SaO2 >94% while breathing room air
- Not already anticoagulated
- No more than two doses of IV narcotics in the emergency department
- Other medical or social reasons to admit
- Creatinine clearance >30mL/min
- Not pregnant, severe liver disease or heparin induced thrombocytopenia OR
B. The physician opinion that a patients' overall social and medical situation is favorable for home treatment and the patient has a zero score on the simplified pulmonary embolism severity index (sPESI).
All of the following must true:
- Age < 81 years
- No history of cancer
- No history of heart failure or chronic lung disease
- Pulse < 110 beats/min
- SBP > 99 mm Hg
- O2 sat >89%%
We have chosen either criteria because both have been found equal in terms of safety for outpatient treatment of PE.6,22 Hestia includes implicit questions that most emergency physicians would use as criteria for discharge (e.g., overall medical status and social situation), whereas sPESI does not. For that reason, we have added the additional gestalt assessment question about physician discretion.
- Patients must be discharged in <24 hours after triage in an ED visit with diagnosis of VTE using objective criteria in the emergency department.
Exclusion Criteria:
- VTE diagnosis while taking anticoagulants with evidence of compliance (e.g., physician opinion that patient is taking a Eliquis®, Xarelto® or Pradaxa®, low molecular weight heparin injections or warfarin as prescribed for any condition)
- Sensitivity or contraindication to use of apixaban
- Troponin assay value, drawn as part of usual care and found to be positive, using local standards
- High risk for hemorrhage defined by a score>1.5 using the method of Ruiz Gimenez.3 (Note that several criteria are already excluded by Hestia):
Recent major bleeding, 2 points Creatinine levels >1.2 mg/dl, 1.5 points Anemia, 1.5 points Cancer, 1 point Clinically overt PE, 1 point Age >75 years, 1 point
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Apixaban for VTE
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Apixaban as standard of care for VTE
|
Rivaroxaban for VTE
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Rivaroxaban as standard of care for VTE
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of re-hospitalization visits for VTE recurrence or bleeding
Time Frame: 30 days
|
Re-hospitalization for > 24 hours due to VTE recurrence or bleeding
|
30 days
|
Collaborators and Investigators
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- CV185-562
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
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