- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04504318
Apixaban vs Enoxaparin Following Microsurgical Breast Reconstruction-An RCT
February 14, 2024 updated by: Arash Momeni, Stanford University
A Randomized Controlled Trial Comparing Apixaban Versus Enoxaparin Following Microsurgical Breast Reconstruction
Subcutaneous enoxaparin is currently the gold standard for VTE chemoprophylaxis.
However, the efficacy of chemoprophylaxis with subcutaneous enoxaparin is affected by patient-level factors, thus, resulting in VTE events despite guideline-compliant prophylaxis.
A population at particular risk is the growing number of patients who undergo autologous breast reconstruction.
Direct oral anticoagulants (DOAC) might be a less invasive, yet, more efficacious mode of chemoprophylaxis in this patient population.
Hence, the proposed work has the potential to cause a paradigm shift in chemoprophylaxis guidelines in a large population of patients undergoing plastic surgery.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Estimated)
106
Phase
- Phase 2
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Arash Momeni, MD
- Phone Number: 650-723-6189
- Email: amomeni@stanford.edu
Study Contact Backup
- Name: Shannon Meyer
- Phone Number: 650-498-6000
- Email: smeyer27@stanford.edu
Study Locations
-
-
California
-
Stanford, California, United States, 94305
- Recruiting
- Stanford University Medical Center
-
Contact:
- Arash Momeni, MD
- Phone Number: 650-723-6189
- Email: smeyer27@stanford.edu
-
Contact:
- Shannon Meyer
- Email: smeyer27@stanford.edu
-
-
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
18 years to 89 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Adult (>18 years) women
- Scheduled to undergo unilateral or bilateral microsurgical breast reconstruction with free abdominal flaps (i.e. muscle-sparing transverse rectus abdominis musculocutaneous [TRAM] and/or deep inferior epigastric artery perforator [DIEP]) flap)
- Caprini score of 6 or greater.
Exclusion Criteria:
- Contraindication to the use of apixaban or enoxaparin
- Active bleeding
- History of bleeding disorder
- History of coagulopathy
- History of heparin-induced thrombocytopenia
- History of liver disease
- History of renal disease (creatinine clearance <30 mL/min; serum creatinine >1.6 mg/dL)
- Major neurosurgical intervention (brain/spine) within the past 90 days
- Ophthalmologic procedure within the past 90 days
- Uncontrolled hypertension
- History of alcohol and/or substance abuse
- Need for therapeutic anticoagulation
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
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Apixaban
Patients assigned to this group will receive Apixaban 2.5 mg PO BID starting 12 hours after completing skin closure.
|
Patients will be assigned to the respective study groups postoperatively upon arrival in the post-anesthesia care unit.
Hence, surgeons are blinded at the time of surgery as to study group assignment.
Chemoprophylaxis will continue for the duration of the hospitalization.
|
Active Comparator: Enoxaparin
Patients assigned to this group will receive Enoxaparin 40 mg SC QD starting 12 hours after completing skin closure.
|
Patients will be assigned to the respective study groups postoperatively upon arrival in the post-anesthesia care unit.
Hence, surgeons are blinded at the time of surgery as to study group assignment.
Chemoprophylaxis will continue for the duration of the hospitalization.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Apixaban vs. Enoxaparin - Bleeding event
Time Frame: 90-day events
|
To examine the rate of bleeding events in patients receiving oral apixaban versus subcutaneous enoxaparin following microsurgical breast reconstruction
|
90-day events
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Apixaban vs. Enoxaparin - Venous Thromboembolism (VTE) event
Time Frame: 90-day events
|
To examine the rate of VTE events in patients receiving oral apixaban versus subcutaneous enoxaparin following microsurgical breast reconstruction
|
90-day events
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Arash Momeni, MD, Stanford University
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 (Actual)
August 12, 2020
Primary Completion (Estimated)
August 1, 2024
Study Completion (Estimated)
August 1, 2024
Study Registration Dates
First Submitted
August 5, 2020
First Submitted That Met QC Criteria
August 5, 2020
First Posted (Actual)
August 7, 2020
Study Record Updates
Last Update Posted (Actual)
February 15, 2024
Last Update Submitted That Met QC Criteria
February 14, 2024
Last Verified
February 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Embolism and Thrombosis
- Thromboembolism
- Venous Thromboembolism
- Molecular Mechanisms of Pharmacological Action
- Enzyme Inhibitors
- Fibrinolytic Agents
- Fibrin Modulating Agents
- Protease Inhibitors
- Factor Xa Inhibitors
- Antithrombins
- Serine Proteinase Inhibitors
- Anticoagulants
- Apixaban
- Enoxaparin
Other Study ID Numbers
- IRB-49355
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
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.
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