- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT07618988
Rivaroxaban in Pediatric Patients With DVT
Safety and Efficacy of Rivaroxaban in Pediatric Patients With Deep Venous Thrombosis
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Treatment of deep venous thrombotic events in children is based on data obtained in adults with little direct documentation of its efficacy and safety in children. Rivaroxaban is a direct oral anticoagulant which has been approved by FDA in 2021 for the use in pediatric patients with venous thrombosis.
In a randomized controlled trial we will study the safety and efficacy of rivaroxaban use in the pediatric population with acute deep venous thrombosis.
Study Type
Enrollment (Actual)
Phase
- Phase 4
Contacts and Locations
Study Locations
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-
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Cairo, Egypt, 11566
- Ain Shams University Children's Hospital
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patients from 6 months to less than 18 years of age.
- Patients with acute deep venous thrombosis diagnosed based on site-appropriate imaging tools e.g., magnetic resonance venography (MRV) in Cerebral sinus venous thrombosis (CSVT), venous duplex in Central Venous Access Devices (CVAD) related thrombosis or other non-CSVT DVT.
- Patients with cancer associated thrombosis are eligible.
- Patients with provoked or unprovoked acute VT are eligible.
- Patients with first thrombotic event or recurrent VT are eligible.
Exclusion Criteria:
- Patients with active bleeding
High-risk of bleeding including:
- Platelet count of less than 50 x 109/L,
- Liver disease associated either a coagulopathy leading to a clinically relevant bleeding risk, or ALT > 5× ULN.
- Sustained uncontrolled hypertension defined as systolic and/or diastolic blood pressure > 95th age percentile.
- Severe renal impairment (Estimated glomerular filtration rate < 30 mL/min/1.73m2).
- Gastrointestinal disease associated with impaired absorption.
- Hypersensitivity or any other contraindication listed in the local labelling for Rivaroxaban or comparator treatment.
- Patients with rheumatic heart disease or prosthetic heart valves.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
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Active Comparator: LMWH arm
Patients assigned to LMWH will receive standard anticoagulation with enoxaparin sodium at a dose 1mg/kg twice daily for 3 months duration.
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Patients in arm 1 will receive standard anticoagulation with enoxaparin sodium at a dose 1mg/kg twice daily for 3 months duration
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Experimental: Rivaroxaban
Patients allocated to Rivaroxaban: after 5 to 9 days of therapy with low molecular weight heparin (LMWH), patients will receive body weight-adjusted 20-mg equivalent doses with an age-appropriate serving of fluid given with or shortly after a meal. Crushed Rivaroxaban tablet is stable for up to 4 hours and displays similar relative bioavailability compared to a whole tablet administered orally. |
Patients allocated to Rivaroxaban arm: after 5 to 9 days of therapy with low molecular weight heparin (LMWH), patients will receive body weight-adjusted 20-mg equivalent doses with an age-appropriate serving of fluid given with or shortly after a meal. Crushed Rivaroxaban tablet is stable for up to 4 hours and displays similar relative bioavailability compared to a whole tablet administered orally. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Degree of vein recanalization
Time Frame: 3 months
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A Repeat site-appropriate imaging at 3 months will be done to assess the degree of vein recanalization and response will be classified as
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3 months
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Collaborators and Investigators
Sponsor
Investigators
- Study Director: Fatma SE Ebeid, MD, Faculty of Medicine Ain Shams University
- Principal Investigator: Amira Adly, Faculty of Medicine Ain Shams University
Publications and helpful links
General Publications
- Moore KT, Krook MA, Vaidyanathan S, Sarich TC, Damaraju CV, Fields LE. Rivaroxaban crushed tablet suspension characteristics and relative bioavailability in healthy adults when administered orally or via nasogastric tube. Clin Pharmacol Drug Dev. 2014 Jul;3(4):321-7. doi: 10.1002/cpdd.123. Epub 2014 May 16.
- Lensing AWA, Male C, Young G, Kubitza D, Kenet G, Patricia Massicotte M, Chan A, Molinari AC, Nowak-Goettl U, Pap AF, Adalbo I, Smith WT, Mason A, Thelen K, Berkowitz SD, Crowther M, Schmidt S, Price V, Prins MH, Monagle P. Rivaroxaban versus standard anticoagulation for acute venous thromboembolism in childhood. Design of the EINSTEIN-Jr phase III study. Thromb J. 2018 Dec 21;16:34. doi: 10.1186/s12959-018-0188-y. eCollection 2018.
- Young G, Lensing AWA, Monagle P, Male C, Thelen K, Willmann S, Palumbo JS, Kumar R, Nurmeev I, Hege K, Bajolle F, Connor P, Hooimeijer HL, Torres M, Chan AKC, Kenet G, Holzhauer S, Santamaria A, Amedro P, Beyer-Westendorf J, Martinelli I, Massicotte MP, Smith WT, Berkowitz SD, Schmidt S, Price V, Prins MH, Kubitza D; EINSTEIN-Jr. Phase 3 Investigators. Rivaroxaban for treatment of pediatric venous thromboembolism. An Einstein-Jr phase 3 dose-exposure-response evaluation. J Thromb Haemost. 2020 Jul;18(7):1672-1685. doi: 10.1111/jth.14813. Epub 2020 Jun 4.
- Male C, Lensing AWA, Palumbo JS, Kumar R, Nurmeev I, Hege K, Bonnet D, Connor P, Hooimeijer HL, Torres M, Chan AKC, Kenet G, Holzhauer S, Santamaria A, Amedro P, Chalmers E, Simioni P, Bhat RV, Yee DL, Lvova O, Beyer-Westendorf J, Biss TT, Martinelli I, Saracco P, Peters M, Kallay K, Gauger CA, Massicotte MP, Young G, Pap AF, Majumder M, Smith WT, Heubach JF, Berkowitz SD, Thelen K, Kubitza D, Crowther M, Prins MH, Monagle P; EINSTEIN-Jr Phase 3 Investigators. Rivaroxaban compared with standard anticoagulants for the treatment of acute venous thromboembolism in children: a randomised, controlled, phase 3 trial. Lancet Haematol. 2020 Jan;7(1):e18-e27. doi: 10.1016/S2352-3026(19)30219-4. Epub 2019 Nov 5.
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
- Vascular Diseases
- Cardiovascular Diseases
- Embolism and Thrombosis
- Thrombosis
- Venous Thrombosis
- Sulfur Compounds
- Organic Chemicals
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Carbohydrates
- Heparin, Low-Molecular-Weight
- Glycosaminoglycans
- Polysaccharides
- Morpholines
- Oxazines
- Thiophenes
- Rivaroxaban
- Enoxaparin
- Heparin
Other Study ID Numbers
- FMASU MD 156/2024
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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