Pradaxa or Warfarin for Prevention of Recurrent VTE in Patients With Angiographically Confirmed Acute Massive Pulmonary Embolism undergoIng Endovascular Mechanical Fragmentation and Thrombolytic Therapy (Re-Spire)
A Prospective Randomised Controlled Study to Evaluate Outcomes of the Treatment With Pradaxa or Warfarin for Prevention of Recurrent VTE in Patients With Angiographically Confirmed Acute Massive Pulmonary Embolism Undergoing Endovascular Mechanical Fragmentation and Thrombolytic Therapy
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Forventet)
Tilmelding
Fase
Fase
- Fase 4
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Andrey Karpenko, MD\PhD
- E-mail: a_karpenko@meshalkin.ru
Studiesteder
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Novosibirsk, Den Russiske Føderation, 630055
- Rekruttering
- Federal State Institution Academician E.N.Meshalkin Novosibirsk State Research Institute Of Circulation Pathology Rusmedtechnology
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Men and women aged > 18 years
- Angiographically confirmed acute massive pulmonary embolism with involvement of Central pulmonary arteries.
- endovascular mechanical thrombus fragmentation + thrombolytic therapy (using recombinant tissue activator of plasminogen), performed for treatment of the above-mentioned pulmonary embolism in less than 48 hours before randomization. The patient should be randomized no earlier than 24 hours after procedures endovascular mechanical thrombus fragmentation + thrombolytic therapy
- Written informed consent signed by patient.
Exclusion Criteria:
- Signs of hemodynamic instability (i.e. systolic blood pressure <100 mm Hg.St. or episode of systolic blood pressure fall for ≥40 mm Hg. / or heart rate > 110 lasting more than 15 min) or need for ventilatory support within 12 hours prior to randomisation.
- The indication for oral anticoagulation, associated with others disease.
- malignant neoplasm of any location
- Contraindications to warfarin or pradaxa according to Russian Instructions for medical use of these drugs
- Indications for concomitant treatment with antiplatelet agents
- Any stroke within 6 months before randomization
- Intracranial hemorrhage in anamnesis
- Active bleeding, bleeding diathesis.
- Clinically significant bleeding within the last 30 days.
- Trauma or extensive surgery within 1 month before randomization or surgery planned in the next 6 months after randomization.
- Intracranial pathology: tumor, arteriovenous fistula or aneurysm.
- Gastrointestinal bleeding in the previous 3 months.
- Gastric ulcer or duodenal ulcer with clinical manifestations or endoscopically identified acute ulcer without signs of scarring during previous 30 days.
- Uncontrolled hypertension (systolic blood pressure> 180 mm Hg. and / or diastolic blood pressure> 100 mm.hg in patients receiving antihypertensive drugs).
- Pregnancy, lactation.
- Life expectancy <6 months.
- Clinically significant liver disease.
- Creatinine clearance (estimated by Cockcroft-Gault) <30 ml / min.
- hemoglobin level <90 g/l), thrombocytopenia <100x10^9 / L.
- Patients who, in the opinion of the researcher, are not suitable for inclusion in the study, for example, due to the low likelihood of doctor's recommendations following.
- Long-term use of NSAIDs
- Current participation in another clinical study.
- Allergic to contrast substance or radioisotope drugs used in procedures to assess endpoints of the study, which according to researchers, may be a contraindication to the implementation of these research methods.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: group of dabigatran
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All patients in this group continue to receive unfractionated heparin for 5-7 days, and then transferred to the drug Pradaxa dose of 150 mg 2 times a day.
Pradaxa administration continued until the end of the treatment period.
The treatment period starts on the day of randomization and lasts for 6 months.
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Aktiv komparator: group of warfarin
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all patients continue to receive unfractionated heparin intravenously and at the same time (from the date of randomization) start warfarin, accompanied by regular measurement of the INR every day or every other day.
As soon as INR reaches the range of 2.0 to 3.0, the administration of the unfractionated heparin should be discontinued.
Further measurements of INR should be performed once a month during outpatient visits.
The patient continues to receive warfarin under the control of the INR till the end of the treatment period.
The treatment period starts on the day of randomization and lasts for 6 months.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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recurrent PE
Tidsramme: 6 month
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according to Echocardiogram, scintigraphy of the lungs
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6 month
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death
Tidsramme: 6 month
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6 month
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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hemorrhagic complications
Tidsramme: 6 month
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according to the ISTH criteria
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6 month
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postembolic residual pulmonary hypertension
Tidsramme: 6 month
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according to scintigraphy of the lungs
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6 month
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recurrent deep vein thrombosis
Tidsramme: 3 month
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according to ultrasound of the deep veins
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3 month
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recurrent deep vein thrombosis
Tidsramme: 6 month
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according to ultrasound of the deep veins
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6 month
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart
Studiestart
Primær færdiggørelse (Forventet)
Primær færdiggørelse
Studieafslutning (Forventet)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Skøn)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- RE-SPIRE study
Plan for individuelle deltagerdata (IPD)
Planlægger du at dele individuelle deltagerdata (IPD)?
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