- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT01357941
Need for Antepartum Thromboprophylaxis in Pregnant Women With One Prior Episode of Venous Thromboembolism (VTE) (ROCITP2)
Prospective Study Assessing the Need for Antepartum Thromboprophylaxis in Pregnant Women With One Prior Episode of Venous Thromboembolism
Pregnant women with a prior history of venous thromboembolism (VTE) are at increased risk of recurrent VTE. Current guidelines assessing the role of prophylaxis in pregnant women with prior VTE are based primarily on expert opinion and the optimal clinical management strategy remains unclear.
This multicentre, prospective cohort study aims to test the following hypotheses:
- Antepartum prophylaxis with fixed-dose low molecular-weight heparin (LMWH) is safe, convenient and associated with an acceptably low risk of recurrent VTE in women with a single prior episode of VTE that was either unprovoked or associated with a minor transient risk factor. (Moderate risk cohort)
- Withholding antepartum prophylaxis is safe (recurrence risk <1%) in pregnant women with a single prior episode of VTE provoked by a major transient risk factor. (Low risk cohort)
All study patients will receive 6 weeks of postpartum prophylaxis.
Tutkimuksen yleiskatsaus
Tila
Opintotyyppi
Ilmoittautuminen (Odotettu)
Yhteystiedot ja paikat
Opiskelupaikat
-
-
Ontario
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Hamilton, Ontario, Kanada, L8N 4A6
- St. Joseph's Healthcare Hamilton
-
Hamilton, Ontario, Kanada, L8N 3Z5
- McMaster University Medical Centre
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Näytteenottomenetelmä
Tutkimusväestö
Kuvaus
Inclusion Criteria:
- Confirmed pregnancy (positive serum or urine)
- At least 18 years of age
- History of one prior episode of VTE consisting of DVT (diagnosed by compression ultrasonography [CUS] or venography) and/or PE (diagnosed by ventilation-perfusion [V/Q] lung scintigraphy, computed tomographic pulmonary angiography [CTPA], or traditional pulmonary angiography)
Exclusion Criteria:
- Ongoing need for therapeutic anticoagulation for prevention or treatment of cardioembolic stroke
- Known high-risk thrombophilia (specifically antithrombin deficiency, protein S deficiency, protein C deficiency, homozygosity for the factor V Leiden or prothrombin G20210A mutations, antiphospholipid antibody or compound abnormalities)
- VTE within 3 months of the current pregnancy
- Clinical risk factor for initial episode of VTE, if present, not resolved (excluding pregnancy)
- Known contraindication to anticoagulation (including active, uncontrolled bleeding or major bleed within the previous 4 weeks)
- For patients with prior unprovoked VTE, contraindication to LMWH (including allergy, HIT, impaired renal function, osteoporosis)
- Geographic or social factors precluding follow-up
- Inability or unwillingness to provide informed consent
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
Kohortit ja interventiot
Ryhmä/Kohortti |
|---|
|
Prior VTE minor transient risk factor
Pregnant women with a single prior VTE episode that was either unprovoked or associated with a minor transient risk factor - Prophylaxis with fixed-dose LMWH
|
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Prior VTE major transient risk factor
Pregnant women with a single prior VTE episode that was provoked by a major transient risk factor - Surveillance
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Symptomatic venous thromboembolism
Aikaikkuna: antepartum period (expected average 7 months)
|
Symptomatic objectively confirmed recurrent VTE, including proximal DVT, non-fatal PE, and fatal PE during antepartum period
|
antepartum period (expected average 7 months)
|
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Symptomatic recurrent venous thromboembolism
Aikaikkuna: antepartum period (expected average 7 months) and first 3 months postpartum
|
Symptomatic recurrent VTE antepartum and within first 3 months postpartum
|
antepartum period (expected average 7 months) and first 3 months postpartum
|
|
Symptomatic recurrent pulmonary embolism
Aikaikkuna: antepartum period (expected average 7 months) and first 3 months postpartum
|
Symptomatic objectively confirmed recurrent PE antepartum and within first 3 months postpartum
|
antepartum period (expected average 7 months) and first 3 months postpartum
|
|
Thrombocytopenia or heparin-induced thrombocytopenia (HIT)
Aikaikkuna: antepartum period (expected average 7 months)
|
Thrombocytopenia or HIT during antepartum period
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antepartum period (expected average 7 months)
|
|
Symptomatic osteoporosis
Aikaikkuna: antepartum period (expected average 7 months) and first 3 months postpartum
|
Symptomatic osteoporosis antepartum and within first 3 months postpartum
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antepartum period (expected average 7 months) and first 3 months postpartum
|
|
Other complications
Aikaikkuna: antepartum (expected average 7 months) and within first 3 months postpartum
|
Other complications sufficient to stop treatment (e.g., local and systemic reactions) antepartum and within first 3 months postpartum
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antepartum (expected average 7 months) and within first 3 months postpartum
|
|
Pregnancy complications and outcomes
Aikaikkuna: antepartum period (expected average 7 months)
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Pregnancy complications and outcomes including fetal death, pre-eclampsia, toxemia, intrauterine growth restriction, prematurity during antepartum period
|
antepartum period (expected average 7 months)
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Fetal anomalies
Aikaikkuna: antepartum (expected average 7 months) and during first 3 months postpartum
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Fetal anomalies
|
antepartum (expected average 7 months) and during first 3 months postpartum
|
|
Major and minor bleeding
Aikaikkuna: antepartum (expected average 7 months)
|
Major and minor bleeding
|
antepartum (expected average 7 months)
|
Yhteistyökumppanit ja tutkijat
Sponsori
Yhteistyökumppanit
Tutkijat
- Päätutkija: Shannon M Bates, MD, McMaster University Medical Centre
Julkaisuja ja hyödyllisiä linkkejä
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus
Ensisijainen valmistuminen (Odotettu)
Opintojen valmistuminen (Odotettu)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Arvio)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Arvio)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Avainsanat
- tromboembolia
- sydän-ja verisuonitaudit
- antikoagulantit
- laskimotukos
- laskimotromboembolia
- syvä laskimotromboosi
- keuhkoveritulppa
- tromboosi
- enoksapariini
- tromboprofylaksia
- kardiovaskulaariset aineet
- verisuonitaudit
- tintsapariini
- daltepariini
- raskauden komplikaatioita
- embolia ja tromboosi
- hematologic agents
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
- HHS130511
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