- ICH GCP
- Registre américain des essais cliniques
- Essai clinique NCT07663825
Acetylsalicylic Acid Versus Placebo as an add-on Treatment to Local Non-steroidal Anti-inflammatory Drug for the Management of Thrombotic Episodes in Superficial Venous Malformations in Children Aged 6 to 17 Years. (ASPIRIN)
Acetylsalicylic Acid Versus Placebo as an add-on Treatment to Local Non-steroidal Anti-inflammatory Drug for the Management of Thrombotic Episodes in Superficial Venous Malformations in Children Aged 6 to 17 Years: a Controlled Randomised, Double-blind, Cross-over, Multicenter Trial
Superficial venous malformations (SVMs) are rare congenital anomalies that present as bluish masses. These masses may be focal, with limited skin involvement, or segmental, with more extensive involvement. They may be associated with syndromic conditions such as blue rubber nevus syndrome.
SVMs are characterised by a progressive worsening course, with repeated episodes of superficial venous thrombosis occurring. These episodes become more frequent over time, causing acute, intense and often highly debilitating pain.
To limit progression and in cases of functional impairment, long-term treatments may be offered. These include venous compression, targeted therapies such as mTOR inhibitors, and, where possible, surgical treatment or sclerotherapy.
However, the management of intra-SVM superficial venous thrombosis is not currently standardised, especially in the pediatric population. This study aims to evaluate the benefits of Acetylsalicylic acid (ASA) as an add-on treatment to local non-steroidal anti-inflammatory drug for the management of thrombotic episodes in superficial venous malformations in children aged 6 to 17 years.
Aperçu de l'étude
Statut
Les conditions
Type d'étude
Inscription (Estimé)
Phase
- Phase 2
Contacts et emplacements
Coordonnées de l'étude
- Nom: Sophie LEDUCQ, MD, PhD
- Numéro de téléphone: +332 47 47 56 02
- E-mail: S.LEDUCQ@chu-tours.fr
Sauvegarde des contacts de l'étude
- Nom: Coralie TAILLEBUIS
- E-mail: cpcq@chu-tours.fr
Lieux d'étude
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Angers, France
- Centre Hospitalier Universitaire d'Angers
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Contact:
- Ludovic MARTIN
- Numéro de téléphone: +332 41 35 34 19
- E-mail: lumartin@chu-angers.fr
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Brest, France
- Centre Hospitalier Universitaire de Brest
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Contact:
- Claire ABASQ-THOMAS
- Numéro de téléphone: +332 98 22 33 15
- E-mail: claire.abasq@chu-brest.fr
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Marseille, France
- AP-HM
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Contact:
- Stéphanie MALLET
- Numéro de téléphone: +334 91 38 88 01
- E-mail: Stephanie.MALLET@ap-hm.fr
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Nantes, France
- Centre Hospitalier Universitaire de Nantes
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Contact:
- Sébastien BARBAROT, MD
- Numéro de téléphone: +332 40 08 40 86
- E-mail: sebastien.barbarot@chu-nantes.fr
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Paris, France
- AP-HP
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Contact:
- Olivia BOCCARA
- Numéro de téléphone: +331 44 49 46 63
- E-mail: olivia.boccara@aphp.fr
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Rennes, France
- Centre Hospitalier Universitaire de Rennes
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Contact:
- Catherine DROITCOURT
- Numéro de téléphone: +332 99 28 98 89
- E-mail: catherine.droitcourt@chu-rennes.fr
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Enfant
Accepte les volontaires sains
La description
Inclusion Criteria:
- Patients aged 6 to 17 years
- Weight ≥ 20 kg
- Isolated or combined superficial venous malformation, confirmed by imaging, with the presence of phleboliths indicating the occurrence of previous superficial venous thrombosis
- Complicated by acute thrombotic episodes (2 or more in the previous 12 months)
- Written consent of the child's legal representatives or of the participant if over 18 years of age
- Affiliation of a social security scheme
- Highly effective contraception for young women of childbearing age
Exclusion Criteria:
- Patients with deep or syndromic venous malformation
- Patients with known G6PD deficiency
- Patients with known mastocytosis
- History of hemarthrosis
- Simultaneous participation in another biomedical study
- Constitutional or acquired haemostasis pathology
- Current treatment affecting haemostasis (anticoagulants, platelet anti aggregants, oral NSAIDs)
- Frequent bleeding (epistaxis, other) requiring management
- Basic treatment of venous malformation (mTOR inhibitor)
- Active neoplasia or infection (altered coagulation balance)
- Known allergy to acetylsalicylic acid
- Injured skin, whatever the lesion: oozing dermatitis, eczema, infected lesions, burns or wounds
- Pregnant and breastfeeding women
- Severe renal insufficiency, severe hepatic insufficiency, severe uncontrolled cardiac insufficiency
- Methotrexate ≥ 20 mg/week
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation croisée
- Masquage: Quadruple
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Autre: ASA + local NSAID then placebo + local NSAIDs
This is a cross-over design.
Patients randomized in this sequence will receive ASA + local NSAIDs during their first flare-up, then placebo + local NSAIDs during their second flare-up (with a wash out period of two weeks).
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AAS at anti-inflammatory doses administered orally for a minimum of 3 days and a maximum of 14 days.
Orally administered AAS is combined with the application of 1% diclofenac gel (NSAID) twice a day.
Placebo administered orally for a minimum of 3 days and a maximum of 14 days.
Oral placebo is combined with the application of 1% diclofenac gel (NSAID) twice a day.
Application of 1% diclofenac gel (NSAID) twice a day.
|
|
Autre: Placebo + local NSAID then AAS + local NSAIDs
This is a cross-over design.
Patients randomized in this sequence will receive placebo + local NSAIDs during their first flare-up, then AAS + local NSAIDs during their second flare-up (with a wash out period of two weeks).
|
AAS at anti-inflammatory doses administered orally for a minimum of 3 days and a maximum of 14 days.
Orally administered AAS is combined with the application of 1% diclofenac gel (NSAID) twice a day.
Placebo administered orally for a minimum of 3 days and a maximum of 14 days.
Oral placebo is combined with the application of 1% diclofenac gel (NSAID) twice a day.
Application of 1% diclofenac gel (NSAID) twice a day.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
The primary criterion is the total pain experienced during the episode, reflecting both intensity and duration.
Délai: The first measurement is defined as the start of treatment following the onset of pain reported by the child. VAS data will be collected until the child has a VAS of 0 for two consecutive days, or for up to 14 days.
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Pain intensity will be measured using a visual analog scale (VAS) ranging from 0 (no pain) to 10 (the most intense pain imaginable).
The child will self-assess their pain, with a parent's help if necessary, twice a day (morning and evening).
The area under the EVA-time curve is calculated using the trapezoidal method based on the available values over the duration of the episode.
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The first measurement is defined as the start of treatment following the onset of pain reported by the child. VAS data will be collected until the child has a VAS of 0 for two consecutive days, or for up to 14 days.
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Total consumption of analgesics
Délai: Over the 14-day period after the start of treatment
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Total consumption of analgesics over the 14-day period.
Each day, parents will record in a patient logbook, in addition to the pain VAS score, all medication doses (study medications and others)
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Over the 14-day period after the start of treatment
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Child's quality of life
Délai: At baseline and 2 weeks after the start of the treatment;
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Child's quality of life as measured by the C-DLQI [Children's Dematology Quality of Life Index] scoring from 0 to 30, 0-1 = no effect on child's life · 2-6 = small effect · 7-12 = moderate effect · 13-18 = very large effect · 19-30 = extremely large effect.
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At baseline and 2 weeks after the start of the treatment;
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Child's quality of life
Délai: At baseline and 2 weeks after the start of the treatment;
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Child's quality of life measured by the CLFMQol [Specific Quality of Life Questionnaire for Slow-Flow Vascular Malformations] including 15 items, with a total score ranging from 0 to 45, 0 being the worst value and 45 the best value.
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At baseline and 2 weeks after the start of the treatment;
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Sleep quality
Délai: Measured once a day for 14 days
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Fast Score SLEEP VASC a scale scoring from 0 to 10, 10 being the best sleep quality
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Measured once a day for 14 days
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Functional impairment
Délai: Daily over 14 days, at baseline and 2 weeks after the start of the treatment;
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Functional impairment related to the malformation will be assessed using a VAS ranging from 0 to 10 (0 = no discomfort, 10 = maximum discomfort; inability to move a limb or body segment)
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Daily over 14 days, at baseline and 2 weeks after the start of the treatment;
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Coagulation markers: Hemoglobin
Délai: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
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Hemoglobin
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At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
|
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Coagulation markers: Platelets
Délai: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
|
Platelets
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At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
|
|
Coagulation markers: Prothrombin time
Délai: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
|
Prothrombin time
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At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
|
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Coagulation markers: Activated partial thromboplastin time
Délai: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
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Activated partial thromboplastin time
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At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
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Coagulation markers: Fibrinogen
Délai: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
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Fibrinogen
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At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
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Coagulation markers: D-dimer
Délai: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
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D-dimer
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At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
|
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Coagulation markers: Factor V
Délai: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
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Factor V
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At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
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Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Tolerability: Serious and non-serious adverse events
Délai: Through study completion, an average of 2 years
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Number of serious and non-serious adverse events
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Through study completion, an average of 2 years
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Collaborateurs et enquêteurs
Parrainer
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Autres numéros d'identification d'étude
- DR200086
- 2024-517595-38-00 (Ctis)
Plan pour les données individuelles des participants (IPD)
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Informations sur les médicaments et les dispositifs, documents d'étude
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