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- Klinische proef 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.
Studie Overzicht
Toestand
Studietype
Inschrijving (Verwacht)
Contacten en locaties
Studie Locaties
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Ontario
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Hamilton, Ontario, Canada, L8N 4A6
- St. Joseph's Healthcare Hamilton
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Hamilton, Ontario, Canada, L8N 3Z5
- McMaster University Medical Centre
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Bemonsteringsmethode
Studie Bevolking
Beschrijving
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
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
Cohorten en interventies
Groep / Cohort |
|---|
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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
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Symptomatic venous thromboembolism
Tijdsspanne: antepartum period (expected average 7 months)
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Symptomatic objectively confirmed recurrent VTE, including proximal DVT, non-fatal PE, and fatal PE during antepartum period
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antepartum period (expected average 7 months)
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
|
Symptomatic recurrent venous thromboembolism
Tijdsspanne: antepartum period (expected average 7 months) and first 3 months postpartum
|
Symptomatic recurrent VTE antepartum and within first 3 months postpartum
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antepartum period (expected average 7 months) and first 3 months postpartum
|
|
Symptomatic recurrent pulmonary embolism
Tijdsspanne: antepartum period (expected average 7 months) and first 3 months postpartum
|
Symptomatic objectively confirmed recurrent PE antepartum and within first 3 months postpartum
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antepartum period (expected average 7 months) and first 3 months postpartum
|
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Thrombocytopenia or heparin-induced thrombocytopenia (HIT)
Tijdsspanne: antepartum period (expected average 7 months)
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Thrombocytopenia or HIT during antepartum period
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antepartum period (expected average 7 months)
|
|
Symptomatic osteoporosis
Tijdsspanne: antepartum period (expected average 7 months) and first 3 months postpartum
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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
Tijdsspanne: antepartum (expected average 7 months) and within first 3 months postpartum
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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
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|
Pregnancy complications and outcomes
Tijdsspanne: 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
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antepartum period (expected average 7 months)
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Fetal anomalies
Tijdsspanne: antepartum (expected average 7 months) and during first 3 months postpartum
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Fetal anomalies
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antepartum (expected average 7 months) and during first 3 months postpartum
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Major and minor bleeding
Tijdsspanne: antepartum (expected average 7 months)
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Major and minor bleeding
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antepartum (expected average 7 months)
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Medewerkers en onderzoekers
Medewerkers
Onderzoekers
- Hoofdonderzoeker: Shannon M Bates, MD, McMaster University Medical Centre
Publicaties en nuttige links
Studie record data
Bestudeer belangrijke data
Studie start
Primaire voltooiing (Verwacht)
Studie voltooiing (Verwacht)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Schatting)
Updates van studierecords
Laatste update geplaatst (Schatting)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- HHS130511
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