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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)

16. juni 2026 oppdatert av: University Hospital, Tours

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.

Studieoversikt

Studietype

Intervensjonell

Registrering (Antatt)

34

Fase

  • Fase 2

Kontakter og plasseringer

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Studiekontakt

Studer Kontakt Backup

Studiesteder

      • Angers, Frankrike
        • Centre Hospitalier Universitaire d'Angers
        • Ta kontakt med:
      • Brest, Frankrike
        • Centre Hospitalier Universitaire de Brest
        • Ta kontakt med:
      • Marseille, Frankrike
      • Nantes, Frankrike
      • Paris, Frankrike
      • Rennes, Frankrike

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

  • Barn

Tar imot friske frivillige

Nei

Beskrivelse

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

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Crossover-oppdrag
  • Masking: Firemannsrom

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Annen: 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).
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.
Annen: 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.

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
The primary criterion is the total pain experienced during the episode, reflecting both intensity and duration.
Tidsramme: 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.
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.
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.

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Total consumption of analgesics
Tidsramme: Over the 14-day period after the start of treatment
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)
Over the 14-day period after the start of treatment
Child's quality of life
Tidsramme: At baseline and 2 weeks after the start of the treatment;
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.
At baseline and 2 weeks after the start of the treatment;
Child's quality of life
Tidsramme: At baseline and 2 weeks after the start of the treatment;
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.
At baseline and 2 weeks after the start of the treatment;
Sleep quality
Tidsramme: Measured once a day for 14 days
Fast Score SLEEP VASC a scale scoring from 0 to 10, 10 being the best sleep quality
Measured once a day for 14 days
Functional impairment
Tidsramme: Daily over 14 days, at baseline and 2 weeks after the start of the treatment;
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)
Daily over 14 days, at baseline and 2 weeks after the start of the treatment;
Coagulation markers: Hemoglobin
Tidsramme: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
Hemoglobin
At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
Coagulation markers: Platelets
Tidsramme: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
Platelets
At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
Coagulation markers: Prothrombin time
Tidsramme: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
Prothrombin time
At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
Coagulation markers: Activated partial thromboplastin time
Tidsramme: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
Activated partial thromboplastin time
At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
Coagulation markers: Fibrinogen
Tidsramme: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
Fibrinogen
At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
Coagulation markers: D-dimer
Tidsramme: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
D-dimer
At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
Coagulation markers: Factor V
Tidsramme: At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment
Factor V
At baseline, within 72 hours after the start of the treatment, and 2 weeks after the start of the treatment

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Tolerability: Serious and non-serious adverse events
Tidsramme: Through study completion, an average of 2 years
Number of serious and non-serious adverse events
Through study completion, an average of 2 years

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Studierekorddatoer

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Studer hoveddatoer

Studiestart (Antatt)

1. september 2026

Primær fullføring (Antatt)

1. september 2030

Studiet fullført (Antatt)

31. oktober 2030

Datoer for studieregistrering

Først innsendt

26. mai 2026

Først innsendt som oppfylte QC-kriteriene

16. juni 2026

Først lagt ut (Faktiske)

23. juni 2026

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

23. juni 2026

Siste oppdatering sendt inn som oppfylte QC-kriteriene

16. juni 2026

Sist bekreftet

1. juni 2026

Mer informasjon

Begreper knyttet til denne studien

Andre studie-ID-numre

  • DR200086
  • 2024-517595-38-00 (Ctis)

Plan for individuelle deltakerdata (IPD)

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NEI

Legemiddel- og utstyrsinformasjon, studiedokumenter

Studerer et amerikansk FDA-regulert medikamentprodukt

Nei

Studerer et amerikansk FDA-regulert enhetsprodukt

Nei

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