- ICH GCP
- Registro de ensaios clínicos dos EUA
- Ensaio Clínico 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.
Visão geral do estudo
Status
Tipo de estudo
Inscrição (Antecipado)
Contactos e Locais
Locais de estudo
-
-
Ontario
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Hamilton, Ontario, Canadá, L8N 4A6
- St. Joseph's Healthcare Hamilton
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Hamilton, Ontario, Canadá, L8N 3Z5
- McMaster University Medical Centre
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-
Critérios de participação
Critérios de elegibilidade
Idades elegíveis para estudo
Aceita Voluntários Saudáveis
Gêneros Elegíveis para o Estudo
Método de amostragem
População do estudo
Descrição
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
Plano de estudo
Como o estudo é projetado?
Detalhes do projeto
Coortes e Intervenções
Grupo / Coorte |
|---|
|
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
|
|
Prior VTE major transient risk factor
Pregnant women with a single prior VTE episode that was provoked by a major transient risk factor - Surveillance
|
O que o estudo está medindo?
Medidas de resultados primários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Symptomatic venous thromboembolism
Prazo: 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)
|
Medidas de resultados secundários
Medida de resultado |
Descrição da medida |
Prazo |
|---|---|---|
|
Symptomatic recurrent venous thromboembolism
Prazo: 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
Prazo: 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)
Prazo: antepartum period (expected average 7 months)
|
Thrombocytopenia or HIT during antepartum period
|
antepartum period (expected average 7 months)
|
|
Symptomatic osteoporosis
Prazo: antepartum period (expected average 7 months) and first 3 months postpartum
|
Symptomatic osteoporosis antepartum and within first 3 months postpartum
|
antepartum period (expected average 7 months) and first 3 months postpartum
|
|
Other complications
Prazo: 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
Prazo: antepartum period (expected average 7 months)
|
Pregnancy complications and outcomes including fetal death, pre-eclampsia, toxemia, intrauterine growth restriction, prematurity during antepartum period
|
antepartum period (expected average 7 months)
|
|
Fetal anomalies
Prazo: antepartum (expected average 7 months) and during first 3 months postpartum
|
Fetal anomalies
|
antepartum (expected average 7 months) and during first 3 months postpartum
|
|
Major and minor bleeding
Prazo: antepartum (expected average 7 months)
|
Major and minor bleeding
|
antepartum (expected average 7 months)
|
Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Shannon M Bates, MD, McMaster University Medical Centre
Publicações e links úteis
Datas de registro do estudo
Datas Principais do Estudo
Início do estudo
Conclusão Primária (Antecipado)
Conclusão do estudo (Antecipado)
Datas de inscrição no estudo
Enviado pela primeira vez
Enviado pela primeira vez que atendeu aos critérios de CQ
Primeira postagem (Estimativa)
Atualizações de registro de estudo
Última Atualização Postada (Estimativa)
Última atualização enviada que atendeu aos critérios de controle de qualidade
Última verificação
Mais Informações
Termos relacionados a este estudo
Palavras-chave
- tromboembolismo
- doenças cardiovasculares
- anticoagulantes
- trombose venosa
- tromboembolismo venoso
- trombose venosa profunda
- embolia pulmonar
- trombose
- enoxaparina
- tromboprofilaxia
- agentes cardiovasculares
- doenças vasculares
- tinzaparina
- dalteparina
- complicações na gravidez
- embolia e trombose
- hematologic agents
Termos MeSH relevantes adicionais
Outros números de identificação do estudo
- HHS130511
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