Optimizing the Use of Aspirin for the Prevention of Preeclampsia (Optim-PRE)
Pregnant women at higher risk for preeclampsia (PE) are currently recommended to take low-dose aspirin (acetylsalicylic acid, ASA) daily from the first trimester until 36 weeks of gestation. High-risk women are identified through a multiparametric first-trimester screening that combines maternal history, blood pressure, uterine artery blood flow, and placental growth factor (PlGF). Although this screening effectively identifies women at risk, the majority of those classified as high risk will not develop PE. As a result, a large proportion of pregnant women receive prolonged aspirin treatment without benefit, while remaining exposed to its potential side effects, including increased bleeding risk.
Aspirin prevents PE primarily by improving placental development during the first half of pregnancy. Whether continuing ASA beyond 24-28 weeks provides additional protection remains unclear. A previous randomized trial demonstrated that stopping ASA at 24-28 weeks was non-inferior to continuing until 36 weeks in a predominantly European population. However, whether this finding applies to more diverse populations, including women of African origin who carry a substantially higher baseline risk of PE, has not been established.
This is a multicenter, randomized, open-label, parallel-group, phase III non-inferiority trial conducted across sites in Europe and Africa. A total of 15,160 pregnant women at high risk for PE from first-trimester screening, currently under ASA treatment, will be randomized in a 1:1 ratio before 28 weeks of gestation to either discontinue ASA at 24-28 weeks or continue ASA until 36 weeks of gestation.
研究概览
地位
条件
详细说明
研究类型
注册 (估计的)
阶段
- 第三阶段
联系人和位置
学习联系方式
- 姓名:Manel Mendoza Cobaleda, Professor
- 电话号码:6548 +34 93 489 30 00
- 邮箱:manel.mendoza@vallhebron.cat
学习地点
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Sofia、保加利亚
- Dr Shterev Hospital
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接触:
- Petya Chaveeva
- 电话号码:+359 2 920 0901
- 邮箱:international@shterevhospital.com
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Banjul、冈比亚
- Bundung Maternal and Child Health Hospital
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接触:
- Dado Jarju
- 电话号码:+220 7933758
- 邮箱:jabbiedado29@gmail.com
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Brikama、冈比亚
- Brikama District Hospital
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接触:
- Karamba Suwareh
- 电话号码:+2203379857
- 邮箱:k.suwareh@yahoo.com
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Ofinso、加纳
- Saint Patrick Hospital
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接触:
- Seth Ampor
- 电话号码:+233 5427 21341
- 邮箱:sethonto@gmail.com
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Techiman、加纳
- Holy Family Hospital
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接触:
- Seryam Kaali
- 电话号码:+233 546381925
- 邮箱:kaali.seyram@kintampo-hrc.org
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Dakar、塞内加尔
- Hopital Phillipe Senghor
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接触:
- Mamour Gueye
- 电话号码:+221 33 820 12 28
- 邮箱:mamourmb@gmail.com
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Saint-Louis、塞内加尔
- Centre Hospitalier Régional de Saint-Louis
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接触:
- Thian Ousman
- 电话号码:+221772890244
- 邮箱:cassoumane@yahoo.fr
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Vienna、奥地利
- Medical University of Vienna
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接触:
- Gülen Yerlikaya-Schatten
- 电话号码:+43 1 401600
- 邮箱:guelen.yerlikaya@meduniwien.ac.at
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Vienna、奥地利
- St Josef Hospital
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接触:
- Sarah
- 邮箱:s.lausegger@gmx.at
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London、英国
- King's College Hospital
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接触:
- Argyro Syngelaki
- 电话号码:+44 20 7836 5454
- 邮箱:argyro.syngelaki@nhs.net
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London、英国
- Medway Maritime Hospital
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接触:
- Ranjit Akolekar
- 电话号码:+44 1634 830000
- 邮箱:ranjit.akolekar@gmail.com
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A Coruña、西班牙
- Complejo Hospitalario Universitario de A Coruña
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接触:
- Nuria Valiño
- 电话号码:034981178000
- 邮箱:Nuria.Valino.Calvino@sergas.es
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Alicante、西班牙
- Hospital General de Alicante
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接触:
- Ana Palacios
- 电话号码:+34965262297
- 邮箱:ana.palacios.marques@gmail.com
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Barcelona、西班牙
- Hospital Universitari Vall d'Hebron
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接触:
- Manel Mendoza
- 电话号码:6548 +34 93 489 30 00
- 邮箱:manel.mendoza@vallhebron.cat
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接触:
- Mireia Armengol
- 电话号码:6548 +34 93 489 30 00
- 邮箱:mireia.armengol@vallhebron.cat
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Barcelona、西班牙、08035
- Hospital Universitari Vall d'Hebron
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接触:
- Manel Mendoza, PhD
- 电话号码:3264 0034934893085
- 邮箱:manel.mendoza@vallhebron.cat
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Barcelona、西班牙
- Hospital de La Santa Creu i Sant Pau
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接触:
- Pablo Garcia-Manau
- 邮箱:pgarciama@santpau.cat
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接触:
- 电话号码:+34935537048
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Burgos、西班牙
- Hospital Universitario de Burgos
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接触:
- Leire González
- 电话号码:947281800
- 邮箱:lgonzalezm@saludcastillayleon.es
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Cadiz、西班牙
- Hospital Universitario Puerta del Mar
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接触:
- Maria Angeles Anaya
- 电话号码:+34956 00 21 00
- 邮箱:angeles.anaya.sspa@juntadeandalucia.es
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Granada、西班牙
- Hospital Universitario Virgen de las Nieve
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接触:
- María Setefilla López
- 电话号码:+34958 02 00 89
- 邮箱:mmefilla@gmail.com
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Jerez de la Frontera、西班牙
- Hospital Universitario de Jerez
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接触:
- Cristina Romero
- 电话号码:+34956 03 20 00
- 邮箱:CRGARRI@GMAIL.COM
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Las Palmas de Gran Canaria、西班牙
- Hospital Materno Infantil de Gran Canaria
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接触:
- Laura Molero
- 电话号码:+34 928 444 830
- 邮箱:lmolsal@gobiernodecanarias.org
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Leganés、西班牙
- Hospital Universitario Severo Ochoa
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接触:
- Laura De Mingo
- 电话号码:+34 914818000
- 邮箱:laura.demingo@salud.madrid.org
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León、西班牙
- Hospital de León
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接触:
- Camino Fernandez
- 电话号码:34-987 237 400
- 邮箱:cfdezfdez@saludcastillayleon.es
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Lleida、西班牙
- Hospital Arnau de Vilanova de Lleida
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接触:
- Ivanna Llordella
- 邮箱:Lsarmiento.lleida.ics@gencat.cat
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Madrid、西班牙
- Fundación Jiménez Díaz
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接触:
- Miguel Alvaro Navidad
- 电话号码:(+34)915 50 48 00
- 邮箱:MAlvaro@quironsalud.es
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Murcia、西班牙
- Hospital Clínico Universitario Virgen de la Arrixaca
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接触:
- Laura Hernandez
- 电话号码:+34968 36 95 00
- 邮箱:sms_medicinafetalmurcia@carm.es
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Móstoles、西班牙
- Hospital Universitario Rey Juan Carlos
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接触:
- Marina Perez Serrano
- 电话号码:+34 914816225
- 邮箱:marina.pserrano@hospitalreyjuancarlos.es
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Pamplona、西班牙
- Clinica Universidad de Navarra
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接触:
- Laura Muñoz Saa
- 邮箱:lmunozs@unav.es
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San Cristóbal de La Laguna、西班牙
- Hospital Universitario de Canarias
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接触:
- Armando Torres, MD, PhD
- 电话号码:+34 922 31 93 38
- 邮箱:atorres@gmail.com
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接触:
- Mercedes Hernández
- 电话号码:+34922 67 80 00
- 邮箱:mercedes021281@hotmail.com
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Santa Cruz de Tenerife、西班牙
- Hospital Universitario Nuestra Señora de Candelaria
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接触:
- Sara Caamiña
- 邮箱:sara_caaminya@hotmail.com
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Terrassa、西班牙
- Consorci Sanitari de Terrassa
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接触:
- Angels Vives
- 邮箱:MAVives@cst.cat
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Terrassa、西班牙
- Hospital Universitari Mutua Terrassa
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接触:
- Eva Lopez-Quesada
- 电话号码:20361 (+34) 937365050
- 邮箱:evalopez@mutuaterrassa.es
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Torrejón de Ardoz、西班牙
- Hospital Universitario De Torrejon
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接触:
- Raquel Martin, MD
- 电话号码:+34916262626
- 邮箱:raqmaral@gmail.com
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Andalusia
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Granada、Andalusia、西班牙
- Hospital San Cecilio
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接触:
- Elena Benitez
- 电话号码:+34958 02 30 00
- 邮箱:elena.benitezcano.sspa@juntadeandalucia.es
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BARCELONA
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Barcelona、BARCELONA、西班牙、08024
- Hospital Universitari Dexeus
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接触:
- Raquel Mula
- 电话号码:+3493 227 47 47
- 邮箱:raqmul@dexeus.com
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Girona
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Girona、Girona、西班牙、17007
- Hospital Dr.Josep Trueta
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接触:
- Roser Masó
- 电话号码:2235 972940200
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Tarragona
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Tarragona、Tarragona、西班牙、43007
- Hospital Joan XXIII
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接触:
- Monica Lopez
- 电话号码:+34977295800
- 邮箱:mlopezrodriguez.hj23.ics@gencat.cat
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Vizcaya
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Barakaldo、Vizcaya、西班牙、48903
- Hospital De Cruces
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接触:
- Elena Gibbone
- 电话号码:946 00 60 00
- 邮箱:elena.gibbone@osakidetza.eus
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
Inclusion Criteria:
- Age 18 years or older at time of enrollment.
- Singleton pregnancy.
- Ability to read and understand the informed consent form.
- Having undergone first-trimester preeclampsia screening between 11+0 and 13+6 weeks of gestation using a validated multiparametric algorithm (FMF algorithm at a risk cutoff of 1:100, or Gaussian algorithm at a cutoff of 1:170) and being classified as high risk for preterm preeclampsia.
- Currently taking aspirin 150 mg/day initiated after first-trimester high-risk classification, in accordance with standard clinical practice.
- Voluntary signing of the informed consent form and willingness to comply with the study requirements, including acceptance of the assigned aspirin treatment duration, additional blood tests, and additional ultrasound assessments.
Exclusion Criteria:
- Early pregnancy loss, intrauterine fetal death, or fetus with major structural malformations diagnosed at the time of enrollment.
- Fetus affected by a known genetic or chromosomal disease.
- Contraindication, allergy, or intolerance to aspirin (acetylsalicylic acid).
- Any medical condition that makes aspirin discontinuation unsafe or impossible (e.g., antiphospholipid syndrome, mechanical heart valve, or other conditions requiring indefinite antiplatelet or anticoagulant therapy).
学习计划
研究是如何设计的?
设计细节
- 主要用途:预防
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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实验性的:ASA withdrawn group
ASA is discontinued at 24-28 weeks of gestation
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Intervention group will discontinuate of Acetyl Salicylic acid at 24-28 weeks of gestation while Control Group will continue Acetyl Salicylic acid 150 mg/day until 36 weeks of gestation.
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无干预:Continue ASA Group
ASA is continued until 36 weeks of gestation
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Rate of preterm preeclampsia in both arms of the study (ASA vs no ASA).
大体时间:From 20 weeks of gestation onwards
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Rate of pre-eclampsia <37 weeks in pregnant women at high-risk for early-onset PE from the first-trimester screening in both arms of the study (ASA vs no ASA).
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From 20 weeks of gestation onwards
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合作者和调查者
调查人员
- 首席研究员:Manel Mendoza Cobaleda, Professor、Hospital Universitari Vall Hebron - Vall Hebrón Institut de Recerca
- 首席研究员:Kypros Nicolaides, Professor、Fetal Medicine Foundation
研究记录日期
研究主要日期
学习开始 (估计的)
初级完成 (估计的)
研究完成 (估计的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
其他研究编号
- Optim-PRE26
- INV-093057 (其他赠款/资助编号:Bill And Melinda Gates Foundation)
- INV-108812 (其他赠款/资助编号:Bill And Melinda Gates Foundation)
- PI25/00497 (其他赠款/资助编号:Instituto de Salud Carlos III)
- 2025-524646-94-00 (克蒂斯)
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
IPD 计划说明
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
在美国制造并从美国出口的产品
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