D-dimer to Select Patients With First Unprovoked Venous Thromboembolism Who Can Have Anticoagulants Stopped at 3 Months

NCT ID: NCT00720915

Last Updated: 2016-12-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

410 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-09-30

Study Completion Date

2016-12-31

Brief Summary

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The purpose of this study is to determine if the risk of recurrent venous thromboembolism (VTE) after stopping therapy is low and acceptable in patients with a first unprovoked proximal deep vein thrombosis (DVT) or pulmonary embolism (PE) who have completed 3 months of therapy and who have a negative D-dimer test on therapy and 1 month after stopping therapy.

Detailed Description

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Conditions

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Deep Vein Thrombosis Pulmonary Embolism

Keywords

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unprovoked deep vein thrombosis unprovoked pulmonary embolism anticoagulant therapy

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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No Anticoagulant Therapy

No Anticoagulant Therapy

Group Type OTHER

Discontinue anticoagulant therapy (Negative d-dimer)

Intervention Type OTHER

Patients with negative d-dimer discontinue long-term anticoagulant therapy.

Anticoagulant Therapy

Continue on anticoagulant therapy

Group Type OTHER

Continue on anticoagulant therapy (positive d-dimer)

Intervention Type OTHER

Patients with positive d-dimer continue or re-start on anticoagulant therapy

Interventions

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Discontinue anticoagulant therapy (Negative d-dimer)

Patients with negative d-dimer discontinue long-term anticoagulant therapy.

Intervention Type OTHER

Continue on anticoagulant therapy (positive d-dimer)

Patients with positive d-dimer continue or re-start on anticoagulant therapy

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Be \>= 18 years of age
2. Have had ONE episode of unprovoked proximal DVT and/or PE
3. Have completed 3 uninterrupted months of warfarin therapy (target INR of 2.0-3.0)

Exclusion Criteria

1. Another indication for long-term anticoagulation (e.g., atrial fibrillation)
2. A high risk of bleeding as evidenced by any of the following:

* Age greater than 75 years
* Previous episode of major bleeding where the cause was not effectively treated
* Known chronic thrombocytopenia with a platelet count of less than 120,000 x 10\^9 /L
* Known chronic renal impairment with a creatinine of more than 150 mumols /litre (1.7 mg/dl)
* Known chronic liver disease with a total bilirubin of more than 25 mumols /litre (1.5 mg/dl)
* Active peptic ulcer disease
* Poor compliance with, or control of, anticoagulant therapy during initial treatment
* Requires dual antiplatelet therapy (e.g. aspirin and clopidogrel)
3. A vena caval filter
4. Has had D-dimer testing performed within 2 months of potential enrollment other than for evaluation of suspected recurrent VTE that was not confirmed
5. Has a life expectancy less than 5 years
6. Is unable to attend follow-up visits because of geographic inaccessibility
7. Is participating in a competing clinical investigation
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Canadian Institutes of Health Research (CIHR)

OTHER_GOV

Sponsor Role collaborator

McMaster University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clive Kearon, MB MRCP(I) FRCP(C) PhD

Role: PRINCIPAL_INVESTIGATOR

McMaster University

Locations

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Lombardi Cancer Center

Washington D.C., District of Columbia, United States

Site Status

University of Iowa Hospitals and Clinics

Iowa City, Iowa, United States

Site Status

Brigham and Women's Hospital

Boston, Massachusetts, United States

Site Status

Beth Israel Deaconess Medical Centre

Boston, Massachusetts, United States

Site Status

Henry Ford Hospital

Detroit, Michigan, United States

Site Status

UNC Thrombophilia Program

Chapel Hill, North Carolina, United States

Site Status

Intermountain Medical Centre

Murray, Utah, United States

Site Status

Hamilton General Hospital

Hamilton, Ontario, Canada

Site Status

McMaster University

Hamilton, Ontario, Canada

Site Status

St. Joseph's Health Care Centre

Hamilton, Ontario, Canada

Site Status

Henderson Hospital

Hamilton, Ontario, Canada

Site Status

Limerick, Mid Western Regional Hospital

Limerick, , Ireland

Site Status

Addenbrooke's Hospital

Cambridge, , United Kingdom

Site Status

Countries

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Sweden United States Canada Ireland United Kingdom

References

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Kearon C, Parpia S, Spencer FA, Schulman S, Stevens SM, Shah V, Bauer KA, Douketis JD, Lentz SR, Kessler CM, Connors JM, Ginsberg JS, Spadafora L, Julian JA. Long-term risk of recurrence in patients with a first unprovoked venous thromboembolism managed according to d-dimer results; A cohort study. J Thromb Haemost. 2019 Jul;17(7):1144-1152. doi: 10.1111/jth.14458. Epub 2019 May 20.

Reference Type DERIVED
PMID: 31033194 (View on PubMed)

Kearon C, Parpia S, Spencer FA, Baglin T, Stevens SM, Bauer KA, Lentz SR, Kessler CM, Douketis JD, Moll S, Kaatz S, Schulman S, Connors JM, Ginsberg JS, Spadafora L, Bhagirath V, Liaw PC, Weitz JI, Julian JA. Antiphospholipid antibodies and recurrent thrombosis after a first unprovoked venous thromboembolism. Blood. 2018 May 10;131(19):2151-2160. doi: 10.1182/blood-2017-09-805689. Epub 2018 Feb 28.

Reference Type DERIVED
PMID: 29490924 (View on PubMed)

Kearon C, Spencer FA, O'Keeffe D, Parpia S, Schulman S, Baglin T, Stevens SM, Kaatz S, Bauer KA, Douketis JD, Lentz SR, Kessler CM, Moll S, Connors JM, Ginsberg JS, Spadafora L, Julian JA; D-dimer Optimal Duration Study Investigators. D-dimer testing to select patients with a first unprovoked venous thromboembolism who can stop anticoagulant therapy: a cohort study. Ann Intern Med. 2015 Jan 6;162(1):27-34. doi: 10.7326/M14-1275.

Reference Type DERIVED
PMID: 25560712 (View on PubMed)

Other Identifiers

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CTMG-2007-DODS

Identifier Type: -

Identifier Source: org_study_id