Prevention of Preeclampsia With Aspirin in Recipients of Donated Oocytes.

NCT ID: NCT02174328

Last Updated: 2019-04-26

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

81 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-05-21

Study Completion Date

2018-04-20

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

The main objective of this trial is to study the occurrence of preeclampsia in recipients of donated oocytes receiving aspirin at an early stage during pregnancy and to compare the results with those obtained in patients receiving placebo.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Various markers have been proposed for the early diagnosis of preeclampsia: determination of mean arterial pressure; presence of multiple risk factors of preeclampsia; biochemical, ultrasound, and angiogenic markers; uterine artery Doppler, etc. These are used to determinate which patients have an increased risk of developing preeclampsia during gestation, and therefore carry out closer monitoring of pregnancy in this population. In addition, these markers can also identify patients at increased risk of developing other problems such as IUGR or preterm labor.

For nearly 30 years, there have been multiple studies trying to demonstrate that aspirin prevents the onset of preeclampsia with inconclusive results. However, recent studies in which aspirin was administered at an early stage (before 16 weeks of gestation) in patients at high risk of complications, have demonstrated a decrease in the incidence of this entity. Thus, administration of aspirin to patients at high risk (patients classified with a high risk of complications during pregnancy, based on markers mentioned above) seems to be useful in preventing onset of preeclampsia, IUGR and other complications, whenever it is administered at an early stage, as shown by several studies carried out so far.

The incidence of preeclampsia, IUGR and other complications of pregnancy is increased in patients undergoing treatment for ovulation induction, being much higher in recipients of donated oocytes. It appears that this increase may be explained by immunological processes. The focus lies on the interaction between HLA-C fetal antigen with the maternal natural killer cells. We postulate, therefore, that the administration of aspirin in recipients of donated oocytes at an early stage of pregnancy, may also reduce the incidence of preeclampsia in this group of patients.

Moreover, it has been observed that patients with preeclampsia exhibit lower levels of VEGF, PlGF and PAPP-A (factors involved in placental angiogenesis) and that this is accompanied by an increase in the sFlt1 (a potent PIGF and VEGF antagonist).

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Pre-Eclampsia

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

acetylsalicylic acid

This group will receive 1 tablet of acetylsalicylic acid (100 mg) orally daily from 5-10 weeks gestation until the end of gestation, about week 36

Group Type EXPERIMENTAL

Acetylsalicylic acid

Intervention Type DRUG

Acetylsalicylic acid once a day until 36 week

Placebo

This group will receive 1 tablet of placebo orally each day from 5-10 weeks gestation until the end of gestation, about week 36

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Placebo once a day until 36 week

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Acetylsalicylic acid

Acetylsalicylic acid once a day until 36 week

Intervention Type DRUG

Placebo

Placebo once a day until 36 week

Intervention Type DRUG

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

ADIRO 100 Not active drug

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Patients over 18 years.
* Recipients of donated oocytes.
* Pregnant women.
* Single or twin gestations.
* Patients who accept the conditions of the study by signing the appropriate informed consent.

Exclusion Criteria

* Known allergy to acetylsalicylic acid .
* Personal history of peptic ulcer.
* Triplets.
* Use of prostaglandin inhibitors within 10 days prior to baseline.
* Personal history of chronic kidney, thyroid, liver or heart disease.
* Psychiatric or cognitive pathology that prevents understanding of the conditions of informed consent.
Minimum Eligible Age

18 Years

Maximum Eligible Age

50 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Instituto de Investigacion Sanitaria La Fe

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Alfredo Perales, PhD

Role: PRINCIPAL_INVESTIGATOR

Hospital Universitario La Fe

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Obstetrics Unit of La Fe University and Politechnic Hospital

Valencia, , Spain

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Spain

References

Explore related publications, articles, or registry entries linked to this study.

Ebrashy A, Ibrahim M, Marzook A, Yousef D. Usefulness of aspirin therapy in high-risk pregnant women with abnormal uterine artery Doppler ultrasound at 14-16 weeks pregnancy: randomized controlled clinical trial. Croat Med J. 2005 Oct;46(5):826-31.

Reference Type BACKGROUND
PMID: 16158479 (View on PubMed)

ACOG Committee on Practice Bulletins--Obstetrics. ACOG practice bulletin. Diagnosis and management of preeclampsia and eclampsia. Number 33, January 2002. Obstet Gynecol. 2002 Jan;99(1):159-67. doi: 10.1016/s0029-7844(01)01747-1.

Reference Type BACKGROUND
PMID: 16175681 (View on PubMed)

Akolekar R, de Cruz J, Foidart JM, Munaut C, Nicolaides KH. Maternal plasma soluble fms-like tyrosine kinase-1 and free vascular endothelial growth factor at 11 to 13 weeks of gestation in preeclampsia. Prenat Diagn. 2010 Mar;30(3):191-7. doi: 10.1002/pd.2433.

Reference Type BACKGROUND
PMID: 20101671 (View on PubMed)

Akolekar R, Syngelaki A, Sarquis R, Zvanca M, Nicolaides KH. Prediction of early, intermediate and late pre-eclampsia from maternal factors, biophysical and biochemical markers at 11-13 weeks. Prenat Diagn. 2011 Jan;31(1):66-74. doi: 10.1002/pd.2660.

Reference Type BACKGROUND
PMID: 21210481 (View on PubMed)

Akolekar R, Zaragoza E, Poon LC, Pepes S, Nicolaides KH. Maternal serum placental growth factor at 11 + 0 to 13 + 6 weeks of gestation in the prediction of pre-eclampsia. Ultrasound Obstet Gynecol. 2008 Nov;32(6):732-9. doi: 10.1002/uog.6244.

Reference Type BACKGROUND
PMID: 18956425 (View on PubMed)

Audibert F, Boucoiran I, An N, Aleksandrov N, Delvin E, Bujold E, Rey E. Screening for preeclampsia using first-trimester serum markers and uterine artery Doppler in nulliparous women. Am J Obstet Gynecol. 2010 Oct;203(4):383.e1-8. doi: 10.1016/j.ajog.2010.06.014. Epub 2010 Aug 5.

Reference Type BACKGROUND
PMID: 20691410 (View on PubMed)

Brosens I, Pijnenborg R, Vercruysse L, Romero R. The "Great Obstetrical Syndromes" are associated with disorders of deep placentation. Am J Obstet Gynecol. 2011 Mar;204(3):193-201. doi: 10.1016/j.ajog.2010.08.009. Epub 2010 Nov 20.

Reference Type BACKGROUND
PMID: 21094932 (View on PubMed)

Brown MA, Lindheimer MD, de Swiet M, Van Assche A, Moutquin JM. The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertens Pregnancy. 2001;20(1):IX-XIV. doi: 10.1081/PRG-100104165. No abstract available.

Reference Type BACKGROUND
PMID: 12044323 (View on PubMed)

Bujold E, Roberge S, Lacasse Y, Bureau M, Audibert F, Marcoux S, Forest JC, Giguere Y. Prevention of preeclampsia and intrauterine growth restriction with aspirin started in early pregnancy: a meta-analysis. Obstet Gynecol. 2010 Aug;116(2 Pt 1):402-414. doi: 10.1097/AOG.0b013e3181e9322a.

Reference Type BACKGROUND
PMID: 20664402 (View on PubMed)

Imperiale TF, Petrulis AS. A meta-analysis of low-dose aspirin for the prevention of pregnancy-induced hypertensive disease. JAMA. 1991 Jul 10;266(2):260-4.

Reference Type BACKGROUND
PMID: 1829118 (View on PubMed)

Keegan DA, Krey LC, Chang HC, Noyes N. Increased risk of pregnancy-induced hypertension in young recipients of donated oocytes. Fertil Steril. 2007 Apr;87(4):776-81. doi: 10.1016/j.fertnstert.2006.08.105. Epub 2007 Jan 29.

Reference Type BACKGROUND
PMID: 17258714 (View on PubMed)

Klatsky PC, Delaney SS, Caughey AB, Tran ND, Schattman GL, Rosenwaks Z. The role of embryonic origin in preeclampsia: a comparison of autologous in vitro fertilization and ovum donor pregnancies. Obstet Gynecol. 2010 Dec;116(6):1387-1392. doi: 10.1097/AOG.0b013e3181fb8e59.

Reference Type BACKGROUND
PMID: 21099607 (View on PubMed)

Levine RJ, Lam C, Qian C, Yu KF, Maynard SE, Sachs BP, Sibai BM, Epstein FH, Romero R, Thadhani R, Karumanchi SA; CPEP Study Group. Soluble endoglin and other circulating antiangiogenic factors in preeclampsia. N Engl J Med. 2006 Sep 7;355(10):992-1005. doi: 10.1056/NEJMoa055352.

Reference Type BACKGROUND
PMID: 16957146 (View on PubMed)

Le Ray C, Scherier S, Anselem O, Marszalek A, Tsatsaris V, Cabrol D, Goffinet F. Association between oocyte donation and maternal and perinatal outcomes in women aged 43 years or older. Hum Reprod. 2012 Mar;27(3):896-901. doi: 10.1093/humrep/der469. Epub 2012 Jan 16.

Reference Type BACKGROUND
PMID: 22252087 (View on PubMed)

Lambers MJ, Groeneveld E, Hoozemans DA, Schats R, Homburg R, Lambalk CB, Hompes PG. Lower incidence of hypertensive complications during pregnancy in patients treated with low-dose aspirin during in vitro fertilization and early pregnancy. Hum Reprod. 2009 Oct;24(10):2447-50. doi: 10.1093/humrep/dep245. Epub 2009 Jul 16.

Reference Type BACKGROUND
PMID: 19608566 (View on PubMed)

Nicolaides KH. A model for a new pyramid of prenatal care based on the 11 to 13 weeks' assessment. Prenat Diagn. 2011 Jan;31(1):3-6. doi: 10.1002/pd.2685. No abstract available.

Reference Type BACKGROUND
PMID: 21210474 (View on PubMed)

Pecks U, Maass N, Neulen J. Oocyte donation: a risk factor for pregnancy-induced hypertension: a meta-analysis and case series. Dtsch Arztebl Int. 2011 Jan;108(3):23-31. doi: 10.3238/arztebl.2011.0023. Epub 2011 Jan 21.

Reference Type BACKGROUND
PMID: 21285999 (View on PubMed)

Poon LC, Akolekar R, Lachmann R, Beta J, Nicolaides KH. Hypertensive disorders in pregnancy: screening by biophysical and biochemical markers at 11-13 weeks. Ultrasound Obstet Gynecol. 2010 Jun;35(6):662-70. doi: 10.1002/uog.7628.

Reference Type BACKGROUND
PMID: 20232288 (View on PubMed)

Ruano R, Fontes RS, Zugaib M. Prevention of preeclampsia with low-dose aspirin -- a systematic review and meta-analysis of the main randomized controlled trials. Clinics (Sao Paulo). 2005 Oct;60(5):407-14. doi: 10.1590/s1807-59322005000500010. Epub 2005 Oct 24.

Reference Type BACKGROUND
PMID: 16254678 (View on PubMed)

Salha O, Sharma V, Dada T, Nugent D, Rutherford AJ, Tomlinson AJ, Philips S, Allgar V, Walker JJ. The influence of donated gametes on the incidence of hypertensive disorders of pregnancy. Hum Reprod. 1999 Sep;14(9):2268-73. doi: 10.1093/humrep/14.9.2268.

Reference Type BACKGROUND
PMID: 10469693 (View on PubMed)

Simhan HN, Caritis SN. Prevention of preterm delivery. N Engl J Med. 2007 Aug 2;357(5):477-87. doi: 10.1056/NEJMra050435. No abstract available.

Reference Type BACKGROUND
PMID: 17671256 (View on PubMed)

Smith GC, Stenhouse EJ, Crossley JA, Aitken DA, Cameron AD, Connor JM. Early pregnancy levels of pregnancy-associated plasma protein a and the risk of intrauterine growth restriction, premature birth, preeclampsia, and stillbirth. J Clin Endocrinol Metab. 2002 Apr;87(4):1762-7. doi: 10.1210/jcem.87.4.8430.

Reference Type BACKGROUND
PMID: 11932314 (View on PubMed)

Soderstrom-Anttila V. Pregnancy and child outcome after oocyte donation. Hum Reprod Update. 2001 Jan-Feb;7(1):28-32. doi: 10.1093/humupd/7.1.28.

Reference Type BACKGROUND
PMID: 11212070 (View on PubMed)

Soderstrom-Anttila V, Tiitinen A, Foudila T, Hovatta O. Obstetric and perinatal outcome after oocyte donation: comparison with in-vitro fertilization pregnancies. Hum Reprod. 1998 Feb;13(2):483-90. doi: 10.1093/humrep/13.2.483.

Reference Type BACKGROUND
PMID: 9557862 (View on PubMed)

Groeneveld E, Lambers MJ, Lambalk CB, Broeze KA, Haapsamo M, de Sutter P, Schoot BC, Schats R, Mol BW, Hompes PG. Preconceptional low-dose aspirin for the prevention of hypertensive pregnancy complications and preterm delivery after IVF: a meta-analysis with individual patient data. Hum Reprod. 2013 Jun;28(6):1480-8. doi: 10.1093/humrep/det022. Epub 2013 Mar 25.

Reference Type BACKGROUND
PMID: 23528915 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

PrOvAS001

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Aspirin and Preeclampsia
NCT04479072 RECRUITING PHASE4