Comparison of Accidents and Their Circumstances With Oral Anticoagulants

NCT ID: NCT02376777

Last Updated: 2017-06-28

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

Total Enrollment

4162 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-04-30

Study Completion Date

2017-06-30

Brief Summary

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Differences in efficacy and safety between new oral anticoagulants (NOAC) and vitamin K antagonist (VKA) in real practice remain uncertain.

The few existing ambulatory studies did not answer all NOAC specific issues, such as prescription habits and motives, patients characteristics, biological monitoring, as well as the occurrence of major and minor thromboembolic events, especially in France where warfarin is less frequently prescribed.

Therefore, in order to describe clinical and follow up characteristics of patients receiving oral anticoagulants, the investigators will set up a national prospective cohort to compare the occurrence of thromboembolic events between VKA and NOAC in primary care.

Detailed Description

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The method includes the use of a national prospective observational cohort, involving 444 general practitioners From april to december 2014, health data of any adult patient consulting a general practitioner and receiving an oral anticoagulant treatment has been entered in a database. Each patient received an information for agreement to participate to the study (agreement for stastical analysis of their health data during one year follow up).

In March 2015, half of those patients will be chosen (stratification), using a matched stratification process, and will be followed up over one year. Every three months, data regarding the occurrence of therapeutics changes, episodes of excessive bleeding, and thromboembolic events will be collected by general practitioners.

The data will be analysed by: - describing the characteristics of patients receiving oral anticoagulant treatment; - describing the changes of medications over the year ; - comparing the occurrence of episodes of excessive bleeding ; - comparing the occurrence of thromboembolic events in patients using VKA versus patients using NOAC.

Conditions

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Cardiovascular Complications Hemorrhagic Disorders Embolism and Thrombosis

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patient receiving NOAC

Follow up of patients receiving new oral anticoagulants (NOAC) medication

Follow up

Intervention Type OTHER

each three months during one year of follow up, general practioners will entered health data in database (hemorrhagic events, changes of medication, biological data...)

Patient receiving VKA

Follow up of patients receiving vitamin K antagonist (VKA) medication

Follow up

Intervention Type OTHER

each three months during one year of follow up, general practioners will entered health data in database (hemorrhagic events, changes of medication, biological data...)

Interventions

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Follow up

each three months during one year of follow up, general practioners will entered health data in database (hemorrhagic events, changes of medication, biological data...)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patient consulting a GP
* Patient Whatever the reason for consultation
* Aged \>18 years
* Receiving oral anticoagulant treatment by NOAC (apixaban, dabigatran or rivaroxaban) or VKA (acenocoumarol, fluindione, or warfarin)
* Whatever the indication (prevention or treatment).
* Having the following indications for anticoagulant treatment : non-valvular atrial fibrillation, prevention of DVT / PE (excluding orthopedic post-surgery) treatment DVT / PE

Exclusion Criteria

* Aged \<18 years
* Receiving concomitant injectable anticoagulant treatment (including relay phase)
* Follow up impossible.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Floralis

INDUSTRY

Sponsor Role collaborator

University Hospital, Grenoble

OTHER

Sponsor Role collaborator

CNGE IRMG Association

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Joël COGNEAU, MD

Role: PRINCIPAL_INVESTIGATOR

IRMG

Paul FRAPPE, MD

Role: STUDY_DIRECTOR

University of Saint-Etienne

Jean-Pierre JACQUET, MD

Role: STUDY_DIRECTOR

University of Grenoble

Jean-Luc BOSSON, MD PhD

Role: STUDY_DIRECTOR

University of Grenoble

François Lacoin, MD

Role: STUDY_DIRECTOR

IRMG

Locations

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Office-based practitioner

Albens, , France

Site Status

Office-based practitioner

Bordeaux, , France

Site Status

Office-based practitioner

Chablis, , France

Site Status

Office-based general practitioner

Dessenheim, , France

Site Status

Office-based general practitioner

Dijon, , France

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Office-based practitioner

Flumet, , France

Site Status

Office-based practitioner

Gémenos, , France

Site Status

Office-based general practitioner

Grenay, , France

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Office-based general practitioner

Guesnain, , France

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Office-based general practitioner

Hatten, , France

Site Status

Office-based practitioner

Hinx, , France

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Office-based practitioner

La Madeleine, , France

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Office-based practitioner

Les Marches, , France

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Office-based practitioner

Limoges, , France

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Office-based practitioner

Mulsanne, , France

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Office-based practitioner

Outreau, , France

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Office-based general practitioner

Paris, , France

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Office-based general practitioner

Rupt-sur-Moselle, , France

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Office-based general practitioner

Saint-Amant-Tallende, , France

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Office-based practitioner

Saint-Etienne, , France

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Office-based practitioner

Saint-Georges-dOrques, , France

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Office-based practitioner

Saint-Jean-d'Arvey, , France

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Office-based practitioner

Saint-Jean-de-Braye, , France

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Office-based practitioner

Saultain, , France

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Office-based general practitioner

Sellières, , France

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Office-based practitioner

Seraincourt, , France

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Office-based general practitioner

Soisy-sous-Montmorency, , France

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Office-based general practioner

Strasbourg, , France

Site Status

Office-based practitioner

Tournus, , France

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Office-based general practitioner

Tours, , France

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Office-based practitioner

Villeurbanne, , France

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Office-based practitioner

Vitry-sur-Seine, , France

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Office-based general practitioner

Vourey, , France

Site Status

Countries

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France

References

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Kearon C. Natural history of venous thromboembolism. Circulation. 2003 Jun 17;107(23 Suppl 1):I22-30. doi: 10.1161/01.CIR.0000078464.82671.78.

Reference Type BACKGROUND
PMID: 12814982 (View on PubMed)

You JJ, Singer DE, Howard PA, Lane DA, Eckman MH, Fang MC, Hylek EM, Schulman S, Go AS, Hughes M, Spencer FA, Manning WJ, Halperin JL, Lip GYH. Antithrombotic therapy for atrial fibrillation: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):e531S-e575S. doi: 10.1378/chest.11-2304.

Reference Type BACKGROUND
PMID: 22315271 (View on PubMed)

Mantilla CB, Horlocker TT, Schroeder DR, Berry DJ, Brown DL. Frequency of myocardial infarction, pulmonary embolism, deep venous thrombosis, and death following primary hip or knee arthroplasty. Anesthesiology. 2002 May;96(5):1140-6. doi: 10.1097/00000542-200205000-00017.

Reference Type BACKGROUND
PMID: 11981154 (View on PubMed)

Galanaud JP, Sevestre-Pietri MA, Bosson JL, Laroche JP, Righini M, Brisot D, Boge G, van Kien AK, Gattolliat O, Bettarel-Binon C, Gris JC, Genty C, Quere I; OPTIMEV-SFMV Investigators. Comparative study on risk factors and early outcome of symptomatic distal versus proximal deep vein thrombosis: results from the OPTIMEV study. Thromb Haemost. 2009 Sep;102(3):493-500. doi: 10.1160/TH09-01-0053.

Reference Type BACKGROUND
PMID: 19718469 (View on PubMed)

Douketis J, Tosetto A, Marcucci M, Baglin T, Cosmi B, Cushman M, Kyrle P, Poli D, Tait RC, Iorio A. Risk of recurrence after venous thromboembolism in men and women: patient level meta-analysis. BMJ. 2011 Feb 24;342:d813. doi: 10.1136/bmj.d813.

Reference Type BACKGROUND
PMID: 21349898 (View on PubMed)

Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD, Camm AJ, Weitz JI, Lewis BS, Parkhomenko A, Yamashita T, Antman EM. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014 Mar 15;383(9921):955-62. doi: 10.1016/S0140-6736(13)62343-0. Epub 2013 Dec 4.

Reference Type BACKGROUND
PMID: 24315724 (View on PubMed)

Miller CS, Grandi SM, Shimony A, Filion KB, Eisenberg MJ. Meta-analysis of efficacy and safety of new oral anticoagulants (dabigatran, rivaroxaban, apixaban) versus warfarin in patients with atrial fibrillation. Am J Cardiol. 2012 Aug 1;110(3):453-60. doi: 10.1016/j.amjcard.2012.03.049. Epub 2012 Apr 24.

Reference Type BACKGROUND
PMID: 22537354 (View on PubMed)

Adam SS, McDuffie JR, Ortel TL, Williams JW Jr. Comparative effectiveness of warfarin and new oral anticoagulants for the management of atrial fibrillation and venous thromboembolism: a systematic review. Ann Intern Med. 2012 Dec 4;157(11):796-807. doi: 10.7326/0003-4819-157-10-201211200-00532.

Reference Type BACKGROUND
PMID: 22928173 (View on PubMed)

Uchino K, Hernandez AV. Dabigatran association with higher risk of acute coronary events: meta-analysis of noninferiority randomized controlled trials. Arch Intern Med. 2012 Mar 12;172(5):397-402. doi: 10.1001/archinternmed.2011.1666. Epub 2012 Jan 9.

Reference Type BACKGROUND
PMID: 22231617 (View on PubMed)

Larsen TB, Rasmussen LH, Skjoth F, Due KM, Callreus T, Rosenzweig M, Lip GY. Efficacy and safety of dabigatran etexilate and warfarin in "real-world" patients with atrial fibrillation: a prospective nationwide cohort study. J Am Coll Cardiol. 2013 Jun 4;61(22):2264-73. doi: 10.1016/j.jacc.2013.03.020. Epub 2013 Apr 3.

Reference Type BACKGROUND
PMID: 23562920 (View on PubMed)

Schulman S, Kearon C; Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost. 2005 Apr;3(4):692-4. doi: 10.1111/j.1538-7836.2005.01204.x.

Reference Type BACKGROUND
PMID: 15842354 (View on PubMed)

Gaboreau Y, Frappe P, Vermorel C, Foote A, Bosson JL, Pernod G; CACAO study investigators. Oral anticoagulant safety in family practice: prognostic accuracy of Bleeding Risk Scores (from the CACAO study). Fam Pract. 2024 Feb 28;41(1):9-17. doi: 10.1093/fampra/cmad121.

Reference Type DERIVED
PMID: 38281089 (View on PubMed)

Frappe P, Cogneau J, Gaboreau Y, Abenhaim N, Bayen M, Guichard C, Jacquet JP, Lacoin F, Liebart S, Bertoletti L, Bosson JL; CACAO study investigators. Anticoagulants' Safety and Effectiveness in General Practice: A Nationwide Prospective Cohort Study. Ann Fam Med. 2020 Mar;18(2):131-138. doi: 10.1370/afm.2495.

Reference Type DERIVED
PMID: 32152017 (View on PubMed)

Frappe P, Cogneau J, Gaboreau Y, Abenhaim N, Bayen M, Calafiore M, Guichard C, Jacquet JP, Lacoin F, Bertoletti L; CACAO study investigators. Areas of improvement in anticoagulant safety. Data from the CACAO study, a cohort in general practice. PLoS One. 2017 Apr 6;12(4):e0175167. doi: 10.1371/journal.pone.0175167. eCollection 2017.

Reference Type DERIVED
PMID: 28384199 (View on PubMed)

Other Identifiers

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DCIC 15 09

Identifier Type: -

Identifier Source: org_study_id

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