Model-based Versus Traditional Warfarin Dosing in Children

NCT ID: NCT02475863

Last Updated: 2015-06-22

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

45 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-08-31

Study Completion Date

2018-01-31

Brief Summary

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This study compares the clinical effectiveness of a new algorithm (model-based warfarin dosing) with standard practice (doctor's own judgement and intuition) designed to determine the most appropriate anticoagulant dose of warfarin in children after congenital heart surgery.

Detailed Description

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Warfarin is widely used in children after heart surgery in order to prevent complications that may arise due to blood clots forming in unwanted places - for example in the brain causing a stroke. If too little warfarin is given, there is a risk that clots may form. If the dose is too high, bleeding will result.

Traditionally, the approach to dosing warfarin in children has been to select a starting dose according to standard guidelines and to then adjust the doses for each child by monitoring the INR (which measures how quickly blood clots). However, a person's make up as well as external factors, such as age, weight, diet and genetics can affect warfarin dosing and this makes controlling the dose and hence controlling the INR, more difficult. Recently however, a more sophisticated dosing model has been developed by researchers which takes into account some of these factors. The model is designed to help doctors select the best dose of warfarin for children by individualising prescriptions.

The aim of the proposed research is, therefore, to compare the model based warfarin dosing with the traditional approach to warfarin dosing in children who have undergone congenital heart surgery. The research will involve children who are started on warfarin for the first time and also children who are already receiving ongoing warfarin therapy.

Conditions

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Congenital Heart Defects

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

NONE

Study Groups

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Warfarin dosing aid

A pharmacokinetic/pharmacodynamic model-based dosing algorithm for warfarin.

Group Type EXPERIMENTAL

Warfarin Dosing Aid

Intervention Type DEVICE

A pharmacokinetic/pharmacodynamic model-based dosing algorithm for warfarin

Standard practice

Dosing adjustments according to the normal unit protocol

Group Type ACTIVE_COMPARATOR

Standard Practice

Intervention Type OTHER

Warfarin dose adjustments according to standard unit protocol

Interventions

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Warfarin Dosing Aid

A pharmacokinetic/pharmacodynamic model-based dosing algorithm for warfarin

Intervention Type DEVICE

Standard Practice

Warfarin dose adjustments according to standard unit protocol

Intervention Type OTHER

Eligibility Criteria

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Exclusion Criteria

1. Patients aged over 18 years who are treated as 'adults'.
2. Children who refuse assent, parents who refuse consent.
3. Any significant disease or disorder which, in the opinion of the direct care team, may either put the participant at risk because of study participation or adversely affect the participants' ability to participate in the study.
Minimum Eligible Age

1 Day

Maximum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospitals, Leicester

OTHER

Sponsor Role collaborator

De Montfort University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hussain Mulla, PhD

Role: PRINCIPAL_INVESTIGATOR

Univesity Hospitals Leicester NHS Trust

Central Contacts

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Hussain Mulla, PhD

Role: CONTACT

0116 2563323

Peter Rivers, PhD

Role: CONTACT

0116 2577039 ext. 7039

Other Identifiers

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DMU-1527

Identifier Type: -

Identifier Source: org_study_id

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