Deep Vein Thrombosis Prophylaxis Adherence: Enoxaparin vs Rivaroxaban

NCT ID: NCT04169269

Last Updated: 2020-01-18

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

PHASE4

Total Enrollment

128 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-13

Study Completion Date

2021-12-31

Brief Summary

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The objective of this study is to compare oral rivaroxaban with injectable enoxaparin in orthopaedic trauma patients to determine if orally administered rivaroxaban once daily carries greater compliance and overall satisfaction than enoxaparin self-administered by subcutaneous injection once daily.

Detailed Description

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This study is a randomized, controlled trial of orthopaedic trauma patients presenting to a single academic level one trauma center that require an extended course of venous thromboembolism event chemoprophylaxis. The goal is to compare oral rivaroxaban with our standard-of-care, injectable enoxaparin in orthopaedic trauma patients to determine if orally administered rivaroxaban once daily carries greater compliance and overall satisfaction than enoxaparin self-administered by subcutaneous injection once daily.

All patients included in the study would be treated with the standard enoxaparin 40 milligram injection while an inpatient. Upon hospital discharge, those requiring extended venous thromboembolism event chemoprophylaxis will be randomized to receive 20 days of either self-injected enoxaparin 40 milligrams or oral rivaroxaban,10 milligrams, a non-vitamin K oral anticoagulant. Both groups will then receive our current standard of care, aspirin 81 milligrams once daily for the remaining 3 weeks, for a total of 6 weeks of venous thromboembolism event chemoprophylaxis. Routine postoperative care will be provided by the treating surgeon.

Conditions

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Deep Vein Thrombosis Venous Thromboembolism

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants are randomized to one of two medications.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Enoxaparin

enoxaparin injectable, 40 milligram subcutaneous injection daily for 20 days

Group Type ACTIVE_COMPARATOR

Enoxaparin 40 milligram/0.4 milliliter Injectable Syringe 0.4 milliliters

Intervention Type DRUG

anticoagulant, subcutaneous injection

Rivaroxaban

rivaroxaban oral 10 milligram tablet daily for 20 days

Group Type ACTIVE_COMPARATOR

Rivaroxaban 10 milligram Oral Tablet

Intervention Type DRUG

anticoagulant, oral

Interventions

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Enoxaparin 40 milligram/0.4 milliliter Injectable Syringe 0.4 milliliters

anticoagulant, subcutaneous injection

Intervention Type DRUG

Rivaroxaban 10 milligram Oral Tablet

anticoagulant, oral

Intervention Type DRUG

Other Intervention Names

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Lovenox Xarelto

Eligibility Criteria

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Inclusion Criteria

* • Orthopaedic trauma patients deemed by the attending, treating surgeon to require an extended duration of venous thromboembolism chemoprophylaxis beyond that provided as an inpatient.

* Patients being discharged directly to home.

Exclusion Criteria

* • Patients being discharged to a rehabilitation center or a skilled nursing facility.

* A contraindication to anticoagulation such as traumatic or other hemorrhage, as determined by the treating surgeon and/or consulting services.
* Ongoing venous thromboembolism treatment or extended prophylaxis (i.e. past history of multiple deep vein thrombosis/pulmonary embolism) for current or recent deep vein thrombosis, pulmonary embolism or other coagulopathic disorder
* Chronic anticoagulation for atrial fibrillation or other medical disorder requiring chronic anticoagulation therapy.
* Perceived low-risk patients requiring only aspirin or no pharmacological venous thromboembolism prophylaxis.
* Pregnant, prisoner, under 18 years old, or do not speak English
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Orthopaedic Trauma Association

OTHER

Sponsor Role collaborator

Florida Orthopaedic Institute

NETWORK

Sponsor Role lead

Responsible Party

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Barbara Steverson

Director of Research, Orthopaedic Trauma Service

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hassan Mir, MD

Role: PRINCIPAL_INVESTIGATOR

Florida Orthopaedic Institute

Locations

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Florida Orthopaedic Institute

Tampa, Florida, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Barbara Steverson, MHA

Role: CONTACT

8132532068

Randi Alexander, MPH

Role: CONTACT

8132532068

Facility Contacts

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Barbara Steverson, MHA

Role: primary

813-253-2068

Randi Alexander, MPH

Role: backup

8132532068

References

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John MP 2nd, Streufert BD, Downes K, Chase CB, Mir HR. A Prospective Randomized Controlled Trial Comparing Enoxaparin & Rivaroxaban for Venous Thromboembolism Prophylaxis in Orthopaedic Trauma. J Orthop Trauma. 2022 Dec 1;36(12):615-622. doi: 10.1097/BOT.0000000000002454.

Reference Type DERIVED
PMID: 36399673 (View on PubMed)

Other Identifiers

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20192684

Identifier Type: -

Identifier Source: org_study_id

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