Once Daily Enoxaparin for Outpatient Treatment of Acute DVT and/or Pulmonary Embolism - Full Text View

Purpose

To investigate the efficacy and safety of once daily enoxaparin as a "bridge" to warfarin for the outpatient treatment of acute deep venous thrombosis or pulmonary embolism.

Condition	Intervention
Deep Vein Thrombosis Pulmonary Embolism	Drug: Enoxaparin

Study Type:	Interventional
Study Design:	Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment
Official Title:	Once Daily Enoxaparin for Outpatient Treatment of Acute Deep Venous Thrombosis and/or Pulmonary Embolism

Resource links provided by NLM:

MedlinePlus related topics: Deep Vein Thrombosis Pulmonary Embolism

Drug Information available for: Enoxaparin sodium

U.S. FDA Resources

Further study details as provided by Brigham and Women's Hospital:

Primary Outcome Measures:

Major Bleeding Complication [ Time Frame: 30 Days ] [ Designated as safety issue: No ]
Major bleeding complication as defined as spinal, retroperitoneal, or intracranial bleeding; drop in hemoglobin ≥2g/dl or transfusion ≥2U or surgical or medical intervention, death related to bleeding.
Recurrent VTE [ Time Frame: 30 Days ] [ Designated as safety issue: No ]
Major clotting complication (recurrent VTE) as defined as recurrent acute pulmonary embolism confirmed on chest CT or recurrent deep vein thrombosis in the contralateral extremity confirmed with venous ultrasound or CT scan while on once daily enoxaparin therapy.
Death [ Time Frame: 30 Days ] [ Designated as safety issue: No ]

Enrollment:	40
Study Start Date:	May 2006
Study Completion Date:	December 2008
Primary Completion Date:	April 2008 (Final data collection date for primary outcome measure)

Arms	Assigned Interventions
Enoxaparin	Drug: Enoxaparin Patient takes 1.5 mg per kilogram, once daily, subcutaneous injections until INR is therapeutic, then medication is stopped. Other Name: Lovenox

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Eligibility

Ages Eligible for Study:	18 Years and older
Genders Eligible for Study:	Both
Accepts Healthy Volunteers:	No

Criteria

Inclusion Criteria:

Symptomatic acute deep venous thrombosis and/or pulmonary embolism confirmed by venous ultrasound and/or CT scan.
Pulmonary embolism patients with normal right ventricular size on chest CT scan.
Age greater than 18 years
Anticipated discharge within 72 hours of admission
Written informed consent

Exclusion Criteria:

Pregnancy or intend to become pregnant
Patients requiring ongoing hospitalization > 72 hours
Hypersensitivity to heparin, pork products or enoxaparin
Creatinine > 2.0 mg/dl
Recurrent DVT and/or PE with oral anticoagulation
Surgery or medical procedure planned during the study that may pose a significant bleeding risk
Prior history of heparin-induced thrombocytopenia
Inability to participate for follow up appointments and study visits
Life expectancy < 30 days
High risk of bleeding:
1. Active major bleeding within 30 days by GUSTO criteria
2. History of intracranial bleeding
3. Major surgery or trauma within 10 days
4. Head injury requiring hospitalization within 1 year
5. Intracranial tumor
6. Neurosurgery or non-cataract ophthalmologic surgery within 1 month
7. Thrombocytopenia

Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00413374

Locations

United States, Massachusetts
Brigham and Women's Hospital
Boston, Massachusetts, United States, 02115

Sponsors and Collaborators

Brigham and Women's Hospital

Sanofi

Investigators

Principal Investigator:

Samuel Z. Goldhaber, MD

Brigham and Women's Hospital

More Information

Additional Information:

North American Thrombosis Forum This link exits the ClinicalTrials.gov site

Publications:

Merli G, Spiro TE, Olsson CG, Abildgaard U, Davidson BL, Eldor A, Elias D, Grigg A, Musset D, Rodgers GM, Trowbridge AA, Yusen RD, Zawilska K; Enoxaparin Clinical Trial Group. Subcutaneous enoxaparin once or twice daily compared with intravenous unfractionated heparin for treatment of venous thromboembolic disease. Ann Intern Med. 2001 Feb 6;134(3):191-202.

Beckman JA, Dunn K, Sasahara AA, Goldhaber SZ. Enoxaparin monotherapy without oral anticoagulation to treat acute symptomatic pulmonary embolism. Thromb Haemost. 2003 Jun;89(6):953-8.

Kucher N, Quiroz R, McKean S, Sasahara AA, Goldhaber SZ. Extended enoxaparin monotherapy for acute symptomatic pulmonary embolism. Vasc Med. 2005 Nov;10(4):251-6.

Kucher N, Rossi E, De Rosa M, Goldhaber SZ. Prognostic role of echocardiography among patients with acute pulmonary embolism and a systolic arterial pressure of 90 mm Hg or higher. Arch Intern Med. 2005 Aug 8-22;165(15):1777-81.

Schoepf UJ, Kucher N, Kipfmueller F, Quiroz R, Costello P, Goldhaber SZ. Right ventricular enlargement on chest computed tomography: a predictor of early death in acute pulmonary embolism. Circulation. 2004 Nov 16;110(20):3276-80. Epub 2004 Nov 8.

Responsible Party:	Samuel Z.Goldhaber, MD, Director, VTE Research Group, Brigham and Women's Hospital
ClinicalTrials.gov Identifier:	NCT00413374 History of Changes
Other Study ID Numbers:	2006-P-000082
Study First Received:	December 15, 2006
Results First Received:	June 22, 2011
Last Updated:	April 27, 2012
Health Authority:	United States: Food and Drug Administration United States: Institutional Review Board

Keywords provided by Brigham and Women's Hospital:

Lovenox
Enoxaparin
Prophylaxis
Pulmonary Embolism

Acute Deep Vein Thrombosis
Venous Thrombosis
Thrombosis
Anticoagulation

Additional relevant MeSH terms:

Embolism
Pulmonary Embolism
Thrombosis
Venous Thrombosis
Venous Thromboembolism
Embolism and Thrombosis
Vascular Diseases
Cardiovascular Diseases
Lung Diseases
Respiratory Tract Diseases

Thromboembolism
Enoxaparin
Anticoagulants
Hematologic Agents
Therapeutic Uses
Pharmacologic Actions
Fibrinolytic Agents
Fibrin Modulating Agents
Molecular Mechanisms of Pharmacological Action
Cardiovascular Agents

ClinicalTrials.gov processed this record on May 21, 2013