Predicting Bleeding Risk on Anticoagulant Therapy for Venous Thromboembolism
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Purpose
The main objective of the study is to develop or validate a clinical prediction rule for major bleeding in patients on oral anticoagulant therapy who have been safely anticoagulated without bleeding or venous thromboembolism (VTE) recurrence for at least 3 months since diagnosis and are being considered for long-term oral anticoagulant therapy.
| Condition |
|---|
|
Venous Thromboembolism |
| Study Type: | Observational |
| Study Design: | Observational Model: Cohort Time Perspective: Prospective |
| Official Title: | Development and Validation of Clinical Prediction Rules for Bleeding for Patients on Anticoagulant Therapy for Venous Thromboembolism |
- Major bleeding (International Society on Thrombosis and Haemostasis(ISTH) criteria) [ Time Frame: ongoing for 3-7 years with follow-up phone calls at 6-month intervals ] [ Designated as safety issue: Yes ]
- Clinically relevant non-major bleeding (International Society on Thrombosis and Haemostasis(ISTH) criteria) [ Time Frame: ongoing for 3-7 years with follow-up phone calls at 6-month intervals ] [ Designated as safety issue: Yes ]
- recurrent venous thromboembolism [ Time Frame: ongoing for 3-7 years with follow-up phone calls at 6-month intervals ] [ Designated as safety issue: Yes ]
- death (all causes) [ Time Frame: ongoing for 3-7 years with follow-up phone calls at 6-month intervals ] [ Designated as safety issue: Yes ]
Biospecimen Retention: Samples With DNA
Subjects may consent to optional DNA and plasma banking
| Estimated Enrollment: | 2450 |
| Study Start Date: | September 2008 |
| Estimated Study Completion Date: | September 2013 |
| Estimated Primary Completion Date: | September 2013 (Final data collection date for primary outcome measure) |
Oral anticoagulant therapy for patients who are at risk of developing blood clotting problems is used by between 400,000-600,000 Canadians annually. The use of this drug represents the most common cause of patient adverse medical outcomes due to medical errors. Furthermore, many patients have adverse outcomes using these drugs because physicians are not able to predict which patients are likely to have bleeding outcomes. Much effort has gone into developing ways to predict which patients are at risk of clotting but almost no work has gone into ways of predicting which patients would be at high risk of bleeding. This information is required to balance off the risk-benefits and to enable physicians and patients to understand the risks and benefits of taking these medications. Our study will develop a tool that can be used to predict bleeding risk in patients taking oral anticoagulant therapy. It will enable more informed decision making by both physicians and patients and will result in better control of the use of these drugs. In addition, patients who are at risk for being difficult to accurately dose on oral anticoagulants will be identified through our study.
Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
| Sampling Method: | Non-Probability Sample |
Outpatients being treated for venous thromboembolism
Inclusion Criteria:
- >=18 years old
- provoked or unprovoked venous thromboembolism
- objectively confirmed venous thromboembolism
- treated with an oral anticoagulant(vitamin K antagonist or new oral anticoagulant) for at least 3 months with plans to continue long-term
- if taking a vitamin K antagonist; INR target is between 2.0-3.0
- if taking a vitamin K antagonist; must have taken it for the last 3 consecutive weeks (minimum)
Exclusion Criteria:
- major bleeding while taking oral anticoagulants
- active bleeding at study enrollment
- active cancer - current or at the time of VTE diagnosis
- unable to provide written informed consent
- refusal to provide written informed consent
Contacts and Locations| Contact: Lynne Cullen, RN | 613-789-5555 ext 17373 | lycullen@ohri.ca |
| Contact: Anne Marie Clement, RN, CCRP | 613 798-5555 ext 18841 | amclement@ohri.ca |
| United States, Massachusetts | |
| Lahey Clinic | Recruiting |
| Burlington, Massachusetts, United States | |
| Contact: Simon Mantha, MD | |
| Principal Investigator: Simon Mantha, MD | |
| United States, Michigan | |
| Henry Ford Health System | Recruiting |
| Detroit, Michigan, United States, 48202 | |
| Principal Investigator: Scott Kaatz, MD | |
| Canada, Nova Scotia | |
| Queen Elizabeth II Health Sciences Centre | Recruiting |
| Halifax, Nova Scotia, Canada, B3H 1V7 | |
| Principal Investigator: David Anderson, MD | |
| Canada, Ontario | |
| Hamilton General Hospital | Recruiting |
| Hamilton, Ontario, Canada, L8L 2X2 | |
| Principal Investigator: Sam Schulman, MD | |
| St. Joseph's Healthcare Hamilton | Withdrawn |
| Hamilton, Ontario, Canada, L8N 4A6 | |
| Hamilton Health Sciences | Recruiting |
| Hamilton, Ontario, Canada, L8V 1C3 | |
| Principal Investigator: Clive Kearon, MB, PhD | |
| London Health Sciences Centre | Recruiting |
| London, Ontario, Canada, N6A 4G5 | |
| Principal Investigator: Michael Kovacs, MD | |
| Sub-Investigator: Alejandro Lazo-Langner, MD, MSc | |
| Ottawa Hospital Research Institute | Recruiting |
| Ottawa, Ontario, Canada, K1Y 4E9 | |
| Contact: Lynne Cullen, RN 613-789-5555 ext 17373 lycullen@ohri.ca | |
| Contact: Anne Marie Clement, RN,CCRP 613 798-5555 ext 19841 amclement@ohri.ca | |
| Principal Investigator: Phil Wells, MD, MSc | |
| Canada, Quebec | |
| Sir Mortimer B Davis Jewish General Hospital | Recruiting |
| Montreal, Quebec, Canada, H3T 1E2 | |
| Principal Investigator: Susan Kahn, MD | |
| Montreal General Hospital | Recruiting |
| Montreal, Quebec, Canada, H3G 1A4 | |
| Principal Investigator: Susan Solymoss, MD | |
| Sub-Investigator: Muna Al-Tarshi | |
| Hopital du Sacre Coeur de Montreal | Recruiting |
| Montreal, Quebec, Canada, H4J 1C5 | |
| Principal Investigator: Isabelle Chagnon, MD | |
| Sub-Investigator: Nathalie Routhier, MD | |
| United Kingdom | |
| Oxford Haemophilia and Thrombosis Centre, Churchill Hospital | Recruiting |
| Oxford, United Kingdom, 0X3 7LJ | |
| Contact: David Keeling +44 (0)1865 225318 david.keeling@ndm.ox.ac.uk | |
| Principal Investigator: David Keeling | |
| Principal Investigator: | Phil S Wells, MD, MSc | Ottawa Hospital Research Institute |
More Information
No publications provided
| Responsible Party: | Phil Wells / Chair, Department of Medicine, Ottawa Hospital Research Institute |
| ClinicalTrials.gov Identifier: | NCT00788736 History of Changes |
| Other Study ID Numbers: | OHREB 2008270-01H, NA 6415 |
| Study First Received: | November 10, 2008 |
| Last Updated: | June 23, 2011 |
| Health Authority: | Canada: Ethics Review Committee |
Keywords provided by Ottawa Hospital Research Institute:
|
venous thromboembolism long-term oral anticoagulant therapy warfarin bleeding risk clinical prediction rule |
predictors deep vein thrombosis pulmonary embolism vitamin k antagonist side effect |
Additional relevant MeSH terms:
|
Hemorrhage Thromboembolism Venous Thromboembolism Venous Thrombosis Pathologic Processes Embolism and Thrombosis Vascular Diseases |
Cardiovascular Diseases Thrombosis Anticoagulants Hematologic Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 16, 2013