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Low Molecular Weight Heparin and Aspirin in the Treatment of Recurrent Pregnancy Loss: A RCT (HepASA)

This study has been terminated.
(interim analysis found no difference in LB rate and lower than expected event rate)
Canadian Institutes of Health Research (CIHR)
Information provided by:
Mount Sinai Hospital, Canada Identifier:
First received: November 26, 2007
Last updated: NA
Last verified: November 2007
History: No changes posted
To compare the livebirth rate of women with recurrent pregnancy loss and autoantibodies randomized to either low molecular weight heparin plus aspirin versus aspirin alone.

Condition Intervention
Recurrent Pregnancy Loss
Antiphospholipid Antibody Syndrome
Drug: Low molecular weight heparin and low dose aspirin
Drug: Low dose aspirin

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: A Randomized Controlled Trial Comparing Low Molecular Weight Heparin and Aspirin to Aspirin Alone in Women With Unexplained Recurrent Pregnancy Loss

Resource links provided by NLM:

Further study details as provided by Mount Sinai Hospital, Canada:

Primary Outcome Measures:
  • To investigate whether treatment with LMW heparin plus ASA results in an increased rate of livebirths compared to treatment with ASA alone. [ Time Frame: Duration of pregnancy ]

Secondary Outcome Measures:
  • Secondary outcomes included adverse events and incidence of bone loss in the two groups. [ Time Frame: pre-pregnancy through postpartum period ]

Enrollment: 88
Study Start Date: March 2000
Study Completion Date: September 2005
Arms Assigned Interventions
Experimental: a Drug: Low molecular weight heparin and low dose aspirin
Fragmin 5000 IU/day by subcutaneous injection started at time of randomization and continued until 35 weeks gestation or delivery and low dose aspirin 81 mg/day started pre-conception and continued until 35 weeks gestation or delivery
Other Names:
  • Fragmin (Dalteparin Sodium)
  • ASA
Active Comparator: b
Low dose aspirin only
Drug: Low dose aspirin
81 mg enteric coated started pre-pregnancy and discontinued at 35 weeks or delivery
Other Name: ASA

Detailed Description:
Previous studies of these therapeutic regimens in the population of recurrent pregnancy loss and autoantibodies, have not provided conclusive evidence of their efficacy due to small sample size and/or weak study design. We undertook a RCT of low molecular weight heparin plus aspirin versus aspirin alone to investigate if the low molecular weight heparin treatment resulted in an increased rate of livebirths as compared to treatment with aspirin alone.

Ages Eligible for Study:   18 Years to 44 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • history of two or more unexplained consecutive pregnancy losses prior to 32 weeks
  • presence of one of the panel of autoantibodies/thrombophilia markers
  • confirmed pregnancy

Exclusion Criteria:

  • SLE
  • known peptic ulcer disease
  • sensitivity to ASA or heparin
  • previous thrombotic event
  • geographic distance from clinic
  • failure to consent
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Please refer to this study by its identifier: NCT00564174

Canada, Ontario
McMaster Medical Centre
Hamilton, Ontario, Canada
Mount Sinai Hosptial
Toronto, Ontario, Canada, M5G 1X5
Sponsors and Collaborators
Mount Sinai Hospital, Canada
Canadian Institutes of Health Research (CIHR)
Principal Investigator: Carl A Laskin, MD Associate Professor, Department of Medicine, University of Toronto
  More Information Identifier: NCT00564174     History of Changes
Other Study ID Numbers: 33762
CIHR 37749
Study First Received: November 26, 2007
Last Updated: November 26, 2007

Keywords provided by Mount Sinai Hospital, Canada:
recurrent pregnancy loss
lupus anticoagulant
anti cardiolipin antibodies
low molecular weight heparin
randomized clinical trial

Additional relevant MeSH terms:
Abortion, Spontaneous
Fetal Death
Antiphospholipid Syndrome
Pregnancy Complications
Pathologic Processes
Autoimmune Diseases
Immune System Diseases
Calcium heparin
Heparin, Low-Molecular-Weight
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Inflammatory Agents
Antirheumatic Agents
Fibrinolytic Agents
Fibrin Modulating Agents
Molecular Mechanisms of Pharmacological Action
Platelet Aggregation Inhibitors
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Anticoagulants processed this record on May 25, 2017