Extended Prophylaxis Comparing low molecular weight heparin (LMWH) to Aspirin in Total hip arthroplasty

ISRCTN ISRCTN11902170
DOI https://doi.org/10.1186/ISRCTN11902170
Secondary identifying numbers MCT-82948
Submission date
27/09/2007
Registration date
27/09/2007
Last edited
05/08/2013
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English Summary

Not provided at time of registration

Contact information

Dr David Robert Anderson
Scientific

Queen Elizabeth II (QEII) Health Sciences Centre and Dalhousie University
Room 430 Bethune Building, 4th floor
1278 Tower Road
Halifax, Nova Scotia
B3H 2Y9
Canada

Phone +1 902 473 8562
Email David.Anderson@cdha.nshealth.ca

Study information

Study designMulticentre, two arm, randomised parallel trial, using placebo, with study participant, research coordinator, study investigator, caregiver, outcome assessor, and data analyst blinded
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Scientific title
Study acronymEPCAT
Study hypothesisCurrent hypothesis as of 05/12/2007:
Extending the duration of anti-thrombotic prophylaxis with aspirin by 28 days following a ten day course of Low Molecular Weight Heparin (LMWH) will be as effective at reducing the rate of symptomatic venous thromboembolic complications and will be safe and more cost-effective than extending prophylaxis by 28 days with LMWH in a group of patients undergoing total hip arthroplasty.

Previous hypothesis:
Extending the duration of anti-thrombotic prophylaxis with aspirin by 28 days following a minimum seven day course of Low Molecular Weight Heparin (LMWH) will be as effective at reducing the rate of symptomatic venous thromboembolic complications and will be safe and more cost-effective than extending prophylaxis by 28 days with LMWH in a group of patients undergoing total hip arthroplasty.

Please note that this record has been updated on the 5th December 2007 due to changes made to this protocol by the suggestion of the Research Ethics Board (REB). All changes were made prior to the recruitment of the first study participant and will be entered in this record under the date 05/12/2007.
Ethics approval(s)Research Ethics Board of Capital District Health Authority, Halifax, Nova Scotia, Canada approved on the 17th September 2007 (ref: CDHA-RS/2007-179)
ConditionVenous thromboembolism following total hip arthoplasty
InterventionCurrent interventions as of 05/12/2007:
1. Aspirin: 81 mg once a day for 28 days
2. Dalteparin: 5000 i.u. subcutaneously once a day
3. Matching placebo (aspirin): one pill once a day for 28 days
4. Matching placebo (dalteparin-normal saline): injection subcutaneously once a day for 28 days

Previous interventions:
1. Aspirin: 81 mg once a day for 28 days
2. Enoxaparin: 40 mg subcutaneously once a day for 28 days
3. Matching placebo (aspirin): one pill once a day for 28 days
4. Matching placebo (enoxaparin): injection subcutaneously once a day for 28 days

Contact for public queries:
Susan Pleasance, Associate Director
Haematology Research
Centre for Clinical Research
5790 University Avenue, Room 132
Halifax, Nova Scotia
B3H 1V7
Canada
Tel: +1 902 473 7585
Fax: +1 902 473 4667
Email: Susan.Pleasance@cdha.nshealth.ca
Intervention typeDrug
Pharmaceutical study type(s)
PhaseNot Applicable
Drug / device / biological / vaccine name(s)Aspirin, dalteparin
Primary outcome measureCurrent primary outcome measures as of 15/01/2008:
Venous thromboembolism (pulmonary embolism of deep vein thrombosis), assessed at 90 days.

Previous primary outcome measures:
1. Symptomatic venous thromboembolic complications, assessed at 90 days
2. Venous thromboembolism (pulmonary embolism of deep vein thrombosis), assessed at 90 days
Secondary outcome measuresCurrent secondary outcome measures as of 15/01/2008:
1. Survival, assessed at 90 days
2. Major bleeding, assessed at 90 days
3. Wound infection, assessed at 90 days
4. Stroke, assessed at 90 days
5. Thrombocytopenia, assessed at 90 days
6. Cost effectiveness, assessed at 90 days

Previous secondary outcome measures:
1. Survival, assessed at 90 days
2. Major bleeding, assessed at 90 days
3. Myocardial infarction, assessed at 90 days
4. Stroke, assessed at 90 days
5. Cost effectiveness, assessed at 90 days
Overall study start date01/09/2007
Overall study end date30/03/2011

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participants2200 (2222 as of 05/12/2007)
Participant inclusion criteria1. Patients undergoing elective total hip arthroplasty at the participating institutions
2. Age 18 years and older, either sex. However, please note that if a patient under 18 years presents to the clinic (although this is unlikely), they will be included.
Participant exclusion criteriaAdded as of 25/02/2009:
15. Investigator decision
16. Bilateral total hip arthroplasty (THA) or simultaneous hip and knee surgery
17. Unable to give consent
18. Geographical inaccessibility
19. Requirement for major surgery within 28 day study-drug period

Amended as of 05/12/2007:
1. Hip fracture in the previous three months
2. Metastatic cancer
3. Life expectancy less than 6 months
4. History of major bleeding that, in the judgement of the investigator, precludes use of anticoagulant prophylaxis
5. History of aspirin allergy, active peptic ulcer disease or gastritis that, in the judgment of the investigator, precludes use of aspirin
6. History of heparin induced thrombocytopenia or heparin allergy
7. Creatine clearance less than 30 ml per minute
8. Platelet count less than 100 x 10^9/L
9. Need for long-term anticoagulation due to pre-existing co-morbid conditions or due to the development of venous thromboembolism following surgery but prior to randomisation
10. Need for aspirin over the course of the study due to pre-existing co-morbid condition
11. Previous participation in this study
12. Refusal to give informed consent
13. Did not, or will not, receive dalteparin post-operatively for Venous Thromboembolism (VTE) prophylaxis
14. Women of child bearing potential who are not abstinent or do not use appropriate contraception throughout the study drug period

Initial information at time of registration:
1. Hip fracture in the previous three months
2. Metastatic cancer
3. Life expectancy less than 6 months
4. History of major bleeding that, in the judgement of the investigator, precludes use of anticoagulant prophylaxis
5. History of aspirin allergy, active peptic ulcer disease or gastritis that, in the judgment of the investigator, precludes use of aspirin
6. History of heparin induced thrombocytopenia or heparin allergy
7. Chonic renal failure (creatine clearance less than 30 ml per minute)
8. Platelet count less than 100 x 10^9/L
9. Need for long-term anticoagulation due to pre-existing co-morbid conditions or due to the development of venous thromboembolism following surgery but prior to randomisation
10. Need for aspirin over the course of the study due to pre-existing co-morbid condition
11. Previous participation in this study
12. Geographic inaccessibility for follow-up
13. Refusal to give informed consent
Recruitment start date01/09/2007
Recruitment end date30/03/2011

Locations

Countries of recruitment

  • Canada

Study participating centre

Queen Elizabeth II (QEII) Health Sciences Centre and Dalhousie University
Halifax, Nova Scotia
B3H 2Y9
Canada

Sponsor information

Dalhousie University (Canada) - Research Services
University/education

Room 321, Henry Hicks Academic Administration Building
6299 South Street
Halifax, Nova Scotia
B3H 4H6
Canada

Phone +1 902 494 6513
Email researchservices@dal.ca
Website http://www.dal.ca/research/
ROR logo "ROR" https://ror.org/01e6qks80

Funders

Funder type

Research organisation

Canadian Institutes of Health Research (CIHR) (Canada) - http://www.cihr.irsc.gc.ca (ref: MCT-82948)

No information available

Bayer Healthcare (Canada)
Private sector organisation / For-profit companies (industry)
Alternative name(s)
BHC
Location
Germany
Pfizer (Canada) - added 05/12/2007

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 04/06/2013 Yes No