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ThromboembolismPhase 3NCT02913326

A Clinical Trial Comparing Efficacy and Safety of Dabigatran Etexilate With Warfarin in Patients With Cerebral Venous and Dural Sinus Thrombosis (RE-SPECT CVT)

A Phase 3 study testing Dabigatran etexilate and Warfarin in people with Thromboembolism, run by Boehringer Ingelheim at 36 sites in 9 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This is a multi-center, prospective, international, randomized (1:1), open-label study with two parallel groups. This phase III study is planned to investigate the efficacy and safety of dabigatran etexilate versus dose-adjusted warfarin on a net clinical benefit endpoint of major bleeding (ISTH criteria) and new… Read more about this study

Who is it for?
Ages 18 to 78 years
Conditions the study is for
Thromboembolism
What is being tested?
Dabigatran etexilate and Warfarin
Could I receive a placebo?
No, everyone receives an active treatment
How many people
120 participants
Where
36 sitesin 9 countries
Study dates
13 Dec 2016to 22 Jun 2018
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 78 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Written informed consent in accordance with International Conference on Harmonization (ICH) Good Clinical Practice (GCP) guidelines and local legislation and/or regulations
  • Confirmed diagnosis of Cerebral Venous or dural sinus thrombosis (CVT), with or without intracranial haemorrhage
  • Completion of anticoagulation therapy for 5-15 days which has been administered until randomisation; anticoagulation must include full-dose low molecular weight heparin or unfractionated heparin
  • Eligibility for treatment with an oral anticoagulant
  • Further inclusion criteria apply

Who cannot join

  • Cerebral Venous or dural sinus thrombosis (CVT) associated with central nervous system infection or due to head trauma
  • Planned surgical treatment for CVT
  • Conditions associated with increased risk of bleeding
  • History of symptomatic non-traumatic intracranial haemorrhage with risk of recurrence according to Investigator judgment
  • Treatment with an antithrombotic regimen for an indication other than CVT and requiring continuation of that treatment for the original diagnosis without change in the regimen
  • Severe renal impairment
Show all 9Show fewer
  • Active liver disease
  • Pregnancy, nursing or planning to become pregnant while in the trial
  • Further exclusion criteria apply

Trial locations and contacts

36 sites in 9 countries.

36 sites in 9 countries

India6 sites
  • Mazumdar Shaw Medical centre

    Bangalore, 560099

  • Nizam's Institute of Medical Sciences

    Hyderabad, 500082

  • Caritas Hospital

    Kottayam, 686630

  • Magnum Heart Institute

    Nashik, 422005

  • All India Institute of Medical Sciences

    New Delhi, 110029

  • Sahyadri Speciality Hospital

    Pune, 411004

Other trials in India

Italy6 sites
  • ASST di Cremona

    Cremona, 26100

  • Fondazione Centro San Raffaele del Monte Tabor

    Milan, 20132

  • Nuovo Ospedale Civile S. Agostino-Estense

    Modena, 41126

  • A.O. San Camillo Forlanini

    Roma, 00152

  • Umberto I Pol. di Roma-Università di Roma La Sapienza

    Roma, 00161

  • A. O. Ospedale Circolo Fond. Macchi

    Varese, 21100

Other trials in Italy

Germany5 sites
  • Vivantes Netzwerk für Gesundheit GmbH

    Berlin, 12351

  • Universitätsklinikum Essen AöR

    Essen, 45147

  • Asklepios Klinik Wandsbek

    Hamburg, 22043

  • Universitätsklinikum Heidelberg

    Heidelberg, 69120

  • Universitätsklinikum Tübingen

    Tübingen, 72076

Other trials in Germany

Portugal5 sites
  • Hospital Fernando Fonseca, EPE

    Amadora, 2720-276

  • CHLO, EPE - Hospital Egas Moniz

    Lisbon, 1349-019

  • CHULN, EPE - Hospital de Santa Maria

    Lisbon, 1649-035

  • Centro Hospitalar São João,EPE

    Porto, 4202-451

  • Centro Hospitalar de Entre o Douro e Vouga, E.P.E. - Hospital de São Sebastião

    Santa Maria da Feira, 4520-211

Other trials in Portugal

Poland4 sites
  • University Clinical Center, Gdansk

    Gdansk, 80211

  • Copernicus Med.Company.Ltd,Hosp.Nicolaus, Gdansk

    Gdansk, 80803

  • Independent Public Clin.Hospital No.4,Neurol.Dept,Lublin

    Lublin, 20-954

  • Psychiatry&Neurol.Instit.Interv.Stroke&Cerebrov.Treatm.Cntr

    Warsaw, 02-957

Other trials in Poland

Russia4 sites
  • Reg.State Budget Hlthcare,City Hosp#5,Neurology Dept,Barnaul

    Barnaul, 656045

  • Interreg. Clinical & Diagnostic Center, Neurol. Dept., Kazan

    Kazan', 420101

  • St.Petersb,State Hlthcare Instit. Elisabeth Hosp,Neurol.dept

    Saint Petersburg, 195257

  • Sverdlovsk Reg.Clin.Hosp.No.1

    Yekaterinburg, 620102

Other trials in Russia

France2 sites
  • HOP Pellegrin

    Bordeaux, 33076

  • HOP Lariboisière

    Paris, 75475

Other trials in France

Netherlands2 sites
  • Academisch Medisch Centrum (AMC)

    Amsterdam, 1105 AZ

  • Universitair Medisch Centrum Utrecht

    Utrecht, 3584 CX

Other trials in Netherlands

Spain2 sites
  • Hospital Ramón y Cajal

    Madrid, 28034

  • Hospital La Paz

    Madrid, 28046

Other trials in Spain

About this study

Official title: RE-SPECT CVT: a Randomised, Open-label, Exploratory Trial With Blinded Endpoint Adjudication (PROBE), Comparing Efficacy and Safety of Oral Dabigatran Etexilate Versus Oral Warfarin in Patients With Cerebral Venous and Dural Sinus Thrombosis Over a 24-week Period

This is a multi-center, prospective, international, randomized (1:1), open-label study with two parallel groups. This phase III study is planned to investigate the efficacy and safety of dabigatran etexilate versus dose-adjusted warfarin on a net clinical benefit endpoint of major bleeding (ISTH criteria) and new venous thrombotic event (VTE) (primary endpoint) with blinded endpoint adjudication.

Conditions
Thromboembolism
Being tested
Dabigatran etexilate, Warfarin
Medical subject headings
Thromboembolism

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT02913326
Study groupRoleWhat they receive
Dabigatran etexilateExperimentalNot described
Receives: Drug: Dabigatran etexilate
WarfarinActive comparatorNot described
Receives: Drug: Warfarin

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants With Composite of Venous Thrombotic Event (VTE) or Major Bleeding Event (MBE) According to International Society on Thrombosis and Haemostasis (ISTH) Criteria in Full Observation Period.

    Composite of the percentage of participants with MBE according to ISTH criteria and VTE (recurring cerebral venous thrombosis (CVT); deep venous thrombosis (DVT) of any limb, pulmonary embolism (PE), splanchnic vein thrombosis) in full observation period. All components were adjudicated in a blinded manner.

    Major bleeds were defined according to the ISTH definition of a major bleed, as follows:

    • Symptomatic bleeding in a critical area or organ, such as intracranial, intraspinal, intraocular, retroperitoneal, intra-articular or pericardial, or intramuscular with compartment syndrome and/or
    • Bleeding associated with a reduction in haemoglobin of at least 2 grams/deciLitre (1.24 millimole/Litre) within 24 h, or leading to transfusion of 2 or more units of blood or packed cells and/or
    • Fatal bleed

    Measured: From first administration of trial medication until 6 days after last administration of trial medication, up to 25 weeks.

Secondary outcomes (7)
  1. Percentage of Participants With Recurring Cerebral Venous and Dural Sinus Thrombosis; DVT of Any Limb, PE or Splanchnic Vein Thrombosis in Full Observation Period

    VTE criterions:

    • New neurological signs/symptoms or worsening of previous signs/symptoms with new CVT on neuroimaging.
    • DVT of any limb was documented by: Abnormal compression ultrasonography; An intraluminal filling defect on venography; At autopsy
    • Splanchnic vein thrombosis: The presence of endoluminal material/absence of flow in the extrahepatic portal veins/mesenteric veins as shown by duplex-Doppler ultrasound/contrast-enhanced CT scan/MRI.
    • PE was documented by: An intraluminal filling defect in segmental/more proximal branches on spiral CT scan; An intraluminal filling defect/an extension of an existing defect/a sudden cut-off of vessels>2.5 mm in diameter on the pulmonary angiogram; Perfusion defect of at least 75% of a segment with a local normal ventilation result on ventilation/perfusion lung scan; Inconclusive spiral CT, pulmonary angiography/lung scintigraphy with demonstration of DVT in the lower extremities by compression ultrasonography/venography; At autopsy.

    Measured: From first administration of trial medication until 6 days after last administration of trial medication, up to 25 weeks.

  2. Cerebral Venous Recanalisation as Measured by the Change in Number of Occluded Cerebral Veins and Sinuses at Week 24

    Cerebral venous recanalisation was assessed by imaging and was adjudicated. Occlusion of cerebral veins and sinuses was scored as: 1 = full occlusion; 0 = no occlusion/partial occlusion. This score was applied using the below conventions: Superior sagittal, straight, cavernous sinuses, left and right jugular veins each scored individually as either 0 or 1; Right lateral transverse and sigmoid sinus were scored together, Left lateral transverse and sigmoid sinus were scored together, Superior petrous sinus and inferior petrous sinus were scored together; Deep venous system, Superficial cortical veins, Cerebellar veins were scored as systems.

    For each patient a total score was calculated at baseline and at EOT and the recanalisation score was calculated as EOT - baseline total scores with conventions as 0 = no cerebral veins or sinuses fully occluded and 11 = all cerebral veins and sinuses fully occluded; the lower the score, the better.

    Measured: Baseline and week 24

  3. Percentage of Participants With Major Bleeding According to ISTH Criteria in Full Observation Period

    Major bleeds were defined according to the ISTH definition of a major bleed, as follows:

    • Symptomatic bleeding in a critical area or organ, such as intracranial, intraspinal, intraocular, retroperitoneal, intra-articular or pericardial, or intramuscular with compartment syndrome and/or
    • Bleeding associated with a reduction in haemoglobin of at least 2 grams/deciLitre (1.24 millimole/Litre) within 24 h, or leading to transfusion of 2 or more units of blood or packed cells and/or
    • Fatal bleed

    Measured: From first administration of trial medication until 6 days after last administration of trial medication, up to 25 weeks.

  4. Composite Endpoint of Percentage of Participants With New Intracranial Haemorrhage or Worsening of the Haemorrhagic Component of a Previous Lesion After up to 24 Weeks

    Intracranial haemorrhage (ICH) comprised the subtypes of intracerebral bleeds, subdural bleeds, epidural bleeds and subarachnoid bleeds that were recorded.

    Measured: From first administration of trial medication until end of treatment visit, up to 24 weeks.

  5. Percentage of Participants With Clinically Relevant Non-major Bleeding Events in Full Observation Period.

    A clinically relevant non-major bleeding event (CRNMBE) was a clinically overt bleed that did not meet the criteria for a major bleed but prompted a clinical response, in that it led to at least 1 of the following: A hospital admission (i.e. overnight stay in the hospital) for bleeding / A physician guided medical or surgical treatment for bleeding / A physician guided change, interruption or discontinuation of trial medication.

    Measured: From first administration of trial medication until 6 days after last administration of trial medication, up to 25 weeks.

  6. Percentage of Participants With Major Bleeding According to ISTH Criteria or CRNMBEs After up to 24 Weeks

    Percentage of participants with major bleeding according to ISTH criteria or CRNMBEs after up to 24 weeks.

    Measured: From first administration of trial medication until end of treatment visit, up to 24 weeks.

  7. Percentage of Participants With Any Bleeding Event After up to 24 Weeks

    Percentage of participants with any bleeding event after up to 24 weeks where any bleeding event is the sum of all major and non-major bleeding events.

    Measured: From first administration of trial medication until end of treatment visit, up to 24 weeks.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Sep 2016 (estimated)
  2. Study start13 Dec 2016
  3. Primary completion22 Jun 2018
  4. Study completion22 Jun 2018

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
120 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02913326
Sponsor's protocol ID
1160.248
Other IDs
2015-004412-38, 2015
Status last verified
Aug 2019
First submitted
21 Sep 2016
Last updated
15 Aug 2019

Publications

  • Ferro JM, Bendszus M, Jansen O, Coutinho JM, Dentali F, Kobayashi A, Aguiar de Sousa D, Neto LL, Miede C, Caria J, Huisman H, Diener HC; RE-SPECT CVT Study Group. Recanalization after cerebral venous thrombosis. A randomized controlled trial of the safety and efficacy of dabigatran etexilate versus dose-adjusted warfarin in patients with cerebral venous and dural sinus thrombosis. Int J Stroke. 2022 Feb;17(2):189-197. doi: 10.1177/17474930211006303. Epub 2021 Apr 4.

    PubMed 33724104
  • Ferro JM, Coutinho JM, Jansen O, Bendszus M, Dentali F, Kobayashi A, van der Veen B, Miede C, Caria J, Huisman H, Diener HC; RE-SPECT CVT Study Group. Dural Arteriovenous Fistulae After Cerebral Venous Thrombosis. Stroke. 2020 Nov;51(11):3344-3347. doi: 10.1161/STROKEAHA.120.031235. Epub 2020 Sep 25.

    PubMed 32972315
  • Ferro JM, Coutinho JM, Dentali F, Kobayashi A, Alasheev A, Canhao P, Karpov D, Nagel S, Posthuma L, Roriz JM, Caria J, Frassdorf M, Huisman H, Reilly P, Diener HC; RE-SPECT CVT Study Group. Safety and Efficacy of Dabigatran Etexilate vs Dose-Adjusted Warfarin in Patients With Cerebral Venous Thrombosis: A Randomized Clinical Trial. JAMA Neurol. 2019 Dec 1;76(12):1457-1465. doi: 10.1001/jamaneurol.2019.2764.

    PubMed 31479105
  • Ferro JM, Dentali F, Coutinho JM, Kobayashi A, Caria J, Desch M, Fraessdorf M, Huisman H, Diener HC. Rationale, design, and protocol of a randomized controlled trial of the safety and efficacy of dabigatran etexilate versus dose-adjusted warfarin in patients with cerebral venous thrombosis. Int J Stroke. 2018 Oct;13(7):766-770. doi: 10.1177/1747493018778125. Epub 2018 May 18.

    PubMed 29775170

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Dabigatran etexilate and Warfarin in people with Thromboembolism, run by Boehringer Ingelheim at 36 sites in 9 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Aug 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 36 sites in India, Italy, Germany, Portugal, Poland and 4 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 15 Aug 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Percentage of Participants With Composite of Venous Thrombotic Event (VTE) or Major Bleeding Event (MBE) According to International Society on Thrombosis and Haemostasis (ISTH) Criteria in Full Observation Period. (time frame: From first administration of trial medication until 6 days after last administration of trial medication, up to 25 weeks.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02913326, which also lists 4 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Aug 2019.

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