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Prevention of Venous Thromboembolism in Patients Undergoing Elective Total Knee Replacement Surgery

Phase 2
Completed
Conditions
Venous Thromboembolism
Interventions
Registration Number
NCT00331838
Lead Sponsor
Sanofi
Brief Summary

The primary objective was to demonstrate the dose-response of Semuloparin sodium (AVE5026) for the prevention of Venous Thromboembolism \[VTE\] in patients undergoing total knee replacement \[TKR\] surgery.

Secondary objectives were to evaluate the safety (incidence of major bleeding) of AVE5026, to document the efficacy and safety of AVE5026 post-operative regimens, and to assess the pharmacokinetic parameters of AVE5026.

Detailed Description

The randomization had to take place before the first study drug injection.

The total duration of observation per participant was 27-33 days from surgery broken down as follows:

* 4 to 10-day double-blind treatment period;

* Follow-up period up to Day 30 ± 3 after surgery.

Mandatory bilateral venography of the lower limbs had to be performed between 5 to 11 days after surgery.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
705
Inclusion Criteria
  • Patient scheduled to undergo elective total knee replacement or revision of a primary procedure performed ≥ 6 months prior to study entry.
Exclusion Criteria
  • Any major orthopedic surgery in the 3 months prior to study entry;
  • Clinical signs or symptoms of DVT or PE within the last 12 months or known post-phlebitic syndrome;
  • Known sensitivity to iodine or contrast dyes;
  • Recent stroke or myocardial infarction;
  • High risk of bleeding;
  • Treatment with other anti-thrombotic agents within 7 days prior to surgery;
  • Any contra-indication to Unfractionated Heparin or Low Molecular Weight Heparin;
  • Pregnant or nursing woman, or woman of childbearing potential who is not using an effective contraceptive method.

The above information is not intended to contain all considerations relevant to a patient's potential participation in a clinical trial.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Placebo pre-op / Semuloparin 40 mgSemuloparin sodiumPlacebo (for Semuloparin sodium) + Placebo (for Enoxaparin sodium) 12 hours before surgery then, Semuloparin sodium 40 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 8 hours after surgery
Semuloparin 10 mgSemuloparin sodiumSemuloparin sodium 10 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 12 hours before or 8 hours after surgery depending on the willingness of the investigator
Semuloparin 20 mgSemuloparin sodiumSemuloparin sodium 20 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 12 hours before or 8 hours after surgery depending on the willingness of the investigator
Semuloparin 5 mgSemuloparin sodiumSemuloparin sodium 5 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 12 hours before or 8 hours after surgery depending on the willingness of the investigator
Semuloparin 5 mgPlacebo (for Enoxaparin sodium)Semuloparin sodium 5 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 12 hours before or 8 hours after surgery depending on the willingness of the investigator
Semuloparin 10 mgPlacebo (for Enoxaparin sodium)Semuloparin sodium 10 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 12 hours before or 8 hours after surgery depending on the willingness of the investigator
Semuloparin 40 mgSemuloparin sodiumSemuloparin sodium 40 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 12 hours before or 8 hours after surgery depending on the willingness of the investigator
Semuloparin 20 mgPlacebo (for Enoxaparin sodium)Semuloparin sodium 20 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 12 hours before or 8 hours after surgery depending on the willingness of the investigator
Semuloparin 60 mgPlacebo (for Enoxaparin sodium)Semuloparin sodium 60 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 12 hours before or 8 hours after surgery depending on the willingness of the investigator
Semuloparin 40 mgPlacebo (for Enoxaparin sodium)Semuloparin sodium 40 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 12 hours before or 8 hours after surgery depending on the willingness of the investigator
Semuloparin 60 mgSemuloparin sodiumSemuloparin sodium 60 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 12 hours before or 8 hours after surgery depending on the willingness of the investigator
Enoxaparin 40 mgEnoxaparin sodiumEnoxaparin sodium 40 mg + Placebo (for Semuloparin sodium) once daily for 4-10 days with an initial dose given 12 hours before or 8 hours after surgery depending on the willingness of the investigator
Placebo pre-op / Semuloparin 20 mgSemuloparin sodiumPlacebo (for Semuloparin sodium) + Placebo (for Enoxaparin sodium) 12 hours before surgery then, Semuloparin sodium 20 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 8 hours after surgery
Placebo pre-op / Semuloparin 20 mgPlacebo (for Enoxaparin sodium)Placebo (for Semuloparin sodium) + Placebo (for Enoxaparin sodium) 12 hours before surgery then, Semuloparin sodium 20 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 8 hours after surgery
Placebo pre-op / Semuloparin 20 mgPlacebo (for Semuloparin sodium)Placebo (for Semuloparin sodium) + Placebo (for Enoxaparin sodium) 12 hours before surgery then, Semuloparin sodium 20 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 8 hours after surgery
Placebo pre-op / Semuloparin 40 mgPlacebo (for Enoxaparin sodium)Placebo (for Semuloparin sodium) + Placebo (for Enoxaparin sodium) 12 hours before surgery then, Semuloparin sodium 40 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 8 hours after surgery
Enoxaparin 40 mgPlacebo (for Semuloparin sodium)Enoxaparin sodium 40 mg + Placebo (for Semuloparin sodium) once daily for 4-10 days with an initial dose given 12 hours before or 8 hours after surgery depending on the willingness of the investigator
Placebo pre-op / Semuloparin 40 mgPlacebo (for Semuloparin sodium)Placebo (for Semuloparin sodium) + Placebo (for Enoxaparin sodium) 12 hours before surgery then, Semuloparin sodium 40 mg + Placebo (for Enoxaparin sodium) once daily for 4-10 days with an initial dose given 8 hours after surgery
Primary Outcome Measures
NameTimeMethod
Number of Participants Who Experienced Venous Thromboembolism Event (VTE) or VTE-related DeathFrom surgery to Day 11 or the day of mandatory venography, whichever came first

VTE included any Deep Vein Thrombosis \[DVT\] identified on mandatory venography of the lower limbs; symptomatic DVT and/or non-fatal pulmonary embolism \[PE\] before mandatory examination; VTE related deaths included fatal PE or deaths which could not be attributed to a documented cause and for which PE could not be ruled out. All events were to be confirmed by a Central Independent Adjudication Committee \[CIAC\] based on venographies, scheduled or unscheduled, and other available diagnostic tests (ultrasonography, ventilation/perfusion lung scan, pulmonary angiography, autopsy report, etc).

Secondary Outcome Measures
NameTimeMethod
Number of Participants Who Experienced DVTFrom surgery up to Day 11 or the day of mandatory venography, whichever came first
Number of Participants Who Experienced Symptomatic VTEFrom surgery up to Day 11 or the day of mandatory venography, whichever came first

Symptomatic VTE included:

* suspected DVT confirmed by the CIAC based on compression ultrasonography or venography;

* suspected PE confirmed by the CIAC based on perfusion/ventilation lung scan, pulmonary angiography or spiral computerized tomography.

Number of Participants Who Experienced BleedingsFrom 1st study drug injection up to 3 days after last study drug injection (median duration of approximately 11 days)

Bleedings were centrally and blindly reviewed by the CIAC and classified as:

* "Major" (fatal bleeding, bleeding that was retroperitoneal or intracranial or that involved any other critical organ (e.g. eye, adrenal gland, pericardium or spine), surgical site bleeding leading to intervention, non-surgical site bleeding requiring surgical intervention or with a bleeding index ≥2);

* "Minor" (overt bleeding considered more than expected but not meeting the criteria for major bleeding);

* "Criteria for bleeding event not satisfied" (not meeting the criteria for major or minor bleeding).

Number of Participants Who Required Initiation of Curative Anticoagulant or Thrombolytic Treatment After VTE AssessmentFrom surgery up to Day 11 or the day of mandatory venography, whichever came first

Initiation of curative anticoagulant or thrombolytic treatment after VTE assessment was defined from investigator's answers to questions asked after diagnostic tests for suspected VTE and/or the mandatory venography.

Trial Locations

Locations (1)

Sanofi-Aventis Administrative Office

🇹🇷

Istanbul, Turkey

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