Assessment of Long-Term Out-of-Hospital Treatment of Patients With Proximal Deep Vein Thrombosis (DVT) Using Low-Molecular-Weight Heparin (LMWH) Versus LMWH Followed by Warfarin

LITE Study, Appendix A (HOME-LITE), Amendment 6

The purpose of this study is to assess the long-term out-of-hospital treatment of patients with proximal venous thrombosis through the administration of subcutaneous low-molecular-weight heparin (tinzaparin sodium) versus low-molecular-weight heparin followed by warfarin sodium.

Two studies demonstrated that out-of-hospital low-molecular-weight heparin given by twice daily subcutaneous injection without laboratory monitoring was as effective and as safe as continuous intravenous heparin given in-hospital. Innohep (tinzaparin) has been shown to be safe and effective for both the initial and long-term treatment of DVT. The Home LITE study compares long-term Innohep treatment to treatment with a combination of initial low-molecular-weight heparin followed by standard long-term warfarin therapy.

Inclusion Criteria:

• Patients having a first or recurrent episode of acute proximal vein thrombosis who are eligible for outpatient or home care during the initial therapy.

Exclusion Criteria:

• Any condition which, in the opinion of the investigator, precludes entire out-of-hospital treatment
• Presence of familial bleeding diathesis or the presence of active bleeding contraindicating anticoagulant therapy
• Receiving therapeutic heparin for more than 48 hours or have already been on warfarin for more than 2 days for the treatment of proximal deep vein thrombosis
• Receiving long-term warfarin treatment
• Females who are pregnant
• Known allergy to heparin, warfarin sodium, or bisulfites
• History of heparin-associated thrombocytopenia
• Severe malignant hypertension
• Hepatic encephalopathy
• Severe renal failure
• Inability to attend follow-up due to geographic inaccessibility
• Inability or refusal to give signed informed consent
• Mothers who are breast-feeding and who are unable to refuse to discontinue breast-feeding during study treatment