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| Name | Class |
|---|---|
| Canadian Institutes of Health Research (CIHR) | OTHER_GOV |
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The purpose of this study is to determine if the risk of recurrent venous thromboembolism (VTE) after stopping therapy is low and acceptable in patients with a first unprovoked proximal deep vein thrombosis (DVT) or pulmonary embolism (PE) who have completed 3 months of therapy and who have a negative D-dimer test on therapy and 1 month after stopping therapy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| No Anticoagulant Therapy | Other | No Anticoagulant Therapy |
|
| Anticoagulant Therapy | Other | Continue on anticoagulant therapy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Discontinue anticoagulant therapy (Negative d-dimer) | Other | Patients with negative d-dimer discontinue long-term anticoagulant therapy. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Suspected Recurrent DVT | up to 7 years | |
| Suspected (recurrent) pulmonary embolism | up to 7 years | |
| Bleeding | up to 7 years | |
| Death | up to 7 years |
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Inclusion Criteria:
Exclusion Criteria:
Another indication for long-term anticoagulation (e.g., atrial fibrillation)
A high risk of bleeding as evidenced by any of the following:
A vena caval filter
Has had D-dimer testing performed within 2 months of potential enrollment other than for evaluation of suspected recurrent VTE that was not confirmed
Has a life expectancy less than 5 years
Is unable to attend follow-up visits because of geographic inaccessibility
Is participating in a competing clinical investigation
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| Name | Affiliation | Role |
|---|---|---|
| Clive Kearon, MB MRCP(I) FRCP(C) PhD | McMaster University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lombardi Cancer Center | Washington D.C. | District of Columbia | 20057 | United States | ||
| University of Iowa Hospitals and Clinics |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 31033194 | Derived | Kearon C, Parpia S, Spencer FA, Schulman S, Stevens SM, Shah V, Bauer KA, Douketis JD, Lentz SR, Kessler CM, Connors JM, Ginsberg JS, Spadafora L, Julian JA. Long-term risk of recurrence in patients with a first unprovoked venous thromboembolism managed according to d-dimer results; A cohort study. J Thromb Haemost. 2019 Jul;17(7):1144-1152. doi: 10.1111/jth.14458. Epub 2019 May 20. | |
| 29490924 |
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| Continue on anticoagulant therapy (positive d-dimer) | Other | Patients with positive d-dimer continue or re-start on anticoagulant therapy |
|
| Iowa City |
| Iowa |
| 52242 |
| United States |
| Brigham and Women's Hospital | Boston | Massachusetts | 02115 | United States |
| Beth Israel Deaconess Medical Centre | Boston | Massachusetts | 02215 | United States |
| Henry Ford Hospital | Detroit | Michigan | 48202 | United States |
| UNC Thrombophilia Program | Chapel Hill | North Carolina | 27599-7035 | United States |
| Intermountain Medical Centre | Murray | Utah | 84152 | United States |
| Hamilton General Hospital | Hamilton | Ontario | L8L 2X2 | Canada |
| McMaster University | Hamilton | Ontario | L8N 3Z5 | Canada |
| St. Joseph's Health Care Centre | Hamilton | Ontario | L8N 4A6 | Canada |
| Henderson Hospital | Hamilton | Ontario | L8V1C3 | Canada |
| Limerick, Mid Western Regional Hospital | Limerick | Ireland |
| Addenbrooke's Hospital | Cambridge | B2 0QQ | United Kingdom |
| Derived |
| Kearon C, Parpia S, Spencer FA, Baglin T, Stevens SM, Bauer KA, Lentz SR, Kessler CM, Douketis JD, Moll S, Kaatz S, Schulman S, Connors JM, Ginsberg JS, Spadafora L, Bhagirath V, Liaw PC, Weitz JI, Julian JA. Antiphospholipid antibodies and recurrent thrombosis after a first unprovoked venous thromboembolism. Blood. 2018 May 10;131(19):2151-2160. doi: 10.1182/blood-2017-09-805689. Epub 2018 Feb 28. |
| 25560712 | Derived | Kearon C, Spencer FA, O'Keeffe D, Parpia S, Schulman S, Baglin T, Stevens SM, Kaatz S, Bauer KA, Douketis JD, Lentz SR, Kessler CM, Moll S, Connors JM, Ginsberg JS, Spadafora L, Julian JA; D-dimer Optimal Duration Study Investigators. D-dimer testing to select patients with a first unprovoked venous thromboembolism who can stop anticoagulant therapy: a cohort study. Ann Intern Med. 2015 Jan 6;162(1):27-34. doi: 10.7326/M14-1275. |
| ID | Term |
|---|---|
| D020246 | Venous Thrombosis |
| D011655 | Pulmonary Embolism |
| ID | Term |
|---|---|
| D013927 | Thrombosis |
| D016769 | Embolism and Thrombosis |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D004617 | Embolism |
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