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| Name | Class |
|---|---|
| Floralis | INDUSTRY |
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The CELEST Long term is a prospective study, assessing the very long term risk of post thrombotic syndrome (PTS) in patients enrolled in the CELEST double-blind RCT. All patients enrolled in CELEST RCT will benefit from a 7-year follow-up visit conducted over the phone. The primary objective is to assess the proportion of patients with moderate-severe PTS assessed with the patient reported Villalta score and the 2 main secondary objectives are to assess predictors of moderate to severe PTS and the impact of initial compression stockings strength (25mmHg vs. 35mmHg) on the development of moderate-severe PTS. Up to 288 patients may participate.
The investigators believe that this study has the potential to significantly improve the knowledge on the epidemiology of burdensome PTS and on the impact of different initial compression stockings strengths on the risk of PTS.
The CELEST double blind RCT demonstrated that 25mmHg elastic compression stockings (ECS) were non inferior to 35mmHg ECS to prevent post thrombotic syndrome (PTS) 2 years after a first proximal deep vein thrombosis (DVT). Likely because of lack of statistical power the investigators were not able to demonstrate that 25mmHg ECS were superior in the overall RCT population and that 35mmHg ECS were superior in patients optimally adherent to ECS. Furthermore, few data are available on the very long term (>5 years).
The CELEST Long term is a prospective study, assessing the very long term risk of PTS in patients enrolled in the CELEST RCT. All patients enrolled in CELEST RCT and willing to participate are eligible and will benefit from a 7-year follow-up visit conducted over the phone.
Primary objective is to assess the proportion of patients with moderate-severe PTS defined as a patient reported Villalta score (PRVS) ≥10 or a venous leg ulcer ipsilateral to index DVT. Secondary objectives include predictors of moderate to severe PTS, impact of initial ECS strength on the development of moderate-severe PTS, impact of anticoagulant treatment (type and duration) on the development of moderate to severe PTS, proportion of PTS (defined as PRVS≥5 or ipsilateral leg ulcer) and impact of PTS on patient's QOL. Study should last 1 year and up to 288 patients may participate.
The investigators believe that this study has the potential to significantly improve the knowledge on the epidemiology of burdensome PTS and on the impact of different initial CE strengths on the risk of PTS.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 35mmHg ECS | Subjects with first proximal DVT allocated to wear 35 mmHg elastic compression stockings (ECS) for 2 years during the CELEST RCT |
| |
| 25mmHg ECS | Subjects with first proximal DVT allocated to wear 25 mmHg elastic compression stockings (ECS) for 2 years during the CELEST RCT |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Phone call | Other | This follow-up will be conducted over the phone and by mail (some questionnaire may be sent by patient, as per his/her preference) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of patients with moderate-severe PTS in the whole cohort | PTS defined with the patient reported Villalta score (PRVS). Moderate-severe PTS: PRVS≥10 or presence of a venous leg ulcer in the leg ipsilateral to index DVT The Villalta score consists in 11 questions (5 on subjective symptoms and 6 on objective signs). Each question is coded between 0 and 3 (0: none - 1: mild - 2: moderate - 3: severe). The total score is the sum of the 11 questions and therefore ranges from 0 to 33, where a high value indicates a high level of disability. An additional question asks about the presence of ulcers. If the calculated score is < 15, a value of 15 is assigned to the ulcer score. The thresholds used are as follows:
| At the phone follow-up up to 3 months |
| Measure | Description | Time Frame |
|---|---|---|
| Predictors of moderate-severe PTS | Predictors of moderate-severe PTS in the whole cohort | Since enrolment in the CELEST CRT |
| Impact of initial ECS strength on the development of moderate-severe PTS |
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Inclusion Criteria:
Exclusion Criteria:
Patients who withdrew consent or died during the 2-year follow-up of the CELEST RCT.
Patients who decline or are unable to participate (including severe memory loss issues) to the long-term follow-up
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Patients who were enrolled in the CELEST RCT
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Carole Rolland, MSc | Contact | 04 76 76 50 40 | carole.rolland@univ-grenoble-alpes.fr | |
| Alexa Comte, MSc | Contact | 04 76 76 50 40 | alexa.comte@univ-grenoble-alpes.fr |
| Name | Affiliation | Role |
|---|---|---|
| Jean Luc Bosson, MD, PhD | University Grenoble Alpes, France | Principal Investigator |
| Jean Philippe Galanaud, MD, PhD | University of Toronto, Canada | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| ROLLAND | Recruiting | Grenoble | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 36455603 | Background | Ten Cate-Hoek AJ. Lower strength stockings: is less better? Lancet Haematol. 2022 Dec;9(12):e865-e866. doi: 10.1016/S2352-3026(22)00266-6. No abstract available. | |
| 26422814 | Background | Utne KK, Ghanima W, Foyn S, Kahn S, Sandset PM, Wik HS. Development and validation of a tool for patient reporting of symptoms and signs of the post-thrombotic syndrome. Thromb Haemost. 2016 Jan;115(2):361-367. doi: 10.1160/th15-04-0318. Epub 2015 Sep 17. |
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Relevant deidentified participant data (with a data dictionary) will be available to other researchers on reasonable request after publication, approval from both principal investigators and sponsor, and after a data access agreement is signed
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| ID | Term |
|---|---|
| D054070 | Postthrombotic Syndrome |
| D020246 | Venous Thrombosis |
| ID | Term |
|---|---|
| D013927 | Thrombosis |
| D016769 | Embolism and Thrombosis |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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Comparison of proportion of moderate-severe PTS between patients randomized in the 25mmHg ECS vs. 35mmHg ECS group
| Since enrollment in the CELEST study |
| Impact of initial type of ECS on the development of moderate-severe PTS | Comparison of proportion of moderate-severe PTS between patients who chose to wear above knee vs. below knee ECS during CELEST RCT | Since enrollment in the CELEST study |
| Impact of adherence to RCT's ECS on the development of moderate-severe PTS | Comparison of proportion of moderate-severe PTS according to adherence to ECS during CELEST RCT | Since enrollment in the CELEST study |
| Assessment of the use of ECS after the end of the RCT in terms of use, strength, length, adherence, duration | Description of the use of ECS among study participants since the end of their participation in the CELEST RCT | Since enrolment in the CELEST study with focus on the period end of RCT to long-term follow-up |
| Factors influencing the the decision to continue, stop or resume ECS | Description of the reasons that led to the decision to continue, stop or resume ECS | During the 2-year celest study and during the long-term follow-up |
| Impact of anticoagulant treatment on the development of moderate-severe PTS | Comparison of proportion of moderate-severe PTS according to type and duration of anticoagulant treatment during CELEST RCT | During the 2-year celest study and during the long-term follow-up |
| Proportion of patients with any PTS | PTS present if PRVS≥5 or presence of a venous leg ulcer in the leg ipsilateral to index DVT | At the phone follow-up up to 3 months |
| Predictors of any PTS | Predictors of PTS (defined as a PRVS≥5 or presence of a venous leg ulcer in the leg ipsilateral to index DVT) in the whole cohort | At the phone follow-up up to 3 months |
| Proportion of patients who developed a serious adverse events (SAE) in the cohort | SAEs assessed are death, venous thromboembolic recurrence, major bleeding and peripheral arterial disease. SAEs are defined according to the International Society on Thrombosis and Haemostasis criteria. These events will be adjudicated by the study adjudication committee | During the 2-year celest study and during the long-term follow-up |
| Impact of PTS on patients' quality of life | Comparison of QOL scores according to the presence or absence of PTS and its severity; QOL will be assessed using CIVIQ-20 questionnaire | At the phone follow-up up to 3 months |
| 23682905 | Background | Ageno W, Squizzato A, Wells PS, Buller HR, Johnson G. The diagnosis of symptomatic recurrent pulmonary embolism and deep vein thrombosis: guidance from the SSC of the ISTH. J Thromb Haemost. 2013 Aug;11(8):1597-602. doi: 10.1111/jth.12301. No abstract available. |
| 26764429 | Background | Kaatz S, Ahmad D, Spyropoulos AC, Schulman S; Subcommittee on Control of Anticoagulation. Definition of clinically relevant non-major bleeding in studies of anticoagulants in atrial fibrillation and venous thromboembolic disease in non-surgical patients: communication from the SSC of the ISTH. J Thromb Haemost. 2015 Nov;13(11):2119-26. doi: 10.1111/jth.13140. No abstract available. |
| 31301689 | Background | Kraaijpoel N, Tritschler T, Guillo E, Girard P, Le Gal G. Definitions, adjudication, and reporting of pulmonary embolism-related death in clinical studies: A systematic review. J Thromb Haemost. 2019 Oct;17(10):1590-1607. doi: 10.1111/jth.14570. Epub 2019 Jul 31. |
| 8993100 | Background | Launois R, Reboul-Marty J, Henry B. Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ). Qual Life Res. 1996 Dec;5(6):539-54. doi: 10.1007/BF00439228. |
| 32230912 | Background | Makedonov I, Kahn SR, Galanaud JP. Prevention and Management of the Post-Thrombotic Syndrome. J Clin Med. 2020 Mar 27;9(4):923. doi: 10.3390/jcm9040923. |
| 25246013 | Background | Kahn SR, Comerota AJ, Cushman M, Evans NS, Ginsberg JS, Goldenberg NA, Gupta DK, Prandoni P, Vedantham S, Walsh ME, Weitz JI; American Heart Association Council on Peripheral Vascular Disease, Council on Clinical Cardiology, and Council on Cardiovascular and Stroke Nursing. The postthrombotic syndrome: evidence-based prevention, diagnosis, and treatment strategies: a scientific statement from the American Heart Association. Circulation. 2014 Oct 28;130(18):1636-61. doi: 10.1161/CIR.0000000000000130. Epub 2014 Sep 22. No abstract available. |
| 36455606 | Result | Galanaud JP, Genty-Vermorel C, Barrellier MT, Becker F, Jabbour V, Blaise S, Bura-Riviere A, Comte A, Grange C, Guenneguez H, Maufus M, Ouvry P, Richaud C, Rolland C, Schmidt J, Sevestre MA, Verriere F, Bosson JL; CELEST trial investigators. 25 mm Hg versus 35 mm Hg elastic compression stockings to prevent post-thrombotic syndrome after deep vein thrombosis (CELEST): a randomised, double-blind, non-inferiority trial. Lancet Haematol. 2022 Dec;9(12):e886-e896. doi: 10.1016/S2352-3026(22)00247-2. |
| 33313464 | Result | Galanaud JP, Genty-Vermorel C, Rolland C, Comte A, Ouvry P, Bertaina I, Verriere F, Bosson JL. Compression stockings to prevent postthrombotic syndrome: Literature overview and presentation of the CELEST trial. Res Pract Thromb Haemost. 2020 Oct 30;4(8):1239-1250. doi: 10.1002/rth2.12445. eCollection 2020 Nov. |
| D014689 |
| Venous Insufficiency |