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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT02260414
Other study ID # 1408049
Secondary ID 2014-000946-31
Status Completed
Phase Phase 2
First received October 2, 2014
Last updated May 10, 2017
Start date April 14, 2015
Est. completion date May 9, 2017

Study information

Verified date May 2017
Source Centre Hospitalier Universitaire de Saint Etienne
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

In cancer, the incidence of venous thromboembolism (VTE) is particularly high in patients with myeloma, especially when it is de novo and treated with thalidomide, lenalidomide or erythropoietin. Curiously, the prevention of VTE with LMWH (low-molecular-weight heparin) in myeloma seems no more effective than that achieved with aspirin, while the effectiveness of the latter in the primary prevention of VTE has never been demonstrated regardless of the type of population considered. Meanwhile, a biological study showed that prophylactic doses of LMWH in patients with different types of cancer did not always optimal reduction of thrombin peak during the 24 hours following the injection of LMWH. These clinical and biological studies lead to the conclusion that patients with myeloma may be resistant to the usual doses of preventive LMWH, which may explain the failure of prevention.

Initially we intend to investigate whether this resistance to prophylactic doses of LMWH is present in patient's biology and if this resistance is specific to myeloma in hematological cancers. For this, we propose to study the evolution of thrombin generation by Thrombinography during 24 hours after subcutaneous injection of 4500 anti-Xa IU Tinzaparin in 6 patients with de novo myeloma whit high thrombo embolic risk ie treated with thalidomide, lenalidomide or erythropoietin. LMWH is Tinzaparin chosen because it does not accumulate in patients with impaired renal function, and has a greater anti-biological activity thrombotic than other LMWH.

To assess whether the observed pattern of thrombin generation is particularly multiple myeloma, we will take the same study in 6 patients with aggressive lymphoma and 6 medical patients hospitalized for acute heart and respiratory failure.


Recruitment information / eligibility

Status Completed
Enrollment 19
Est. completion date May 9, 2017
Est. primary completion date May 9, 2017
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria:

1. Body weight between 40 and 100 kg

2. Patient:

2a- With multiple myeloma indication with de novo standard treatment thalidomide or lenalidomide or erythropoietin (group 1) 2b- Or hospitalized for aggressive lymphoma treated with chemotherapy (group 2) 2c- Or older than 40 years and hospitalized at least three days for an acute medical pathology type of acute respiratory or cardiac (group 3) decompensation

Exclusion Criteria:

- Patient requiring anticoagulant therapy at curative doses

- Patients with a lower platelet count 80 G / L

- Subject with a history of heparin-induced thrombocytopenia

- Subject with a history of hemorrhagic disease

- History of severe trauma within 6 weeks prior to enrollment

- Organic lesion at risk of bleeding

- Poor renal with creatinine clearance <30 ml / min

- Hypersensitivity to Tinzaparin

- Events or bleeding tendencies associated with coagulation disorders

- Subject on oral anticoagulant

- For group 3: Presence of hematological malignancy or active cancer

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
Tinzaparin
single subcutaneous injection of 4500 IU tinzaparin
Other:
Blood sample
blood sample taken at hours 0, 3, 8, 18 and 24 after subcutaneous injection of 4500 IU tinzaparin

Locations

Country Name City State
France CHU de Saint-Etienne Saint-Etienne

Sponsors (2)

Lead Sponsor Collaborator
Centre Hospitalier Universitaire de Saint Etienne LEO Pharma

Country where clinical trial is conducted

France, 

Outcome

Type Measure Description Time frame Safety issue
Primary Endogenous Thrombin Potential (ETP, nM.min) for all patients with de novo myeloma with high thrombotic risk Endogenous Thrombin Potential (i.e. the aera under the thrombin generation curve, nM.min) is measured by Thromboplastin Generation Tests (TGTs) following a single injection of 4500 IU tinzaparin hours : 0, 3, 8, 18, 24
Secondary Endogenous Thrombin Potential (ETP, nM.min) for all patients with aggressive lymphoma treated with chemotherapy Endogenous Thrombin Potential (i.e. the aera under the thrombin generation curve, nM.min) is measured by Thromboplastin Generation Tests (TGTs) following a single injection of 4500 IU tinzaparin hours : 0, 3, 8, 18, 24
Secondary Endogenous Thrombin Potential (ETP, nM.min) for all patients with over 40 years hospitalized for heart or respiratory failure Endogenous Thrombin Potential (i.e. the aera under the thrombin generation curve, nM.min) is measured by Thromboplastin Generation Tests (TGTs) following a single injection of 4500 IU tinzaparin hours : 0, 3, 8, 18, 24
Secondary Differences of Endogenous Thrombin Potential (ETP, nM.min) between group 1 and group 2 et 3 Endogenous Thrombin Potential (i.e. the aera under the thrombin generation curve, nM.min) is measured by Thromboplastin Generation Tests (TGTs) following a single injection of 4500 IU tinzaparin hours : 0, 3, 8, 18, 24
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