Pulmonary Embolism Clinical Trial
Official title:
PREPIC 2 : Interruption of Inferior Vena Cava by a Retrievable Filter for the Prevention of Recurrent Pulmonary Embolism : a Randomised, Open Label Study
The purpose of this study is to assess efficacy and safety of optional vena cava filter implanted 3 months in prevention of recurrent pulmonary embolism in patients presenting with acute pulmonary embolism associated with thrombotic risk factors
Pulmonary embolism is a common pathology, which could be fatal (about 10 000 death/year in
France). It mainly originates from a deep vein thrombosis. In order to reduce mortality,
prevention of new or recurrent PE is a major therapeutic aim. Only one randomised trial
(PREPIC) assessed the interest of a vena cava filter in patients treated by anticoagulant
treatment for a deep vein thrombosis (DVT). Results show a significant 50 % reduction of the
embolic risk with the filter. This benefit occurs from the first days, but are
counterbalanced by a long-term increasing risk of recurrent DVT. The filter appears
promising in patients with a high risk of PE, for exemple the elderly, presenting with a
thromboembolic history, cancer, heart failure or respiratory insufficiency, or a recent PE.
Moreover, retrievable filters, which may be either left in place permanently or retrieved
after some days or weeks, could limit the filter thrombosis risk.
The aim of PREPIC 2 study is to assess, in a multicenter randomised trial, efficacy and
safety of a retrievable vena cava filter implanted 3 months versus no filter in 400 patients
treated with anticoagulant drugs for a symptomatic PE associated with at least one
thrombotic risk factor. A clinical follow-up will be performed at 6 months. The primary
outcome is the incidence of recurrent PE at 3 months, including symptomatic and fatal PE. It
will be adjudicated by an independent committee, blinded to patients' allocation.
This study will assess the benefit risk ratio of the retrievable filter for the prevention
of recurrent PE, without increasing the thrombotic risk and the disadvantage due to post
thrombotic syndrome.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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