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Deep Venous ThrombosisNCT03271450

The DARE Warfarin CER Study

An observational study of Deep Venous Thrombosis and Pulmonary Embolism, run by Brigham and Women's Hospital at 1 site in United States.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Approximately half a million Americans annually experience venous thromboembolic disease, including deep venous thrombosis (DVT) and pulmonary embolism (PE). Since 2010, four new oral anticoagulants have been approved for marketing in addition to the vitamin K antagonist warfarin. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Deep Venous Thrombosis, Pulmonary Embolism
What is being tested?
Dabigatran: extended treatment (e.g at least 90 days), Dabigatran: extended treatment (e.g at least 180 days) and Dabigatran: extended treatment (e.g at least 270 days)
How many people
416,000 participants
Where
1 siteUnited States
Study dates
1 Jul 2017to 30 Oct 2021
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: Cohort derived from a commercial database, MarketScan, and Medicare Research Identifiable Files using data from 2009-2015. Cohort data will be updated as new data come in through 2019.

Who may be able to join

  • Inpatient stay with diagnosis code of DVT/PE (see Appendix A), 1/1/2010 - 9/30/2015 for which the patient has at least 365 days continuous medical and pharmacy eligibility prior and no other inpatient stays with DVT/PE diagnosis. Set discharge date as index diagnosis date. Take only the first eligible episode for a patient, if multiple.
  • Prescription fill for an anticoagulant [generic name=dabigatran (150mg), apixaban (2.5mg, 5mg, 10mg), rivaroxaban (15mg, 20mg), edoxaban (30mg, 60mg), or warfarin] within 30 days of and including index diagnosis date. Set earliest anticoagulant prescription as index generic and date as index rx date.
  • No anticoagulant prescription fill in the 365 days prior to index diagnosis date.
  • Continuous enrollment and use of an anticoagulant for the first 90 days including and following the index rx date, defined as no gaps in therapy >7 days. For each patient, assign a variable to indicate whether the patient filled an anticoagulant with a different generic name as index during this period.

Who cannot join

  • Any safety outcome between index diagnosis date and index rx date + 90, defined as: intracranial bleed, gastrointestinal bleed, or other major bleed.
  • Any DVT/PE between index diagnosis date and index rx date + 90.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Brigham and Women's Hospital

    Boston, Massachusetts, 02120

Other trials in United States

About this study

Official title: The Dabigatran, Apixaban, Rivaroxaban, Edoxaban, Warfarin Comparative Effectiveness Research Study

Approximately half a million Americans annually experience venous thromboembolic disease, including deep venous thrombosis (DVT) and pulmonary embolism (PE). Since 2010, four new oral anticoagulants have been approved for marketing in addition to the vitamin K antagonist warfarin. Very limited head-to-head data exists comparing these treatment options, leaving patients, clinicians, and other stakeholders with little guidance for selecting the best strategy that balances recurrence reduction with risk of bleeding. In the DARE Warfarin CER Study, the researchers compare all five currently available oral anticoagulant agents for the extended treatment of DVT and PE, as well as no extended treatment. This study also aims to evaluate whether treatment heterogeneity exists for specific populations, such as older patients or those with renal dysfunction. In a secondary aim, the study will also leverage a database of linked electronic health record-insurance claims to validate diagnosis definitions and account for potential residual confounding by factors unmeasured in claims data. As the patient population includes all Medicare novel anticoagulant users and large numbers of commercially insured and Medicaid patients, the results will likely be transportable to the majority of US patients experiencing a DVT or PE. Pursuant to the objectives of the Patient-Centered Outcomes Research Institute, a study advisory committee consisting of key stakeholders will be actively involved in the study design and dissemination of results.

Being tested
Dabigatran: extended treatment (e.g at least 90 days), Dabigatran: extended treatment (e.g at least 180 days), Dabigatran: extended treatment (e.g at least 270 days), Apixaban: extended treatment (e.g at least 90 days), Apixaban: extended treatment (e.g at least 180 days)
Keywords
dabigatran, warfarin, apixaban, edoxaban, extended treatment, oral anticoagulant, rivaroxaban, comparative safety, comparative effectiveness
Medical subject headings
Venous Thrombosis, Pulmonary Embolism

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Dabigatran: extended treatment (e.g at least 90 days)Drug

    90 days

  • Dabigatran: extended treatment (e.g at least 180 days)Drug

    180 days

  • Dabigatran: extended treatment (e.g at least 270 days)Drug

    270 days

  • Apixaban: extended treatment (e.g at least 90 days)Drug

    90 days

  • Apixaban: extended treatment (e.g at least 180 days)Drug

    180 days

  • Apixaban: extended treatment (e.g at least 270 days)Drug

    270 days

  • Rivaroxaban: extended treatment (e.g at least 90 days)Drug

    90 days

  • Rivaroxaban: extended treatment (e.g at least 180 days)Drug

    180 days

  • Rivaroxaban: extended treatment (e.g at least 270 days)Drug

    270 days

  • Edoxaban: extended treatment (e.g at least 90 days)Drug

    90 days

  • Edoxaban: extended treatment (e.g at least 180 days)Drug

    180 days

  • Edoxaban: extended treatment (e.g at least 270 days)Drug

    270 days

  • Warfarin: extended treatment (e.g at least 90 days)Drug

    90 days

  • Warfarin: extended treatment (e.g at least 180 days)Drug

    180 days

  • Warfarin: extended treatment (e.g at least 270 days)Drug

    270 days

Study groups in NCT03271450
Study groupRoleWhat they receive
Continuer at 90 Days: DabigatranNot described
Receives: Drug: Dabigatran: extended treatment (e.g at least 90 days)
Continuer at 180 Days: DabigatranNot described
Receives: Drug: Dabigatran: extended treatment (e.g at least 180 days)
Continuer at 270 Days: DabigatranNot described
Receives: Drug: Dabigatran: extended treatment (e.g at least 270 days)
Continuer at 90 Days: ApixabanNot described
Receives: Drug: Apixaban: extended treatment (e.g at least 90 days)
Continuer at 180 Days: ApixabanNot described
Receives: Drug: Apixaban: extended treatment (e.g at least 180 days)
Continuer at 270 Days: ApixabanNot described
Receives: Drug: Apixaban: extended treatment (e.g at least 270 days)
Continuer at 90 Days: RivaroxabanNot described
Receives: Drug: Rivaroxaban: extended treatment (e.g at least 90 days)
Continuer at 180 Days: RivaroxabanNot described
Receives: Drug: Rivaroxaban: extended treatment (e.g at least 180 days)
Continuer at 270 Days: RivaroxabanNot described
Receives: Drug: Rivaroxaban: extended treatment (e.g at least 270 days)
Continuer at 90 Days: EdoxabanNot described
Receives: Drug: Edoxaban: extended treatment (e.g at least 90 days)
Continuer at 180 Days: EdoxabanNot described
Receives: Drug: Edoxaban: extended treatment (e.g at least 180 days)
Continuer at 270 Days: EdoxabanNot described
Receives: Drug: Edoxaban: extended treatment (e.g at least 270 days)
Continuer at 90 Days: WarfarinNot described
Receives: Drug: Warfarin: extended treatment (e.g at least 90 days)
Continuer at 180 Days: WarfarinNot described
Receives: Drug: Warfarin: extended treatment (e.g at least 180 days)
Continuer at 270 Days: WarfarinNot described
Receives: Drug: Warfarin: extended treatment (e.g at least 270 days)
Discontinuer at 90 Days: DabigatranNot described
Receives: Drug: Dabigatran: extended treatment (e.g at least 90 days)
Discontinuer at 180 Days: DabigatranNot described
Receives: Drug: Dabigatran: extended treatment (e.g at least 180 days)
Discontinuer at 270 Days: DabigatranNot described
Receives: Drug: Dabigatran: extended treatment (e.g at least 270 days)
Discontinuer at 90 Days: ApixabanNot described
Receives: Drug: Apixaban: extended treatment (e.g at least 90 days)
Discontinuer at 180 Days: ApixabanNot described
Receives: Drug: Apixaban: extended treatment (e.g at least 180 days)
Discontinuer at 270 Days: ApixabanNot described
Receives: Drug: Apixaban: extended treatment (e.g at least 270 days)
Discontinuer at 90 Days: RivaroxabanNot described
Receives: Drug: Rivaroxaban: extended treatment (e.g at least 90 days)
Discontinuer at 180 Days: RivaroxabanNot described
Receives: Drug: Rivaroxaban: extended treatment (e.g at least 180 days)
Discontinuer at 270 Days: RivaroxabanNot described
Receives: Drug: Rivaroxaban: extended treatment (e.g at least 270 days)
Discontinuer at 90 Days: EdoxabanNot described
Receives: Drug: Edoxaban: extended treatment (e.g at least 90 days)
Discontinuer at 180 Days: EdoxabanNot described
Receives: Drug: Edoxaban: extended treatment (e.g at least 180 days)
Discontinuer at 270 Days: EdoxabanNot described
Receives: Drug: Edoxaban: extended treatment (e.g at least 270 days)
Discontinuer at 90 Days: WarfarinNot described
Receives: Drug: Warfarin: extended treatment (e.g at least 90 days)
Discontinuer at 180 Days: WarfarinNot described
Receives: Drug: Warfarin: extended treatment (e.g at least 180 days)
Discontinuer at 270 Days: WarfarinNot described
Receives: Drug: Warfarin: extended treatment (e.g at least 270 days)

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Composite Safety Outcome: Intracranial bleed, Gastrointestinal bleed, Other Major bleed

    Defined as a new episode of either Intracranial bleed, Gastrointestinal bleed or another Major bleed event during follow-up.

    Measured: 1-2 Years

  2. Composite Effectiveness Outcome: Deep Venous Thrombosis, Pulmonary Embolism

    Defined as a new episode of either Deep Venous Thrombosis or Pulmonary Embolism during follow-up.

    Measured: 1-2 Years

  3. Death

    Measured after index prescription date + 90 days and on date on which the event occurred and defined as hospitalization with discharge status code of: 20, 22-29, 40-42

    Measured: 1-2 Years

  4. Composite safety and effectiveness outcome

    defined as earlier of safety or DVT/PE outcomes

    Measured: 1-2 years

  5. Composite safety and effectiveness outcome, including death

    Measured after index prescription date + 90 days and on date on which the event occurred and defined as hospitalization with discharge status code of: 20, 22-29, 40-42

    Measured: 1-2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted5 Sep 2017
  2. Study start1 Jul 2017
  3. Primary completion30 Oct 2021 (estimated)
  4. Study completion30 Oct 2021 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Other
Enrolment
416,000 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03271450
Sponsor's protocol ID
2017P000215
Status last verified
Jun 2021
First submitted
24 Aug 2017
Last updated
23 Jun 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Krumme AA, Pawar A, Schneeweiss S, Glynn RJ, Choudhry NK, Kulldorff M, Ortiz AS, Avorn J, Gagne JJ. Study protocol for the dabigatran, apixaban, rivaroxaban, edoxaban, warfarin comparative effectiveness research study. J Comp Eff Res. 2018 Jan;7(1):57-66. doi: 10.2217/cer-2017-0053. Epub 2017 Dec 21.

    PubMed 29264930

Questions about this trial

What is this clinical trial studying?

An observational study of Deep Venous Thrombosis and Pulmonary Embolism, run by Brigham and Women's Hospital at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 23 Jun 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Composite Safety Outcome: Intracranial bleed, Gastrointestinal bleed, Other Major bleed (time frame: 1-2 Years). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03271450, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 23 Jun 2021.

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The DARE Warfarin CER Study (NCT03271450) | AzTrials