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Post-Thrombotic SyndromePhase 3MUFFIN-PTSNCT03833024

The MUFFIN-PTS Trial

A Phase 3 study testing Micronized Purified Flavonoid Fraction in people with Post-Thrombotic Syndrome, run by Sir Mortimer B. Davis - Jewish General Hospital at 7 sites in Canada.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

In this randomized controlled trial (RCT), the investigators will determine whether a 6-month course of oral Micronized Purified Flavonoid Fraction (MPFF 1000 mg daily), compared with placebo, improves the symptoms and signs of the post-thrombotic syndrome (PTS) and quality of life (QOL) at 6 months follow-up. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Post-Thrombotic Syndrome
What is being tested?
Micronized Purified Flavonoid Fraction
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
88 participants
Where
7 sitesCanada
Study dates
4 Feb 2022to 30 May 2024
Phase
Phase 3
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

Who may be able to join

  • Villalta score ≥5 with at least two of the following four PTS manifestations (daily heaviness, cramps, pain, and objective edema) in the leg ipsilateral to a previous objectively diagnosed DVT, or DVT of unknown date but with presence of residual proximal or distal venous obstruction on ultrasound. Females of childbearing age must use medically approved method of birth control and must have negative pregnancy test results at the time of randomization.

Who cannot join

  • Recent acute ipsilateral DVT (<3 months)
  • Active ipsilateral venous ulcer
  • Acute or chronic altered mental status
  • Any venoactive drug intake within 3 months of the start of the study
  • Allergy or hypersensitivity to MPFF/Venixxa
  • Age<18 years
Show all 15Show fewer
  • Pregnant or breastfeeding women
  • Life expectancy <1 year
  • Refuse or unwilling to provide consent
  • Unable to speak English or French
  • Alcohol/drug abuse
  • Hospitalized patients
  • End-stage kidney disease (dialysis, creatinine clearance < 10ml/min)
  • Liver cirrhosis Child-Pugh class C.
  • Currently enrolled in other clinical trials, other than trials of prevention or treatment of venous thromboembolism

Trial locations and contacts

7 sites in 1 country.

7 sites in 1 country

Canada7 sites
  • Queen Elizabeth II Health Sciences Centre

    Halifax, Nova Scotia, B3H 3A7

  • Hamilton General Hospital

    Hamilton, Ontario, L8L 2X2

  • Sir Mortimer B. Davis - Jewish General Hospital

    Montreal, Quebec, H3T 1E2

  • Ottawa Hospital Research Institute

    Ottawa, Ontario, K1Y 4E9

  • Sunnybrook Health Sciences Centre

    Toronto, Ontario, M4N 3M5

  • Toronto General Hospital

    Toronto, Ontario, M5G 1Z5

  • Vancouver General Hospital

    Vancouver, British Columbia

Other trials in Canada

About this study

Official title: The MUFFIN-PTS Trial: Micronized Purified Flavonoid Fraction for the Treatment of Post-Thrombotic Syndrome

In this randomized controlled trial (RCT), the investigators will determine whether a 6-month course of oral Micronized Purified Flavonoid Fraction (MPFF 1000 mg daily), compared with placebo, improves the symptoms and signs of the post-thrombotic syndrome (PTS) and quality of life (QOL) at 6 months follow-up.

Read the detailed description

The post thrombotic syndrome (PTS) is a form of secondary chronic venous insufficiency (CVI) that develops after a deep vein thrombosis (DVT). It affects up to 50% of patients after a proximal DVT (i.e. DVT involving popliteal vein or more proximal veins), and 5-10% of patients develop severe PTS. PTS is a chronic condition that reduces quality of life (QOL) and for which no curative treatment is available. Cornerstones of PTS treatment include the use of elastic compression stockings (ECS) to reduce leg symptoms and prevent PTS progression. However, ECS are incompletely effective, burdensome and costly to patients. Micronized Purified Flavonoid Fraction (MPFF, Venixxa), a venoactive drug, has been reported to be effective in reducing venous symptoms and signs and improving QOL in patients with CVI and has the potential to be effective for the treatment of PTS. Further, use of Venixxa is safe, with only few very mild and reversible reported side effects. However, studies of MPFF in patients with CVI have been of low to moderate quality, and there has been little use of this drug in North America. In addition, the effectiveness of MPFF has never been specifically evaluated in patients with PTS. Given that the pathophysiological mechanism of PTS is complex and unique (combination of obstructive and reflux mechanisms as well as inflammation), it is uncertain if MPFF is effective in patients with PTS, even if it may be effective for CVI more generally.

The MUFFIN-PTS study will be a multicentre (8-10 centres), randomized, placebo-controlled trial. Patients will be randomized (1:1 with stratification by centre) to receive 1000 mg of oral MPFF (Venixxa, one 500mg tablet BID) or an identically appearing placebo (one tablet BID) for 6 months, in addition to their usual PTS and DVT treatment (i.e. ECS and/or anticoagulation, at their treating physician's discretion). Its objectives are to evaluate the effectiveness and safety of MPFF (Venixxa) compared to placebo for the treatment of PTS.

86 patients with lower limb PTS will be enrolled in the study.

Being tested
Micronized Purified Flavonoid Fraction, Placebo
Keywords
deep vein thrombosis, chronic venous insufficiency, venoactive drug, Micronized Purified Flavonoid Fraction, DVT, post thrombotic syndrome
Medical subject headings
Postthrombotic Syndrome, Venous Thrombosis

What participants receive

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

  • Micronized Purified Flavonoid FractionDrug

    Also called Venixxa group

    After randomization (1:1 with stratification by centre) patients will receive 1000 mg of oral MPFF (Venixxa, one 500mg tablet BID) for 6 months, in addition to their usual PTS and DVT treatment

  • PlaceboDrug

    Also called Placebo group

    After randomization (1:1 with stratification by centre) patients will receive an oral placebo (one tablet BID) for 6 months, in addition to their usual PTS and DVT treatment

Study groups in NCT03833024
Study groupRoleWhat they receive
VenixxaActive comparatorMicronized Purified Flavonoid Fraction (MPFF) for 6 months MPFF 500 mg, BID (morning and evening) for 6 months
Receives: Drug: Micronized Purified Flavonoid Fraction
PlaceboPlacebo comparatorPlacebo for 6 months 1 Tablet, BID (morning and evening) for 6 months
Receives: Drug: Placebo

What is being measured

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

  1. Change in PTS

    Improvement will be defined as a decrease of at least 30% in the Villalta score or a Villalta score <5 in the PTS-affected leg.

    Measured: 6 months

Secondary outcomes (19)
  1. Severity of PTS

    Villalta score category (mild, moderate, severe)

    Measured: baseline, 3, 6 and 9 months

  2. Change in PTS

    Improvement will be defined as a decrease of at least 30% in the Villalta score or a Villalta score <5 in the PTS-affected leg.

    Measured: 3 and 9 months

  3. Venous specific Quality of life

    Venous-disease specific (VEINES-QOL) score

    Measured: 3, 6 and 9 months

  4. General Quality of life

    Generic QOL (EQ-5D-5L) score. The EQ-5D-5L consists of the EQ-5D-5L descriptive system and the EQ Visual Analogue scale (EQ VAS). The descriptive system comprises 5 dimensions (mobility, self care, usual activities, pain/discomfort, anxiety/depression). Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. This decision results in a 1-digit number expressing the level selected for that dimension. The digits for 5 dimensions can be combined in a 5-digit number describing the respondent's health state.

    The EQ VAS records the respondent's self-rated health on a 20 cm vertical, visual analogue scale with endpoints labelled 'the best health you can imagine' and 'the worst health you can imagine'. This information can be used as a quantitative measure of health as judged by the individual respondents.

    Measured: 3, 6 and 9 months

  5. Serious Adverse Events (SAE)

    Includes drug-related SAE, DVT, Pulmonary Embolism (PE), death

    Measured: 9 months

  6. Patient compliance with treatment

    Judged satisfactory if at least 80% of the study drug was reportedly taken

    Measured: 3 and 6 months

  7. Patients' overall satisfaction with treatment

    Assessed with a 5-point Likert visual analog scale questionnaire (1 indicate patient is very satisfied with treatment and 5 that he is very unsatisfied)

    Measured: 3 and 6 months

  8. Villalta score

    Villalta score assessed as a continuous variable (greater score indicates more severe disease, score range 0 to 33)

    Measured: 3, 6, 9 months

  9. Pain as a symptom of PTS

    Analyzed as individual component of Villalta score (0 absent to 3 severe)

    Measured: 3, 6, 9 months

  10. Cramps

    Analyzed as individual component of Villalta score (0 absent to 3 severe)

    Measured: 3, 6, 9 months

  11. Heaviness

    Analyzed as individual component of Villalta score (0 absent to 3 severe)

    Measured: 3, 6, 9 months

  12. Paresthesia

    Analyzed as individual component of Villalta score (0 absent to 3 severe)

    Measured: 3, 6, 9 months

  13. Pruritus

    Analyzed as individual component of Villalta score (0 absent to 3 severe)

    Measured: 3, 6, 9 months

  14. Pre-tibial edema

    Analyzed as individual component of Villalta score (0 absent to 3 severe)

    Measured: 3, 6, 9 months

  15. Hyperpigmentation

    Analyzed as individual component of Villalta score (0 absent to 3 severe)

    Measured: 3, 6, 9 months

  16. Redness

    Analyzed as individual component of Villalta score (0 absent to 3 severe)

    Measured: 3, 6, 9 months

  17. Skin induration

    Analyzed as individual component of Villalta score (0 absent to 3 severe)

    Measured: 3, 6, 9 months

  18. Venous ectasia

    Analyzed as individual component of Villalta score (0 absent to 3 severe)

    Measured: 3, 6, 9 months

  19. Venous Ulcer

    Analyzed as individual component of Villalta score (0 absent or 1 present)

    Measured: 3, 6, 9 months

Timeline

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

  1. First posted6 Feb 2019
  2. Study start4 Feb 2022
  3. Primary completion30 Mar 2024 (estimated)
  4. Study completion30 May 2024 (estimated)

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Multicentre, randomized, placebo-controlled trial
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
88 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03833024
Sponsor's protocol ID
332593-S1
Acronym
MUFFIN-PTS
Status last verified
Nov 2023
First submitted
30 Jan 2019
Last updated
30 Nov 2023
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: Open access to individual patient data is not planned, but all requests for the trial's data will be considered on an individual basis by the trial steering committee

Publications

  • Kahn SR, Pengo V. Special issue: Late consequences of venous thromboembolism. Thromb Res. 2018 Apr;164:99. doi: 10.1016/j.thromres.2018.02.005. Epub 2018 Feb 13. No abstract available.

    PubMed 29459016
  • Rabinovich A, Kahn SR. How I treat the postthrombotic syndrome. Blood. 2018 May 17;131(20):2215-2222. doi: 10.1182/blood-2018-01-785956. Epub 2018 Mar 15.

    PubMed 29545327
  • 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.

    PubMed 25246013
  • Galanaud JP, Monreal M, Kahn SR. Epidemiology of the post-thrombotic syndrome. Thromb Res. 2018 Apr;164:100-109. doi: 10.1016/j.thromres.2017.07.026. Epub 2017 Jul 24.

    PubMed 28844444
  • Cohen JM, Akl EA, Kahn SR. Pharmacologic and compression therapies for postthrombotic syndrome: a systematic review of randomized controlled trials. Chest. 2012 Feb;141(2):308-320. doi: 10.1378/chest.11-1175.

    PubMed 22315114
  • Martinez-Zapata MJ, Vernooij RW, Uriona Tuma SM, Stein AT, Moreno RM, Vargas E, Capella D, Bonfill Cosp X. Phlebotonics for venous insufficiency. Cochrane Database Syst Rev. 2016 Apr 6;4(4):CD003229. doi: 10.1002/14651858.CD003229.pub3.

    PubMed 27048768
  • Bush R, Comerota A, Meissner M, Raffetto JD, Hahn SR, Freeman K. Recommendations for the medical management of chronic venous disease: The role of Micronized Purified Flavanoid Fraction (MPFF). Phlebology. 2017 Apr;32(1_suppl):3-19. doi: 10.1177/0268355517692221.

    PubMed 28211296
  • Rabe E, Agus GB, Roztocil K. Analysis of the effects of micronized purified flavonoid fraction versus placebo on symptoms and quality of life in patients suffering from chronic venous disease: from a prospective randomized trial. Int Angiol. 2015 Oct;34(5):428-36. Epub 2015 May 14.

    PubMed 25972136
  • Galanaud JP, Abdulrehman J, Lazo-Langner A, Le Gal G, Shivakumar S, Schulman S, Kahn S. MUFFIN-PTS trial, Micronized Purified Flavonoid Fraction for the Treatment of Post-Thrombotic Syndrome: protocol of a randomised controlled trial. BMJ Open. 2021 Sep 13;11(9):e049557. doi: 10.1136/bmjopen-2021-049557.

    PubMed 34518263

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Micronized Purified Flavonoid Fraction in people with Post-Thrombotic Syndrome, run by Sir Mortimer B. Davis - Jewish General Hospital at 7 sites in Canada.

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 1 inclusion and 15 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 30 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 7 sites in Canada. 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

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?

Change in PTS (time frame: 6 months). 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 NCT03833024, which also lists 9 linked publications.

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 30 Nov 2023.

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