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Venous ThromboembolismETHERNCT06731244

Shared Decision-making Process for Unprovoked vEnous THromboEmbolism Management. (ETHER )

A study testing shared decision-making process in people with Venous Thromboembolism, run by University Hospital, Brest at 20 sites in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) is a frequent disease and the third most common cause of cardiovascular death in the world after myocardial infarction and stroke. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Venous Thromboembolism
What is being tested?
shared decision-making process
Could I receive a placebo?
No, everyone receives an active treatment
How many people
2,400 participants
Where
20 sitesFrance
Study dates
30 Oct 2025to Oct 2035
Phase
Interventional
Are there results?
Not yet: the study is under way

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

  • Patient > or = 18 years,
  • Patient with a first episode of symptomatic unprovoked pulmonary embolism (PE) and/or proximal deep vein thrombosis (DVT) treated for 3 to 6 uninterrupted months with full dose anticoagulant therapy,
  • Signed informed consent.

Who cannot join

  • Unable or refusal to give informed consent,
  • Isolated distal DVT,
  • Isolated sub-segmental PE
  • Previous unprovoked VTE
  • Known CTEPH
  • Indication for anticoagulation other than DVT or PE (e.g.; atrial fibrillation, mechanic valves…),
Show all 11Show fewer
  • Interruption of anticoagulation for 14 days or more before the inclusion,
  • Active cancer of less than 24 months,
  • Current pregnancy,
  • Life expectancy <18 months (e.g.; patients with an end-stage chronic disease)
  • Not affiliated to national insurance, social security (only for France)

Trial locations and contacts

20 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Francis COUTURAUD, Prof. contact

+33298347348

francis.couturaud@chu-brest.fr

Hélène FORTIN-PRUNIER contact

+33221744115

helene.fortin-prunier@chu-brest.fr

20 sites in 1 country

France20 sites, 20 recruiting
  • CHU d'Amiens - Picardie

    Amiens, 80054

    Marie-Antoinette SEVESTRE, Dr., + 33322087306, sevestre.marie-antoinette@chu-amiens.fr

    Not yet recruiting
  • CHU d'Angers

    Angers, 49933

    Jeanne HERSANT, Dr., +33241353689, Jeanne.Hersant@chu-angers.fr

    Not yet recruiting
  • CHU Brest

    Brest, France, 29609

    Francis COUTURAUD, Prof, +33298347348, francis.couturaud@chu-brest.fr

    Recruiting
  • Hôpital National d'Instruction des Armées Percy

    Clamart, 92140

    Caroline DOUTRELON, Dr., +33141466252, caroline.doutrelon@intradef.gouv.fr

    Not yet recruiting
  • CHU de Clermont Ferrand

    Clermont-Ferrand, 63000

    Jeannot SCHMIDT, Prof., +33473754549, jschmidt@chu-clermontferrand.fr

    Not yet recruiting
  • APHP-Colombes

    Colombes, 92700

    Isabelle MAHE, Prof., +33147606490, isabelle.mahe@aphp.fr

    Not yet recruiting
  • CHU de Dijon - Hôpital François Mitterand

    Dijon, 21079

    Nicolas FALVO, Dr., +33380295586, nicolas.falvo@chu-dijon.fr

    Not yet recruiting
  • CH Le Mans

    Le Mans, 72037

    Claire NEVEUX, Dr., +33243434343, cneveux@ch-lemans.fr

    Not yet recruiting
  • HCL - Hôpital Edouard Herriot

    Lyon, 69003

    Judith CATELLA, Dr., +33472117791, judith.catella@chu-lyon.fr

    Not yet recruiting
  • APHM - Hôpital la Timone

    Marseille, 13005

    Gabrielle SARLON BARTOLI, Dr., +33491387023, gabrielle.sarlon@ap-hm.fr

    Not yet recruiting
  • CHU de Montpellier

    Montpellier, 34295

    Isabelle QUERE, Prof., +33467337025, i-quere@chu-montpellier.fr

    Not yet recruiting
  • CHU de Nancy

    Nancy, 54511

    Stéphane ZUILY, Prof., +33383153614, s.zuily@chru-nancy.fr

    Not yet recruiting
  • CHU de Nantes

    Nantes, 44093

    Jérôme CONNAULT, Dr., +33240083848, jerome.connault@chu-nantes.fr

    Not yet recruiting
  • CHU de Nîmes

    Nîmes, 30029

    Valérie RAY, Dr., +33466685131, valerie.ray@chu-nimes.fr

    Not yet recruiting
  • Aphp-Hegp

    Paris, 75015

    Olivier SANCHEZ, Prof., +33156093487, olivier.sanchez@aphp.fr

    Not yet recruiting
  • Aphp-Hegp

    Paris, 75015

    Lina Khider, Dr., +33156093077, lina.khider@aphp.fr

    Not yet recruiting
  • CHU de Rennes

    Rennes, 35200

    Alice BALLERIE, Prof., +33299284321, alice.ballerie@chu-rennes.fr

    Not yet recruiting
  • CHU Saint Etienne

    Saint-Etienne, 42270 Saint Priest En Jarez

    Laurent BERTOLETTI, Prof., + 33477127596, laurent.bertoletti@chu-st-etienne.fr

    Not yet recruiting
  • CHU de Strasbourg

    Strasbourg, 67091

    Dominique STEPHAN, Prof., +33369550952, Dominique.Stephan@chru-strasbourg.fr

    Not yet recruiting
  • CHU de Toulouse

    Toulouse, 31000

    Alessandra BURA-RIVIERE, Prof., +33561322448, bura-riviere.a@chu-toulouse.fr

    Not yet recruiting

Other trials in France

About this study

Official title: Prognosis Improvement of Unprovoked vEnous THromboEmbolism With the Use of a Shared Decision-making Process Including a Time-dependent Multicomponent Risk Prediction Scores inteRvention.

Venous thromboembolism (VTE) including deep vein thrombosis (DVT) and pulmonary embolism (PE) is a frequent disease and the third most common cause of cardiovascular death in the world after myocardial infarction and stroke. Anticoagulant therapy drastically reduces the risk of early VTE recurrence and death, but it exposes patients to a substantial risk of bleeding. Hence, determining the optimal duration of anticoagulant treatment for VTE is a major public health issue.

When major transient risk factors for VTE are identified (major surgery, immobilization...), patients generally do not need to extend anticoagulation beyond 3 months, whereas for VTE diagnosed in the context of cancer, therapeutic anticoagulation is required for as long as the cancer is considered "active".

Read more

However, in more than 50% of cases, venous thromboembolic disease occurs spontaneously, i.e. without any significant clinically detectable circumstance (known as unprovoked venous thromboembolic disease). In such patients, the risk of recurrence is high (35% recurrence rate at 5 years, with a 10% risk of death per recurrence). Scientific societies therefore recommend continuing anticoagulant treatment "indefinitely" (i.e. without programming a stop date or long-term treatment). However, this practice exposes these patients to an ongoing, non-negligible increase in the risk of bleeding, which could ultimately exceed the risk of recurrence of venous thrombo-embolic disease.

Optimizing anticoagulant therapy beyond the first three to six months of treatment is therefore a crucial and challenging issue, which could improve the long-term prognosis of patients with unprovoked thromboembolic venous disease.

Based on the quantitative and qualitative approaches implemented in MORPHEUS project granted by European Commission (HORIZON-HLTH-2022-TOOL-11-01 call), the investigators have combined predictive personalized medicine, through the use of risk biomarkers, with a patient-centered model of medicine, which, while based on an understanding of the patient's experience, leading to develop Time-Dependent Multicomponent risk prediction scores and socIo-anthropological scales (TDMI) integrated in a shared decision-making process regarding anticoagulant treatment duration in patients with a first episode of unprovoked VTE.

The aim of this study is to demonstrate that this strategy, based on a medical decision-making process shared between patients and physicians and including TDMI, reduces the risk of recurrence of thromboembolic venous disease (fatal or non-fatal), the risk of bleeding and all-cause mortality, and is associated with greater patient satisfaction after a first episode of unprovoked thromboembolic venous disease.

Being tested
Usual Care Group, shared decision-making process
Keywords
venous thrombosis, pulmonary embolism, Anticoagulant, deep vein thrombosis, stepped-wedge cluster randomized trial, shared-decision making
Medical subject headings
Venous Thromboembolism, Venous Thrombosis, Pulmonary Embolism

What participants receive

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

  • Usual Care GroupOther

    Patients will be managed as regards their anticoagulant treatment according to usual practice and in accordance with international guidelines.

  • shared decision-making processOther

    The intervention is based on a strategy based on a shared decision-making process which is a collaborative process that involves a patient and their healthcare professional working together to reach a joint decision about care (anticoagulant treatment).

    The shared decision-making process will be conducted as follows:

    • Step 1: prepare the risk estimates (risk of recurrent VTE, risk of bleeding) for the patient, based on time-dependent multicomponent risk prediction scores and socio-anthropological scales (TDMI) and other validated risk prediction scores and evidence-based medicine;
    • Step 2: Communicating risks, benefits and consequences to the patient;
    • Step 3: Make a joint decision about treatment and care, and agree together when this will be reviewed.
Study groups in NCT06731244
Study groupRoleWhat they receive
Control armActive comparatorAnticoagulant treatment management according to usual practice and international guidelines
Receives: Other: Usual Care Group
Experimental armExperimentalShared decision-making process integrating time-dependent multicomponent risk prediction scores and socio-anthropological scales (TDMI)
Receives: Other: shared decision-making process

What is being measured

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

  1. Hierarchical composite of adjudicated all-cause mortality, adjudicated symptomatic recurrent VTE (fatal or non-fatal PE or proximal DVT), adjudicated major and clinically relevant non-major bleeding, and patient's satisfaction

    For the statistical analysis, the investigators will analyse hierarchically each component of the composite (all-cause mortality, then VTE recurrence, then major bleeding or clinically relevant non-major bleeding and then patient's satisfaction in this order) using a win ratio approach to assess the primary composite outcome.

    Measured: From inclusion to 18th month follow-up

Secondary outcomes (17)
  1. Composite of adjudicated all-cause mortality, symptomatic recurrent VTE (fatal or non-fatal PE or proximal DVT) and major and clinically relevant non-major bleeding

    This clinical composite outcome will be compared between the intervention group and the control group at the individual level with a mixed effect cox model with a random intercept to account for the correlation between patients of a same cluster. The random intercept will correspond to a random period effect nested in a random cluster effect. Different covariance structure will be tested, the model will be selected as the best identifiable model that produces the lowest Bayesian Information Criterion (BIC) value. The effect of the intervention (shared decision-making process including a TDMI) will be then presented as the hazard ratio between the two groups of treatment and its corresponding 95% CI. A random cluster effect will be added to the treatment group effect, if necessary, to quantify any heterogeneity in the benefit of the intervention. The superiority test on this outcome will be performed only if the primary outcome is statistically demonstrated.

    Measured: At 18-month follow-up after inclusion

  2. Adjudicated all-cause mortality,

    Measured: At 18 months follow-up after inclusion

  3. Adjudicated symptomatic VTE recurrence

    Measured: At 18-month follow-up after inclusion

  4. Adjudicated major bleeding or clinically relevant non-major bleeding

    Measured: At 18-month follow-up after inclusion

  5. Adjudicated fatal recurrent VTE and fatal bleeding

    Measured: At 18-month follow-up after inclusion

  6. Patient's satisfaction

    Patient's satisfaction will be defined with the Patient Activation Measure - PAM score using 13 items measures that assess patient's knowledge, skill, and confidence for self-management. The scoring (for each criteria) is:

    • Strongly disagree = 1
    • Disagree = 2
    • Agree = 3
    • Strongly agree = 4

    Measured: At 18-month follow-up after inclusion

  7. Quality of life (QoL) assessed using PembQoL questionnaire

    Evaluation only for patients with symptomatic PE. The PEmb-QoL Score is ranged between 0% and 100% for each of its 6 dimensions. Higher scores indicate worse outcome.

    Measured: At 18 months after inclusion

  8. Quality of life (QoL) assessed using mMRC dyspnea score

    Evaluation only for patients with symptomatic PE. Scale ranged from 0 (no dyspnea) to 5 (worst grade)

    Measured: At 18 months after inclusion

  9. Quality of life (QoL) assessed using VEINQol questionnaire

    Evaluation only for patients with symptomatic DVT. Responses are rated on two-point to seven-point Likert response scales of intensity, frequency, or agreement.

    Measured: At 18 months after inclusion

  10. Quality of life (QoL) assessed using Villalta score

    Evaluation only for patients with symptomatic DVT. The total Villalta score, ranging from 0 to 33, will be assessed in both legs and used to categorize the severity of PTS in the index leg as mild (score, 5-9), moderate (score, 10-14), or severe (score, ≥15 or presence of ulceration).

    Measured: At 18 months after inclusion

  11. Quality of life (QoL) assessed using EQ-5D5L questionnaire

    Five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels. The patient is asked to indicate his/her health state.

    Measured: At 18 months after inclusion

  12. Quality of life (QoL) assessed using PVFS scale patients

    Scale ranged from 0 (normal functional status) to 5 (worse grade)

    Measured: At 18 months after inclusion

  13. Therapeutic adherence to anticoagulant treatment

    Therapeutic adherence using Girerd's questionnaire: 6 items. Score 0 = good compljance ; Score 1-2 = minor concern in compliance ; Score ≥ 3 = bad compliance.

    Measured: At18-month follow-up after inclusion

  14. Occurence of objectively diagnosed cancer: site, localized, locally advanced, metastatic

    Cancers will be classified according the site and the extend (localized, locally advanced, metastatic).

    Measured: From inclusion to 18th months follow-up

  15. Occurence of minor or atypical venous thrombosis

    Minor venous thrombosis includes superficial vein thrombosis, muscular and distal deep vein thrombosis. Atypical venous thrombosis includes: Proximal upper limbs Superior vena cava, Cerebral venous thrombosis, Portal thrombosis, Mesenteric thrombosis, Sus-hepatic vein thrombosis, Renal thrombosis, Ovarian vein thrombosis, Uterine vein thrombosis, Retinal vein thrombosis.

    Measured: At 18-month follow-up after inclusion

  16. Adjudicated objectively diagnosed acute arterial thromboembolic events according to international guidelines: stroke, myocardial infarction, peripheral arterial thromboembolic event, atrial fibrillation, any cardiac event other than VTE

    Measured: At 18-month follow-up after inclusion

  17. Adjudicated objectively confirmed chronic thromboembolic pulmonary disease and chronic thromboembolic pulmonary hypertension

    Measured: At 18-month follow-up after inclusion

Timeline

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

  1. First posted12 Dec 2024
  2. Study start30 Oct 2025
  3. Primary completionOct 2035 (estimated)
  4. Study completionOct 2035 (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 N/A
Primary purpose
Other
Allocation
Randomised
Intervention model
Sequential
Model description
ETHER is a stepped wedge cluster randomized trial
Masking
None (open label)
Enrolment
2,400 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06731244
Sponsor's protocol ID
29BRC23.0189
Other IDs
2024-A01652-45
Acronym
ETHER
Status last verified
Nov 2025
First submitted
8 Nov 2024
Last updated
28 Nov 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing shared decision-making process in people with Venous Thromboembolism, run by University Hospital, Brest at 20 sites in France.

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 3 inclusion and 11 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: looking for participants now, as of the sponsor's last update on 28 Nov 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 20 sites in France. 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?

This study is still under way. Results are not available in the source record yet.

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

Contact Francis COUTURAUD, Prof. (+33298347348, francis.couturaud@chu-brest.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Hierarchical composite of adjudicated all-cause mortality, adjudicated symptomatic recurrent VTE (fatal or non-fatal PE or proximal DVT), adjudicated major and clinically relevant non-major bleeding, and patient's satisfaction (time frame: From inclusion to 18th month follow-up). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 28 Nov 2025.

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