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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00687882
Registration number
NCT00687882
Ethics application status
Date submitted
6/05/2008
Date registered
2/06/2008
Titles & IDs
Public title
Evaluation of the Duration of Therapy for Thrombosis in Children
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Scientific title
Prospective Multi-Center Evaluation of the Duration of Therapy for Thrombosis in Children
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Secondary ID [1]
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1U01HL130048-01A1
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Secondary ID [2]
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IRB00063928
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Universal Trial Number (UTN)
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Trial acronym
Kids-DOTT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Venous Thrombosis
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Condition category
Condition code
Cardiovascular
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Diseases of the vasculature and circulation including the lymphatic system
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Cardiovascular
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Other cardiovascular diseases
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Blood
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Clotting disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Other interventions - Shortened duration (6 weeks) of anticoagulant therapy
Other interventions - Conventional duration (3 months) of anticoagulant therapy
Other interventions - No Intervention
Other interventions - No Intervention
Experimental: Intervention: A - Patients with non-occlusive thrombus or resolved thrombosis at 6 weeks.
Active comparator: B - Patients with non-occlusive thrombus or resolved thrombosis at 6 weeks.
Other: Parallel Cohort: Persistent Occlusive Thrombosis - Patients with completely occlusive thrombosis at 6 weeks.
Other: Parallel Cohort: Persistent Antiphospholipid Antibody - Patients with persistent Positive Antiphospholipid Antibody at 6 weeks.
Other interventions: Shortened duration (6 weeks) of anticoagulant therapy
Subjects with evidence of non-occlusive or resolved thrombus at 6 weeks time will be randomized to receive a total duration of anticoagulant therapy of 6 weeks.
Other interventions: Conventional duration (3 months) of anticoagulant therapy
Subjects with evidence of non-occlusive or resolved thrombus at 6 weeks time will be randomized to receive a total duration of anticoagulant therapy of 3 months.
Other interventions: No Intervention
Subjects with evidence of persistent thrombus at 6 weeks time will remain on anticoagulant therapy for 3-6 months at the discretion of their treating physician.
Other interventions: No Intervention
Subjects with evidence of persistent antiphospholipid antibody at 6 weeks will remain on anticoagulant therapy for 3 months to indefinite duration, at the discretion of their treating physician.
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Intervention code [1]
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Other interventions
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Efficacy outcome - Occurrence of symptomatic recurrent venous thromboembolism
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Assessment method [1]
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Occurrence of symptomatic recurrent venous thromboembolism. Primary safety endpoint is occurrence of clinically-relevant bleeding (major + clinically-relevant non-major) bleeding.
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Timepoint [1]
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1 Year
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Primary outcome [2]
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Safety outcome - Occurrence of clinically-relevant (i.e. major plus clinically-relevant non-major [CRNM]
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Assessment method [2]
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Occurrence of clinically-relevant (i.e. major plus clinically-relevant non-major \[CRNM\] bleeding
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Timepoint [2]
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1 year
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Secondary outcome [1]
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Efficacy outcome 1 - Occurrence of symptomatic recurrent venous thromboembolism (VTE) or development of Post Thrombotic Syndrome (PTS) (composite endpoint)
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Assessment method [1]
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Occurrence of symptomatic recurrent venous thromboembolism (VTE) or development of Post Thrombotic Syndrome (PTS) (composite endpoint)
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Timepoint [1]
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1 year
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Secondary outcome [2]
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Efficacy outcome 2 - Occurrence of symptomatic recurrent venous thromboembolism (VTE)
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Assessment method [2]
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Occurrence of symptomatic recurrent venous thromboembolism (VTE)
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Timepoint [2]
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2 years
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Secondary outcome [3]
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Efficacy outcome 3 - Development of Post Thrombotic Syndrome (PTS)
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Assessment method [3]
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Development of Post Thrombotic Syndrome (PTS)
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Timepoint [3]
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1 year
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Secondary outcome [4]
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Efficacy outcome 4 - Development of Post Thrombotic Syndrome (PTS)
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Assessment method [4]
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Development of Post Thrombotic Syndrome (PTS)
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Timepoint [4]
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2 years
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Eligibility
Key inclusion criteria
1. Children (birth to <21 years of age) with radiologically-confirmed acute deep venous thrombosis in the past 30 days
2. In the opinion of the investigator, the venous thrombosis was a provoked (i.e., non-spontaneous) event (e.g.: hospitalization; Central venous catheterization; infection; dehydration; surgery; trauma; immobility; use of estrogen-containing oral contraceptive pills; flare of autoimmune/rheumatologic condition).
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Minimum age
No limit
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Maximum age
20
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Prior episode of VTE
2. Malignancy that, in the opinion of the treating oncologist, is not in remission (note: remission may exist on or off anti-neoplastic therapy)
3. Systemic lupus erythematosus
4. Pulmonary embolism that is not accompanied by DVT or is more proximal than segmental branches of the pulmonary artery
5. Use of, or intent to use, thrombolytic therapy
6. Chronic anticoagulant at prophylactic dosing is being or will be administered beyond 6 months post VTE diagnosis
7. Moderate/severe anticoagulant deficiency (defined by any one of the following):
1. protein C <20 IU/dL if patient is =3 months of age, or protein C below lower limit of detection if patient is <3 months of age;
2. antithrombin <30 IU/dL if patient is =3 months of age, or antithrombin below lower limit of detection if patient is <3 months of age;
3. protein S (free antigen or activity) <20 IU/dL.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/03/2008
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Date of last participant enrolment
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Actual
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Date of last data collection
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Actual
15/02/2022
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Sample size
Target
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Accrual to date
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Final
608
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Royal Children's Hospital - Parkville
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Recruitment postcode(s) [1]
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3052 - Parkville
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Recruitment outside Australia
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United States of America
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Alabama
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Connecticut
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Austria
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Vienna
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Tel-Aviv
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Netherlands
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Rotterdam
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Funding & Sponsors
Primary sponsor type
Other
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Name
Johns Hopkins All Children's Hospital
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Address
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Other collaborator category [1]
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Government body
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Name [1]
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National Heart, Lung, and Blood Institute (NHLBI)
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Ethics approval
Ethics application status
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Summary
Brief summary
The Kids-DOTT trial is a randomized controlled clinical trial whose primary objective is to evaluate non-inferiority of shortened-duration (6 weeks) versus conventional-duration (3 months) anticoagulation in children with first-episode acute venous thrombosis. The first stage of the trial has consisted of a pilot/feasibility component, which then continues as the definitively-powered trial.
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Trial website
https://clinicaltrials.gov/study/NCT00687882
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Trial related presentations / publications
Goldenberg NA, Tripputi M, Crowther M, Abshire TC, DiMichele D, Manco-Johnson MJ, Hiatt WR. The "parallel-cohort RCT": Novel design aspects and application in the Kids-DOTT trial of pediatric venous thromboembolism. Contemp Clin Trials. 2010 Jan;31(1):131-3. doi: 10.1016/j.cct.2009.11.006. Epub 2009 Nov 24. Kittelson JM, Spyropoulos AC, Halperin JL, Kessler CM, Schulman S, Steg G, Turpie AG, Cutler NR, Hiatt WR, Goldenberg NA; Antithrombotic Trials Leadership and Steering (ATLAS) Group. Balancing risk and benefit in venous thromboembolism trials: concept for a bivariate endpoint trial design and analytic approach. J Thromb Haemost. 2013 Aug;11(8):1443-8. doi: 10.1111/jth.12324. Goldenberg NA, Abshire T, Blatchford PJ, Fenton LZ, Halperin JL, Hiatt WR, Kessler CM, Kittelson JM, Manco-Johnson MJ, Spyropoulos AC, Steg PG, Stence NV, Turpie AG, Schulman S; Kids-DOTT Trial Investigators. Multicenter randomized controlled trial on Duration of Therapy for Thrombosis in Children and Young Adults (the Kids-DOTT trial): pilot/feasibility phase findings. J Thromb Haemost. 2015 Sep;13(9):1597-605. doi: 10.1111/jth.13038. Epub 2015 Aug 11. Goldenberg NA, Kittelson JM, Abshire TC, Bonaca M, Casella JF, Dale RA, Halperin JL, Hamblin F, Kessler CM, Manco-Johnson MJ, Sidonio RF, Spyropoulos AC, Steg PG, Turpie AGG, Schulman S; Kids-DOTT Trial Investigators and the ATLAS Group. Effect of Anticoagulant Therapy for 6 Weeks vs 3 Months on Recurrence and Bleeding Events in Patients Younger Than 21 Years of Age With Provoked Venous Thromboembolism: The Kids-DOTT Randomized Clinical Trial. JAMA. 2022 Jan 11;327(2):129-137. doi: 10.1001/jama.2021.23182. Erratum In: JAMA. 2022 Mar 22;327(12):1188. doi: 10.1001/jama.2022.3496.
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Public notes
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Contacts
Principal investigator
Name
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Neil A Goldenberg, MD, PhD
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Address
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Johns Hopkins All Children's Hospital
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT00687882