Skip to content

Aspirin and Compression Devices for VTE Prophylaxis in Orthopaedic Oncology

Aspirin and Compression Devices for VTE Prophylaxis in Orthopaedic Oncology

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01696760
Enrollment
12
Registered
2012-10-01
Start date
2010-10-31
Completion date
2012-12-31
Last updated
2018-12-05

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Bone Metastases, Musculoskeletal Cancer, Soft Tissue Sarcoma, Thromboembolism

Brief summary

This is a research study to compare the efficacy of aspirin (acetylsalicylic acid) and pneumatic compression devices versus enoxaparin (also known as Lovenox) and pneumatic compression devices in preventing deep vein thrombosis in patients with pelvic and lower extremity malignant tumors and undergoing surgery. Pneumatic compression devices are also known as sequential compression devices and are inflatable compression sleeves that are placed around patient's legs to reduce the risk of clot formation deep vein thrombosis. Pneumatic compression devices are made of a soft material that wraps around the lower leg and periodically squeeze the calf. A deep vein thrombosis is a blood clot. Most hospitalized patients wear these as a preventive measure. Pneumatic compression devices alone are not sufficient to prevent deep vein thrombosis formation. Therefore, medicines, such as aspirin and enoxaparin are utilized. Both drugs are used for prevention, but there are no studies in patients with musculoskeletal tumors which have determined whether one drug is better than another. The knowledge gained from this study will determine whether aspirin and pneumatic compression devices is the same or better than enoxaparin and pneumatic compression devices in preventing deep vein thrombosis in this patient population and may result in fewer wound and bleeding complications

Detailed description

PRIMARY OBJECTIVES: I. To perform a randomized prospective study to determine efficacy of acetylsalicylic acid (ASA)+pneumatic compression device (PCD) prophylaxis compared to low-molecular weight heparin (LMWH)+PCD in patients undergoing orthopaedic procedures for musculoskeletal neoplasms (MSN) of the pelvis and lower extremity. II. To prove that ASA+PCD is clinically equivalent to or better than LMWH+PCD in providing deep vein thrombosis (DVT) prophylaxis in this patient population and results in fewer major bleeding complications. III. To measure rates of postoperative DVT and pulmonary embolism (PE) as primary outcomes. SECONDARY OBJECTIVES: I. To measure secondary outcomes including rates of readmission, reoperation, bleeding complications (including hematoma formation and prolonged wound drainage), and death. OUTLINE: Patients are randomized to 1 of 2 treatment arms. ARM I: Patients receive acetylsalicylic acid orally (PO) twice daily (BID) and wear PCD on days 1-28 after surgery. ARM II: Patients receive enoxaparin subcutaneously (SC) once daily (QD) and wear PCD on days 1-28 after surgery. After completion of study treatment, patients are followed up at 2 weeks, 6 weeks, and 3 months.

Interventions

DRUGacetylsalicylic acid

325 mg twice a day

DRUGenoxaparin

40 mg once daily

DEVICEPCD

Wear PCD (Flowtron calf compression). Patients will continue to use PCDs for the duration of their hospitalization. If patients refuse to wear the PCDs, they will be withdrawn from the study.

Sponsors

Ohio State University Comprehensive Cancer Center
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

-Scheduled or to be scheduled for surgery performed on neoplasms of the pelvis or lower limbs, including both primary musculoskeletal lesions as well as metastatic lesions; these neoplasms may include major tumor resections, metastatic and pathologic fractures of the hip and lower extremities (LE), open biopsies, and primary malignant tumors; an active malignant neoplasm must be present at the time of surgery

Exclusion criteria

* Prior history of DVT or PE * Previously placed vena cava filter * No detectable malignant disease at the time of operation * Previous arterial thrombosis (myocardial infarction \[MI\], cerebral vascular accident \[CVA\]) * Severe platelet dysfunction (uremia, medications, dysplastic hematopoiesis); excluded if platelets \< 50,000 * Preoperative anticoagulation or active/serious bleeding in past 2 weeks (prothrombin time \[PT\] & partial thromboplastin time \[PTT\] \> 1.6 & \> 35) * Hypersensitivity or allergy to aspirin or heparin (including those diagnosed with heparin-induced thrombocytopenia) * Conditions associated with bleeding (active ulcer disease, recent neurosurgery, bleeding disorders) * Patients with renal insufficiency (creatinine \[Cr\] \> 1.5) * Pregnant patients * Epidural anesthesia

Design outcomes

Primary

MeasureTime frameDescription
DVT Incident RateUp to 3 monthsThis study will test if the ASA+PCD treatment group has a DVT rate (P1) not more than the DVT rate of the LMWH+PCD treatment group (P0) using a one sided test for these two proportions. Statistical significance will be defined as p \< 0.05.

Secondary

MeasureTime frame
Development of Other Complications (Including Bleeding Complications)Up to 3 months
Readmission Rate to HopsitalUp to 3 months
Pulmonary Embolism RateUp to 3 months
Excessive Wound DrainageUp to 3 months
Death RateUp to 3 months
Hematoma FormationUp to 3 months

Countries

United States

Participant flow

Participants by arm

ArmCount
Arm I (Acetylsalicylic Acid and PCD)
Patients receive acetylsalicylic acid orally PO BID and wear PCD on days 1-28 after surgery. acetylsalicylic acid: 325 mg twice a day PCD: Wear PCD (Flowtron calf compression). Patients will continue to use PCDs for the duration of their hospitalization. If patients refuse to wear the PCDs, they will be withdrawn from the study.
9
Arm II (Enoxaparin and PCD)
Patients receive enoxaparin subcutaneously SC QD and wear PCD on days 1-28 after surgery. enoxaparin: 40 mg once daily PCD: Wear PCD (Flowtron calf compression). Patients will continue to use PCDs for the duration of their hospitalization. If patients refuse to wear the PCDs, they will be withdrawn from the study.
3
Total12

Baseline characteristics

CharacteristicArm I (Acetylsalicylic Acid and PCD)Arm II (Enoxaparin and PCD)Total
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
1 Participants0 Participants1 Participants
Age, Categorical
Between 18 and 65 years
8 Participants3 Participants11 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
2 Participants2 Participants4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
7 Participants1 Participants8 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
1 Participants0 Participants1 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants1 Participants1 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
7 Participants1 Participants8 Participants
Race (NIH/OMB)
White
1 Participants1 Participants2 Participants
Region of Enrollment
United States
9 participants3 participants12 participants
Sex: Female, Male
Female
3 Participants2 Participants5 Participants
Sex: Female, Male
Male
6 Participants1 Participants7 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
— / —— / —
other
Total, other adverse events
0 / 90 / 3
serious
Total, serious adverse events
0 / 90 / 3

Outcome results

Primary

DVT Incident Rate

This study will test if the ASA+PCD treatment group has a DVT rate (P1) not more than the DVT rate of the LMWH+PCD treatment group (P0) using a one sided test for these two proportions. Statistical significance will be defined as p \< 0.05.

Time frame: Up to 3 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Arm I (Acetylsalicylic Acid and PCD)DVT Incident Rate0 Participants
Arm II (Enoxaparin and PCD)DVT Incident Rate0 Participants
Secondary

Death Rate

Time frame: Up to 3 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Arm I (Acetylsalicylic Acid and PCD)Death Rate0 Participants
Arm II (Enoxaparin and PCD)Death Rate0 Participants
Secondary

Development of Other Complications (Including Bleeding Complications)

Time frame: Up to 3 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Arm I (Acetylsalicylic Acid and PCD)Development of Other Complications (Including Bleeding Complications)0 Participants
Arm II (Enoxaparin and PCD)Development of Other Complications (Including Bleeding Complications)0 Participants
Secondary

Excessive Wound Drainage

Time frame: Up to 3 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Arm I (Acetylsalicylic Acid and PCD)Excessive Wound Drainage0 Participants
Arm II (Enoxaparin and PCD)Excessive Wound Drainage0 Participants
Secondary

Hematoma Formation

Time frame: Up to 3 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Arm I (Acetylsalicylic Acid and PCD)Hematoma Formation0 Participants
Arm II (Enoxaparin and PCD)Hematoma Formation0 Participants
Secondary

Pulmonary Embolism Rate

Time frame: Up to 3 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Arm I (Acetylsalicylic Acid and PCD)Pulmonary Embolism Rate0 Participants
Arm II (Enoxaparin and PCD)Pulmonary Embolism Rate0 Participants
Secondary

Readmission Rate to Hopsital

Time frame: Up to 3 months

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
Arm I (Acetylsalicylic Acid and PCD)Readmission Rate to Hopsital0 Participants
Arm II (Enoxaparin and PCD)Readmission Rate to Hopsital0 Participants

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026