The general aim of this study is to determine the comparative safety and efficacy of dabigatran etexilate administered orally and warfarin (International Normalized Ratio (INR) of 2.0-3.0) for the long-term treatment and secondary prevention of symptomatic venous thromboembolism in patients who have been successfully treated with standard doses of an approved anticoagulant for three to twelve months for confirmed acute symptomatic Venous Thrombo-embolism.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
2,867
Dabigatran 150 mg BID (twice daily)
Warfarin dosed individually to maintain INR 2.0-3.0
Composite of Recurrent VTE or VTE Death at 36 Months
Endpoint is a composite of recurrent Venous Thromboembolic Event (VTE) and death related to VTE. VTE was defined as the composite of symptomatic Deep Vein Thrombosis (DVT) of the leg and Pulmonary embolism (PE). All recurrent VTEs required objective verification by definitive diagnostic evaluation. In case of death, autopsy was an additional way to confirm VTE.
Time frame: 36 months
Composite of Recurrent VTE or VTE Death at 18 Months
Endpoint is a composite of recurrent Venous Thromboembolic Event (VTE) and death related to VTE. VTE was defined as the composite of symptomatic Deep Vein Thrombosis (DVT) of the leg and Pulmonary embolism (PE). All recurrent VTEs required objective verification by definitive diagnostic evaluation. In case of death, autopsy was an additional way to confirm VTE.
Time frame: 18 months
Composite of Recurrent VTE or All Cause Death at 36 Months
Endpoint is a composite of recurrent Venous Thromboembolic Event (VTE) and all cause death. VTE was defined as the composite of symptomatic Deep Vein Thrombosis (DVT) of the leg and Pulmonary embolism (PE). All recurrent VTEs required objective verification by definitive diagnostic evaluation.
Time frame: 36 months
Composite of Recurrent VTE or All Cause Death at 18 Months
Endpoint is a composite of recurrent Venous Thromboembolic Event (VTE) and all cause death. VTE was defined as the composite of symptomatic Deep Vein Thrombosis (DVT) of the leg and Pulmonary embolism (PE). All recurrent VTEs required objective verification by definitive diagnostic evaluation.
Time frame: 18 months
Deep Vein Thrombosis (DVT) at 36 Months
Symptomatic Deep vein thrombosis (DVT). All DVT events required objective verification through definitive diagnostic evaluation.
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1160.47.01035 Boehringer Ingelheim Investigational Site
Mobile, Alabama, United States
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Hartford, Connecticut, United States
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Decatur, Georgia, United States
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Baltimore, Maryland, United States
1160.47.01018 Boehringer Ingelheim Investigational Site
Roxbury Crossing, Massachusetts, United States
1160.47.01023 Boehringer Ingelheim Investigational Site
Detroit, Michigan, United States
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Saint Louis Park, Minnesota, United States
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Lebanon, New Hampshire, United States
...and 265 more locations
Time frame: 36 months
DVT at 18 Months
Symptomatic Deep vein thrombosis (DVT). All DVT events required objective verification through definitive diagnostic evaluation.
Time frame: 18 months
Symptomatic Pulmonary Embolism (PE) at 36 Months
Symptomatic pulmonary embolism (PE) at 36 Months (fatal or non-fatal). All suspected PEs required confirmation by one of the following: ventilation-perfusion (V-Q) lung scan, pulmonary angiography, or spiral (helical) Computed tomography.
Time frame: 36 months
Symptomatic Pulmonary Embolism (PE) at 18 Months
Symptomatic pulmonary embolism (PE) at 18 Months (fatal or non-fatal). All suspected PEs required confirmation by one of the following: ventilation-perfusion (V-Q) lung scan, pulmonary angiography, or spiral (helical) Computed tomography.
Time frame: 18 months
Deaths Related to VTE at 36 Months
Deaths related to VTE (i.e. fatal PE) at 36 Months. Deaths related to VTE (i.e. fatal PE) at 18 Months. All deaths were centrally adjudicated by the Independent Central Adjudication Committee for VTE and death in a treatment-blinded way.
Time frame: 36 months
Deaths Related to VTE at 18 Months
Deaths related to VTE (i.e. fatal PE) at 18 Months. All deaths were centrally adjudicated by the Independent Central Adjudication Committee for VTE and death in a treatment-blinded way.
Time frame: 18 months
Deaths of All Causes at 36 Months
Deaths of all causes at 36 Months. All components of the primary efficacy endpoint and all deaths were centrally adjudicated by the Independent Central Adjudication Committee for VTE and death without knowledge of any individual treatment assignments.
Time frame: 36 months
Deaths of All Causes at 18 Months
Deaths of all causes at 18 Months. All components of the primary efficacy endpoint and all deaths were centrally adjudicated by the Independent Central Adjudication Committee for VTE and death without knowledge of any individual treatment assignments.
Time frame: 18 months
Number of Participants With Bleeding Events
MBE (major bleeding event) if it fulfilled at least one of the following criteria * Fatal bleeding * Symptomatic bleeding in a critical area or organ. * Bleeding causing a fall in haemoglobin level of 20 g/L (1.24 mmol/L) or more, or leading to transfusion of 2 or more units of whole blood or red cells. Minor bleeding event was any bleeding that did not fulfil any of the criteria for MBEs CRBE (clinically relevant bleeding event) if it is a minor bleeding events which fulfilled at least one of the following criteria * Spontaneous skin haematoma ≥25 cm2 * Spontaneous nose bleed \>5 min duration * Macroscopic haematuria, either spontaneous or, if associated with an intervention, lasting \>24 h * Spontaneous rectal bleeding * Gingival bleeding \>5 min * Bleeding leading to hospitalisation or requiring surgical treatment * Bleeding leading to a transfusion of \<2 units of whole blood or red cells * Any other bleeding event considered clinically relevant by the investigator
Time frame: first intake of study drug until 6 days following last intake of study drug
Laboratory Analysis
Patients with LFT (liver function tests) increases of possible clinical significance during treatment. Increases of possible clinical significance were defined as: ≥3 x ULN (AST, ALT), ≥2 x ULN (AP), and ≥2 mg/dL (total bilirubin). Only patients with a baseline value which was not of possible clinical significance (or without any baseline value) could have a PCSA (Possible clinically significant abnormality).
Time frame: 18 months + 30 days follow up
Number of Participants With Definite Acute Coronary Syndrome (ACS)
All suspected ACS occurring during the trial were to be recorded on the CRF and were to be centrally adjudicated by an independent ACS/AC in a treatment-blinded manner.
Time frame: day of first study drug intake until last day of study drug intake; from the day after last intake of study drug until trial termination