Actively Recruiting

Phase Not Applicable
Age: 18Years +
All Genders
ID07270263

Efficacy and Safety of Reduced-Dose Apixaban and Rivaroxaban Versus Low-Molecular-Weight Heparin in Patients With Hematologic Malignancies: A Prospective Randomized Study

Led by Medical University of Gdansk · Updated on 2025-12-26

100

Participants Needed

1

Research Sites

35 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

This research aims to evaluate the safety and effectiveness of reduced-dose direct oral anticoagulants (DOACs), specifically apixaban and rivaroxaban, compared with standard low-molecular-weight heparin (LMWH) in preventing venous thromboembolism (VTE) in patients with hematologic malignancies such as multiple myeloma and lymphoma. The study addresses the challenge of thromboprophylaxis in this high-risk population, where current daily injections of LMWH may be burdensome and affect treatment adherence. The trial is prospective, randomized, and open-label, focusing on improved and patient-friendly prevention methods. Participants will be randomly assigned to one of three groups: one receiving apixaban 2.5 mg orally twice daily, another receiving rivaroxaban 10 mg orally once daily, and the third receiving standard-dose LMWH via subcutaneous injection once daily. Each treatment will continue for at least six months. The study compares these regimens to assess their impact on VTE occurrence and bleeding risks, with a follow-up period of six months after treatment initiation. During the study, participants will be monitored for the incidence of venous thromboembolism, major and clinically relevant non-major bleeding events, overall survival, and adherence to the prescribed treatment over six months. Researchers will use standard clinical definitions and criteria to evaluate these outcomes. The trial includes regular assessments to ensure safety and collect data on any adverse events, aiming to provide high-quality evidence that could influence future thromboprophylaxis practices in patients with blood cancers.

CONDITIONS

Brief Title

Reduced-Dose Apixaban and Rivaroxaban Versus Low-Molecular-Weight Heparin in Patients With Hematologic Malignancies

Who Can Participate

Age: 18Years +
All Genders

Eligibility Criteria

Eligible

You may qualify if you...

  • Adults aged 18 years or older
  • Diagnosed with an active hematologic malignancy such as multiple myeloma, myeloproliferative neoplasm, or lymphoma
  • Khorana score of 2 points or higher indicating intermediate or high risk of venous thromboembolism
  • Receiving anticoagulant treatment for primary thromboprophylaxis with reduced-dose apixaban, reduced-dose rivaroxaban, or standard-dose low-molecular-weight heparin
Not Eligible

You will not qualify if you...

  • Major bleeding within the last month, including gastrointestinal or intracranial bleeding
  • Active major bleeding at the time of screening
  • Hemoglobin concentration less than 8 g/dL
  • Platelet count below 30 x 10⁹/L
  • Eastern Cooperative Oncology Group (ECOG) performance status of 3 or 4
  • Expected survival less than 6 months
  • History of mechanical heart valve or severe mitral stenosis
  • Estimated glomerular filtration rate (eGFR) less than 25 mL/min
  • Liver impairment with ALT levels 3 times above normal or bilirubin levels 2 times above normal
  • Acute coronary syndrome or ischemic stroke within the last 6 months
  • Expected significant drug interactions between DOACs and anticancer treatments
  • Known diagnosis of antiphospholipid syndrome (APS)

AI-Screening

AI-Powered Screening

Complete this quick 3-step screening to check your eligibility

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

Treatment

Duration - At least 6 months

Participants receive reduced-dose apixaban, reduced-dose rivaroxaban, or low-molecular-weight heparin to prevent venous thromboembolism.

Daily medication intake with regular follow-up visits

Trial Site Locations

Total: 1 location

1

Department of Haematology & Transplantology

Gdansk, Pomeranian Voivodeship, Poland, 80-152

Actively Recruiting

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Research Team

A

Agata Ogłoza-Puchowska, MD

E

Ewa Lewicka, Professor

How is the study designed?

Study Type

INTERVENTIONAL

Masking

NONE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

PREVENTION

Number of Arms

3

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