Clinical Study to Assess the Equivalence of Tranexamic Acid vs Oxytocin in Reducing the PPH (TRANOXY2015) (TRANOXY2015)
Primary Purpose
Postpartum Hemorrhage
Status
Suspended
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Tranexamic Acid
Tranexamic Acid
Oxytocin
Sponsored by
About this trial
This is an interventional treatment trial for Postpartum Hemorrhage
Eligibility Criteria
Inclusion Criteria:
- Subjects at the end of pregnancy ( 37-42 w ) at low risk of PPH Mean by low-risk of PPH subjects without any of the following risk factors : hypertension/preeclampsia, placental abruption during pregnancy , placenta previa , tocolysis two hours before delivery, multiple pregnancy , previous PPH, obesity ( BMI > 35 ), anemia (Hb < 7 g/dL), elective caesarean section , induction of labor, retention of placental material , polyhydramnios , fever during labor, use of high doses of heparin low molecular weight.
- Subjects full capacity and the willingness to give written informed consent .
Exclusion Criteria:
- Subjects with preterm pregnancy (<37 weeks ) or with prolonged pregnancy ( > 42 weeks )
- Subjects at the end of pregnancy ( 37 weeks - 42 weeks ) with the following risk factors for PPH (Tab1)
- multiple pregnancy
- history of thromboembolic disease or high incidence of thromboembolic events in family history ( patients at high risk of thrombophilia )
- Patients with Long - QT syndrome or who are taking drugs that cause QT prolongation
- Intrauterine fetal Death
- epilepsy
- autoimmune disease Tab1 medical history :
- Placental abruption during pregnancy
- placenta previa
- Hypertension / preeclampsia
- previous PPH
- polyhydramnios
- Obesity ( BMI > 35 )
- Anemia ( < 7 g / dL )
Detectable in labor:
- Elective caesarean section
- Tocolysis two hours before delivery
- Induction of labor
- Retention of placental material
- Fever during labor
- Use of low molecular weight heparin
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Experimental
Experimental
Active Comparator
Arm Label
arm A
arm B
arm C
Arm Description
2 vials ( =1 gram) of Tranexamic Acid oral administered within 5 minutes from the delivery (third stage after labor)
2 vials (=1 gram ) of Tranexamic Acid administered slow intravenous infusion within 5 minutes from the delivery(third stage after labor)
2 vials (=10 IU/International Unit) of oxytocin administered intramuscularly within 5 minutes from the delivery (third stage after labor)
Outcomes
Primary Outcome Measures
assessment of total blood loss expressed in mL
global blood loss > 500 mL
assessment of total blood loss expressed in mL
global blood loss > 500 mL
Secondary Outcome Measures
assessment of the number of hemodynamic changes
hypotension (number of women with Arterial Pressure < 100/60 mm/Hg )
assessment of the number of hemodynamic changes
hypotension (number of women with Arterial Pressure < 100/60 mm/Hg )
assessment of the number of hemodynamic changes
increased heart rate (number of women with Heart Rate > 60 bpm )
assessment of the number of hemodynamic changes
increased heart rate (number of women with Heart Rate > 60 bpm )
assessment of the need of using additional uterotonic
administration additional drug for the treatment of PPH
assessment of the need of using additional uterotonic
administration additional drug for the treatment of PPH
assessment the need for surgical manoeuvres for the bleeding control
need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or hysterectomy
assessment the need for surgical manoeuvres for the bleeding control
need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or hysterectomy
assessment the need for the blood transfusions
Hb <7 g/dL
Full Information
NCT ID
NCT02503319
First Posted
June 26, 2015
Last Updated
January 20, 2017
Sponsor
Azienda U.S.L. 1 di Massa e Carrara
Collaborators
Dr.Antonio Franco Ragusa
1. Study Identification
Unique Protocol Identification Number
NCT02503319
Brief Title
Clinical Study to Assess the Equivalence of Tranexamic Acid vs Oxytocin in Reducing the PPH (TRANOXY2015)
Acronym
TRANOXY2015
Official Title
Clinical Study,Longitudinal,Controlled, Randomized, Open-label, Phase III,to Assess the Equivalence of Tranexamic Acid vs Oxytocin in Reducing the Post Partum Hemorrhage (PHH) in Patients at the End of Pregnancy (37-42 w) at Low Risk of PPH
Study Type
Interventional
2. Study Status
Record Verification Date
July 2016
Overall Recruitment Status
Suspended
Why Stopped
Authorization denied
Study Start Date
October 2015 (undefined)
Primary Completion Date
September 2016 (Actual)
Study Completion Date
March 2017 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Azienda U.S.L. 1 di Massa e Carrara
Collaborators
Dr.Antonio Franco Ragusa
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study was to evaluate that the tranexamic acid (TXA)Intravenous and oral, is equivalent oxytocin (OXY),intramuscularly, in reducing the blood loss in post partum period (mL) in patients at the end of pregnancy ( 37-42 w ) at low risk of post partum hemorrhage (PPH). The PPH means a blood loss equal to or greater than 500 ml after a vaginal delivery ( the bleeding is defined severe if it exceeds 1000 mL). PPH is called "primary" when blood loss arose within 24 hours after birth.
This is a open-trial randomized, longitudinal, controlled that including 486 subjects .
Detailed Description
This trial includes three arms of treatment :
arm A (IMP1Test): TXA 500mg/ 2 vials (1 gr) oral within 5 minutes from the delivery (third stage af labor)
arm B (IMP2Test): TXA 500 mg/ 2 vials (1 gr) slow intravenous infusion 1ml/min within 5 minutes from the delivery(third stage af labor)
arm C (control): OXY 5 IU/ml/ 2 vials (10 International Unit) intramuscularly within 5 minutes from the delivery (third stage af labor) The clamping of the umbilical cord will be executed immediately after birth The randomization 1:1:1 (block design), generated by the computer. Primary outcomes: assessment of total blood loss expressed in mL
immediately after delivery
two hours after delivery
The measurement of the overall blood loss at delivery (ml) will be performed by the graduated bag, immediately after birth.
The measurement two hours after delivery will be performed by weighing of the adsorbent material [ N.ml = N. gr indicated by the balance - dry weight of the sanitary napkin]. The overall loss in blood measured (ml) two hours of delivery will then be performed by adding the two collections.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Postpartum Hemorrhage
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
486 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
arm A
Arm Type
Experimental
Arm Description
2 vials ( =1 gram) of Tranexamic Acid oral administered within 5 minutes from the delivery (third stage after labor)
Arm Title
arm B
Arm Type
Experimental
Arm Description
2 vials (=1 gram ) of Tranexamic Acid administered slow intravenous infusion within 5 minutes from the delivery(third stage after labor)
Arm Title
arm C
Arm Type
Active Comparator
Arm Description
2 vials (=10 IU/International Unit) of oxytocin administered intramuscularly within 5 minutes from the delivery (third stage after labor)
Intervention Type
Drug
Intervention Name(s)
Tranexamic Acid
Other Intervention Name(s)
TXA
Intervention Description
2 vials ( =1 gram) of Tranexamic Acid oral administered within 5 minutes from the delivery (third stage after labor)
2 vials (=1 gram ) of Tranexamic Acid administered slow intravenous infusion within 5 minutes from the delivery (third stage after labor)
Intervention Type
Drug
Intervention Name(s)
Tranexamic Acid
Other Intervention Name(s)
TXA
Intervention Description
2 vials ( =1 gram) of Tranexamic Acid slow intravenous infusion administered within 5 minutes from the delivery (third stage after labor)
Intervention Type
Drug
Intervention Name(s)
Oxytocin
Other Intervention Name(s)
OXY
Intervention Description
2 vials (=10 IU/International Unit) of oxytocin administered intramuscularly within 5 minutes from the delivery (third stage after labor)
Primary Outcome Measure Information:
Title
assessment of total blood loss expressed in mL
Description
global blood loss > 500 mL
Time Frame
immediately after delivery
Title
assessment of total blood loss expressed in mL
Description
global blood loss > 500 mL
Time Frame
two hours after delivery
Secondary Outcome Measure Information:
Title
assessment of the number of hemodynamic changes
Description
hypotension (number of women with Arterial Pressure < 100/60 mm/Hg )
Time Frame
immediately after delivery
Title
assessment of the number of hemodynamic changes
Description
hypotension (number of women with Arterial Pressure < 100/60 mm/Hg )
Time Frame
two hours after delivery
Title
assessment of the number of hemodynamic changes
Description
increased heart rate (number of women with Heart Rate > 60 bpm )
Time Frame
immediately after delivery
Title
assessment of the number of hemodynamic changes
Description
increased heart rate (number of women with Heart Rate > 60 bpm )
Time Frame
two hours after delivery
Title
assessment of the need of using additional uterotonic
Description
administration additional drug for the treatment of PPH
Time Frame
immediately after delivery
Title
assessment of the need of using additional uterotonic
Description
administration additional drug for the treatment of PPH
Time Frame
two hours after delivery
Title
assessment the need for surgical manoeuvres for the bleeding control
Description
need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or hysterectomy
Time Frame
immediately after delivery
Title
assessment the need for surgical manoeuvres for the bleeding control
Description
need of intrauterine balloon or uterine compression sutures for surgical treatment of the PPH or hysterectomy
Time Frame
two hours after delivery
Title
assessment the need for the blood transfusions
Description
Hb <7 g/dL
Time Frame
two days after delivery
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Subjects at the end of pregnancy ( 37-42 w ) at low risk of PPH Mean by low-risk of PPH subjects without any of the following risk factors : hypertension/preeclampsia, placental abruption during pregnancy , placenta previa , tocolysis two hours before delivery, multiple pregnancy , previous PPH, obesity ( BMI > 35 ), anemia (Hb < 7 g/dL), elective caesarean section , induction of labor, retention of placental material , polyhydramnios , fever during labor, use of high doses of heparin low molecular weight.
Subjects full capacity and the willingness to give written informed consent .
Exclusion Criteria:
Subjects with preterm pregnancy (<37 weeks ) or with prolonged pregnancy ( > 42 weeks )
Subjects at the end of pregnancy ( 37 weeks - 42 weeks ) with the following risk factors for PPH (Tab1)
multiple pregnancy
history of thromboembolic disease or high incidence of thromboembolic events in family history ( patients at high risk of thrombophilia )
Patients with Long - QT syndrome or who are taking drugs that cause QT prolongation
Intrauterine fetal Death
epilepsy
autoimmune disease Tab1 medical history :
Placental abruption during pregnancy
placenta previa
Hypertension / preeclampsia
previous PPH
polyhydramnios
Obesity ( BMI > 35 )
Anemia ( < 7 g / dL )
Detectable in labor:
Elective caesarean section
Tocolysis two hours before delivery
Induction of labor
Retention of placental material
Fever during labor
Use of low molecular weight heparin
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Antonio Ragusa, Dr
Organizational Affiliation
Azienda USL1 di Massa e Carrara
Official's Role
Principal Investigator
12. IPD Sharing Statement
Learn more about this trial
Clinical Study to Assess the Equivalence of Tranexamic Acid vs Oxytocin in Reducing the PPH (TRANOXY2015)
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