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Trial registered on ANZCTR
Registration number
ACTRN12609000699268
Ethics application status
Approved
Date submitted
8/06/2009
Date registered
13/08/2009
Date last updated
1/03/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
The EPPI Trial – Enoxaparin for the Prevention of Preeclampsia and Intrauterine growth restriction – a pilot randomised open-label trial.
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Scientific title
The EPPI Trial – Enoxaparin for the Prevention of Preeclampsia and Intrauterine growth restriction – a pilot randomised open-label trial.
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Secondary ID [1]
251698
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EPPI trial - Enoxaparin for the Prevention of Preeclampsia and Intrauterine growth restriction - a pilot randomised open-label trial.
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Secondary ID [2]
281160
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EPPI trial - Enoxaparin for the Prevention of Preeclampsia and Intrauterine growth restriction - a pilot randomised open-label trial.
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Universal Trial Number (UTN)
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Trial acronym
EPPI
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Preeclampsia
236946
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Intrauterine growth restriction
236947
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Condition category
Condition code
Reproductive Health and Childbirth
237297
237297
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0
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Fetal medicine and complications of pregnancy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
enoxaparin 40mg once daily subcutaneous injection from randomisation (between 6 weeks to 15 weeks + 6 days gestation) until delivery or 35 weeks + 6 days gestation
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Intervention code [1]
236727
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Prevention
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Comparator / control treatment
Control treatment is standard of care i.e. low dose aspirin (75-100mg) and calcium (1-1.5g) daily for women with previous preeclampsia or low dose aspirin alone (75-100mg) daily for women with a previous small-for-gestational age pregnancy
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Control group
Active
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Outcomes
Primary outcome [1]
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rate of preeclampsia
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Assessment method [1]
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Timepoint [1]
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from 20 weeks pregnancy until delivery
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Primary outcome [2]
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rate of intrauterine growth restriction
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Assessment method [2]
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Timepoint [2]
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from 20 weeks pregnancy until delivery
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Secondary outcome [1]
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To determine the effect of enoxaparin on
uterine artery Doppler waveforms using antenatal Doppler ultrasound
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Assessment method [1]
242319
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Timepoint [1]
242319
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20 and 24 weeks gestation
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Secondary outcome [2]
242320
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To determine the effect of enoxaparin on
maternal serum markers and placental and angiogenic growth factors
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Assessment method [2]
242320
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Timepoint [2]
242320
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Recruitment, 2nd and 3rd trimesters
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Eligibility
Key inclusion criteria
Women who have developed previous preeclampsia delivered <36 weeks in last pregnancy, previous intrauterine growth restriction (IUGR)<10th centile delivered <36 weeks in last pregnancy or previous IUGR<3rd centile in last pregnancy.
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Minimum age
No limit
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Any contraindication to low molecular weight heparin (LMWH), requirement for LMWH eg. previous thrombosis or antiphospholipid syndrome, previous successful pregnancy with LMWH, multiple pregnancy, known pre-existing type 1/2 diabetes, renal disease (with serum creatinine >150), thrombocytopenia (platelet count <80) or known major fetal anomaly.
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Study design
Purpose of the study
Prevention
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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)
central randomisation by phone/computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/05/2010
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Actual
26/07/2010
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Date of last participant enrolment
Anticipated
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Actual
28/10/2015
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Date of last data collection
Anticipated
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Actual
26/04/2016
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Sample size
Target
160
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Accrual to date
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Final
160
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
5471
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Sunshine Hospital - St Albans
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Recruitment hospital [2]
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Royal Hospital for Women - Randwick
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Recruitment hospital [3]
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Mercy Hospital for Women - Heidelberg
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Recruitment postcode(s) [1]
5718
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3052
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Recruitment outside Australia
Country [1]
1829
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New Zealand
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State/province [1]
1829
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Country [2]
7720
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Netherlands
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State/province [2]
7720
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Amsterdam
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Funding & Sponsors
Funding source category [1]
237124
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University
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Name [1]
237124
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University of Auckland
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Address [1]
237124
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Level 12
Support Building
Auckland City Hospital
2 Park Rd
Grafton
Auckland
1023
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Country [1]
237124
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New Zealand
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Primary sponsor type
University
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Name
University of Auckland
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Address
Level 12
Support Building
Auckland City Hospital
2 Park Rd
Grafton
Auckland
1023
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Country
New Zealand
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Secondary sponsor category [1]
4617
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Hospital
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Name [1]
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Auckland City Hospital
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Address [1]
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National Women's Health
Level 9
Support Building
Auckland City Hospital
2 Park Rd
Grafton
Auckland
1023
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Country [1]
4617
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern X Regional Ethics Committee
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Ethics committee address [1]
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Private Bag 92-522 Wellesley St Auckland
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
239224
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26/06/2009
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Approval date [1]
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07/09/2009
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Ethics approval number [1]
239224
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Summary
Brief summary
Brief summary: Preeclampsia and fetal intrauterine growth restriction (IUGR) are common complications during pregnancy that can cause long lasting health effects for mother and baby in later life. It is believed both conditions are caused by abnormal development of the placenta (whenua/after-birth) and can often recur in future pregnancies. There are several therapies that have been studied to prevent these diseases but, until now, none have been proven to be very effective. Heparin is a drug that prevents blood clots and is believed to help the placenta to develop well. Some studies have suggested that heparin may reduce the risk of preeclampsia and IUGR but this has not been properly assessed in a randomised trial. Our study will invite women who have had a previous pregnancy severely affected by these conditions. Half of the women will be given the heparin injection each day as well as current standard of care (aspirin for all women and calcium for women with previous preeclampsia) and the other half will receive the current standard of care. All women will be monitored very closely. At the end of the study we will be able to assess if the heparin injections reduce the risk of preeclampsia and IUGR.
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Trial website
www.eppi.org.nz
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Claire McLintock
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Address
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National Women's Health
Auckland City Hospital
Park Road
Grafton
Auckland
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Country
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New Zealand
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Phone
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+6493670000
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Claire McLintock
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Address
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National Women's Health
Level 9 Support Building
Auckland City Hospital
2 Park Rd
Grafton
Auckland
1023
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Country
12961
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New Zealand
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Phone
12961
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+6493670000
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Fax
12961
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Email
12961
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[email protected]
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Contact person for scientific queries
Name
3889
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Dr Claire McLintock
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Address
3889
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National Women's Health
Level 9 Support Building
Auckland City Hospital
2 Park Rd
Grafton
Auckland
1023
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Country
3889
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New Zealand
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Phone
3889
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+64 9 367 0000
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Fax
3889
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Email
3889
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Low-molecular-weight heparin for prevention of placenta-mediated pregnancy complications: Protocol for a systematic review and individual patient data meta-analysis (AFFIRM).
2015
https://dx.doi.org/10.1186/2046-4053-3-69
Embase
Enoxaparin for the prevention of preeclampsia and intrauterine growth restriction in women with a prior history - an open-label randomised trial (the EPPI trial): Study protocol.
2016
https://dx.doi.org/10.1186/s12884-016-1162-y
Embase
Enoxaparin for the prevention of preeclampsia and intrauterine growth restriction in women with a history: a randomized trial.
2017
https://dx.doi.org/10.1016/j.ajog.2017.01.014
Dimensions AI
4: Is magnesium sulfate use of benefit post partum? A randomized controlled trial
2017
https://doi.org/10.1016/j.ajog.2016.11.005
N.B. These documents automatically identified may not have been verified by the study sponsor.
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