NCT03129555

Brief Summary

No randomized head-to-head comparison between the individual Non-vitamin K Antagonist Oral Anticoagulants (NOAC) exists. The DANNOAC-VTE study is a nationwide cluster randomized cross-over study comparing efficacy and safety of the four NOACs, edoxaban, apixaban, rivaroxaban and dabigatran for oral anticoagulation in venous thromboembolism across Danish hospitals.

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
5,000

participants targeted

Target at P75+ for phase_4

Timeline
35mo left

Started Apr 2023

Longer than P75 for phase_4

Geographic Reach
1 country

26 active sites

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress52%
Apr 2023Mar 2029

First Submitted

Initial submission to the registry

April 18, 2017

Completed
8 days until next milestone

First Posted

Study publicly available on registry

April 26, 2017

Completed
5.9 years until next milestone

Study Start

First participant enrolled

April 1, 2023

Completed
4 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

March 31, 2027

Expected
2 years until next milestone

Study Completion

Last participant's last visit for all outcomes

March 31, 2029

Last Updated

May 15, 2025

Status Verified

May 1, 2025

Enrollment Period

4 years

First QC Date

April 18, 2017

Last Update Submit

May 14, 2025

Conditions

Keywords

Non-vitamin K antagonist oral anticoagulationNon-vitamin K Antagonist Oral AnticoagulantsDirect-acting Oral AnticoagulantsNovel oral anticoagulant drugs

Outcome Measures

Primary Outcomes (1)

  • Primary efficacy outcome: a composite endpoint of new venous thromboembolism or all-cause death.

    First occurrence of new venous thromboembolism or all-cause death. Information of endpoints and comorbidity is obtained from the Danish National Patient Register based on ICD-10 diagnostic codes and information of vital status and date of death will be obtained from the Central Person Register. Information of prescribed drug will be obtained using information from the Danish Registry of Medicinal Product Statistics.

    6 months.

Secondary Outcomes (3)

  • Secondary efficacy outcome: New venous thromboembolism.

    6 months.

  • Secondary efficacy outcome: All-cause death.

    6 months.

  • Primary safety outcome: bleeding requiring hospitalization.

    6 months.

Other Outcomes (2)

  • Discontinuation of therapy.

    6 months.

  • Adherence to therapy.

    6 months.

Study Arms (4)

Dabigatran

ACTIVE COMPARATOR

After randomization, the cluster will use dabigatran to all their patients with venous thromboembolism when possible for six months. Hereafter the cluster will use the other three NOACs for six months one at the time.

Drug: Dabigatran Etexilate Oral CapsuleDrug: Rivaroxaban Oral TabletDrug: Edoxaban Oral TabletDrug: Apixaban Oral Tablet

Rivaroxaban

ACTIVE COMPARATOR

After randomization, the cluster will use rivaroxaban to all their patients with venous thromboembolism when possible for six months. Hereafter the cluster will use the other three NOACs for six months one at the time.

Drug: Dabigatran Etexilate Oral CapsuleDrug: Rivaroxaban Oral TabletDrug: Edoxaban Oral TabletDrug: Apixaban Oral Tablet

Edoxaban

ACTIVE COMPARATOR

After randomization, the cluster will use edoxaban to all their patients with venous thromboembolism when possible for six months. Hereafter the cluster will use the other three NOACs for six months one at the time.

Drug: Dabigatran Etexilate Oral CapsuleDrug: Rivaroxaban Oral TabletDrug: Edoxaban Oral TabletDrug: Apixaban Oral Tablet

Apixaban

ACTIVE COMPARATOR

After randomization, the cluster will use apixaban to all their patients with venous thromboembolism when possible for six months. Hereafter the cluster will use the other three NOACs for six months one at the time.

Drug: Dabigatran Etexilate Oral CapsuleDrug: Rivaroxaban Oral TabletDrug: Edoxaban Oral TabletDrug: Apixaban Oral Tablet

Interventions

After cluster randomization, the cluster will use dabigatran to all their patients with venous thromboembolism when possible for six months. Hereafter the cluster will use the other three NOACs for six months one at the time. It is the clusters and not the patient that are randomized.

ApixabanDabigatranEdoxabanRivaroxaban

After cluster randomization, the cluster will use rivaroxaban to all their patients with venous thromboembolism when possible for six months. Hereafter the cluster will use the other three NOACs for six months one at the time. It is the clusters and not the patient that are randomized.

ApixabanDabigatranEdoxabanRivaroxaban

After cluster randomization, the cluster will use edoxaban to all their patients with venous thromboembolism when possible for six months. Hereafter the cluster will use the other three NOACs for six months one at the time. It is the clusters and not the patient that are randomized.

ApixabanDabigatranEdoxabanRivaroxaban

After cluster randomization, the cluster will use apixaban to all their patients with venous thromboembolism when possible for six months. Hereafter the cluster will use the other three NOACs for six months one at the time. It is the clusters and not the patient that are randomized.

ApixabanDabigatranEdoxabanRivaroxaban

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • A diagnosis of VTE in outpatient clinic or as discharge diagnosis after hospitalization.
  • A claimed prescription of a NOAC from a Danish pharmacy within 14 days of discharge or outpatient clinic visit.

You may not qualify if:

  • A prescription of a NOAC within 90 days prior to hospitalization or outpatient clinic visit for VTE.
  • Patients with NOAC preference apart from preference consistent with current cluster randomized NOAC.
  • Other contraindications mentioned in the "Summary of Product Characteristics" for the respective NOAC.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (26)

Aarhus University Hospital

Aarhus, 8200, Denmark

Location

Bispebjerg and Frederiksberg Hospital

Copenhagen, 2400, Denmark

Location

Bispebjerg Hospital

Copenhagen NV, 2400, Denmark

Location

Amager Hospital

Copenhagen S, 2300, Denmark

Location

Rigshospitalet

Copenhagen Ø, 2100, Denmark

Location

Esbjerg Hospital

Esbjerg, 6700, Denmark

Location

Nordsjællands Hospital - Frederiksund

Frederikssund, 3600, Denmark

Location

Herlev Gentofte Hospital

Gentofte Municipality, 2900, Denmark

Location

Glostrup Hospital - Department of Emergency Medicine

Glostrup Municipality, 2600, Denmark

Location

Glostrup Hospital - Department of Medicine / Cardiology

Glostrup Municipality, 2600, Denmark

Location

Glostrup Hospital - Department of Neurology

Glostrup Municipality, 2600, Denmark

Location

Herlev-Gentofte Hospital - Department of Medicine

Herlev, 2730, Denmark

Location

Nordsjællands Hospital - Hillerød

Hillerød, 3400, Denmark

Location

Hjørring Hospital

Hjørring, 9800, Denmark

Location

Holbæk Hospital

Holbæk, 4300, Denmark

Location

Hvidovre Hospital

Hvidovre, 2650, Denmark

Location

Næstved Hospital

Næstved, 4700, Denmark

Location

Odense University Hospital - Department of Cardiology

Odense, 5000, Denmark

Location

Odense University Hospital - Department of Emergency Medicine

Odense, 5000, Denmark

Location

Odense University Hospital - Department of Geriatrics

Odense, 5000, Denmark

Location

Zealand University Hospital - Department of Neurology

Roskilde, 4000, Denmark

Location

Zealand University Hospital Roskilde - Department of Cardiology

Roskilde, 4000, Denmark

Location

Bornhoms Hospital

Rønne, 3700, Denmark

Location

Slagelse Hospital

Slagelse, 4200, Denmark

Location

Odense University Hospital Svendborg

Svendborg, 5700, Denmark

Location

Vejle Hospital

Vejle, 7100, Denmark

Location

Related Links

MeSH Terms

Conditions

Venous ThrombosisPulmonary Embolism

Interventions

DabigatranRivaroxabanedoxabanapixaban

Condition Hierarchy (Ancestors)

ThrombosisEmbolism and ThrombosisVascular DiseasesCardiovascular DiseasesLung DiseasesRespiratory Tract DiseasesEmbolism

Intervention Hierarchy (Ancestors)

PyridinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsBenzimidazolesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-RingThiophenesSulfur CompoundsOrganic ChemicalsMorpholinesOxazines

Study Officials

  • Gunnar H Gislason, MD, PhD

    Herlev Gentofte Hospital

    STUDY CHAIR

Study Design

Study Type
interventional
Phase
phase 4
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Masking Details
The Outcome Assessor will only have a code of each drug and a code for each cluster. Therefore he will not know what drug the clusters have been using. The randomization key will be safely stored at servers at "Statens Serums Institute" (An institute under the Danish Ministry of Health). After the primary and secondary outcome have been evaluated data will be unblinded.
Purpose
TREATMENT
Intervention Model
CROSSOVER
Model Details: Cluster randomized cross-over study
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
MD,PhD

Study Record Dates

First Submitted

April 18, 2017

First Posted

April 26, 2017

Study Start

April 1, 2023

Primary Completion (Estimated)

March 31, 2027

Study Completion (Estimated)

March 31, 2029

Last Updated

May 15, 2025

Record last verified: 2025-05

Locations