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Completed

NCT Number: NCT07124819

Dimolegin® (60 mg) Given Once Daily in Patients Undergoing Total Hip or Knee Replacement Compared to Enoxaparin

This clinical study aims to evaluate the efficacy and safety of the anticoagulant Dimolegin® compared to low molecular weight heparin (Clexane®) for the prevention of venous thromboembolic events (VTE) in patients undergoing major joint (hip or knee) replacement surgery. The study will assess the incidence of VTE, VTE-related mortality, and all-cause mortality during different follow-up periods in both treatment groups. Additionally, the study will evaluate the frequency of bleeding events and the incidence, number, and characteristics of all adverse events associated with Dimolegin® and Clexane® therapy.

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Key information

Age range

18 year–80 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Bryansk City Hospital No. 1, Bryansk, Russia

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Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Men and women between the ages of 18 and 80.
  • Patients scheduled for unilateral elective total hip or knee arthroplasty.
  • The patient's voluntary informed consent.
  • Negative pregnancy test result (for female patients with preserved reproductive potential).
  • Patients with reproductive potential should agree to use methods of contraception according to the protocol.

Exclusion criteria

  • Surgery for an acute fracture (<4 weeks).
  • Revision or extraction arthroplasty.
  • Septic arthritis.
  • The only lower limb.
  • Increased risk of thrombosis.
  • Active bleeding or increased risk of bleeding.
  • Current coagulopathy (patient's or his relative's) or congenital thrombophilia.
  • Collection of at least one volume unit of donated blood (≥ 450 ml) or blood transfusion during the previous 12 weeks.
  • Surgery or injury during the last 90 days.
  • Diseases of the digestive system that may disrupt the absorption of the study drug.
  • Significant cardiovascular diseases currently or within 6 months prior to screening.
  • Active liver or biliary tract diseases.
  • Creatinine clearance, calculated according to the Cockcroft-Gault formula, less than 30 ml/min.
  • Positive test result for HIV, syphilis, hepatitis B and C markers.
  • The development of trophic disorders of the lower extremities that are not amenable to drug treatment.
  • Any condition in which, in the opinion of the researcher, surgical intervention or the use of anticoagulants is contraindicated.
  • Body mass index is less than 18.5 or more than 40 kg/m2.
  • Body weight for women is less than 45 kg, for men less than 57 kg and above 130 kg for both.
  • Systolic blood pressure > 180 mmHg and/or diastolic blood pressure >110 mmHg.
  • Hemoglobin < 105 g/l in women or < 115 g/l in men.
  • Abnormal results aboratory parameters of the coagulation system (platelets, APTT, prothrombin time, INR) beyond the limits of normal values.
  • An increase in ALT or ACT ≥ 2 times from the upper limit of normal (ULN) or total bilirubin ≥ 1.5 times from ULN.
  • Hypersensitivity or contraindications to the administration of Dimolegin®, enoxaparin sodium, unfractionated heparin or warfarin.
  • The need for constant use of parenteral or oral anticoagulants.
  • The need for continuous use of antiplatelet drugs, which cannot be discontinued at least 4 days before the start of the investigational therapy.
  • Systemic therapy with drugs with strong inducers and inhibitors of CYP3A4 and P-glycoprotein, which cannot be discontinued at least 7 days before the start of the investigational therapy.
  • Pregnant or breast-feeding women.
  • Participation in another clinical trial currently or within 90 days prior to screening.
  • Affiliation to a research center, Sponsor, or contractual research organization.
  • Inability to read or write; unwillingness to understand and follow the procedures of the study protocol; non-compliance with the study therapy or procedures.

Treatment and study plan

Sodium enoxaparin

Drug

Subgroup 2A (Hip Arthroplasty): Patients undergoing total hip arthroplasty will receive Clexane® subcutaneously administered 12±1 hours before surgery starting 6-10 hours after surgery everyday for 35±2 days.

Subgroup 2B (Knee Arthroplasty): Patients undergoing total knee arthroplasty will receive Clexane® subcutaneously administered 12±1 hours before surgery everyday for 14±1 days.

Other names: Clexane

Dimolegin

Drug

Subgroup 1A (Hip Arthroplasty): Patients undergoing total hip arthroplasty will receive Dimolegin® starting 6-10 hours after surgery everyday for 35±2 days.

Subgroup 1B (Knee Arthroplasty): Patients undergoing total knee arthroplasty will receive Dimolegin® starting 6-10 hours after surgery everyday for 14±1 days.

Dimolegin placebo

Drug

Subgroup 2A (Hip Arthroplasty): Patients undergoing total hip arthroplasty will receive placebo Dimolegin® starting 6-10 hours after surgery everyday for 35±2 days. Subgroup 2B (Knee Arthroplasty): Patients undergoing total knee arthroplasty will receive placebo Dimolegin® starting 6-10 hours after surgery everyday for 14±1 days.

Sodium enoxaparine placebo

Drug

Subgroup 1A (Hip Arthroplasty): Patients undergoing total hip arthroplasty will receive palcebo Clexane® subcutaneously administered 12±1 hours before surgery starting 6-10 hours after surgery everyday for 35±2 days.

Subgroup 2B (Knee Arthroplasty): Patients undergoing total knee arthroplasty will receive placebo Clexane® subcutaneously administered 12±1 hours before surgery everyday for 14±1 days.

Other names: Clexane placebo

Primary outcomes

  1. Composite endpoint i.e.: confirmed symptomatic DVT, asymptomatic DVT, non fatal PE, death of all causes

    Time frame: up to the follow-up visit (28±2 days after the end of therapy)

Secondary outcomes

  1. Composite endpoint i.e.: confirmed symptomatic DVT, asymptomatic DVT, non fatal PE, death due to thrombosis

    Time frame: up to the follow-up visit (28±2 days after the end of therapy)

  2. Switching to other anticoagulant therapy

    Time frame: up to the follow-up visit (28±2 days after the end of therapy)

  3. Incidence of DVT (proximal, distal)

    Time frame: up to the follow-up visit (28±2 days after the end of therapy)

  4. Incidence of non fatal PE

    Time frame: up to the follow-up visit (28±2 days after the end of therapy)

  5. Incidence of symptomatic VTE

    Time frame: up to the follow-up visit (28±2 days after the end of therapy)

  6. Death due to VTE

    Time frame: up to the follow-up visit (28±2 days after the end of therapy)

  7. Death of all causes

    Time frame: up to the end of therapy (for subgroup A - up to 14±1 days, for subgroup B - up to 35±2 days)

Sponsors and collaborators

Lead sponsor

Avexima Diol LLC

Industry

Registry information

Official study title

Randomized, Double-blind, Double-masked Prospective Multicenter Trial to Evaluate the Efficacy and Safety of the Oral Anticoagulant Dimolegin® Compared With Low Molecular Weight Heparin (Clexane®) as a Means of Preventing VTE in Patients Undergoing Elective Endoprosthetics of Large Joints

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Aug 15, 2025
Registry last updated
Jan 16, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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