INNOVTE (Investigation Network On Venous Thromboembolism) is a national network accredited by F-CRIN whose goal is to advance clinical and translational research on venous thromboembolism. The network currently comprises approximately 50 centers, accredited teams, clinical research centers, Inserm units, and host teams throughout France, as well as two European collaborations with Brussels and Geneva. INNOVTE collaborates with other international networks: CAN-VECTOR in Canada, RIETE in Spain, the DUTCH network in the Netherlands, and INVENT, a global network.
INNOVTE, the national clinical research network on venous thromboembolism
The INNOVTE network is the culmination of a long process of development that can be traced back to the mid-1980s—that is, the time when the first low-molecular-weight heparins appeared in clinical practice.
The Emergence of a Group
As early as that time, two professors of therapeutic medicine, Hervé Decousus in Saint-Étienne and Dominique Mottier in Brest, recognized that the introduction of these new molecules—for a common condition affecting nearly all medical specialties—presented an opportunity to establish high-quality clinical research. This was also the era of the first PHRCs and the early days of “evidence-based medicine.”
Together with others, they helped establish local academic centers dedicated to clinical research, supported by public and industry funding, and very early on developed the concept of “networks ” of investigators, bringing together clinicians, biologists, pharmacologists, and epidemiologists, and later basic researchers.
Formalization
In 2009, they founded GIRC Thrombose France (Clinical Investigation and Research Group), whose purpose was to “bring together French clinical researchers in the field of venous thromboembolic disease, with the goal of conducting multicenter institutional studies and also to offer industrial sponsors a one-stop shop for the setup and conduct of industrial clinical trials in the field of venous thromboembolic disease.”
From GIRC to INNOVTE
The creation in 2013 of the “network of networks” ” F-CRIN in 2013 provided an opportunity to support GIRC, which then almost naturally joined F-CRIN—starting with the very first calls for proposals—under the name INNOVTE.
Organization
To oversee all of its activities, INNOVTE relies on five governing bodies:
1. The Executive Board
It is chaired by Prof. Francis Couturaud and co-chaired by Prof. Laurent Bertoletti.
It approves the actions to be implemented, financial statements, projects submitted by members and network partnerships, as well as training proposals put forward by the Scientific Council. It also seeks the funding necessary for the network’s smooth operation.
2. The Steering Committee
It defines the network’s objectives and strategies, appoints network members, approves the scientific program proposed by the Scientific Council, and decides on applications for new members to join the network. It consists of 20 members in addition to the members of the Executive Board.
3. The Scientific Council
Currently co-chaired by Prof. Marie Antoine Sevestre and Prof. Isabelle Gouin, it fulfills several complementary roles. It develops and implements scientific projects in collaboration with industry partners. It proposes training topics and the scientific program. It assists in setting up the network’s projects: responding to calls for proposals, providing methodological advice, and connecting project leaders with other members and partners.
4. The Coordination Unit
Serving as the network’s logistical and administrative backbone, the Coordination Unit maintains ongoing communication with members (such as distributing calls for proposals) and organizes all of the network’s meetings and training sessions. It also manages the network’s administrative affairs and financial budgets, drafts activity reports, and monitors the network’s performance indicators. It implements a continuous quality improvement process within the network.
5. The Communications Group
It manages the network’s visibility through communications (website, social media, newsletter, and outreach to partners).
Scientific Expertise
INNOVTE makes its scientific expertise and operational infrastructure available to academic researchers and industrial partners for all projects focused on venous thromboembolism (VTE).
Conducting and coordinating clinical trials
- Academic and industrial trials: Full implementation and management of clinical studies in MVTE, from rapid patient recruitment to rigorous follow-up.
- International projects: Coordination of large-scale multinational trials in collaboration with our global partner networks (INVENT, CAN-VECTOR, RIETE, etc.).
Engineering, Methodology, and Data Management
- Overall study design: Execution of study design, implementation, data management, and statistical analysis of epidemiological, therapeutic, and diagnostic studies.
- Specialized meta-analyses: High-level methodological synthesis, particularly regarding the evaluation and comparison of therapeutic strategies in VTE.
Governance, Safety, and Pharmacology
- Adjudication and Monitoring Committees: Independent management of clinical event adjudication committees and Data Safety Monitoring Boards (DSMBs) for industry and academic studies.
- Pharmacokinetics and pharmacodynamics: In-depth PK/PD evaluation of anticoagulant therapies to optimize and personalize dosing regimens.
Pathophysiology and Translational Research
- Thrombophilia and Biological Mechanisms: Ongoing development of expertise in the pathophysiology of thrombosis.
- Prognostic and diagnostic biomarkers: Identification and validation of biological targets using a bench-to-bedside approach to refine risk stratification
Completed Projects and Notable Results
Each year, the network contributes to tangible advances in clinical research, with several studies completed. Here are a few examples:
The prospective randomized trial FONCE-HTAP evaluated the long-term impact of an exercise rehabilitation program in patients with pulmonary arterial hypertension (PAH). It demonstrates the long-term efficacy and safety of exercise retraining in improving functional capacity, exercise tolerance, and quality of life in these patients.
Link to the publication: https://pubmed.ncbi.nlm.nih.gov/42474242/
The API-CAT trial (Extended Reduced-Dose Apixaban for Cancer-Associated Venous Thromboembolism) is a major clinical trial that demonstrated that after 6 months of initial treatment at a therapeutic dose, reducing the apixaban dose (2.5 mg × 2/day) maintains the antithrombotic benefit while reducing the iatrogenic risk in patients with cancer-associated VTE.
Link to the publication: https://pubmed.ncbi.nlm.nih.gov/40162636/
The RENOVE trial evaluated the extension of anticoagulant therapy beyond 6 months in patients at high risk of recurrence without active cancer. It demonstrates that reduced-dose DOACs (apixaban 2.5 mg twice daily or rivaroxaban 10 mg daily) are non-inferior to the full dose in preventing recurrent VTE, while offering a better safety profile.
Link to the publication: https://pubmed.ncbi.nlm.nih.gov/40023651/
The CASTING clearly demonstrates that patients with a TRiP(cast) score < 7 have an extremely low risk of venous thromboembolism and can safely avoid thromboprophylaxis. This implementation study proves that a large proportion of patients with an immobilized lower limb can avoid unnecessary, painful (injections), and potentially iatrogenic anticoagulant therapy.
Link to the publication: https://pubmed.ncbi.nlm.nih.gov/38368901/
The international HIGHLOW trial compared an intermediate dose to a low dose of LMWH (standard) in 1,110 pregnant women with a history of VTE. It demonstrates that the intermediate dose is no more effective than the standard prophylactic dose in preventing thromboembolic recurrence during pregnancy and the postpartum period (2% vs. 3%).
Link to the publication: https://pubmed.ncbi.nlm.nih.gov/36354038/
The pivotal CARAVAGGIO trial evaluated apixaban compared with dalteparin in 1,155 patients with active cancer and acute VTE. It demonstrated that apixaban is non-inferior to dalteparin in preventing thrombotic recurrence at 6 months (5.6% vs. 7.9%), without increasing the risk of major bleeding (3.8% vs. 4.0%), including in patients with gastrointestinal cancers.
Link to the publication: https://pubmed.ncbi.nlm.nih.gov/32223112/
Current Projects
The network is currently involved in several multicenter studies aimed at advancing knowledge and clinical practice, including:
The international MORPHEUS project lays the groundwork for personalized medicine in spontaneous VTE by combining prognostic prediction and shared medical decision-making. By integrating advanced predictive models (genetic data, biomarkers, imaging, AI) with patients’ explicit preferences and ethical/societal considerations, this program aims to optimize and individualize the duration of extended anticoagulant therapy. It transforms patient care by shifting from a standardized approach to a tailored and informed therapeutic choice.
Link to the trial: https://pubmed.ncbi.nlm.nih.gov/42447897/
The ongoing international prospective clinical trial BAT-VTE is evaluating the benefits of discontinuing or continuing antiplatelet therapy (e.g., aspirin, clopidogrel) when anticoagulant therapy is initiated for venous thromboembolism. It aims to determine whether discontinuing antiplatelet therapy significantly reduces the risk of major bleeding without increasing the risk of cardiovascular or atherothrombotic events.
Link to the trial: https://clinicaltrials.gov/study/NCT05627375?term=NCT05627375&rank=1
The international randomized trial PEITHO-3 evaluates the efficacy and safety of reduced-dose systemic thrombolysis (alteplase 0.6 mg/kg, max 50 mg) combined with anticoagulation versus anticoagulation alone in patients with intermediate-to-high-risk pulmonary embolism. It aims to demonstrate that a reduced dose maintains the reperfusion efficacy of thrombolysis (reduction in mortality, hemodynamic decompensation, and 30-day recurrence) while avoiding the increased risk of major and intracranial hemorrhages observed with the full dose in the initial PEITHO trial.
Link to the trial: https://clinicaltrials.gov/study/NCT04430569
Contact the network
Would you like more information about INNOVTE or the network's areas of expertise?
Feel free to send an email to innovte@chu-st-etienne.fr.
Network Partners
- F-CRIN | French Clinical Research Infrastructure Network
- National Institute of Health and Medical Research · Inserm, Science for Health
- Ecrin | Facilitating European Clinical Research
- Home - Invent VTE
- RIETE Registry
- French Society of Vascular Medicine - (SFMV, formerly Portail Vasculaire) - Home
- French Society of Cardiology (SFC) - SFCARDIO
- French-Language Pulmonology Society
- SFPT, French Society of Pharmacology and Therapeutics
- Home - The French Society of Thrombosis and Hemostasis (SFTH) %
- SFAR French Society of Anesthesia and Resuscitation
- GITA-thrombosis: Trousseau Interdisciplinary Group on Antithrombotic Agents
