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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03661385
Registration number
NCT03661385
Ethics application status
Date submitted
4/09/2018
Date registered
7/09/2018
Titles & IDs
Public title
Nitric Oxide During Bypass for Arterial Switch Operation
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Scientific title
A Randomised Controlled Trial of Nitric Oxide Administration During Cardiopulmonary Bypass in Infants Undergoing Arterial Switch Operation for Repair of Transposition of the Great Arteries
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Secondary ID [1]
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ACTRN12618000089235p
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Secondary ID [2]
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38017
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Universal Trial Number (UTN)
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Trial acronym
NASO
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Low Cardiac Output Syndrome
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Transposition of Great Vessels
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Condition category
Condition code
Cardiovascular
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Other cardiovascular diseases
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Human Genetics and Inherited Disorders
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Nitric Oxide
Active comparator: Intervention arm - • Intervention arm will receive nitric oxide 20 parts per million (ppm) into the oxygenator of a cardio-pulmonary bypass circuit
No intervention: Control arm - Control arm will not receive nitric oxide, they will receive standard bypass as per local policy
Treatment: Drugs: Nitric Oxide
Addition of nitric oxide 20ppm into bypass circuit
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Major adverse events
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Assessment method [1]
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The primary outcome is the number of participants with major adverse events (MAEs) within 28 days post-operatively. MAEs include cardiac arrest, emergency chest opening, use of ECMO, and death.
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Timepoint [1]
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28 days post intervention
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Secondary outcome [1]
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Length of stay in ICU (hours)
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Assessment method [1]
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Length of stay in ICU (hours) will be calculated from date and time of admission to ICU date and time of discharge to ICU.
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Timepoint [1]
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This will be calculated from date and time of admission to ICU to date and time of discharge from ICU in hours up to 28 days
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Secondary outcome [2]
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Length of stay in hospital (days)
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Assessment method [2]
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Length of stay in hospital (days) will be calculated from date and time of admission to hospital to date and time of discharge to hospital.
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Timepoint [2]
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28 days (or until hospital discharge)
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Secondary outcome [3]
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Ventilator-free days
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Assessment method [3]
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Ventilator-free days will be calculated from date and time of intubation to date and time of extubation. Each day (or part of a day) will be counted as a day.
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Timepoint [3]
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28 days (or until ICU discharge)
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Secondary outcome [4]
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Inotrope hours
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Assessment method [4]
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Inotrope hours will be calculated from data input into REDCAP.
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Timepoint [4]
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Number of hours inotropes have been administered during first 28 days post operatively
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Secondary outcome [5]
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Dialysis-free days
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Assessment method [5]
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Dialysis-free days will be calculated from date and time of start of dialysis to date and time of stopping dialysis. Each day (or part of a day) will be counted as a day.
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Timepoint [5]
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28 days (or until ICU discharge)
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Secondary outcome [6]
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Inhaled NO hours
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Assessment method [6]
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Inhaled NO hours will be calculated from data input into REDCAP.
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Timepoint [6]
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Number of hours inhaled NO have been administered during first 28 days post operatively
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Secondary outcome [7]
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ECMO-free days
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Assessment method [7]
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ECMO-free days will be calculated from date and time of start of ECMO to date and time of stopping ECMO. Each day (or part of a day) will be counted as a day.
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Timepoint [7]
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28 days (or until ICU discharge)
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Secondary outcome [8]
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Closed sternum days
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Assessment method [8]
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Closed sternum days will be calculated from date and time of start of chest opening (or return to ICU time if delayed chest closure) to date and time of chest closure. Each day (or part of a day) will be counted as a day.
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Timepoint [8]
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28 days (or until ICU discharge)
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Secondary outcome [9]
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Composite free-day score
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Assessment method [9]
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This score is a combination of scores 1-8 to create a composite free-day score. Composite free-day score is a score highlighting the number of days free from post-operative complications including free of hospitalization within the first 28 days post operatively. For each score, the days free of complication will be calculated to create an individual free from score these will be then added together to create an overall free-from score. Higher scores suggest a better outcome (free from hospital and complications).
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Timepoint [9]
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28 days (or until hospital discharge)
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Eligibility
Key inclusion criteria
Inclusion criteria;
Each participant must meet all of the following criteria to be enrolled in this study:
* Infant aged greater than or equal to 36 weeks gestation
* Infants less than 2 years
* Diagnosed with TGA and requiring Arterial Switch Operation
* Consent of parents/guardian.
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Minimum age
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Days
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion criteria
Potential participants will be excluded if they meet any of the following criteria:
* They have multiple major congenital anomalies (anomalies which affect the infant's life expectancy or health status)
* They have multiple other cardiac abnormalities (with the exception of ASD, VSD or PDA)
* They weigh less than 2.2kgs.
* Prior surgical exposure to cardio-pulmonary bypass
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
11/07/2018
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
23/04/2023
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Sample size
Target
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Accrual to date
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Final
300
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Royal Children's Hospital - Melbourne
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Recruitment postcode(s) [1]
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3050 - Melbourne
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Recruitment outside Australia
Country [1]
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Canada
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State/province [1]
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Alberta
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Country [2]
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Indonesia
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State/province [2]
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Jakarta
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Country [3]
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Malaysia
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State/province [3]
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Kuala Lumpur
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Funding & Sponsors
Primary sponsor type
Other
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Name
Murdoch Childrens Research Institute
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
This trial will test if adding nitric oxide (NO) gas to the cardiopulmonary bypass (CPB) circuit in infants undergoing an arterial switch operation (ASO) for Transposition of the Great Arteries (TGA) changes the incidence of major postoperative adverse events (AEs). Major postoperative AEs include cardiac arrest, emergency chest opening, use of ECMO (machine that acts as an artificial heart and lung during surgery), and death. Participants will be randomised to receive oxygen plus nitric oxide (intervention arm) or oxygen without nitric oxide (control arm) during CPB.
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Trial website
https://clinicaltrials.gov/study/NCT03661385
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Trial related presentations / publications
Chello M, Mastroroberto P, Perticone F, Celi V, Colonna A. Nitric oxide modulation of neutrophil-endothelium interaction: difference between arterial and venous coronary bypass grafts. J Am Coll Cardiol. 1998 Mar 15;31(4):823-6. doi: 10.1016/s0735-1097(97)00560-3. Hataishi R, Rodrigues AC, Neilan TG, Morgan JG, Buys E, Shiva S, Tambouret R, Jassal DS, Raher MJ, Furutani E, Ichinose F, Gladwin MT, Rosenzweig A, Zapol WM, Picard MH, Bloch KD, Scherrer-Crosbie M. Inhaled nitric oxide decreases infarction size and improves left ventricular function in a murine model of myocardial ischemia-reperfusion injury. Am J Physiol Heart Circ Physiol. 2006 Jul;291(1):H379-84. doi: 10.1152/ajpheart.01172.2005. Epub 2006 Jan 27. Levy JH, Tanaka KA. Inflammatory response to cardiopulmonary bypass. Ann Thorac Surg. 2003 Feb;75(2):S715-20. doi: 10.1016/s0003-4975(02)04701-x. Zahler S, Massoudy P, Hartl H, Hahnel C, Meisner H, Becker BF. Acute cardiac inflammatory responses to postischemic reperfusion during cardiopulmonary bypass. Cardiovasc Res. 1999 Mar;41(3):722-30. doi: 10.1016/s0008-6363(98)00229-6. Checchia PA, Bronicki RA, Muenzer JT, Dixon D, Raithel S, Gandhi SK, Huddleston CB. Nitric oxide delivery during cardiopulmonary bypass reduces postoperative morbidity in children--a randomized trial. J Thorac Cardiovasc Surg. 2013 Sep;146(3):530-6. doi: 10.1016/j.jtcvs.2012.09.100. Epub 2012 Dec 8. James C, Millar J, Horton S, Brizard C, Molesworth C, Butt W. Nitric oxide administration during paediatric cardiopulmonary bypass: a randomised controlled trial. Intensive Care Med. 2016 Nov;42(11):1744-1752. doi: 10.1007/s00134-016-4420-6. Epub 2016 Sep 30.
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Public notes
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Contacts
Principal investigator
Name
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Warwick Butt
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Address
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MRCI
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
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Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/85/NCT03661385/Prot_002.pdf
Informed consent form
https://cdn.clinicaltrials.gov/large-docs/85/NCT03661385/ICF_001.pdf
Results publications and other study-related documents
Type
Citations or Other Details
Journal
Checchia PA, Bronicki RA, Muenzer JT, Dixon D, Rai...
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Journal
James C, Millar J, Horton S, Brizard C, Molesworth...
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Results not provided in
https://clinicaltrials.gov/study/NCT03661385