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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT04192435
Registration number
NCT04192435
Ethics application status
Date submitted
27/11/2019
Date registered
10/12/2019
Titles & IDs
Public title
Tranexamic Acid to Reduce Infection After Gastrointestinal Surgery
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Scientific title
Tranexamic Acid to Reduce Infection After Gastrointestinal Surgery; The TRIGS Trial
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Secondary ID [1]
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087
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Universal Trial Number (UTN)
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Trial acronym
TRIGS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Infection Wound
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Gastrointestinal Complication
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0
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Anesthesia
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0
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Bleeding
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0
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Healthcare Associated Infection
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0
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Condition category
Condition code
Infection
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0
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Studies of infection and infectious agents
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Infection
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0
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Other infectious diseases
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Infection
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0
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Sexually transmitted infections
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Tranexamic Acid
Treatment: Drugs - Placebos
Active comparator: Tranexamic acid - At induction of anesthesia and prior to surgical incision a bolus of 0.15 ml/kg ( up to a maximum of 15 ml) , and then commence an infusion of 0.05 ml/kg/h until the end of surgery. The total maximal administered study drug volume will be 30 ml.
Placebo comparator: Placebo - At induction of anesthesia and prior to surgical incision a bolus of 0.15 ml/kg ( up to a maximum of 15 ml) , and then commence an infusion of 0.05 ml/kg/h until the end of surgery. The total maximal administered study drug volume will be 30 ml.
Treatment: Drugs: Tranexamic Acid
100mg/ml
Treatment: Drugs: Placebos
Placebo will be 5ml vials calculated to equivalent to the 100mg/ml of active drug.
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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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Incidence of Surgical Site Infection
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Assessment method [1]
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defined by the US Centers for Disease Control (CDC)
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Timepoint [1]
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from surgical incision to 30 days post surgical incision
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Secondary outcome [1]
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Red cell transfusion
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Assessment method [1]
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Total units given
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Timepoint [1]
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from surgical incision to hospital discharge (from index surgery) or 30 days.
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Secondary outcome [2]
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Other healthcare-associated infections
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Assessment method [2]
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sepsis, pneumonia, blood stream infection, UTI, etc; all using CDC-guided definitions
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Timepoint [2]
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from surgical incision to 30 days
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Secondary outcome [3]
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C-reactive protein
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Assessment method [3]
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peak
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Timepoint [3]
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Postoperative Day 3 (three days after surgical incision)
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Secondary outcome [4]
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Days at home up to 30 days after surgery (DAH30).
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Assessment method [4]
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Time that patient spends at home in the 30 days following surgery
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Timepoint [4]
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From surgical incision to 30 days
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Eligibility
Key inclusion criteria
1. Adult patients scheduled for elective or semi-elective (inpatient) open or lap-assisted GI surgery (oesophageal, gastric, hepatobiliary, colorectal) with one or more risk factors for complications:
* Age =70 years
* ASA physical status 3 or 4
* Known or suspected history of: heart failure, diabetes, peripheral vascular disease, or chronic respiratory disease
* Obesity (BMI =30 kg/m2)
* Anaemia (preoperative haemoglobin <130 g/l in males and <120 g/l in females)
* Renal impairment (se. creatinine =150mol/l)
* Low albumin (<30 g/L)
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Minimum age
18
Years
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Maximum age
99
Years
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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
* Poor spoken and or written language comprehension
* Laparoscopic cholecystectomy and other minor (eg. closure of stoma) surgery
* Pre-existing infection/sepsis
* Known history of: spontaneous pulmonary embolism, arterial thrombosis familial thrombophilia (e.g. Lupus anticoagulant, protein C deficiency, factor V Leiden)
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Study design
Purpose of the study
Treatment
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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 4
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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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
18/05/2022
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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
31/01/2026
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Actual
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Sample size
Target
3300
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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Alfred Hospital - Melbourne
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Recruitment postcode(s) [1]
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3004 - Melbourne
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Funding & Sponsors
Primary sponsor type
Government body
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Name
Bayside Health
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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National Health and Medical Research Council, Australia
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
This international, multicentre, pragmatic, double-blind, placebo-controlled, randomised trial of TxA versus placebo will enrol 3,300 patients throughout Australia and internationally. This is an effectiveness trial - some elements of the trial are deliberately left to the perioperative clinicians' discretion in order to reflect usual practice and maximise generalisability.
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Trial website
https://clinicaltrials.gov/study/NCT04192435
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Trial related presentations / publications
Draxler DF, Yep K, Hanafi G, Winton A, Daglas M, Ho H, Sashindranath M, Wutzlhofer LM, Forbes A, Goncalves I, Tran HA, Wallace S, Plebanski M, Myles PS, Medcalf RL. Tranexamic acid modulates the immune response and reduces postsurgical infection rates. Blood Adv. 2019 May 28;3(10):1598-1609. doi: 10.1182/bloodadvances.2019000092. Bell M, Eriksson LI, Svensson T, Hallqvist L, Granath F, Reilly J, Myles PS. Days at Home after Surgery: An Integrated and Efficient Outcome Measure for Clinical Trials and Quality Assurance. EClinicalMedicine. 2019 Apr 27;11:18-26. doi: 10.1016/j.eclinm.2019.04.011. eCollection 2019 May-Jun.
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Public notes
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Contacts
Principal investigator
Name
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Paul S Myles, MD, DSc
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Address
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Alfred Hospital and Monash University
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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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Paul S Myles, MD, DSc
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Address
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Country
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Phone
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+61390763176
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Fax
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Email
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[email protected]
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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)?
Yes
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What data in particular will be shared?
This decision will be made on a individual case by case basis, with formal request and review by the PI and steering committee.
Supporting document/s available: Study protocol, Statistical analysis plan (SAP), Informed consent form (ICF)
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When will data be available (start and end dates)?
Before recruitment of final patient
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Available to whom?
Patient and illness eligibility
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT04192435