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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT05742243
Registration number
NCT05742243
Ethics application status
Date submitted
15/02/2023
Date registered
23/02/2023
Titles & IDs
Public title
Insulin and Abatacept in Recently-diagnosed Type 1 Diabetes
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Scientific title
Abatacept Combined With Nasal Insulin to Preserve Beta-cell Function in Recently-diagnosed Type 1 Diabetes
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Secondary ID [1]
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2022.079
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Universal Trial Number (UTN)
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Trial acronym
IAA
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 1 Diabetes
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Diabetes Mellitus, Type 1
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Condition category
Condition code
Metabolic and Endocrine
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Abatacept (CTLA4-Ig) and nasal insulin (Humulin R®)
Treatment: Drugs - Abatacept (CTLA4-Ig) and nasal placebo (0.9% sodium chloride)
Active comparator: Abatacept and nasal insulin - Abatacept (CTLA4-Ig; 50 mg for participant weight \<25 kg, 87.5 mg for participant weight 25-50 kg, 125 mg for participant weight \>50 kg) will be injected subcutaneously once per week and nasal insulin (Humulin R®, 100 Units/mL) will be inhaled for 10 consecutive days initially and twice per week thereafter, for 48-weeks.
Placebo comparator: Abatacept and nasal placebo - Abatacept (CTLA4-Ig; 50 mg for participant weight \<25 kg, 87.5 mg for participant weight 25-50 kg, 125 mg for participant weight \>50 kg) will be injected subcutaneously once per week and nasal placebo (0.9% sodium chloride) will be inhaled for 10 consecutive days initially and twice per week thereafter, for 48-weeks.
Treatment: Drugs: Abatacept (CTLA4-Ig) and nasal insulin (Humulin R®)
Abatacept injected subcutaneously once per week and nasal insulin inhaled for 10 consecutive days initially and twice per week thereafter
Treatment: Drugs: Abatacept (CTLA4-Ig) and nasal placebo (0.9% sodium chloride)
Abatacept injected subcutaneously once per week and nasal placebo inhaled for 10 consecutive days initially and twice per week thereafter
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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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Beta-cell function at 48 weeks
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Assessment method [1]
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Change in average C-peptide concentration during a 2-hour mixed meal challenge
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Timepoint [1]
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0 weeks - 48 weeks
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Secondary outcome [1]
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Beta-cell function at 24, 72 and 96 weeks
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Assessment method [1]
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Change in average C-peptide concentration during a 2-hour mixed meal challenge
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Timepoint [1]
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0, 24, 72 and 96 weeks
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Secondary outcome [2]
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Glucose regulation
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Assessment method [2]
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Proportion of time in the range 3.9-10mmol/l, time below 3.9mmol/l and glucose %CV measured by continuous glucose monitoring (CGM)
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Timepoint [2]
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0, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 60, 72 and 96 weeks
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Secondary outcome [3]
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Estimated C-peptide concentration
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Assessment method [3]
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Average C-peptide concentration estimated from fasting glucose, C-peptide, HbA1c, body mass index, disease duration and insulin dose
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Timepoint [3]
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-2, 24, 48, 72 and 96 weeks
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Secondary outcome [4]
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Frequency of hypoglycemic events
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Assessment method [4]
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Frequency of glucose readings \<3.0mmol/l, determined by CGM and correcting for CGM wear time
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Timepoint [4]
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0, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, 44, 48, 60, 72 and 96 weeks
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Secondary outcome [5]
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Hemoglobin A1c levels
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Assessment method [5]
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Change in HbA1c levels
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Timepoint [5]
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0, 12, 24, 36, 48, 60, 72 and 96 weeks
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Secondary outcome [6]
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Insulin use
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Assessment method [6]
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Daily insulin dose at all visits
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Timepoint [6]
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Every 4 weeks for 96 weeks
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Secondary outcome [7]
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Weight, body mass index and sitting blood pressure
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Assessment method [7]
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Change in weight, body mass index and blood pressure
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Timepoint [7]
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0, 12, 24, 48, 60, 72 and 96 weeks
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Secondary outcome [8]
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Diabetes antibody levels
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Assessment method [8]
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Insulin, GAD, IA2 and ZnT8 autoantibody concentrations
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Timepoint [8]
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-2, 0, 4, 12, 24, 48, 60, 72 and 96 weeks
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Secondary outcome [9]
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Quality of life assessment
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Assessment method [9]
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Assessed by questionnaire
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Timepoint [9]
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-2, 0, 24, 48, 72 and 96 weeks
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Secondary outcome [10]
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Adverse events
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Assessment method [10]
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Frequency and severity of adverse events
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Timepoint [10]
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All visits for 96 weeks
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Eligibility
Key inclusion criteria
* Age between 6 and 21 years and weight at least 20kg at Visit 1
* Diabetes mellitus diagnosed according to ADA criteria (53) within 100 days of Visit 2
* Presence of at least one antibody against insulin (if <10 days since starting insulin therapy), GAD, IA2 or ZnT8
* Random C-peptide >0.3nmol/l, measured by a NATA-accredited pathology laboratory within 2 weeks of Visit 2
* Willing to use CGM for the duration of the study
* Demonstrated ability to record home glucose measurements and insulin doses, as judged by the study doctor
* Willing to forego other forms of experimental treatment during the study
* Fully vaccinated against Covid-19, as recommended by the Australian Technical Advisory Group on Immunisation
* Up to date with other vaccinations recommended by the Australian Technical Advisory Group on Immunisation
* Willing to postpone any live vaccine immunisations for 3 months after treatment
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Minimum age
6
Years
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Maximum age
21
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
* Clinical or laboratory evidence of active infection other than localised skin infection, including viral hepatitis, EBV, CMV or tuberculosis
* Immunodeficiency or chronic use of immunosuppressive drugs other than topical or inhaled glucocorticoid
* Vaccination with live or dead virus within 4 weeks of Visit 2
* History of malignancy
* Pregnant or lactating, or of child-bearing potential not using an effective method of contraception
* Any pathology of the nasal passages that would preclude safe application of the nasal spray
* Any condition that would interfere with study conduct or participant safety
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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 analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not 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
13/02/2023
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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
13/02/2027
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Actual
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Sample size
Target
62
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,VIC,WA
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Recruitment hospital [1]
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The Children's Hospital at Westmead - Westmead
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Recruitment hospital [2]
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Queensland Children's Hospital - South Brisbane
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Recruitment hospital [3]
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Women's and Children's Hospital - North Adelaide
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Recruitment hospital [4]
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The Royal Melbourne Hospital - Parkville
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Recruitment hospital [5]
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The Royal Children's Hospital - Parkville
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Recruitment hospital [6]
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Perth Children's Hospital - Nedlands
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Recruitment postcode(s) [1]
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2145 - Westmead
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Recruitment postcode(s) [2]
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4101 - South Brisbane
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Recruitment postcode(s) [3]
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5006 - North Adelaide
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Recruitment postcode(s) [4]
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3050 - Parkville
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Recruitment postcode(s) [5]
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3052 - Parkville
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Recruitment postcode(s) [6]
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6009 - Nedlands
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Funding & Sponsors
Primary sponsor type
Other
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Name
Melbourne 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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Other collaborator category [2]
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Other
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Name [2]
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Juvenile Diabetes Research Foundation
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Address [2]
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Country [2]
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Ethics approval
Ethics application status
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Summary
Brief summary
The goal of this clinical trial is to test whether the combination of two safe immune therapies called abatacept and nasal insulin can preserve pancreas function in recently-diagnosed type 1 diabetes. When type 1 diabetes is first diagnosed, the pancreas is still able to make small amounts of insulin, which helps control glucose levels. Preserving pancreas function can make glucose control easier and reduce the need to use injected insulin. Participants will be asked to inject abatacept under their skin once per week and inhale nasal insulin or nasal placebo using a spray for 10 consecutive days initially and twice per week thereafter. The treatment period is for 48 weeks, with another 48-week follow-up period.
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Trial website
https://clinicaltrials.gov/study/NCT05742243
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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John Wentworth
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Address
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Melbourne Health
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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
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT05742243