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Trial registered on ANZCTR
Registration number
ACTRN12612000584831
Ethics application status
Approved
Date submitted
28/05/2012
Date registered
30/05/2012
Date last updated
19/03/2021
Date data sharing statement initially provided
11/02/2019
Date results provided
11/09/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
STRIDER (NZAus): A randomised placebo-controlled trial of a new therapy (sildenafil) to help growth in severely growth restricted fetuses at very early gestations.
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Scientific title
STRIDER (NZAus): A randomised placebo controlled trial of sildenafil therapy to improve fetal growth velocity in dismal prognosis early-onset intrauterine growth restriction (New Zealand and Australia).
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Secondary ID [1]
280564
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Nil
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Universal Trial Number (UTN)
U1111-1131-2408
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Trial acronym
STRIDER (NZAus)
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Severe early onset fetal growth restriction
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Condition category
Condition code
Reproductive Health and Childbirth
286840
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0
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Fetal medicine and complications of pregnancy
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Sildenafil 25mg three times a day as an oral tablet from randomisation until delivery (or 32 weeks gestation, whichever occurs first).
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
Placebo. Identical in appearance to sildenafil (film-coated, rounded-diamond-shaped tablets).
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The proportion of pregnancies with increased abdominal circumference (AC) growth velocity post treatment compared to pretreatment.
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Assessment method [1]
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Timepoint [1]
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Post-treatment growth velocity will be calculated 14 days after treatment commenced (if delivered prior then at 10, 5 or 2 days post-treatment).
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Secondary outcome [1]
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Mean absolute change in abdominal circumference (mm) per day
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Assessment method [1]
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Timepoint [1]
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14 days after treatment commenced (if delivered prior then at 10, 5 or 2 days post-treatment).
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Secondary outcome [2]
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Mean birthweight and mean birthweight centile
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Assessment method [2]
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Timepoint [2]
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At time of delivery
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Secondary outcome [3]
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Changes in uteroplacental, umbilical and fetal Doppler waveform studies.
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Assessment method [3]
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Timepoint [3]
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2, 5, 10 and 14 days after treatment commenced.
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Secondary outcome [4]
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Randomisation-to-delivery interval
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Assessment method [4]
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Timepoint [4]
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At time of delivery
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Secondary outcome [5]
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Measures of neonatal outcome; live-births, survival to hospital discharge, major morbidity including chronic lung disease requiring ambulatory oxygen therapy on hospital discharge, intraventricular haemorrhage grade 3-4, >grade 2 retinopathy of prematurity, necrotising enterocolitis, number of doses of surfactant, ventilator days, supplemental oxygen days and number of days to full feeds
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Assessment method [5]
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Timepoint [5]
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to time of hospital discharge
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Secondary outcome [6]
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Primary outcome of the childhood follow up assessment (STRIDER NZAus Childhood Follow Up Study): Survival free of neurosensory impairment at 2.5 years’ corrected age, defined by absence of cerebral palsy, deafness, blindness, cognitive delay (Bayley-III composite score cognition or language >1 SD below test mean) and motor delay (Bayley-III composite motor score >1 SD below test mean).
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Assessment method [6]
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Timepoint [6]
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2.5 years' corrected age (+/- 6 months)
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Eligibility
Key inclusion criteria
1. Singleton pregnancy.
2a. At 22+0 weeks to 27+6 weeks: AC measure less than or equal to 3 percentile for gestational age; OR
2b. At 28+0 weeks to 29+6 weeks ultrasound estimate of fetal weight (EFW) <700grams.
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Minimum age
No limit
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Maximum age
No limit
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Sex
Females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Known major fetal anomaly/syndrome/congenital infection deemed to be the likely cause of IUGR.
2. Known fetal aneuploidy.
3. Already made plan for termination of pregnancy.
4. Maternal disease (e.g. pre-eclampsia) where it is expected that delivery is necessary within 48 hours.
5. Any contraindication to sildenafil therapy.
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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)
Randomisation will be by central randomisation by phone/computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomised stratified for gestational age at recruitment (less than 24 weeks vs. greater than or equal to 24 weeks) and present or absent/reversed end diastolic flow in umbilical arteries.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2 / Phase 3
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/02/2014
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Actual
11/03/2014
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Date of last participant enrolment
Anticipated
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Actual
17/03/2017
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Date of last data collection
Anticipated
31/12/2019
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Actual
28/02/2020
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Sample size
Target
122
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Accrual to date
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Final
122
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,SA,WA,VIC
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Health Research Council of NZ (HRC)
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Address [1]
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PO Box 5541, Wellesley Street, Auckland 1141, New Zealand
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Country [1]
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New Zealand
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Funding source category [2]
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Charities/Societies/Foundations
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Name [2]
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Cure Kids
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Address [2]
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PO Box 90 907
Victoria Street West
Auckland 1142
New Zealand
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Country [2]
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New Zealand
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Funding source category [3]
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Charities/Societies/Foundations
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Name [3]
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Auckland Medical Research Foundation
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Address [3]
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Ground Floor, 89 Grafton Road
P O Box 110139, Auckland Hospital
Auckland 1148
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Country [3]
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New Zealand
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Funding source category [4]
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Charities/Societies/Foundations
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Name [4]
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Neurological Foundation NZ
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Address [4]
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66 Grafton Road, Grafton, Auckland?PO Box 110022, Auckland City Hospital, Auckland 1148
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Country [4]
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New Zealand
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Funding source category [5]
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Other Collaborative groups
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Name [5]
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Mercia Barnes Trust RANZCOG
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Address [5]
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PO Box 10611, The Terrace, WELLINGTON 6143
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Country [5]
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New Zealand
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Funding source category [6]
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Charities/Societies/Foundations
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Name [6]
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Maurice & Phyllis Paykel Trust
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Address [6]
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PO Box 110008
Auckland Hospital
Auckland 1148
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Country [6]
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New Zealand
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Funding source category [7]
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University
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Name [7]
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University of Auckland FRDF
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Address [7]
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Private Bag 92019, Auckland 1142, New Zealand
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Country [7]
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New Zealand
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Primary sponsor type
University
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Name
University of Auckland
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Address
Park Road, Grafton, Auckland 1023
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Country
New Zealand
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Auckland City Hospital
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Address [1]
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Park Road
Grafton
Auckland 1023
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Country [1]
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern A Health and Disability Ethics Committee, New Zealand
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Ethics committee address [1]
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140 New Zealand
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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28/05/2012
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Approval date [1]
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02/10/2012
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Ethics approval number [1]
287344
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Summary
Brief summary
Intrauterine growth restriction (IUGR) describes conditions where fetuses are smaller than expected for their gestational age. This puts the fetus at risk of death, hypoxia and preterm birth. If IUGR occurs early in pregnancy (i.e before 28 weeks gestation) survival rates are only 70% and survival free of major handicap (intact survival) is much lower at 20%. Current management involves intensive fetal surveillance and delivery when there is evidence of serious compromise (to avoid death in utero) but this leads to the consequent risks of prematurity. There is no known treatment for IUGR. This is a double blind randomised placebo controlled trial of Sildenafil, a nitric oxide donor drug, that has the potential to vasodilate uteroplacental vessels improving placental function. It may represent a novel therapy for IUGR. It has been used in pregnancy without adverse events and in a small case-control study it improved daily fetal growth velocity. Women with severe early onset IUGR will be invited to take part in the study at MFM units across NZ and Australia. This study will demonstrate if Sildenafil improves fetal growth, the results will be used in collaboration with other similar studies planned worldwide to demonstrate if Sildenafil improves rates of survival free of major handicap. This trial incorporates the STRIDER NZAus Childhood Outcome Study: a follow up assessment of all surviving children at 2-3 years’ corrected age to determine whether any benefit (or harm) seen in the newborn as a consequence of antenatal sildenafil therapy is sustained, or develops, through childhood.
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Trial website
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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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Dr Katie Groom
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Address
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Department of Obstetrics and Gynaecology, Faculty of Medical and Health Science, University of Auckland, Private Bag 92019 Auckland 1142, New Zealand
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Country
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New Zealand
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Phone
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+64 9 373 7599 ext 89823
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Katie Groom
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Address
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Department of Obstetrics and Gynaecology
Faculty of Medical and Health Science
University of Auckland
Private Bag 92019
Auckland 1142
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Country
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New Zealand
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Phone
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+64 9 373 7599 ext 89823
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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
Name
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Dr Katie Groom
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Address
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Department of Obstetrics and Gynaecology
Faculty of Medical and Health Science
University of Auckland
Private Bag 92019
Auckland 1142
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Country
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New Zealand
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Phone
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+64 9 373 7599 ext 89823
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Fax
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Email
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[email protected]
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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?
De-identified individual participant data underlying published results will be made available to the IPD group and upon request to other researchers.
The STRIDER NZAus trial and the Childhood Outcome Study are part of an international STRIDER IPD Consortium which will include data from four national trials undertaken in NZAus, UK, Netherlands and Canada which will be used in individual patient data (IPD) meta-analyses. It is expected that this collaboration will have sufficient power to assess the effect of sildenafil on survival free of major morbidity to primary discharge from hospital and will also explore effects in early childhood (age 2-3 years).
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When will data be available (start and end dates)?
Data will be available from completion of primary analysis for STRIDER NZAus and the STRIDER NZAus Childhood Outcome sub-study. No end date.
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Available to whom?
The de-identified data that support the findings of this study will be made available to the IPD Consortium, and upon request to researchers who provide a methodologically sound proposal and whose proposed use of the data has been approved by an independent review committee identified for this purpose. Access is subject to approval by the Trial Steering Committee and any ethics requirements.
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Available for what types of analyses?
Any purpose approved by the Trial Steering Committee.
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How or where can data be obtained?
By contacting the Principal Investigator via email:
[email protected]
. Access subject to approvals by Trial Steering Committee.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
11092
Study protocol
Groom, K., Baker, P., McCowan, L., Stone, P., & Lee, A. (2016, May 18). STRIDER (NZAus): A Randomised Controlled Trial of Sildenafil Therapy In Dismal Prognosis Early-Onset Intrauterine Growth Restriction (New Zealand and Australia). Zenodo. http://doi.org/10.5281/zenodo.56150
11093
Statistical analysis plan
Groom, Katie, Mackay, Laura, & Lee, Arier. (2017, August 15). STRIDER (NZAus): A Randomised Controlled Trial of Sildenafil Therapy In Dismal Prognosis Early-Onset Intrauterine Growth Restriction (New Zealand and Australia) - Statistical Analysis Plan. Zenodo. http://doi.org/10.5281/zenodo.998139
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
STRIDER NZAus: a multicentre randomised controlled trial of sildenafil therapy in early-onset fetal growth restriction.
2019
https://dx.doi.org/10.1111/1471-0528.15658
N.B. These documents automatically identified may not have been verified by the study sponsor.
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