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Trial registered on ANZCTR
Registration number
ACTRN12612000590864
Ethics application status
Approved
Date submitted
29/05/2012
Date registered
1/06/2012
Date last updated
12/03/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Prednisolone in Preschool wheeze
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Scientific title
In children between age 1 and 5 years with salbutamol responsive wheeze does treatment with prednisolone compared with placebo result in lower PRAM at 24 hours?
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Secondary ID [1]
280575
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Nil
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Universal Trial Number (UTN)
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Trial acronym
WASP (Wheeze And Steroids in Pre-schooler's)
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Wheeze in Preschool aged children.
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Condition category
Condition code
Respiratory
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
2mg/kg of prednisolone. Orally, Once Daily for 3 days.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
Placebo, oral placebo formulation, "orabase". Orally, Once daily for 3 days.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The respiratory assessment measure, PRAM .
(PRAM = Preschool Respiratory Assessment Measure)
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Assessment method [1]
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Timepoint [1]
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Initial pram assessed at time of arrival in the emergency department.
Second pram Score assessed between 24 - 36 hours following the administration of the study medication.
The Majority of patients will be discharged from the emergency department. They will have a PRAM score assessed in their home by home care nurses between 24 and 36 hours following discharge.
Pateints admitted will have their PRAm score assessed at 24 hours by the nurse caring for them.
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Secondary outcome [1]
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Salbutamol usage.
Parents will be asked how many puffs of salbutamol they have administered to their child using a questionaire. The values collected will be the following:
0-6 puffs
7-12 puffs
13-24 puffs
25-49 puffs
more the 49 puffs
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Assessment method [1]
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Timepoint [1]
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24 - 36 hours, the time of the PRAM score assessment.
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Secondary outcome [2]
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Disturbed sleep, parents will be asked about how many extra times their child wake in the previous night using a standard questionnaire:
0, 1 ,2 ,3 or more times
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Assessment method [2]
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Timepoint [2]
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24 - 36 hours, the time of the PRAM score assessment.
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Secondary outcome [3]
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visit to doctors: parents will be asked if they have taken their child to a doctor since discharge using a standard questionnaire.
If the answer is yes parents will be asked if this was because the were concerned about their childs breathing.
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Assessment method [3]
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Timepoint [3]
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24 - 36 hours, the time of the PRAM score assessment
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Secondary outcome [4]
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Parents perception of their child's health: Parents will be asked how do they feel about their child's condition in a standard questionnaire. The responses are: Better, Same or Worse.
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Assessment method [4]
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Timepoint [4]
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24 - 36 hours, the time of the PRAM score assessment
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Secondary outcome [5]
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Adherence to Medication: parents will be asked if they have administered their child's study medication: If the answer is no then they will be asked for a reason. THis is freeform.
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Assessment method [5]
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Timepoint [5]
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24 - 36 hours, the time of the PRAM score assessment
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Eligibility
Key inclusion criteria
Preschool age.
Presenting with an acute respiratory illness to the Emergency Department of Starship Childrens Hospital.
Wheeze.
A significant clinical response to Salbutamol. This will be asses using a standard scoring measure, The PRAM score.
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Minimum age
12
Months
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Maximum age
59
Months
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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
Unable to be followed up in 20-36 hours.
Corticosteriods in last 7 days.
Chronic respiratory, neurological or cardiac disease.
Contraindication to corticosteriods or allergy to prednisolone.
History consistent with foreign body inhalation.
Current severe disease (i.e. life threatening asthma).
History of life threatening asthma.
Previously randomised to the WASP study.
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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)
Preschool patients with wheeze will be identified at triage, by the asigned nurse or medical staff caring for the patient in the emergency department of our tertiary children's hospital.
A PRAM score will be taken prior to the administration of any salbutamol.
Patients will receive standard treatment with salbutamol for wheeze. This is 3 dose of 6 puffs via spacer every 20 minutes. If the PRAM score reduces by 2 points or more then patients will be invited to take part in the study.
If they agree then the treating nurse will select a sequential envelope from a closed box. The card inside has the study number written on it corresponding to a number on the medication bottle.
The study numbers have been randomised to treatment or placebo.
The study cards have been radomised to the envelopes.
The allocation of the study number and the cards to the envelopes are both random.
The nurse then calculates a dose in mls to be administered to the patient this is written on the bottle.
The bottles are identical.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The allocation of study numbers to treatement or placebo was done using the random number generation feature in excel.
The allocation of study number cards to sequential envelopes was done using the random number generation feature in excel.
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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 4
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Type of endpoint/s
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
5/06/2012
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Actual
5/06/2012
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Date of last participant enrolment
Anticipated
5/09/2012
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Actual
20/01/2013
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
200
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Accrual to date
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Final
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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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Charities/Societies/Foundations
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Name [1]
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A+ Auckland ADHB charitable Trust, research grant.
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Address [1]
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ADHB
Private Bag 92024,
Auckland 1142,
New Zealand
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Country [1]
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Richard Aickin,
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Address
Clinical director Children's health
Starship Children's Hospital
ADHB
Private Bag 92024,
Auckland 1142,
New Zealand
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Country
New Zealand
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Secondary sponsor category [1]
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Individual
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Name [1]
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Dr Michael Shepherd
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Address [1]
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Clinical Director Children's Emergency Department
Starship Children's Hospital
ADHB
Private Bag 92024,
Auckland 1142,
New Zealand
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Country [1]
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New Zealand
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Other collaborator category [1]
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Individual
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Name [1]
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Dr Stuart Dalzeil
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Address [1]
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Director of Research Children's Emergency Department
Starship Children's Hospital
ADHB
Private Bag 92024,
Auckland 1142,
New Zealand
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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 X Regional Ethics Committee
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Ethics committee address [1]
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Private Bag 92522 Wellesley St Auckland 1141
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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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12/01/2012
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Approval date [1]
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12/03/2012
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Ethics approval number [1]
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NTX/12/02/002
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Summary
Brief summary
Wheeze in preschool children is the most common cause of admission to hospital in the age group. In older children and adults, oral corticosteroids are proven to be an effective treatment for wheeze (asthma). However a similar treatment effect has not been demonstrated in the preschool population and effective treatment for preschool wheeze has proved to be difficult to find. There have only been a handful of studies on the clinical effects of corticosteroids (usually prednisolone) in preschool children with wheeze. These have typically been small studies, had some study design problems and have produced conflicting results – some suggesting they work, some suggesting they don’t. So currently no-one knows whether to continue to give preschool children with wheeze steroids. Administrationof steroids preschool wheeze use is included in clinical guidelines in New Zealand and internationally. However current practice varies greatly and often depends on personal presence. None of the previous trials have measured salbutamol response or used this to guide treatment, although this is currently used by clinicians to help guide treatment. Salbutamol response is an indicator of airway responsiveness and we hypothesise that a positive response is likely to increase the chance of steroids being effective. We aim to determine the clinical effect of oral corticosteroids in salbutamol responsive preschool wheeze
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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 Mike Shepherd
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Address
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Children's Emergency Department Starship Children's Hospital, ADHB Private Bag 92024, Auckland 1142
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Country
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New Zealand
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Phone
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+64 9 3074902
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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 Owen Sinclair
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Address
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Owen Sinclair, Paediatric Emergency Fellow
Children's Emergency Department
Starship Children's Hospital, ADHB
Private Bag 92024, Auckland 1142
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Country
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New Zealand
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Phone
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+64 (0)21 242 3001
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Fax
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(64 9) 3757055
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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 Owen Sinclair
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Address
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Owen Sinclair, Paediatric Emergency Fellow
Children's Emergency Department
Starship Children's Hospital, ADHB
Private Bag 92024, Auckland 1142
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Country
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New Zealand
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Phone
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+64 (0)21 242 3001
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Fax
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(64 9) 3757055
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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