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Trial registered on ANZCTR
Registration number
ACTRN12612001002875
Ethics application status
Approved
Date submitted
8/08/2012
Date registered
18/09/2012
Date last updated
7/12/2020
Date data sharing statement initially provided
7/12/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
A Randomised Controlled Trial to Compare Administration of Prothrombin Complex Concentrate with Standard Haemostasis Management in Adult Patients Undergoing Peritoneal Cytoreductive Surgery Requiring Massive Transfusion.
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Scientific title
Efficacy of prothrombin complex in achieving haemostasis compared to standard treatment in adult patients undergoing peritoneal cytoreductive surgery requiring massive transfusion.
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Secondary ID [1]
280793
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Nil
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Universal Trial Number (UTN)
U1111-1132-5054
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Patients undergoing peritoneal cytoreductive surgery
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Peritoneal cancer
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Condition category
Condition code
Surgery
287177
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0
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Other surgery
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Cancer
287598
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0
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Ovarian and primary peritoneal
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Patients to receive early administration of prothrombin complex concentrate. It may be administered after surgery has commenced and based on the peritoneal carcinomatosis index (PCI) count, it is considered that the patient is at high risk of massive transfusion. Prothrombinex will be administered at a dose of 20IU/kg ( up to a maximum of 50IU/kg), given intravenously. The dose given will be at the discretion of the physician.
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Intervention code [1]
285223
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Treatment: Drugs
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Comparator / control treatment
Patients will receive usual standard haemostasis management- this includes administration of blood products (FFP, cryoprecipitate) according to laboratory coagulation results.
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Control group
Active
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Outcomes
Primary outcome [1]
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Efficacy of Prothrombinex in achieving haemostasis compared to standard treatment. Achievement of haemostasis shall be defined as stable haematocrit and no increase in drain losses with blood.
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Assessment method [1]
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Timepoint [1]
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24 hours post surgery
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Primary outcome [2]
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Reduction in the number of units of blood products transfused in the first 24 hours, including the time of surgery.
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Assessment method [2]
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Timepoint [2]
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24 hours post surgery
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Secondary outcome [1]
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Measured blood loss and other fluid loss (cell saver, etc). This will be assessed by visual assessment.
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Assessment method [1]
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Timepoint [1]
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24 hours post surgery
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Secondary outcome [2]
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Volume of other fluids received
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Assessment method [2]
298235
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Timepoint [2]
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During surgery
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Secondary outcome [3]
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Requirement for take-back to operating theatre (OT) to control bleeding within 7 days of surgery
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Assessment method [3]
298236
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Timepoint [3]
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Within 7 days of surgery
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Secondary outcome [4]
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Thrombotic events to be recorded as adverse events
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Assessment method [4]
298237
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Timepoint [4]
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Within 7 days of surgery
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Eligibility
Key inclusion criteria
1. Age greater than or equal to 18 years
2. Planned for peritonectomy
3. Informed consent
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Minimum age
18
Years
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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
1. Known bleeding disorder
2. Known requirement for anti-coagulation e.g. prior DVT/PE requiring anti-coagulation, requirement for caval filter
3. Known hypersensitivity to any pooled-blood or recombinant blood products
4. Known hypersensitivity to any constituents in Prothrombinex-VF, including know allergy to heparin or a history of heparin-induced thrombocytopenia
5. Evidence of active thrombosis or disseminated intravascular coagulation (DIC)
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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)
Eligible patients will be pre-consented for participation in the study prior . As only a proportion of patients will be eligible for randomization (as explained below in study procedures) and in view of the logistic impossibility of real-time consenting, patients will be pre-consented for participation prior to surgery. During surgery, and at the discretion of the surgical and anaesthetic teams, the patient will be determined to be suitable for randomisation based on their anticipated risk of massive transfusion. Eligible participants will be randomised to standard care or early use of Prothrombinex-VF.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation: If the patient is at risk of massive transfusion (as evaluated by the anaesthetist and surgeon), the patient will be randomised to either arm by contacting an independent data manager holding the code. The randomisation code will be one to one using variable block sizes to allocate the patient to either arm.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Nil
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Phase
Phase 3 / Phase 4
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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
1/11/2012
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Actual
8/10/2013
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Date of last participant enrolment
Anticipated
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Actual
28/02/2017
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Date of last data collection
Anticipated
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Actual
13/11/2017
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Sample size
Target
80
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Accrual to date
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Final
80
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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St George Public Hospital
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Address [1]
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Gray St, Kogarah, NSW 2217
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Country [1]
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Australia
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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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Australian New Zealand Society of Blood Transfusion
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Address [2]
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145 Macquarie St,
Sydney NSW 2000
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Country [2]
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Australia
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Primary sponsor type
Hospital
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Name
St George Hospital
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Address
Gray St, Kogarah, NSW 2217
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
284418
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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SESLHD Human Research Ethics Committee (Southern Sector)
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Ethics committee address [1]
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St George and sutherland Hospital research Office, Level 3 James Law House, St George Hospital, Gray St, Kogarah NSW 2217
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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10/02/2012
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Ethics approval number [1]
287592
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Summary
Brief summary
The purpose of this study is to investigate whether the early use of a blood clotting drug during peritonectomy surgery reduces the amount of bleeding that occurs and so reduces the amount of blood transfusion you may need. Who is it for? You may be eligible to join this study if you are aged 18 years or above and are scheduled to undergo a peritonectomy. Trial details: Peritonectomy surgery is associated with a high risk of bleeding and many patients will require what is known as massive blood transfusion. This typically involves a transfusion of at least 10 units of blood or roughly your whole blood volume. In this research we hope to compare two treatments. Half the participants will receive the standard treatment used in this hospital. This involves the use of blood clotting factors and blood transfusion. In addition patients who have persistently high blood loss are sometimes given a treatment called recombinant factor VIIa. The other half of the participants will receive a product known as Prothrombinex-VF early in the operation when the anaesthetist suspects that there will be high blood loss. Prothrombinex-VF is a commercial product that contains blood clotting factors – these help the blood clot. All other treatment will be the same as usual practice. With this research we hope to be able to show that early use of Prothrombinex-VF reduces the need for blood transfusion and the overall need for blood products such as blood clotting factor preparations.
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Trial website
Nil
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Trial related presentations / publications
Presented at HSANZ Annual Scientific Meeting Oct 2018
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Public notes
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Contacts
Principal investigator
Name
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Dr Shir Jing Ho
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Address
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Lvl 4 Clinical Services Building, St George Hospital, Gray St, Kogarah, NSW 2217
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Country
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Australia
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Phone
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+61 414835018
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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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Ms Roslyn Ristuccia
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Address
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St George Hospital Clinical Trials Unit, Ground FLoor, Pitney Building, St George Hospital, Gray St, Kogarah, NSW 2217
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Country
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Australia
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Phone
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61 2 91132977
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Fax
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61 2 91132960
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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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Shir-Jing Ho
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Address
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Department of Haematology,
St George Hospital, Gray st, Kogarah NSW 2217
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Country
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Australia
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Phone
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61 2 91133851
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Fax
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61 2 91133942
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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)?
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
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
9990
Study protocol
[email protected]
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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