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Trial registered on ANZCTR
Registration number
ACTRN12613001229763
Ethics application status
Approved
Date submitted
29/10/2013
Date registered
8/11/2013
Date last updated
8/11/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomised control trial of the effect of Niacinamide on Fibroblast Growth factor 23 (FGF23) levels in Chronic Kidney Disease.
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Scientific title
A randomised, double-blind, placebo-controlled trial to assess the effect of niacinamide on levels of Fibroblast Growth factor 23 (FGF23) in patients with chronic kidney disease stages 3b-4.
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Secondary ID [1]
283474
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Nil Known
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Universal Trial Number (UTN)
U1111-1146-6508
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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:
Elevated levels of FGF23 in chronic kidney disease
290388
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Condition category
Condition code
Renal and Urogenital
290781
290781
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0
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Niacinamide (500mg 4 x daily)
Administration: oral capsules
Duration of treatment: 16 weeks
Adherence will be monitored by count of remaining capsules at each trial visit every 4 weeks
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Intervention code [1]
288185
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Treatment: Drugs
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Comparator / control treatment
Matched placebo (500mg 4 x daily)
Administration: oral capsules
Duration of treatment: 16 weeks
Placebo (maltodextrin) that is indistinguishable from the active treatment but containing no active ingredients.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Change in serum intact FGF23 (measured by Kainos hFGF-23 Elisa assay)
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Assessment method [1]
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Timepoint [1]
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At baseline, 4 weeks, 8 weeks, 12 weeks and 16 weeks
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Secondary outcome [1]
305264
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Serum phosphate
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Assessment method [1]
305264
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Timepoint [1]
305264
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At baseline, 4 weeks, 8 weeks, 12 weeks and 16 weeks
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Secondary outcome [2]
305265
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24 hour urinary phosphate
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Assessment method [2]
305265
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Timepoint [2]
305265
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At baseline, 4 weeks, 8 weeks, 12 weeks and 16 weeks
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Secondary outcome [3]
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Serum parathyroid hormone (PTH)
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Assessment method [3]
305389
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Timepoint [3]
305389
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At baseline, 4 weeks, 8 weeks, 12 weeks and 16 weeks
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Secondary outcome [4]
305390
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estimated Glomerular Filtration rate (eGFR)
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Assessment method [4]
305390
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Timepoint [4]
305390
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At baseline, 4 weeks, 8 weeks, 12 weeks and 16 weeks
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Secondary outcome [5]
305391
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Serum high-density lipoprotein (HDL)
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Assessment method [5]
305391
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Timepoint [5]
305391
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At baseline, 4 weeks, 8 weeks, 12 weeks and 16 weeks
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Eligibility
Key inclusion criteria
1. Patients with Chronic Kidney Disease (CKD) Stages 3b-4 (eGFR between 15-45ml/ min/1.73m2)
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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. Patients with a history of psychological illness or condition which interferes with their ability to understand or comply with the requirements of the study
2. Medical conditions that impact on phosphate metabolism (apart from CKD), eg. primary hyperparathyroidism or hypoparathyroidism; previous subtotal parathyroidectomy; gastrointestinal malabsorption disorders such as Crohn’s disease, ulcerative colitis, coeliac disease or severe liver dysfunction
3. Treatment with any drug that could impact on mineral metabolism
4. Treatment with anti-epileptic drugs
5. Treatment with anticoagulants
6. Renal transplantation
7. Rapid changes of residual renal function
8. Serum PTH greater than 50 pmol/L
9. Serum albumin less than 30g/L
10. Active malignancy
11. Pregnancy or breast feeding
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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)
Allocation by sealed opaque envelopes.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation by the use of sequentially numbered opaque sealed envelopes for each trial cohort.
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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
A randomised double blind, double dummy, placebo-controlled trial
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
For sample size considerations, we used published literature reporting repeated measures of FGF23. Based on published data, we assume the mean (SD) FG23 to be 72 (39) RU/mL in the control group. Based on a reduction in FGF23 of 33% we assume the mean (SD) FGF23 to be 48 (39) RU/mL in the experimental group, which is a clinically important and detectable difference. We have assumed an overall correlation between baseline and follow-up measurements of 0.7 based on a number of studies, but have also tested the sensitivity of power calculations using modelled correlation values of 0.1 and 0.9. Modelling these assumptions using repeated-measures analysis of covariance (ANCOVA), allowing for a 25% drop-out rate, and using a correlation value of 0.7, treatment groups of 18 would provide adequate power (power 0.9, 2-sided alpha 0.05). When correlation values of 0.1 or 0.9 are assumed sufficient treatment groups are 22 and 7 respectively.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
7/01/2014
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Actual
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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
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Actual
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Sample size
Target
90
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
5542
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New Zealand
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State/province [1]
5542
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Funding & Sponsors
Funding source category [1]
288180
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Charities/Societies/Foundations
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Name [1]
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The Auckland Medical Research Foundation
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Address [1]
288180
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Ground Floor
89 Grafton Rd
Grafton
Auckland 1010
PO Box 110139
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Country [1]
288180
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New Zealand
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Primary sponsor type
Individual
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Name
Christopher Hood
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Address
Renal Department
Middlemore Hospital
Private Bag 93311
Otahuhu
Auckland 1640
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Country
New Zealand
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Secondary sponsor category [1]
286903
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None
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Name [1]
286903
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Address [1]
286903
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Country [1]
286903
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290092
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New Zealand Health and Disability Ethics Committees
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Ethics committee address [1]
290092
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C/- MEDSAFE, Level 6, Deloitte House 10 Brandon Street PO Box 5013 Wellington 6011
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Ethics committee country [1]
290092
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New Zealand
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Date submitted for ethics approval [1]
290092
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Approval date [1]
290092
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22/10/2013
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Ethics approval number [1]
290092
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13/STH/124
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Summary
Brief summary
The primary goal of this study is to determine if treatment with niacinamide will reduce levels of FGF23 in patients with CKD. FGF23 is elevated in CKD and has been associated with left ventricular hypertrophy and cardiac death. Low phosphate diet and phosphate binders have been shown to reduce levels of FGF23. If niacinamide is shown to successfully reduce FGF23 levels it will provide an easier "real world" approach to the early treatment of the mineral and bone disorder associated with CKD.
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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 Christopher Hood
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Address
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Middlemore Hospital
Private Bag 93311
Otahuhu
Auckland 1640
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Country
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New Zealand
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Phone
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+64 9 276 0000
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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
43927
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Christopher Hood
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Address
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Middlemore Hospital
Private Bag 93311
Otahuhu
Auckland 1640
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Country
43927
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New Zealand
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Phone
43927
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+64 9 276 0000
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Fax
43927
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Email
43927
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[email protected]
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Contact person for scientific queries
Name
43928
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Christopher Hood
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Address
43928
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Middlemore Hospital
Private Bag 93311
Otahuhu
Auckland 1640
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Country
43928
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New Zealand
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Phone
43928
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+64 9 276 0000
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Fax
43928
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Email
43928
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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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