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Trial registered on ANZCTR
Registration number
ACTRN12614000375651
Ethics application status
Not yet submitted
Date submitted
2/04/2014
Date registered
8/04/2014
Date last updated
8/04/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
The Avastin in Trabeculectomy Study
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Scientific title
A randomised double-blinded study to assess the ability for intravitreal bevacizumab to increase the proportion of glaucoma patients with intraocular pressure at or below target following glaucoma drainage surgery.
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Secondary ID [1]
284384
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Nil known
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Universal Trial Number (UTN)
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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:
Glaucoma
291554
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Condition category
Condition code
Eye
291936
291936
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0
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Diseases / disorders of the eye
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Surgery
291960
291960
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0
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Surgical techniques
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A single intraoperative intravitreal injection of bevacizumab 1.25mg in 0.05ml
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Intervention code [1]
289114
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Treatment: Drugs
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Comparator / control treatment
A single intraoperative intravitreal injection of balanced-salt solution
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Proportion of patients with intraocular pressure at or below target on no medication measured with goldmann applanation tonometry
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Assessment method [1]
291840
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Timepoint [1]
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One year
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Primary outcome [2]
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Proportion of patients with intraocular pressure at or below target with or without topical medication measured with goldmann applanation tonometry
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Assessment method [2]
291841
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Timepoint [2]
291841
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One year
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Secondary outcome [1]
307645
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Number of topical medications by data linkage to patient medical records
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Assessment method [1]
307645
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Timepoint [1]
307645
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One year
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Secondary outcome [2]
307646
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Number of bleb needlings by data linkage to patient medical records
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Assessment method [2]
307646
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Timepoint [2]
307646
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One year
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Secondary outcome [3]
307647
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Number of 5 Fluorouracil injections by data linkage to patient medical records
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Assessment method [3]
307647
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Timepoint [3]
307647
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One year
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Eligibility
Key inclusion criteria
Those requiring a trabeculectomy or a phaco-trabeculectomy based on the judgement of the treating surgeon
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Minimum age
40
Years
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Maximum age
90
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
Anterior segment dysgenesis, irido-corneal-endothelial syndrome, proliferative diabetic retinopathy, congenital or juvenile-onset glaucoma, traumatic glaucoma, rubeotic glaucoma, previous corneal graft surgery, previous vitrectomy surgery requiring silicone oil, any condition for which the patient is currently receiving intravitreal anti-VEGF medication. However, previous cataract or trabeculectomy surgery is not an exclusion.
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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)
Subjects will be selected from those attending glaucoma clinics at the Flinders Medical Centre and the Repatriation General Hospital eye outpatients department. Once a patient has been identified as being appropriate for the study, they will be invited to be involved. If they agree, then their details will be forwarded to the department of pharmacy at the Flinders Medical Centre where randomization will take place. Patients will be allocated to either receive an intravitreal injection of Avastin (1.25mg in 0.05ml) or a sham/placebo injection of balanced-salt solution. This injection will be dispensed to the surgeon who will administer it and the completion of the trabeculectomy surgery. Patients will then be followed by the surgeon over the following 12 months.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
This will be achieved using a pseudorandom number generator.
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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 assessing the outcomes
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 3 / Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Based on previous work and when considering an IOP of less than 21 mmHg, the 1 year complete success rate for trabeculectomy surgery can be expected to be 85%. However, this target would not be considered a success in the advanced patients who are now requiring surgery. Therefore, we would be aiming for a lower target IOP, but with that we would also expect a lower success rate. We therefore feel that an expected complete success rate of 75% would be a conservative estimate. Furthermore, we would expect that an improvement in success rate of 20% would be required for a change in practice to occur. We would therefore aim to recruit a minimum of approximately 100 patients (50 cases and 50 controls). This would allow us to detect a difference of at least 20% between groups, with 80% power and type 1 error of 5%.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/06/2014
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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
100
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
SA
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Recruitment hospital [1]
2291
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Flinders Medical Centre - Bedford Park
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Recruitment hospital [2]
2292
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Repatriation Hospital - Daw Park
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Recruitment postcode(s) [1]
7968
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5042 - Bedford Park
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Recruitment postcode(s) [2]
7969
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5041 - Daw Park
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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A/Prof John Landers
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Address [1]
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Flinders Medical Centre
1 Flinders Drive
BEDFORD PARK SA 5042
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Country [1]
289028
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Australia
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Primary sponsor type
Individual
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Name
A/Prof John Landers
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Address
Flinders Medical Centre
1 Flinders Drive
BEDFORD PARK SA 5042
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Country
Australia
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Secondary sponsor category [1]
287701
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None
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Name [1]
287701
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Address [1]
287701
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Country [1]
287701
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
290832
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South Adelaide Health Service Human Research Ethics Committee
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Ethics committee address [1]
290832
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Flinders University 1 Sturt Road BEDFORD PARK SA 5042
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Ethics committee country [1]
290832
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Australia
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Date submitted for ethics approval [1]
290832
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14/04/2014
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Approval date [1]
290832
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Ethics approval number [1]
290832
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Summary
Brief summary
Glaucoma is a progressive disease of the optic nerve, which if undiagnosed, can lead to blindness. Surgery is often reserved for very severe cases and as such, surgical success is imperative. Our project will address this by performing a randomised double blinded assessment of the adjunctive use of intraoperative intravitreal bevacizumab (Avastin), a currently available and widely used anti-VEGF drug, on post-operative glaucoma surgery success. If this intervention is successful, the outcomes could undoubtedly influence future surgical management.
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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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A/Prof John Landers
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Address
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Flinders Medical Centre
1 Flinders Drive
BEDFORD PARK SA 5042
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Country
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Australia
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Phone
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+61414804090
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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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John Landers
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Address
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Flinders Medical Centre
1 Flinders Drive
BEDFORD PARK SA 5042
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Country
47419
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Australia
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Phone
47419
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+61414804090
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Fax
47419
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Email
47419
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[email protected]
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Contact person for scientific queries
Name
47420
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John Landers
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Address
47420
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Flinders Medical Centre
1 Flinders Drive
BEDFORD PARK SA 5042
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Country
47420
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Australia
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Phone
47420
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+61414804090
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Fax
47420
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Email
47420
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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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