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Trial registered on ANZCTR
Registration number
ACTRN12617000726358
Ethics application status
Approved
Date submitted
18/01/2017
Date registered
18/05/2017
Date last updated
1/08/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Efficacy of iodine solution administered via a treatment applicator for treating human papillomavirus (HPV) infection of the cervix.
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Scientific title
Efficacy of iodine solution delivered through a delivery device for eradication of persistent HPV infection following treatment for high-grade cervical intraepithelial neoplasia.
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Secondary ID [1]
290838
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None
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Universal Trial Number (UTN)
U1111-1191-3159
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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:
Cervical human papillomavirus infection
301514
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Condition category
Condition code
Infection
301228
301228
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0
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Sexually transmitted infections
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
5% iodine solution will be applied to the cervix using a delivery device in a single outpatient treatment. Half of the recipients will have active treatment (iodine) and the other half placebo (saline Sodium Chloride injection 0.9% BP (90mg in 10mL) administered via the medical delivery device. The first 20 participants will receive the treatment for 10 minutes, the next 20 participants enrolled will receive the treatment for 15 minutes, and the final 20 participants will receive the treatment for 20 minutes. The treatment duration is only increased if a therapeutic response has not been demonstrated at an earlier time interval.. The treatment is to be administered by a gynaecologist in a hospital outpatient clinic. The treating gynaecologist determines the volume of iodine administered based on the size of the cervix, between 10ml and 30ml, The amount of iodine absorbed by each individual patient will depend on the size of the patients cervix and the patients individual diffusion rate for iodine. Assuming a 4-cm2 area saturated to a depth of 0.1mm the amount of iodine would be 0.002g. The delivery device consists of a tube with a balloon to be inserted into the endocervix. The balloon is then inflated to prevent solution entering the uterus and the solution is then delivered to the endocervix. A sponge saturated with additional iodine within a silicon cup is then applied to the outer cervix. Patients will be reminded of follow up appointments.
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Intervention code [1]
296763
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Treatment: Devices
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Intervention code [2]
296764
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Treatment: Drugs
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Comparator / control treatment
Placebo using saline into the treatment device
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Proportion of participants with an 80% reduction in human papillomavirus viral load on the uterine cervix. Measurements of viral load will be taken using a cervical lavage and a swab from the cervix.
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Assessment method [1]
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Timepoint [1]
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6 weeks post treatment
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Secondary outcome [1]
330479
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None
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Assessment method [1]
330479
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Timepoint [1]
330479
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None
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Eligibility
Key inclusion criteria
Women previously treated for CIN 2 - 3 with persistent HrHPV post treatment.
Women Digene Hybrid Capture 2 positive (or other HPV test)
Women 25 year or over
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Minimum age
25
Years
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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
Under the age of 25
Male
Pregnancy, or planning to become pregnant
Current thyroid disease
Past history of thyroid disease
Family history of thyroid disease
History of allergy to iodine
History of allergy to rubber
History of anaphylaxis
Untreated gonorrhoea, or chlamydia
Current CIN 2 – 3 on cytology or biopsy
HIV infection or other immune deficiency
Impaired renal function
Autoimmune disorders
Systemic or topical steroid therapy
IUCD in situ
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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 involved contacting the holder of the allocation schedule who was "off-site" or at central administration site.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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 analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 1
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The study is a placebo controlled proof of concept study and based on work by Ho Y, Bierman R, Beardsley L, Chang C, Burk R. Natural history of cervicovaginal papillomavirus infection in young women. N Engl J Med. 1998; 336:423-8. Up to 60 women will be recruited and allow for a 20% drop out rate. The 10 patients in each group will be used to determine a treatment effect + standard deviation. This data will then be used to determine the number of patients that need to be treated to show an effect at a power (1) of at least 80% and < 0.05, provided the treatment has been found to be acceptable within the preceding treatment time interval. It is estimated there will be 20 patients in each treatment time group (10 active, 10 placebo). Data analysis will be with simple proportions using chi square analysis.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/10/2018
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Actual
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Date of last participant enrolment
Anticipated
30/10/2019
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Actual
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Date of last data collection
Anticipated
30/04/2019
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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King Edward Memorial Hospital - Subiaco
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Recruitment postcode(s) [1]
14965
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6008 - Subiaco
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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 Department of Western Australia
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Address [1]
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189 Royal Street, EAST PERTH WA 6004
PO Box 8172, Perth Business Centre WA 6849
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Country [1]
295267
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Australia
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Primary sponsor type
Individual
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Name
Jenny McClloskey
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Address
Sexual Health Clinic
Royal Perth Hospital
BoxX2213 GPO Perth WA6847
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Country
Australia
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Secondary sponsor category [1]
294093
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None
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Name [1]
294093
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Address [1]
294093
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Country [1]
294093
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296602
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King Edward Memorial Hospital
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Ethics committee address [1]
296602
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374 Bagot Road
Subiaco 6008 WA, Australia
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Ethics committee country [1]
296602
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Australia
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Date submitted for ethics approval [1]
296602
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26/01/2016
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Approval date [1]
296602
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01/03/2016
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Ethics approval number [1]
296602
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Summary
Brief summary
World-wide cervical cancer is the fourth leading cause of cancer in women. Infection of the uterine cervix with human papillomavirus (HPV) is very common, with a small proportion of those infected progressing to cervical cancer. To date, no treatment of viral infection has been available and only the cell changes brought about by the virus relatively late in the infection are treated by one of the standard surgical methods which remove parts of the cervix affected by the virus.
This proof of concept research is to trial application of iodine via a novel delivery device to the upper vaginal vault, ectocervix (outside of the cervix) and endocervical canal (passage that leads from the cervix to the uterus). Women who have persisting HPV despite standard surgical treatment to the cervix are to be recruited and treated as an outpatient procedure, the trial assessing the duration of treatment required for successful eradication of the virus. Should the treatment be found to be effective, women at long term risk of acquiring cervical cancer or adenocarcinoma as a consequence of persistent HPV infection will be offered treatment to eradicate the infection, the HPV vaccine if unvaccinated, then returned to normal follow up as mandated by the accepted guidelines. Health savings will be significant to the WA government by offering a treatment that eradicates an infection linked to potential cancer development (not currently possible) and the necessary follow up the infection entails.
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Trial website
nil
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Trial related presentations / publications
nil
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Public notes
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Contacts
Principal investigator
Name
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Dr Jenny McCloskey
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Address
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Royal Perth Hospital
Box X2213, GPO Perth, WA 6847
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Country
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Australia
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Phone
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+61892243560
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Fax
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+61892243557
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Email
71446
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[email protected]
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Contact person for public queries
Name
71447
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Dr Jenny McCloskey
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Address
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Royal Perth Hospital
Box X2213, GPO Perth, WA 6847
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Country
71447
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Australia
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Phone
71447
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+61892243560
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Fax
71447
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+61892243557
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Email
71447
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[email protected]
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Contact person for scientific queries
Name
71448
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Dr Jenny McCloskey
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Address
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Royal Perth Hospital
Box X2213, GPO Perth, WA 6847
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Country
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Australia
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Phone
71448
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+61892243560
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Fax
71448
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+61892243557
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Email
71448
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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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