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Trial registered on ANZCTR
Registration number
ACTRN12621000928819
Ethics application status
Approved
Date submitted
9/06/2021
Date registered
15/07/2021
Date last updated
7/04/2024
Date data sharing statement initially provided
15/07/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Cessation Of Pharmacotherapy In Recovered Chemotherapy induced cardioToxicity (COP-RCT) – a pilot study
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Scientific title
Cessation Of Pharmacotherapy In Recovered Chemotherapy induced cardioToxicity (COP-RCT) – a pilot study
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Secondary ID [1]
303891
0
None
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Universal Trial Number (UTN)
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Trial acronym
COP-RCT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Recovered chemotherapy induced cardiotoxicity
321470
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Condition category
Condition code
Cardiovascular
319231
319231
0
0
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Other cardiovascular diseases
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Cancer
320223
320223
0
0
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Any cancer
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Supervised withdrawal of cardioprotective therapies will occur in a staged fashion soon post randomisation by the research team, which includes a cardiologist. The prinicipal investigator will be responsible for the overall medication withdrawal.
Firstly, beta-blockers will be titrated down to cessation with weekly dose reductions. Subsequently, angiotensin converting enzyme inhibitors/angiotensin receptor blockers will be titrated down to cessation with weekly dose reductions. We aim for participants to cease all revelant medications within 6 weeks of randomisation.
Should participants experience symptoms suggestive of heart failure, they will be reviewed by the research team and discussed with an independent cardiologist for recommencement of medical therapy.
Adherence to withdrawal will be monitored at protocol stipulated clinical reviews.
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Intervention code [1]
320198
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Treatment: Other
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Comparator / control treatment
Continuation of current prescribed cardioprotective therapy will occur for 6 monts post-enrollment. Medication adherence will be monitored at protocol stipulated clinical reviews.
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Control group
Active
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Outcomes
Primary outcome [1]
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Change in Left Ventricular Ejection Fraction (LVEF) by cardiac magnetic resonance.
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Assessment method [1]
327101
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Timepoint [1]
327101
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6 months post-randomisation
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Secondary outcome [1]
393789
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Change in Kansas City Cardiomyopathy Questionnaire (KCCQ) score to measure quality of life
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Assessment method [1]
393789
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Timepoint [1]
393789
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6 months post-randomisation
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Secondary outcome [2]
397617
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Change in baseline NT-pro-BNP concentration through a blood sample
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Assessment method [2]
397617
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Timepoint [2]
397617
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6 months post-randomisation
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Secondary outcome [3]
397618
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Changes in cardiac volumes assessed with cardiac MRI (*depending on funding success)
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Assessment method [3]
397618
0
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Timepoint [3]
397618
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6 months post-randomisation
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Secondary outcome [4]
397619
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Change in EQ-5D survey score to assess quality of life
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Assessment method [4]
397619
0
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Timepoint [4]
397619
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6 months post-randomisation
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Secondary outcome [5]
398276
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Change in baseline Troponin T concentration through a blood sample
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Assessment method [5]
398276
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Timepoint [5]
398276
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6 months post-randomisation
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Secondary outcome [6]
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Reduction in 3D Left Ventricular Ejection Fraction (LVEF) of more than 10% and to less than 50% assessed using echocardiogram.
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Assessment method [6]
404931
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Timepoint [6]
404931
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6 months post randomisation
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Secondary outcome [7]
404932
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Heart failure requiring hospital admission assessed by review of participant medical records
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Assessment method [7]
404932
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Timepoint [7]
404932
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6 months post randomisation
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Secondary outcome [8]
404933
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Worsening heart failure requiring medical treatment as adjudicated by the independent cardiologists.
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Assessment method [8]
404933
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Timepoint [8]
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6 months post randomisation
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Secondary outcome [9]
406401
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Change in 3D Left Ventricular Ejection Fraction (LVEF) by echocardiography.
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Assessment method [9]
406401
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Timepoint [9]
406401
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6 months post randomisation
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Eligibility
Key inclusion criteria
Previously diagnosed asymptomatic chemotherapy related cardiac dysfunction (CTRCD) (defined as: LVEF drop >10% to a value below <55% from baseline or GLS drop greater than or equal to 12% from baseline)
LVEF of >50%.
NYHA Class I
Current CTRCD therapy – Angiotensin Converting Enzyme inhibitor (ACEi) AND/OR Beta Blocker (BB)
Completed HER2 receptor therapy (traztuzumab/pertuzumab)
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Minimum age
17
Years
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Maximum age
80
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
• History of ischaemic heart disease
• Hypertension requiring medical therapy
• Moderate or greater severity valvular disease
• Chronic kidney disease
• Atrial, supraventricular, or ventricular arrhythmia requiring BB therapy
• Pregnancy
• < 16 years old
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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
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Phase
Not Applicable
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Type of endpoint/s
Safety
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
14/03/2022
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Actual
14/03/2022
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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
70
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Accrual to date
17
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
19698
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Nepean Hospital - Kingswood
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Recruitment hospital [2]
21472
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Calvary Mater Newcastle - Waratah
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Recruitment hospital [3]
21473
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John Hunter Hospital - New Lambton
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Recruitment hospital [4]
21474
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The Royal Adelaide Hospital - Adelaide
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Recruitment hospital [5]
24453
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Westmead Hospital - Westmead
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Recruitment postcode(s) [1]
34329
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2747 - Kingswood
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Recruitment postcode(s) [2]
36376
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2298 - Waratah
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Recruitment postcode(s) [3]
36377
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2305 - New Lambton
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Recruitment postcode(s) [4]
36378
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5000 - Adelaide
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Recruitment postcode(s) [5]
40035
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2145 - Westmead
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Recruitment outside Australia
Country [1]
24494
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Singapore
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State/province [1]
24494
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Singapore
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Country [2]
24660
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Japan
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State/province [2]
24660
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Tokyo
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Funding & Sponsors
Funding source category [1]
308281
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University
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Name [1]
308281
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University of Sydney
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Address [1]
308281
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Nepean Clinical School
University of Sydney
PO Box 63
Penrith
NSW
2751
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Country [1]
308281
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Australia
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Funding source category [2]
310555
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Commercial sector/Industry
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Name [2]
310555
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Takeda
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Address [2]
310555
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Grosvenor Place, Level 39
225 George Street
Sydney NSW 2000
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Country [2]
310555
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Australia
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Primary sponsor type
Government body
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Name
Nepean Blue Mountains Local Health District
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Address
Derby St
Kingswood
NSW
2747
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Country
Australia
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Secondary sponsor category [1]
309084
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None
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Name [1]
309084
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Address [1]
309084
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Country [1]
309084
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
308256
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Nepean Blue Mountains Local Health District Ethic Committee
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Ethics committee address [1]
308256
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Human Research Ethics Office Nepean Hospital PO Box 63 Penrith NSW 2751
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Ethics committee country [1]
308256
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Australia
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Date submitted for ethics approval [1]
308256
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02/02/2021
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Approval date [1]
308256
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28/04/2021
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Ethics approval number [1]
308256
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2021/ETH00190
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Summary
Brief summary
The purpose of this research is to explore the effect of stopping heart medication in cancer patients whose hearts have recovered from chemotherapy-related cardiac dysfunction (CTRCD). Who is it for? You may be eligible for this study if you are aged 18 or older, you have been previously diagnosed with asymptomatic CTRCD and you are currently taking CTRCD medications including Angiotensin Converting Enzyme inhibitors (ACEi) and/or Beta Blockers (BB). Study details All participants who choose to enrol in this study will be randomly divided into one of two groups by chance (similar to flipping a coin). One group will continue their heart medications as prescribed. The second group will cease their heart medications (Angiotensin Converting Enzyme inhibitors (ACEi) and/or Beta Blockers (BB)) under medical supervision, this will occur over a staged period. All participants regardless of their group allocation will undergo monthly clincial review. An echocardiogram (heart ultrasound, approximately one hour), Electrocardiogram (ECG), blood tests and cardiac magnetic resonance imaging (CMR) will be taken at the start and end of study involvement. It is hoped this research will determine whether completely stopping cardiac medications including ACE inhibitors and beta blockers is safe and whether this has any negative impacts on patients with previous chemotherapy related cardiac dysfunction. If this treatment cessation is safe it may be used to improve health outcomes for future cancer patients who are affected by chemotherapy related cardiac dysfunction.
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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
110098
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Prof Kazuaki Negishi
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Address
110098
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Nepean Clinical School
PO Box 63
Penrith
NSW
2751
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Country
110098
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Australia
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Phone
110098
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+61 2 4734 4278
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Fax
110098
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Email
110098
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[email protected]
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Contact person for public queries
Name
110099
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Kazuaki Negishi
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Address
110099
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Nepean Clinical School
PO Box 63
Penrith
NSW
2751
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Country
110099
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Australia
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Phone
110099
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+61 2 4734 4278
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Fax
110099
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Email
110099
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[email protected]
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Contact person for scientific queries
Name
110100
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Kazuaki Negishi
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Address
110100
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Nepean Clinical School
PO Box 63
Penrith
NSW
2751
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Country
110100
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Australia
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Phone
110100
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+61 2 4734 4278
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Fax
110100
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Email
110100
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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
We do not have ethics consent for sharing of IPD.
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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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