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Trial registered on ANZCTR
Registration number
ACTRN12623000014651
Ethics application status
Approved
Date submitted
15/11/2022
Date registered
9/01/2023
Date last updated
9/01/2023
Date data sharing statement initially provided
9/01/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
The effects of antioxidants on health and exercise ability in individuals with peripheral artery disease.
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Scientific title
The effects of antioxidants on vascular function and exercise capacity in peripheral artery disease.
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Secondary ID [1]
308416
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none
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Universal Trial Number (UTN)
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Trial acronym
Ex-PAD
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
peripheral artery disease
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Condition category
Condition code
Cardiovascular
325269
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0
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Other cardiovascular diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intravenous infusion of an antioxidant glutathione will be performed on one occasion. Rate of infusion will be 15 mg/min over 4 hours (approximately 3600mg). The infusion will be ongoing during the exercise test.
Outcome measures will be measured at baseline, after 1 hour of infusion (pre-exercise), immediately post an acute exercise bout and 30 minutes after exercise.
These measures will be conducted in the Exercise Science Laboratory at Deakin University, Burwood by research staff who are members of the research team and are trained in cannulation and first aid.
The exercise bout will be a single maximal exercise test performed on a treadmill in a one-on-one scenario. This exercise will be performed approximately 60 minutes after the infusion is commenced. The exercise test will be supervised by a minimum of two first aid trained and experienced research team members. The test is completed at 3.2 km/h and begins at a grade of 0% for the first 5 minutes and then is increased by 3.5% every 3 minutes until subjects reach their maximum exercise capacity. Alternatively, we will use the graded Gardner-Skinner treadmill exercise test which is a well-accepted modified-load treadmill exercise test that is frequently used in randomized trials of therapeutic interventions in PAD. In this protocol, participants begin walking on the treadmill at 2.0 mph with a grade of zero. The treadmill speed is maintained at 2.0 mph throughout testing, and the treadmill grade is increased by 2% every 2 minutes. Participants with PAD who are unable to walk at 2.0 mph should perform a modified Gardner treadmill test in which the speed begins at 0.5 mph and a grade of zero and speed is increased by 0.5 mph every 2 minutes until 2.0 mph is achieved. When a speed of 2.0 mph is reached, the treadmill grade is increased by 2% every 2 minutes. Participants are asked to continue walking as long as possible until ischemic leg symptoms, fatigue, or other symptoms prevent them from continuing.
A minimum of one week washout will separate the two trial sessions (intervention and control session).
The entire testing sessions will be supervised by two members of the research team.
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Intervention code [1]
324872
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Treatment: Other
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Comparator / control treatment
The control group will undergo the same intervention with a saline placebo infusion (sodium chloride 0.9% - normal saline 500mL IV freeflex bag).
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Cardiorespiratory fitness/exercise capacity.
Cardiopulmonary exercise test: Participants will undergo a graded exercise test to exhaustion on a cycle ergometer to determine exercise capacity using standard clinical exercise testing and indirect calorimetry equipment.
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Assessment method [1]
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Timepoint [1]
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60 minutes after infusion is commenced, at the beginning of the maximal exercise test.
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Secondary outcome [1]
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Microvascular blood flow will be measured in the thigh via contrast enhanced ultrasound imaging during contrast agent infusion.
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Assessment method [1]
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Timepoint [1]
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Pre-exercise (after 1 hour of infusion), post exercise and after 30 minutes of recovery.
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Secondary outcome [2]
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Cardiac function will be assessed via echocardiographic assessment using a commercial ultrasound machine.
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Assessment method [2]
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Timepoint [2]
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Baseline, pre-exercise (after 1 hour of infusion), post exercise and after 30 minutes of recovery.
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Secondary outcome [3]
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Cerebral blood flow will be measured via transcranial Doppler and duplex ultrasound.
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Assessment method [3]
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Timepoint [3]
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Baseline, pre-exercise (after 1 hour of infusion), post exercise and after 30 minutes of recovery.
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Secondary outcome [4]
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Femoral arterial diameter and blood velocity will be assessed using 2D and Doppler ultrasound imaging. This will be assessed as a composite outcome.
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Assessment method [4]
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Timepoint [4]
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Baseline, pre-exercise (after 1 hour of infusion), post exercise and after 30 minutes of recovery.
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Eligibility
Key inclusion criteria
Inclusion Criteria: Aged 40-75 y, BMI less than or equal to 35 kg/m2, ankle brachial index (ABI) of less than or equal to 0.90.
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Minimum age
40
Years
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Maximum age
75
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
Exclusion Criteria: History of myocardial infarction, stroke, dementia, or respiratory disease, non-cardiovascular barriers to exercise, critical limb ischemia or foot ulcers, identification of any medical condition requiring immediate therapeutic intervention and/or current or previous smoker (within the last 12 months).
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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)
sealed opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
block randomization
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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 assessing the outcomes
The people analysing the results/data
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Intervention assignment
Crossover
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Other design features
Randomized, cross over, placebo-controlled trial.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
16/01/2023
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Actual
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Date of last participant enrolment
Anticipated
1/12/2023
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Actual
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Date of last data collection
Anticipated
31/12/2023
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Actual
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Sample size
Target
10
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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Institute for Physical Activity and Nutrition, Deakin University.
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Address [1]
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221 Burwood Hwy, Burwood, Victoria 3125
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Institute for Physical Activity and Nutrition, Deakin University.
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Address
221 Burwood Hwy, Burwood, Victoria 3125
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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]
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Other collaborator category [1]
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University
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Name [1]
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University of the Sunshine Coast
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Address [1]
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90 Sippy Downs Drive, Sippy Downs Queensland 4556
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Deakin University Human Research Ethics Committee
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Ethics committee address [1]
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Melbourne Burwood Campus, 221 Burwood Highway, Burwood, VIC 3125
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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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27/05/2022
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Approval date [1]
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20/06/2022
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Ethics approval number [1]
311972
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2022-153
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Summary
Brief summary
Peripheral artery disease (PAD) can result in extensive functional alterations including vascular dysfunction, reduced capacity to exercise, and reduced quality of life. The progression and cause of PAD is thought to be associated with increased oxidative stress and tissue injury related to increased production of reactive oxygen species (ROS) and a decrease in antioxidant defenses. Oxidative stress and inflammation are major features in the development of atherosclerosis and are therefore extremely relevant in the development of PAD. Several important enzymatic antioxidant defenses have been shown to be deficient in the muscle of PAD individuals compared to controls. Endogenous antioxidants function as defenses to remove or regulate ROS production. Therefore, antioxidant deficiencies can lead to a state of excess oxidative stress which contributes to vascular dysfunction, decreased exercise capacity, and the development of PAD, cardiovascular disease, and cerebrovascular disease. However, few studies have adequately explored antioxidant treatment in PAD patients, and none have explored antioxidant treatment and the effects on the extensive vascular network during exercise. The aims of this developmental work are to directly test whether antioxidant treatment (via the intravenous infusion of an antioxidant) can acutely improve vascular function and exercise capacity in patients with PAD.
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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 Hannah Thomas
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Address
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Deakin University, 221 Burwood Hwy, Burwood, Victoria 3125
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Country
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Australia
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Phone
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+61404293441
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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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Hannah Thomas
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Address
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Deakin University, 221 Burwood Hwy, Burwood, Victoria 3125
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Country
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Australia
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Phone
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+61404293441
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Fax
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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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Hannah Thomas
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Address
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Deakin University, 221 Burwood Hwy, Burwood, Victoria 3125
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Country
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Australia
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Phone
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+61404293441
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Fax
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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
Participant privacy
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
17636
Study protocol
384990-(Uploaded-06-01-2023-16-25-05)-Study-related document.pdf
17637
Informed consent form
384990-(Uploaded-06-01-2023-16-25-20)-Study-related document.pdf
17638
Ethical approval
384990-(Uploaded-15-11-2022-16-56-36)-Study-related document.pdf
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.
Download to PDF