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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT02699645
Registration number
NCT02699645
Ethics application status
Date submitted
2/03/2016
Date registered
4/03/2016
Titles & IDs
Public title
Triple Therapy Prevention of Recurrent Intracerebral Disease EveNts Trial
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Scientific title
Triple Therapy Prevention of Recurrent Intracerebral Disease EveNts Trial (TRIDENT), Substudies: MRI, Cognitive
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Secondary ID [1]
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TRIDENT-1103886
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Universal Trial Number (UTN)
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Trial acronym
TRIDENT
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Intracerebral Haemorrhage (ICH)
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Hypertension
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Condition category
Condition code
Stroke
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Haemorrhagic
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Neurological
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - telmisartan 20mg, amlodipine 2.5mg, and indapamide 1.25mg
Treatment: Drugs - Placebo
Experimental: Triple Pill (active treatment) - telmisartan 20mg, amlodipine 2.5mg, and indapamide 1.25mg;
Placebo comparator: Placebo - Matched placebo
Treatment: Drugs: telmisartan 20mg, amlodipine 2.5mg, and indapamide 1.25mg
1 pill taken orally once daily for average of 72 months
Treatment: Drugs: Placebo
1 pill taken orally once daily for average of 72 months
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Recurrent Stroke
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Assessment method [1]
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Time to first occurrence of recurrent stroke, whether ischaemic or haemorrhagic.
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Timepoint [1]
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Average of 6 years
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Secondary outcome [1]
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Recurrent ICH
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Assessment method [1]
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Time to first occurrence of recurrent ICH
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Timepoint [1]
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Average of 6 years
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Secondary outcome [2]
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Ischaemic Stroke
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Assessment method [2]
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Time to first occurrence of ischaemic stroke
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Timepoint [2]
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Average of 6 years
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Secondary outcome [3]
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Fatal or disabling stroke
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Assessment method [3]
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Time to first occurrence of fatal or disabling stroke
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Timepoint [3]
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Average of 6 years
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Secondary outcome [4]
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Mortality
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Assessment method [4]
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Mortality
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Timepoint [4]
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Average of 6 years
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Secondary outcome [5]
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MACE
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Assessment method [5]
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Major adverse cardiovascular events - CV death, non-fatal MI or non-fatal stroke
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Timepoint [5]
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Average of 6 years
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Secondary outcome [6]
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Physical function
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Assessment method [6]
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Physical function as assessed by smRS
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Timepoint [6]
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Average of 6 years
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Secondary outcome [7]
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Change in SBP
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Assessment method [7]
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Change in SBP
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Timepoint [7]
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Average of 6 years
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Secondary outcome [8]
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HRQoL according to the EQ-5D-3L
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Assessment method [8]
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Health-related quality of life according to the European Quality of Life 5-Dimensional Assessment, 3-Level version
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Timepoint [8]
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Average of 6 years
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Secondary outcome [9]
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Cognitive Impairment
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Assessment method [9]
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Overall defined by standard cut-points on the Montreal Cognitive Assessment (MoCA)
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Timepoint [9]
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Average of 6 years
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Secondary outcome [10]
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Cognitive Impairment Supplement
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Assessment method [10]
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Overall defined by standard cut-points with Brief Memory and Executive Test (BMET) together with assessments of functional impairment related to cognition defined by QDRS score and short form IQCODE, which will also allow subtyping of 'probable' or 'definite' dementia or mild cognitive impairment according to standard diagnostic criteria.
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Timepoint [10]
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Average of 6 years
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Secondary outcome [11]
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Depression
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Assessment method [11]
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According to standard cut-point scores on the PHQ-9
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Timepoint [11]
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Average of 6 years
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Secondary outcome [12]
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Cerebral small vessel disease
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Assessment method [12]
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Defined by various standard markers on routine MRI, measured by individual components and overall CSVD burden. The primary measure of CSVD is FLAIR WMH volume.
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Timepoint [12]
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Average of 6 years
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Secondary outcome [13]
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Medication Adherence
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Assessment method [13]
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Self-reported measures, pill counts
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Timepoint [13]
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Average of 6 years
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Secondary outcome [14]
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Safety in terms of Serious Adverse Events (SAEs)
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Assessment method [14]
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SAEs
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Timepoint [14]
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Average of 6 years
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Secondary outcome [15]
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Tolerability in terms of Adverse Events of Special Interest (AESIs)
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Assessment method [15]
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AESIs: Headache, Syncope/collapse, Falls, Pedal oedema/ankle swelling, Hypo/hyperkalaemia, Hyponatraemia
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Timepoint [15]
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Average of 6 years
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Eligibility
Key inclusion criteria
* Adults (=18 years) with a history of primary ICH that is confirmed by imaging (copy of the brain imaging report to be uploaded to the database, labelled with participant identification (ID) and with personal identifiers removed)
* Clinically stable, as judged by investigator
* Average of two resting SBP levels measured 5 minutes apart in the range 130-160mmHg recorded in a seated position (National Heart Foundation of Australia Guidelines). (Patients with higher SBP can be included if considered by attending clinician that management is consistent with local standards of clinical practice)
* Geographical proximity to the recruiting hospital and/or follow-up medical clinic site to allow ready access for in-person clinic visits during follow-up
* No clear contraindication to any of the study treatments
* Provision of written informed consent
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Minimum age
18
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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
* Taking an ACE-I that cannot be switched to any of the following alternatives:
* telmisartan 20 or 40mg, amlodipine 2.5 or 5mg, indapamide 1.25mg, or
* an equivalent class (ARB, CCB or thiazide [TZ]-like diuretic), or
* a BB
* Contraindication to any of the study medications, in the context of currently prescribed BP-lowering medication
* Unable to complete the study procedures and/or follow-up
* Females of child-bearing age and capability, who are pregnant or breast-feeding, or those of child-bearing age and capability who are not using adequate birth control
* Significant hyperkalaemia and/or hyponatremia, in the opinion of the responsible physician
* Estimated glomerular filtration rate (eGFR) <30mL/min/1.73m2
* Severe hepatic impairment (alanine aminotransferase [ALT] or aspartate aminotransferase [AST] >3x the upper limit of normal [ULN])
* Any other condition that in the opinion of the responsible physician or investigator renders the patient unsuitable for the study (e.g. severe disability [i.e. simplified modified Rankin Scale (smRS) of 4-5] or significant memory or behavioural disorder)
Exclusion Criteria for MRI (as applies)
• Any MRI contraindication (e.g. metallic implants, claustrophobia, etc) or participant refusal.
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Study design
Purpose of the study
Prevention
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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
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
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
28/09/2017
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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
1/06/2025
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Actual
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Sample size
Target
1600
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,VIC,WA
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Recruitment hospital [1]
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Liverpool Hospital - Liverpool
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Recruitment hospital [2]
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Port Macquarie Base Hospital - Port Macquarie
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Recruitment hospital [3]
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Royal Prince Alfred Hospital - Sydney
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Recruitment hospital [4]
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Sunshine Coast University Hospital - Birtinya
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Recruitment hospital [5]
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Princess Alexandra Hospital - Woolloongabba
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Recruitment hospital [6]
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Royal Melbourne Hospital - Melbourne
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Recruitment hospital [7]
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Fiona Stanley Hospital - Murdoch
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Recruitment postcode(s) [1]
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2170 - Liverpool
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Recruitment postcode(s) [2]
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2444 - Port Macquarie
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Recruitment postcode(s) [3]
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2050 - Sydney
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Recruitment postcode(s) [4]
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4575 - Birtinya
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Recruitment postcode(s) [5]
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4102 - Woolloongabba
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Recruitment postcode(s) [6]
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3050 - Melbourne
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Recruitment postcode(s) [7]
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6150 - Murdoch
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Recruitment outside Australia
Country [1]
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Brazil
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Botucatu
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Brazil
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Curitiba
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Brazil
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Fortaleza
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Joinville
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Brazil
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Porto Alegre
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Ribeirão Preto
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Brazil
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Rio Prêto
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Salvador
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Brazil
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São Paulo
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Georgia
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Tbilisi
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Hulu Langat
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Kota Kinabalu
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Nottingham
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Salford
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Sheffield
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Stoke-on-Trent
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Swansea
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Vietnam
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Hanoi
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Funding & Sponsors
Primary sponsor type
Other
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Name
The George Institute
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Address
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Other collaborator category [1]
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Other
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Name [1]
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The University of New South Wales
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Address [1]
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Ethics approval
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Summary
Brief summary
An investigator initiated and conducted, multicentre, international, double-blinded, placebo-controlled, parallel-group, randomised controlled trial to determine the effect of more intensive blood pressure control provided by a fixed low-dose combination blood pressure lowering pill ("Triple Pill") strategy on top of standard of care, on time to first occurrence of recurrent stroke in patients with a history of stroke due to intracerebral haemorrhage.
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Trial website
https://clinicaltrials.gov/study/NCT02699645
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Trial related presentations / publications
Li L, Poon MTC, Samarasekera NE, Perry LA, Moullaali TJ, Rodrigues MA, Loan JJM, Stephen J, Lerpiniere C, Tuna MA, Gutnikov SA, Kuker W, Silver LE, Al-Shahi Salman R, Rothwell PM. Risks of recurrent stroke and all serious vascular events after spontaneous intracerebral haemorrhage: pooled analyses of two population-based studies. Lancet Neurol. 2021 Jun;20(6):437-447. doi: 10.1016/S1474-4422(21)00075-2. Erratum In: Lancet Neurol. 2021 Aug;20(8):e5. doi: 10.1016/S1474-4422(21)00185-X.
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Public notes
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Contacts
Principal investigator
Name
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Craig Anderson
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Address
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The George Institute
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Natalie Espinosa
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Address
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Phone
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+61 2 8052 4561
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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
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Supporting document/s available: Study protocol, Statistical analysis plan (SAP), Informed consent form (ICF), Clinical study report (CSR)
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When will data be available (start and end dates)?
2 years after publication of main results
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Available to whom?
Bone fide researchers submit protocol to the Research Office of The George Institute for Global Health
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Available for what types of analyses?
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How or where can data be obtained?
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT02699645