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Trial registered on ANZCTR
Registration number
ACTRN12607000046404
Ethics application status
Not yet submitted
Date submitted
10/01/2007
Date registered
12/01/2007
Date last updated
12/01/2007
Type of registration
Prospectively registered
Titles & IDs
Public title
Randomised Controlled Trial of Lanthanum carbonate vs Calcium carbonate on Vascular Calcification and Arterial Stiffness in Haemodialysis Patients:
A Pilot Study
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Scientific title
A Randomised Controlled Trial of Lanthanum carbonate vs Calcium carbonate on Vascular Calcification and Arterial Stiffness in Haemodialysis Patients
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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:
Cardiovascular disease and arterial stiffness in end-stage kidney disease
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Condition category
Condition code
Renal and Urogenital
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0
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Kidney disease
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Cardiovascular
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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
Randomised trial comparing the impact of two different phosphate binders (lanthanum carbonate vs calcium carbonate) on vascular calcification and arterial stiffness in haemodialysis patients over 18 months. Group 1 will receive lanthanum carbonate 750mg three times daily, increasing to max 3750mg daily, and Group 2 will receive calcium carbonate 1500mg three times daily (with equivalent 600mg caclium tds), with increase to max 9 tablets daily, aiming for serum phosphate <1.7 in both groups. Both medications will be administered orally and with meals.
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Intervention code [1]
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Prevention
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Comparator / control treatment
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Control group
Active
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Outcomes
Primary outcome [1]
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Changes in vascular calcification as measured by Computed tomography (CT) scans (of aorta and superficial artery)
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Assessment method [1]
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Timepoint [1]
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At 12 months and 18 months
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Secondary outcome [1]
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Changes in arterial stiffness (measured by pulse wave velocity)
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Assessment method [1]
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Timepoint [1]
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at 3-6 month intervals
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Secondary outcome [2]
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Changes in bone mineral density
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Assessment method [2]
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Timepoint [2]
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at 18 months
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Eligibility
Key inclusion criteria
Patients established on haemodialysis for at least 3 months.
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Minimum age
18
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
If expected life-span <3 months; scheduled for renal transplant or parathyroidectomy in next 6 months; active peptic ulcer disease, and ulcerative colitis or Crohn's; and if on daily or nocturnal haemodialysis.
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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 will occur by concealed envelopes by an associate researcher.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Random order generation, using a randomization table created by a computer software (i.e., computerised 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
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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
1/03/2007
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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
50
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Oprhan Australia (Shire Pharmaceuticals)
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Department of Nephrology, Monash Medical Centre, Clayton
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Address
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Country
Australia
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Secondary sponsor category [1]
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Commercial sector/Industry
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Name [1]
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Orphan Australia (Shire Pharmaceuticals)
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Address [1]
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Country [1]
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Australia
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Ethics approval
Ethics application status
Not yet submitted
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Ethics committee name [1]
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Monash Medical Centre-Southern Health Reasearch and Ethics Committee
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Ethics committee address [1]
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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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Approval date [1]
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Ethics approval number [1]
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Summary
Brief summary
Cardiovascular disease (CVD) is the commonest cause of mortality in patients with chronic kidney disease (CKD) and end-stage kidney disease (CKD Stage 5). Reasons for the greater incidence of CVD in this group include traditional CVD risk factors of hypertension, dyslipidemia and diabetes but more importantly also include non-traditional risk factors such as calcium and phosphate imbalance. The latter is thought most likely to contribute to vascular calcification, especially for those on dialysis, and this in turn leads to arterial stiffness and left ventricular hypertrophy, the two commonest cardiovascular complications. Arterial stiffness and calcification have been found to be independent predictors of all-cause and cardiovascular mortality in CKD. Pharmacological management to control calcium and phosphate imbalance can reduce vascular calcification and CVD by reducing serum phosphate and PTH. Unfortunately the majority of phosphate binders are calcium based and may contribute to raised serum calcium and worsening calcification. Newer phosphate binders, such as lanthanum carbonate, are non-calcium based and may prove to reduce CVD as well as controlling phosphate balance. We aim to perform a prospective, randomised study assessing the impact of lanthanum carbonate on cardiovascular and bone mineral parameters. This will be a single-centre study involving subjects with CKD Stage 5 on haemodialysis. Arterial stiffness (by pulse wave analysis and pulse wave velocity) and vascular calcification (using CT scans through superficial femoral artery and aorta) will be followed as well as serum markers of calcium, phosphate and PTH. Differences in these end-points will be compared between participants taking lanthanum and calcium carbonate. The study will be conducted over an 18 month period and we aim to recruit about 50 patients (25 randomised to lanthanum carbonate and 25 to calcium carbonate).
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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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Address
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Country
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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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Dr Nigel Toussaint
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Address
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Department of Nephrology
Monash Medical Centre
246 Clayton Rd, Clayton
Victoria 3168
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Country
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Australia
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Phone
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+61 3 9594 3072
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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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Dr Nigel Toussaint
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Address
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Department of Nephrology
Monash Medical Centre
246 Clayton Rd, Clayton
Victoria 3168
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Country
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Australia
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Phone
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+61 3 9594 3072
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Fax
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Email
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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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