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Trial registered on ANZCTR
Registration number
ACTRN12610000462088
Ethics application status
Approved
Date submitted
21/05/2010
Date registered
7/06/2010
Date last updated
26/05/2022
Date data sharing statement initially provided
26/05/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Nutriceuticals in Duchenne muscular dystrophy
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Scientific title
Nutriceuticals in Duchenne muscular dystrophy: a double blind, randomised controlled trial investigating the use of a multicomponent nutritional supplement to maintain or improve function as measured by StepWatch Step Activity Monitors.
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Secondary ID [1]
251837
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nil
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Universal Trial Number (UTN)
U1111-1115-0920
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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:
Duchenne muscular dystrophy
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Condition category
Condition code
Neurological
257584
257584
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0
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Other neurological disorders
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Human Genetics and Inherited Disorders
257670
257670
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0
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Other human genetics and inherited disorders
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Musculoskeletal
257671
257671
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The enhanced dietary supplement regime will consist of a shake made from 22g whey protein isolate powder administered to provide 20g protein; creatine monohydrate (5g); and glutamine (0.6g/kg fat free mass/day). The enhanced dietary will also include beta-hydroxy-beta-methylbutyrate (38mg/kg/day rounded to nearest 500mg) given in capsule form. Inactive ingredients used in the shake are maltodextrin powder (8g) and sucralose (5g). The shake will be made on 250ml skim milk and will be consumed once per day. The supplement regime also includes a paediatric multivitamin (Vitamin A 582.5 IU, Vitamin B1 350 microg, Vitamin B2 550 microg, Vitamin B3 6 mg, Vitamin B5 1.5 mg, Vitamin B6 650 microg, Vitamin B12 750 microg, Folic acid 50 microg, Vitamin C 20 mg, Vitamin D3 100 IU, Natural Vitamin E 15 IU, Biotin 25 microg, Calcium 5 mg, Iodine 75 microg, Iron 1.3 mg, Magnesium 5 mg, Manganese 12.5 microg, Zinc 1mg; 1 chewable capsules per day for participants aged 5 to 6 years; 2 chewable capsules per day for participants aged 7-12 years), fish oil (1050mg per day in 2 chewable capsules), and vitamin D (2000 IU/day in two gel capsules). This regime will be consumed for 20 weeks. During the two week washout period, participants will be supplied with a standard supplement regime. This consists of a shake made from 22g whey protein isolate powder administered to provide 20g protein. The shake will be made on 250ml skim milk and will be consumed once per day. The standard regime also includes a paediatric multivitamin (Vitamin A 582.5 IU, Vitamin B1 350 microg, Vitamin B2 550 microg, Vitamin B3 6 mg, Vitamin B5 1.5 mg, Vitamin B6 650 microg, Vitamin B12 750 microg, Folic acid 50 microg, Vitamin C 20 mg, Vitamin D3 100 IU, Natural Vitamin E 15 IU, Biotin 25 microg, Calcium 5 mg, Iodine 75 microg, Iron 1.3 mg, Magnesium 5 mg, Manganese 12.5 microg, Zinc 1mg; 1 chewable capsules per day for participants aged 5 to 6 years; 2 chewable capsules per day for participants aged 7-12 years), fish oil (1050mg per day in 2 chewable capsules) , and vitamin D (2000 IU/day in two gel capsules).
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Intervention code [1]
256535
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Treatment: Drugs
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Intervention code [2]
256605
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Treatment: Other
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Comparator / control treatment
The standard supplement regime consists of a shake made from 22g whey protein isolate powder administered to provide 20g protein. Inactive ingredients used in the shake are maltodextrin powder (16g) and sucralose (5g). The shake will be made on 250ml skim milk and will be consumed once per day. Gel caps with maltodextrin (38mg/kg/day rounded to nearest 500mg) will be used for the beta-hydroxy-beta-methylbutyrate placebo. The standard regime also includes a paediatric multivitamin (Vitamin A 582.5 IU, Vitamin B1 350 microg, Vitamin B2 550 microg, Vitamin B3 6 mg, Vitamin B5 1.5 mg, Vitamin B6 650 microg, Vitamin B12 750 microg, Folic acid 50 microg, Vitamin C 20 mg, Vitamin D3 100 IU, Natural Vitamin E 15 IU, Biotin 25 microg, Calcium 5 mg, Iodine 75 microg, Iron 1.3 mg, Magnesium 5 mg, Manganese 12.5 microg, Zinc 1mg; 1 chewable capsules per day for participants aged 5 to 6 years; 2 chewable capsules per day for participants aged 7-12 years), fish oil (1050mg per day in 2 chewable capsules) , and vitamin D (2000 IU/day in two gel capsules). This regime will be consumed for 20 weeks.
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Control group
Active
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Outcomes
Primary outcome [1]
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Inactive minutes as measured by StepWatch Step Activity Monitor.
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Assessment method [1]
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Timepoint [1]
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Boys will by required to wear the monitor for five days each at five time points (25 days total): week 0 (baseline); week 8; week 28; week 30; week 50.
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Secondary outcome [1]
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Distance covered in six minute walk test.
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Assessment method [1]
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Timepoint [1]
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Week 0 (baseline); week 8; week 28; week 30; week 50.
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Secondary outcome [2]
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Fat free mass as measured by Dual Energy X-ray Absorptiometry (DXA) scan.
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Assessment method [2]
264302
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Timepoint [2]
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Week 0; week 28; week 50.
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Secondary outcome [3]
264303
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ACTIVLIM survey on activity limitations
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Assessment method [3]
264303
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Timepoint [3]
264303
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Week 0 (baseline); week 8; week 28; week 30; week 50.
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Secondary outcome [4]
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PedsQL survey: general and neuromuscular models.
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Assessment method [4]
264304
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Timepoint [4]
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Week 0 (baseline); week 8; week 28; week 30; week 50.
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Secondary outcome [5]
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Vitamin D measured by venous blood test for serum 25-hydroxy vitamin D.
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Assessment method [5]
264305
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Timepoint [5]
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Week 0 (baseline); week 8; week 28; week 30; week 50.
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Eligibility
Key inclusion criteria
Boys will be considered for inclusion if they have a definite diagnosis: phenotypic evidence of Duchenne muscular dystrophy (DMD) based on the onset of characteristic clinical symptoms or signs (ie, proximal muscle weakness, waddling gait, and Gowers’ maneuver) by 9 years of age, an elevated serum creatine kinase (CK), and ongoing difficulty with ambulation, with documentation of a deletion or duplication in the dystrophin gene, or absence of Dystrophin on muscle biopsy. Boys also need to be sufficiently ambulatory to walk = 75 meters unassisted during a 6 minute walk test (6MWT). Other personal assistance or use of assistive devices for ambulation (eg, short leg braces, long leg braces, or walkers) is not permitted. Parents/guardians need to be able to give full informed written consent.
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Minimum age
5
Years
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Maximum age
13
Years
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
use of a wheelchair/motorised scooter/similar mobility aid for >75 % of activity during the day; cows milk protein allergy or lactose intolerance; history of kidney or liver disease; unable to attend the seven required hospital appointments within the 12 month period; unable to swallow tablets; parents wish to continue using other complementary therapies; participation in other muscular dystrophy trials involving an active intervention; use of medications which are contraindicated due to possible drug interactions.
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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)
Potential participants will be approached by the Neuromuscular clinic at The Royal Children's Hospital. If interested, participants will be screened by an associate investigator. Upon obtaining consent, participants will be allocated a unique code. This code will be provided to the study statistician who is off site with the subjects age. The allocation will be provided by locked data file to an associate investigator who is not involved in assessments or data analysis. The associate investigator will provide allocation details to an offsite formula room that will prepare the supplement. Participants will receive individual shake sachets labelled only with their unique code.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
A random sequence will be generated in Excel.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
The design features a two month lead in period and a two week wash out period at week 28 to week 30. The standard nutritional supplement will continue through the washout period. The participants will be allocated to treatment as aged matched pairs.
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/11/2010
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Actual
11/01/2011
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Date of last participant enrolment
Anticipated
31/12/2016
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Actual
4/09/2015
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Date of last data collection
Anticipated
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Actual
30/10/2016
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Sample size
Target
48
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Accrual to date
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Final
38
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Recruitment in Australia
Recruitment state(s)
NSW,QLD,VIC
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Recruitment hospital [1]
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The Royal Childrens Hospital - Parkville
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Recruitment hospital [2]
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Royal Children's Hospital - Herston
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Recruitment hospital [3]
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The Children's Hospital at Westmead - Westmead
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Recruitment hospital [4]
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Sydney Children's Hospital - Randwick
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Murdoch Children's Research Institute: Critical Care and Neurosciences Theme
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Address [1]
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The Royal Children's Hospital
Flemington Road
Parkville
VIC 3052
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Country [1]
257025
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Australia
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Funding source category [2]
258088
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Charities/Societies/Foundations
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Name [2]
258088
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John T Reid Charitable Trust
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Address [2]
258088
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PO Box 438, Canterbury, VIC, 3126
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Country [2]
258088
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Australia
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Funding source category [3]
258089
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Charities/Societies/Foundations
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Name [3]
258089
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Muscular Dystrophy Australia
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Address [3]
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111 Boundary Road, North Melbourne, VIC 3051
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Country [3]
258089
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Australia
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Funding source category [4]
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Charities/Societies/Foundations
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Name [4]
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Duchenne Foundation
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Address [4]
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PO Box A83, Australind, WA 6233
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Country [4]
291376
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Australia
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Funding source category [5]
291377
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Charities/Societies/Foundations
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Name [5]
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Muscular Dystrophy Foundation
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Address [5]
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36-38 Henley Beach Road, Mile End, SA 5031
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Country [5]
291377
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Australia
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Primary sponsor type
Hospital
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Name
The Royal Children's Hospital
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Address
The Royal Children's Hospital
Flemington Road
Parkville
VIC 3052
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Country
Australia
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Secondary sponsor category [1]
256281
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University
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Name [1]
256281
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Monash University; Department of Nutrition and Dietetics
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Address [1]
256281
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Monash Medical Centre
246 Clayton Road
Level 5; Block E
Clayton
VIC, 3168
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Country [1]
256281
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Australia
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Other collaborator category [1]
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Hospital
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Name [1]
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Royal Children's Hospital
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Address [1]
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Royal Children's Hospital
Herston Road
HERSTON Queensland 4029
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Country [1]
252328
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Australia
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Other collaborator category [2]
252329
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Hospital
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Name [2]
252329
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Mater Children's Hospital
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Address [2]
252329
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Mater Children's Hospital,
Raymond Terrace,
South Brisbane Queensland 4101
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Country [2]
252329
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Australia
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Other collaborator category [3]
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Hospital
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Name [3]
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The Children's Hospital at Westmead
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Address [3]
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Postal address: The Children's Hospital at Westmead, Locked Bag 4001, Westmead 2145
Street Address: Cnr Hawkesbury Rd and Hainsworth St, Westmead, Sydney, NSW, 2145
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Country [3]
277682
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Australia
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Other collaborator category [4]
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Hospital
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Name [4]
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Sydney Children's Hospital
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Address [4]
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High St, Randwick NSW 2031, Australia
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Country [4]
278488
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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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The Royal Children's Hospital Human Research Ethics Committee
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Ethics committee address [1]
259040
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The Royal Children's Hospital Flemington Road Parkville VIC 3052
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Ethics committee country [1]
259040
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Australia
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Date submitted for ethics approval [1]
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15/03/2010
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Approval date [1]
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20/10/2010
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Ethics approval number [1]
259040
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30022
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Ethics committee name [2]
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Monash University Human Research Ethics Committee
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Ethics committee address [2]
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Human Ethics Office First Floor, Building 3e Monash Research Office Clayton Campus Monash University VIC 3800
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
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10/11/2010
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Approval date [2]
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17/11/2010
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Ethics approval number [2]
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2010001692
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Ethics committee name [3]
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Royal Children's Hospital Human Research Ethics Committee
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Ethics committee address [3]
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Level 3, Foundation Building Royal Children?s Hospital HERSTON QLD 4029
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Ethics committee country [3]
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Australia
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Date submitted for ethics approval [3]
272101
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Approval date [3]
272101
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02/02/2011
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Ethics approval number [3]
272101
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HREC/11/QRCH/2
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Ethics committee name [4]
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Mater Hospital Human Research Ethics Committee
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Ethics committee address [4]
272102
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Room 51 Level 3, Quarters Building Annerley Road Woolloongabba Qld 4102
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Ethics committee country [4]
272102
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Australia
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Date submitted for ethics approval [4]
272102
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Approval date [4]
272102
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27/06/2011
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Ethics approval number [4]
272102
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1730C
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Ethics committee name [5]
292934
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Hunter New England Human Research Ethics Committee
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Ethics committee address [5]
292934
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Locked Bag 1 New Lambton NSW 2305
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Ethics committee country [5]
292934
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Australia
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Date submitted for ethics approval [5]
292934
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Approval date [5]
292934
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11/06/2014
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Ethics approval number [5]
292934
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13/05/15/3.04
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Summary
Brief summary
This project seeks to explore the efficacy of a standard nutritional supplement in comparison to a standard nutritional supplement enhanced with creatine monohydrate, glutamine and beta-hydroxy-beta-methylbutyrate in maintaining or improving functional ability in boys with Duchenne muscular dystrophy. It combines the expertise of nutrition and dietetics with neurologists to enhance the outcomes of this population group where little is known of their nutritional needs since the standard introduction of steroid therapy. The primary outcome measures functional ability using the StepWatch Activity Monitor. Secondary outcome measures include 6 minute walk test, DXA to measure body composition, functional questionnaires and quality of life questionnaires. Our dietary supplement that we propose to use in this study is contained within a high protein shake, and includes a multivitamin, vitamin D and essential fatty acids given alone or in conjunction with creatine monohydrate (CrM), glutamine, beta-hydroxy-beta-methylbutyrate (HMB). This will be a 12 month, randomized control cross over trial using 24 age matched pairs with a 2 month lead in period and 2 week washout.
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Trial website
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Trial related presentations / publications
Davidson ZE, Hughes I, Ryan MM, Kornberg AJ, Cairns AG, Jones K, et al. Effect of a multicomponent nutritional supplement on functional outcomes for Duchenne muscular dystrophy: A randomized controlled trial. Clin Nutr. 2021;40(7):4702-11.
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Public notes
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Contacts
Principal investigator
Name
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Prof Helen Truby
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Address
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Monash University
Department Nutrition and Dietetics
Level 1
264 Ferntree Gully Road
Notting Hill, VIC, 3168
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Country
31207
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Australia
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Phone
31207
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+61399024261
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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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Zoe Davidson
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Address
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Monash University
Department Nutrition and Dietetics
Level 1
264 Ferntree Gully Road
Notting Hill, VIC, 3168
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Country
14454
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Australia
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Phone
14454
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+61399024274
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Fax
14454
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Email
14454
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[email protected]
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Contact person for scientific queries
Name
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Zoe Davidson
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Address
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Monash University
Department Nutrition and Dietetics
Level 1
264 Ferntree Gully Road
Notting Hill, VIC, 3168
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Country
5382
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Australia
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Phone
5382
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+61399024274
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Fax
5382
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Email
5382
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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)?
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No/undecided IPD sharing reason/comment
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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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