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Trial registered on ANZCTR
Registration number
ACTRN12611001067965
Ethics application status
Approved
Date submitted
11/10/2011
Date registered
13/10/2011
Date last updated
8/04/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Assessment of the effect of single dose dexamethasone on the hypothalamic-pituitary axis
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Scientific title
Double-blind randomised controlled trial assessing the effects of dexamethasone on the hypothalamic-pituitary-adrenal axis in healthy volunteers
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Secondary ID [1]
273201
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Nil
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Universal Trial Number (UTN)
U1111-1125-1949
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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:
hypothalamic-pituitary axis suppression
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postoperative nausea and vomiting
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Condition category
Condition code
Metabolic and Endocrine
279135
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0
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Normal metabolism and endocrine development and function
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Anaesthesiology
279136
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0
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Other anaesthesiology
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Double blind randomised controlled trial assessing the effects of a single dose of 8mg dexamethasone intravenously versus saline control on hypothalamic-pituitary axis suppression in healthy volunteers.
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Intervention code [1]
269534
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Treatment: Drugs
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Comparator / control treatment
Saline control.
Crossover design
Minimum four week washout period between interventions
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Percent cortisol suppression based on 0800hr plasma cortisol measurement pre- and 23-hours post-dexamethasone. Samples for cortisol obtained by blood collection.
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Assessment method [1]
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Timepoint [1]
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23 hours post-dexamethasone administration
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Secondary outcome [1]
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Percent reduction in Synacthen-stimulated plasma cortisol levels obtained by blood collection.
Synacthen testing will be performed pre-dexamethasone and at 24 hours post-dexamethasone administration
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Assessment method [1]
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Timepoint [1]
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24 hours post-dexamethasone administration
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Secondary outcome [2]
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Percent reduction in thyroid hormone levels. Thyroid hormone levels will be measured by blood analysis.
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Assessment method [2]
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Timepoint [2]
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24 hours post-dexamethasone administration
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Secondary outcome [3]
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Percent reduction in gonadal hormones. Gonadal hormones will be measured by blood analysis.
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Assessment method [3]
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Timepoint [3]
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24 hours post-dexamethasone administration
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Secondary outcome [4]
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Duration of cortisol suppression. Plasma cortisol will be measured by blood analysis.
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Assessment method [4]
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Timepoint [4]
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24 hours, 48 hours, 72 hours, 96 hours post dexamethasone administration
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Eligibility
Key inclusion criteria
Healthy male volunteers
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Minimum age
18
Years
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Maximum age
40
Years
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Sex
Males
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Glucocorticoid use within the past 6 months
Psychiatric illness
Uncontrolled hypertension
Diabetes mellitus
Shift workers
Unable to give informed consent
Medications likely to interfere with dexamethasone metabolism
Hypothalamic-pituitary target organ axis disease
Acute illness
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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)
Allocation concealment
Opaque envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using computerised sequence generation
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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
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Phase
Phase 4
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Type of endpoint/s
Pharmacodynamics
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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
17/10/2011
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Actual
17/10/2011
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Date of last participant enrolment
Anticipated
19/12/2011
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Actual
19/12/2011
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Date of last data collection
Anticipated
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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 outside Australia
Country [1]
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New Zealand
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State/province [1]
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Waikato
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Kudos Award. Hamilton Science Excellence Awards. Presented by Hamilton Science Awards Trust
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Address [1]
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Hamilton Science Awards Trust
PO Box 9512
Waikato Mail Centre
Hamilton 3240
Waikato
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Country [1]
270027
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New Zealand
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Funding source category [2]
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Hospital
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Name [2]
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Department of Endocrinology
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Address [2]
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Waikato Hospital
Pembroke Street
Private Bag 3200
Hamilton 3240
Waikato
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Country [2]
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Marianne Elston
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Address
Department of Endocrinology
Waikato Hospital
Private Bag 3200
Hamilton 3240
Waikato
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Country
New Zealand
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Secondary sponsor category [1]
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Individual
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Name [1]
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Mr Goswin Meyer-Rochow
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Address [1]
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Department of Surgery
University of Auckland
Waikato Hospital
Private Bag 3200
Hamilton 3240
Waikato
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Country [1]
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New Zealand
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Other collaborator category [1]
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Individual
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Name [1]
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Associate Professor John V Conaglen
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Address [1]
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Department of Endocrinology
Waikato Hospital
Private Bag 3200
Hamilton 3240
Waikato
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Country [1]
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern Y regional ethics committee
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Ethics committee address [1]
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C/- Ministry of Health 130 Grantham Street Hamilton 3240
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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Approval date [1]
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29/08/2011
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Ethics approval number [1]
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NTY/11/05/050
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Summary
Brief summary
Our adrenal glands produce cortisol which is our body’s natural “stress hormone”. Cortisol production is controlled by the hypothalamus and pituitary glands in the brain (hypothalamic-pituitary adrenal axis). This involves a feedback loop to prevent over- or under-production of cortisol. Dexamethasone (a synthetic form of cortisol) has been shown to significantly reduce postoperative nausea and vomiting. Currently most patients having a general anaesthetic receive a single 8mg dose of dexamethasone. This has been studied in relation to a number of different surgery types and in adults appears to be safe and effective. Dexamethasone has a long duration of action, typically quoted to be 36-72hours although the plasma half-life of dexamethasone is shorter at approximately 6 hours. Dexamethasone is used by endocrinologists to assess whether there is cortisol overproduction i.e. “dexamethasone suppression test” as it doesn’t interfere with the laboratory measurement of cortisol. Similar to the overnight dexamethasone suppression test it has been shown that after a single 8mg dose cortisol suppression occurs. What isn't known is how long the cortisol suppression lasts and whether other pituitary hormone levels are also suppressed.
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Trial website
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Trial related presentations / publications
Elston MS, Conaglen HM, Hughes C, Tamatea JA, Meyer-Rochow GY, Conaglen JV. Duration of cortisol suppression following a single dose of dexamethasone in healthy volunteers: a randomised double-blind placebo-controlled trial. Anaesth Intensive Care. 2013 Sep;41(5):596-601. PubMed PMID: 23977910.
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Public notes
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Contacts
Principal investigator
Name
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Dr Marianne Elston
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Address
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Department of Endocrinology
Waikato Hospital
Private Bag 3200
Hamilton 3240
New Zealand
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Country
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New Zealand
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Phone
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6478398899
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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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Dr Marianne Elston
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Address
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Department of Endocrinology
Waikato Hospital
Private Bag 3200
Hamilton 3240
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Country
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New Zealand
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Phone
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+6478398914
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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 Marianne Elston
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Address
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Department of Endocrinology
Waikato Hospital
Private Bag 3200
Hamilton 3240
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Country
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New Zealand
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Phone
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+6478398914
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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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