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Trial registered on ANZCTR
Registration number
ACTRN12614000201673
Ethics application status
Approved
Date submitted
17/02/2014
Date registered
25/02/2014
Date last updated
20/02/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
A Study to Compare Oral Vitamin D to Placebo for the Prevention of Low Calcium in the Blood after Surgery for the Total Removal of the Thyroid Gland.
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Scientific title
A Randomised, Double Blind, Placebo Controlled Trial to Assess the Efficacy of Preoperative Oral Vitamin D3 at Preventing Postoperative Hypocalcaemia in Patients Undergoing Total Thyroidectomy.
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Secondary ID [1]
284111
0
Nil
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Universal Trial Number (UTN)
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Trial acronym
Vitid Study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Post-operative Hypocalcaemia
291189
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Total Thyroidectomy
291190
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Condition category
Condition code
Metabolic and Endocrine
291524
291524
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0
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Other metabolic disorders
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Surgery
291525
291525
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0
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Other surgery
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
300 000 IU (6 capsules) of oral Vitamin D3 taken once, one week prior to surgery.
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Intervention code [1]
288805
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Treatment: Drugs
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Comparator / control treatment
Placebo 6 capsules (sugar pills) taken once, one week prior to surgery.
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Control group
Placebo
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Outcomes
Primary outcome [1]
291495
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The incidence of low blood calcaemia (defined as any post-operative corrected calcium <2.10 mmol/L)
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Assessment method [1]
291495
0
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Timepoint [1]
291495
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At 6 hours, days 1, 2, 3 (if still in hospital), 1 week, 2 weeks, 4 weeks, and 3 and 6 months post-operatively (reference range 2.10-2.55mmol/L).
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Secondary outcome [1]
306901
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The incidence of symptomatic hypocalcaemia (defined as any one of positive Chvostek’s sign, tetany, perioral paraesthesia or palpitations confirmed with ECG changes associated with any corrected calcium measurement below 2.10 mmol/L).
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Assessment method [1]
306901
0
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Timepoint [1]
306901
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At 6 hours, days 1, 2, 3 (if still in hospital), 1 week, 2 weeks, 4 weeks, and 3 and 6 months post-operatively
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Secondary outcome [2]
306902
0
The incidence of permanent hypoparathyroidsm (defined as a parathyroid blood level of <1.1 pmol/L (lower end of normal range) and requiring ongoing supplementation with 1,25(OH)D3 to maintain a corrected calcium level within the normal range
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Assessment method [2]
306902
0
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Timepoint [2]
306902
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At 6 hours, days 1, 2, 3 (if still in hospital), 1 week, 2 weeks, 4 weeks, and 3 and 6 months post-operatively.
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Secondary outcome [3]
306903
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The dose of calcium and calcitriol as recorded in patient medical record, and prescribed as an outpatient.
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Assessment method [3]
306903
0
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Timepoint [3]
306903
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At day 1, day 2 day 3, 1 week, 2 weeks and 4 weeks from date of surgery.
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Secondary outcome [4]
306904
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Length of inpatient hospital stay in days.
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Assessment method [4]
306904
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Timepoint [4]
306904
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Prior to discharge post-operatively.
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Secondary outcome [5]
306905
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Change in parathyroid hormone blood levels from baseline.
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Assessment method [5]
306905
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Timepoint [5]
306905
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Days one and two post-operatively.
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Eligibility
Key inclusion criteria
Patients undergoing total thyroidectomy for any cause, able to provide written informed consent.
Must be able to complete follow-up.
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Minimum age
18
Years
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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
-Current treatment for vitamin D deficiency at time of assessment with any form of vitamin D supplementation
-Chronic kidney disease (eGFR <60)
-Need for urgent surgery precluding completion of the intervention course
-Known primary parathyroid disease
-Pregnancy
-Current treatment with bisphosphonates
-Known severe liver disease (previous INR >1.4 without anticoagulant treatment in the presence of known liver disease, or Bilirubin > 40 in the presence of obstructive LFT profile )
-Hypercalcaemia (>2.55nmol/L) on initial pre-operative blood tests.
Refuse or are unable to provide written consent to participate
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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)
After written informed consent has been provided, the Research Nurse will randomise the participant via a username and password protected web-based system. A Pharmacist will provide the corresponding allocated drug pack to the participant.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be computer generated randomisation to control and intervention in a 1:1 ratio.
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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
Efficacy
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Statistical methods / analysis
The predicted rate of post-operative hypocalcaemia in a general population undergoing thyroidectomy is between 25 and 30%. As this study is using a more sensitive definition of hypocalcaemia, we can expect a slightly higher incidence and therefore have used 30% as the expected incidence for our control group.
Assuming correction of deficiency between 50 and 75nmols/L, and using a conservative numbers based on prior studies we estimate an incidence on the treatment group of around 10%
Using these numbers, the required sample size to reach signifiacance (alpha 0.05 and beta 0.8) is 72 per arm. After allowing for a 10% dropout rate the sample size is 160 in total.
Categorical data will be analysed using a Chi square test and Fisher’s exact test. Continuous data will be analysed using the Student’s t-test. Furthermore, the treatment groups will be analysed in subgroups (quartiles) according to pre-treatment vitamin D level.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/04/2014
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Actual
14/07/2014
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Date of last participant enrolment
Anticipated
1/08/2017
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Actual
19/01/2018
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Date of last data collection
Anticipated
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Actual
20/02/2018
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Sample size
Target
160
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Accrual to date
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Final
160
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
2099
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John Hunter Hospital Royal Newcastle Centre - New Lambton
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Recruitment hospital [2]
2100
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Newcastle Private Hospital - New Lambton Heights
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Recruitment hospital [3]
2102
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Lingard Private Hospital - Merewether
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Recruitment postcode(s) [1]
7788
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2305 - New Lambton
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Recruitment postcode(s) [2]
7791
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2305 - New Lambton Heights
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Recruitment postcode(s) [3]
7793
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2291 - Merewether
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Funding & Sponsors
Funding source category [1]
288743
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Hospital
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Name [1]
288743
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John Hunter Hospital Staff Specialist Grants
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Address [1]
288743
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Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country [1]
288743
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Australia
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Primary sponsor type
Hospital
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Name
Hunter New England Local Health District
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Address
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
Australia
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Secondary sponsor category [1]
287438
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None
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Name [1]
287438
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Address [1]
287438
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Country [1]
287438
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290576
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Hunter New England Human Research Ethics Committee
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Ethics committee address [1]
290576
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Locked Bag 1 New Lambton NSW 2305
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Ethics committee country [1]
290576
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Australia
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Date submitted for ethics approval [1]
290576
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31/01/2014
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Approval date [1]
290576
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26/02/2014
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Ethics approval number [1]
290576
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14/02/19/3.06
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Summary
Brief summary
Surgical removal of the thyroid gland is a relatively safe procedure, but can be associated with a number of specific complications. The parathyroid glands are close to the thyroid gland and can be affected by the surgery. These glands help to maintain calcium levels in the blood and damage to these glands from the surgery can result in low blood calcium levels. Low calcium levels can result in tingling, numbness and muscle cramps. The condition is usually treated with Vitamin D and calcium supplements after it occurs and may prolong the length of stay in hospital. Vitamin D is a very important vitamin that helps to control bone and calium metabolism in the body. This study wants to see if by giving Vitamin D before the surgery low calcium levels can be prevented.
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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
37326
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Dr Cino Bendinelli
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Address
37326
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Division of Surgery
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
37326
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Australia
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Phone
37326
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+61 2 49855153
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Fax
37326
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+61 2 49214274
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Email
37326
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[email protected]
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Contact person for public queries
Name
37327
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Rosemary Carroll
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Address
37327
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Division of Surgery
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
37327
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Australia
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Phone
37327
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+61 2 49855153
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Fax
37327
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Email
37327
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[email protected]
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Contact person for scientific queries
Name
37328
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Cino Bendinelli
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Address
37328
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Division of Surgery
John Hunter Hospital
Locked Bag 1
Hunter Region Mail Centre NSW 2310
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Country
37328
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Australia
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Phone
37328
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+61 2 49855153
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Fax
37328
0
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Email
37328
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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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