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Trial registered on ANZCTR
Registration number
ACTRN12613000323729
Ethics application status
Approved
Date submitted
21/03/2013
Date registered
22/03/2013
Date last updated
24/11/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Tranexamic Acid in Lower Limb Arthroplasty Pilot Trial
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Scientific title
The Tranexamic Acid in Lower Limb Arthroplasty Pilot Trial - a pilot trial to examine the feasibility of extension of trial methodology to a large multi-centre randomised controlled trial.
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Secondary ID [1]
282156
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Nil known
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Universal Trial Number (UTN)
U1111-1140-8459
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Trial acronym
TALLAS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Hip or knee joint replacement
288662
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Condition category
Condition code
Anaesthesiology
289007
289007
0
0
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Anaesthetics
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Surgery
289021
289021
0
0
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Other surgery
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Musculoskeletal
289022
289022
0
0
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Osteoarthritis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Tranexamic acid - 15mg/kg given intravenously at 50mg/min at skin incision (for total hip replacement) or just prior to tourniquet release (for total knee replacement) and repeated at 8 and 16 hours post-operatively.
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Intervention code [1]
286765
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Treatment: Drugs
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Comparator / control treatment
Placebo - normal saline, given in same volume and method as tranexamic acid.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Feasibility of extending our methodology to a large, pragmatic, multicenter trial using the following criteria;
•At least 1 subject per week per centre can be recruited and consented into the trial.
•>90% receive every dose of study drug in a blinded manner
•Full data collection at 6 weeks in >90% participants
•>90% undergo at least 3 out of 4 troponin assays.
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Assessment method [1]
289123
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Timepoint [1]
289123
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30 days
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Primary outcome [2]
289124
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Proportion of patients receiving allogeneic blood transfusion
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Assessment method [2]
289124
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Timepoint [2]
289124
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30 days
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Secondary outcome [1]
301865
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Incidence of significant clinical events (intended primary endpoints for larger study) at 6 weeks – mortality, myocardial infarction, elevated cardiac markers that do not fulfil criteria for MI, non-fatal cardiac arrest, transient ischemic attack/stroke, deep venous thrombosis, pulmonary embolism, acute kidney injury, atrial fibrillation, infection/sepsis, bleeding, transfusion, congestive heart failure, peripheral arterial thrombosis or coronary intervention
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Assessment method [1]
301865
0
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Timepoint [1]
301865
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6 weeks
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Secondary outcome [2]
301866
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Incidence of surgical complications – need for re-operation (including manipulation under anaesthesia), haemarthrosis, haematoma, infection of wound or joint or wound ooze
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Assessment method [2]
301866
0
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Timepoint [2]
301866
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6 weeks
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Secondary outcome [3]
301867
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Length of ICU and hospital stay
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Assessment method [3]
301867
0
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Timepoint [3]
301867
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6 weeks
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Secondary outcome [4]
301868
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Rate of readmission to hospital
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Assessment method [4]
301868
0
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Timepoint [4]
301868
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6 weeks
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Secondary outcome [5]
301869
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Quality of recovery - assessed using two orthopaedic scores (Oxford hip/knee score) a validated quality of recovery tool (QoR-15) and a quality of life tool (EQ-5D)
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Assessment method [5]
301869
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Timepoint [5]
301869
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Day 3 and 6 weeks
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Secondary outcome [6]
301870
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Persistent post-operative pain - assessed using the modified Brief Pain Inventory and the Neuropathic Pain Questionnaire.
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Assessment method [6]
301870
0
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Timepoint [6]
301870
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3 months
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Secondary outcome [7]
301871
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Change in orthopaedic scores - Oxford hip and knee, WOMAC
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Assessment method [7]
301871
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Timepoint [7]
301871
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6 weeks, 1 year
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Eligibility
Key inclusion criteria
>45 years of age
Undergoing primary or revision total knee or hip replacement
At least one night inpatient stay
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Minimum age
45
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
Poor English language comprehension
Inability to obtain informed consent
Active thrombo-embolic disease such as DVT, PE, or cerebral thrombosis
History of postoperative or spontaneous DVT, pulmonary embolism, spontaneous arterial thrombosis or familial hypercoagulability
End-stage renal failure
Recent haematuria
Contraindication or allergy to TXA
Patients who have received TXA or DDAVP in the last 7 days
Pregnancy
Oral contraceptive (other than low dose Progesterone only)
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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)
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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 4
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Type of endpoint/s
Safety
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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
1/05/2013
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Actual
1/05/2013
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Date of last participant enrolment
Anticipated
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Actual
1/08/2016
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Date of last data collection
Anticipated
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Actual
1/08/2017
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Sample size
Target
140
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Accrual to date
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Final
140
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Recruitment in Australia
Recruitment state(s)
SA,VIC
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Recruitment hospital [1]
784
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The Royal Adelaide Hospital - Adelaide
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Recruitment hospital [2]
9438
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Calvary Wakefield Hospital - Adelaide
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Recruitment hospital [3]
9439
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The Alfred - Prahran
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Recruitment postcode(s) [1]
18150
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3004 - Prahran
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Funding & Sponsors
Funding source category [1]
286925
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Other
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Name [1]
286925
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Australian and New Zealand College of Anaesthetists
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Address [1]
286925
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ANZCA House
630 St Kilda Road
Melbourne Vic 3004
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Country [1]
286925
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Australia
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Primary sponsor type
Hospital
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Name
Royal Adelaide Hospital
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Address
North Terrace
Adelaide
SA 5000
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Country
Australia
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Secondary sponsor category [1]
285713
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Other
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Name [1]
285713
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Australian and New Zealand College of Anaesthetists
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Address [1]
285713
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ANZCA House
630 St Kilda Road
Melbourne Vic 3004
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Country [1]
285713
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
288982
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Royal Adelaide Hospital Human Research Ethics Committee
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Ethics committee address [1]
288982
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Royal Adelaide Hospital North Terrace Adelaide SA 5000
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Ethics committee country [1]
288982
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Australia
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Date submitted for ethics approval [1]
288982
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24/04/2013
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Approval date [1]
288982
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06/05/2013
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Ethics approval number [1]
288982
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HREC/13/RAH/89
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Ethics committee name [2]
299089
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Alfred Hospital Ethics Committee
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Ethics committee address [2]
299089
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Ethics committee country [2]
299089
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Australia
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Date submitted for ethics approval [2]
299089
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24/07/2014
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Approval date [2]
299089
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10/12/2014
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Ethics approval number [2]
299089
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242/14
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Ethics committee name [3]
299090
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Calvary Health Care Adelaide Human Research Ehtics Committee
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Ethics committee address [3]
299090
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89 Strangways Terrace North Adelaide SA 5006 SA
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Ethics committee country [3]
299090
0
Australia
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Date submitted for ethics approval [3]
299090
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23/11/2013
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Approval date [3]
299090
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30/01/2014
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Ethics approval number [3]
299090
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13-CHREC-F007
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Summary
Brief summary
The aim of this pilot trial is to evaluate the feasibility of conducting a large multi-centre trial which will investigate the efficacy and safety of tranexamic acid in patients undergoing lower-limb arthroplasty. Tranexamic acid has been approved for use in lower limb arthroplasty in Australia. Although there is evidence to support its efficacy in reducing bleeding, trials examining the incidence of uncommon but serious thrombotic complications in patients receiving TXA for arthroplasty procedures have been small and heterogeneous. A large randomised controlled trial is required, and this pilot study is designed to enable the refining of trial methodology and to determine the feasibility of conducting trial procedures in a smaller group.
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Trial website
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Trial related presentations / publications
Preliminary results of the TALLAS trial to 6 months were presented by Dr Painter to the 2017 ANZCA ASM, "Breaking Trials' session in May 2017.
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Public notes
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Contacts
Principal investigator
Name
38634
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Dr Tom Painter
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Address
38634
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Department of Anaesthesia
Royal Adelaide Hospital
Port Road
Adelaide
SA 5000
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Country
38634
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Australia
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Phone
38634
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+ 61 8 7074 1250
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Fax
38634
0
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Email
38634
0
[email protected]
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Contact person for public queries
Name
38635
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Tom Painter
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Address
38635
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Department of Anaesthesia
Royal Adelaide Hospital
Port Road
Adelaide
SA 5000
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Country
38635
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Australia
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Phone
38635
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+ 61 8 7074 1250
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Fax
38635
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Email
38635
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[email protected]
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Contact person for scientific queries
Name
38636
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Tom Painter
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Address
38636
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Department of Anaesthesia
Royal Adelaide Hospital
Port Road
Adelaide
SA 5000
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Country
38636
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Australia
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Phone
38636
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+ 61 8 7074 1250
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Fax
38636
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Email
38636
0
[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
Source
Title
Year of Publication
DOI
Embase
Intravenous Tranexamic Acid and Lower Limb Arthroplasty-A Randomised Controlled Feasibility Study.
2018
https://dx.doi.org/10.1177/0310057X1804600407
Embase
Pharmacological interventions for the prevention of bleeding in people undergoing elective hip or knee surgery: a systematic review and network meta-analysis.
2024
https://dx.doi.org/10.1002/14651858.CD013295.pub2
N.B. These documents automatically identified may not have been verified by the study sponsor.
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