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Trial registered on ANZCTR
Registration number
ACTRN12613000762752
Ethics application status
Approved
Date submitted
26/06/2013
Date registered
9/07/2013
Date last updated
9/07/2013
Type of registration
Retrospectively registered
Titles & IDs
Public title
Mortality among dialysis patients prescribed sevelamer hydrochloride and lanthanum carbonate compared with calcium-based phosphate binders: A retrospective cohort study using the Australian and New Zealand Dialysis and Transplant Database (ANZDATA).
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Scientific title
All cause and cardiovascular mortality among Australian adult dialysis patients prescribed sevelamer hydrochloride and lanthanum carbonate compared with calcium-based phosphate binders.
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Secondary ID [1]
282739
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Nil
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Universal Trial Number (UTN)
U1111-1145-0348
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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:
Chronic Kidney Disease stage 5D (dialysis)
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All cause mortality and cardiovascular mortality
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calcium and non calcium-based phosphate binders
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Condition category
Condition code
Renal and Urogenital
289739
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0
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Kidney disease
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Intervention/exposure
Study type
Observational
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Patient registry
True
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Target follow-up duration
6
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Target follow-up type
Years
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Description of intervention(s) / exposure
This is a retrospective observational study to assess whether the introduction of non calcium based phosphate binders sevelamer hydrochloride (Renagel) and lanthanum carbonate (Fosrenal) over the past 6-7 years has influenced the mortality of patients on dialysis.
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Intervention code [1]
287335
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Not applicable
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Comparator / control treatment
Patients not using the newer non calcium-based binders will be the comparator group.
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Control group
Active
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Outcomes
Primary outcome [1]
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All cause mortality as assessed by data linkage of dialysis patient information stored on the Australian and New Zealand Dialysis and Transplant database (ANZDATA) and the pharmaceutical prescription data stored on the Australian Pharmaceutical Benefits Scheme (PBS) database.
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Assessment method [1]
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Timepoint [1]
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Time point: Data collected up to July 31st 2013.
Baseline data to assess mortality prior to introduction of these agents in 2007 will begin In 2002, 5 years before their introduction.
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Secondary outcome [1]
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Cardiovascular mortality as assessed by data linkage of dialysis patient information stored on the ANZDATA database and the pharmaceutical prescription data stored on the PBS database.
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Assessment method [1]
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Timepoint [1]
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Time point: Data collected up to July 31st 2013.
Baseline data to assess mortality prior to introduction of these agents in 2007 will begin In 2002, 5 years before their introduction.
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Eligibility
Key inclusion criteria
Australian dialysis patients aged over 18 years of age and registered in ANZDATA registry will be included in the study.
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Minimum age
18
Years
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Maximum age
100
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
New Zealand patients and patients aged less than 18 years of age in ANZDATA registry will be excluded
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Study design
Purpose
Natural history
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Duration
Longitudinal
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Selection
Defined population
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Timing
Retrospective
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Statistical methods / analysis
There are currently over 10,000 Australians on dialysis in the ANZDATA registry, and approximately 2,500 new patients commence dialysis each year. Therefore over the 6-7 years since introduction of non calcium-based binders, we will be able to follow approximately 15,000 patients to death, transplantation or to the end of the study period.
Statistical analyses will include calculation of all-cause and cardiovascular disease mortality rates before and after the introduction of the non calcium-based phosphate binders and mortality rates will be examined within age and sex categories to examine changes in mortality within dialysis patient sub-groups. Changes in the usage of non calcium-based phosphate binders will be examined overall and within dialysis patient sub-groups. A series of survival analyses will then be conducted to examine whether there is a survival advantage conferred by the use of the newer drugs and these will include Cox models, controlling for covariates (such as presence of concomitant illness such as diabetes, age, dialysis vintage, hours and adequacy, use of other drugs that may influence mortality and centre effects), all of which may affect patient survival. The analysis will be conducted using Excel and SPSS software packages.
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
1/07/2002
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Actual
1/07/2002
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Date of last participant enrolment
Anticipated
1/07/2012
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Actual
1/07/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
15000
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
ACT,NSW,NT,QLD,SA,TAS,WA,VIC
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Recruitment hospital [1]
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Westmead Hospital - Westmead
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
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NA
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Address [1]
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NA
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Country [1]
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Primary sponsor type
Individual
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Name
A/Prof Grahame Elder
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Address
Department of Renal Medicine, Westmead Hospital
Cnr Hawkesbury Road and Darcy Road, Westmead NSW 2145
Osteoporosis and Bone Biology Division, Garvan Institute of Medical Research, 384 Victoria St Darlinghurst NSW 2010
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Country
Australia
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Secondary sponsor category [1]
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Individual
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Name [1]
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A/Prof Jacqueline Center
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Address [1]
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1. Osteoporosis and Bone Biology Division, Garvan Institute of Medical Research, 384 Victoria St Darlinghurst NSW 2010
2. Department of Endocrinology, St Vincents Hospital, 390 Victoria St Darlinghurst NSW 2010
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Country [1]
286213
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Australia
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Secondary sponsor category [2]
286214
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Individual
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Name [2]
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A/Prof R Louise Rushworth
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Address [2]
286214
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School of Medicine, University of Notre Dame,
160 Oxford Street, Darlinghurst NSW 2010
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Country [2]
286214
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Australia
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Secondary sponsor category [3]
286215
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Individual
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Name [3]
286215
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Dr Lorraine Pereira
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Address [3]
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Blacktown Hospital, 18 Blacktown Rd Blacktown NSW 2148
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Country [3]
286215
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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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HREC: Western Sydney Local Health District Human Research Ethics Committee
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Ethics committee address [1]
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Western Sydney Local Health District HREC Research Office Westmead Hospital Rm 2020 Clinical Sciences Building WESTMEAD NSW 2145
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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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08/05/2013
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Approval date [1]
289445
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Ethics approval number [1]
289445
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13/2013
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Ethics committee name [2]
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Department of Health and ageing (DoHA)
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Ethics committee address [2]
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Department of Health and Ageing Portfolio Strategies Division MDP 132 GPO Box 9848 Canberra ACT 2601
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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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29/05/2013
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Approval date [2]
289446
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02/07/2013
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Ethics approval number [2]
289446
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Ethics committee name [3]
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Australian and New Zealand Dialysis and Transplant Registry ( ANZDATA)
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Ethics committee address [3]
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ANZDATA Registry Level 9 East Wing, Room C9-32 The Royal Adelaide Hospital DX 800 - Mail Point 117 SA
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Ethics committee country [3]
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Australia
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Date submitted for ethics approval [3]
289447
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01/07/2013
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Approval date [3]
289447
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Ethics approval number [3]
289447
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Ethics committee name [4]
289448
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Australian Institute of Health and Welfare ( AIHW)
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Ethics committee address [4]
289448
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Ethics committee country [4]
289448
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Australia
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Date submitted for ethics approval [4]
289448
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01/07/2013
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Approval date [4]
289448
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Ethics approval number [4]
289448
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Summary
Brief summary
The proposed study is a national, retrospective cohort study, which aims to determine if the introduction of non calcium-based phosphate binders sevelamer hydrochloride and lanthanum carbonate, since their PBS listing in 2007/2008, has been associated with a change in all-cause or cardiovascular disease mortality. We hypothesize that for patients on dialysis, most of whom require the use of phosphate binding medication, the progressive displacement of traditional calcium-based phosphate binders by the non calcium-based drugs sevelamer hydrochloride (Renagel) and lanthanum carbonate (Fosrenal) will have reduced cardiovascular and/or all-cause mortality after adjustment for covariates.
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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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A/Prof Grahame Elder
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Address
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1. Department of Renal Medicine, Westmead Hospital,
Cnr Hawkesbury Road and Darcy Road, Westmead NSW 2145
2. Osteoporosis and Bone Biology Division, Garvan Institute of Medical Research, 384 Victoria St Darlinghurst NSW 2010
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Country
40774
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Australia
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Phone
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+61 412 357 246
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Fax
40774
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+61 2 96339351
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Email
40774
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[email protected]
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Contact person for public queries
Name
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Lorraine Pereira
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Address
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Blacktown Hospital,
18 Blacktown Rd Blacktown NSW 2148
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Country
40775
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Australia
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Phone
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+61 422223782
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Fax
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Email
40775
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[email protected]
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Contact person for scientific queries
Name
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Grahame Elder
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Address
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1. Department of Renal Medicine, Westmead Hospital,
Cnr Hawkesbury Road and Darcy Road, Westmead NSW 2145
2. Osteoporosis and Bone Biology Division, Garvan Institute of Medical Research, 384 Victoria St Darlinghurst NSW 2010
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Country
40776
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Australia
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Phone
40776
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+61 412 357 246
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Fax
40776
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+61 2 96339351
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Email
40776
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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.
Download to PDF