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Trial registered on ANZCTR
Registration number
ACTRN12617001299392
Ethics application status
Not required
Date submitted
11/08/2017
Date registered
11/09/2017
Date last updated
24/08/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
An audit of clinical service delivery and outcomes using Tumour Necrosis Factor Inhibition therapy (- a Biological agent that targets inflammation) for the treatment of Diffuse Idiopathic Skeletal Hyperostosis (a condition where calcification of ligaments, tendons and joint capsule insertions in the spine causes pain, stiffness and restricted movements).
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Scientific title
An Audit Of Clinical Service Delivery And Outcomes In Diffuse Idiopathic Skeletal Hyperostosis – Preliminary Evidence For The Efficacy Of Tumour Necrosis Factor Inhibition Therapy.
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Secondary ID [1]
292451
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Nil known
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Universal Trial Number (UTN)
Nil known
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Trial acronym
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Linked study record
Nil
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Health condition
Health condition(s) or problem(s) studied:
Diffuse idiopathic skeletal hyperostosis
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Hyperostosis
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Condition category
Condition code
Inflammatory and Immune System
303387
303387
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0
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Autoimmune diseases
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
To investigate outcomes of treatment over an 11-year period (2006 to 2017 inclusive), in patients with diffuse idiopathic skeletal hyperostosis (DISH) the medical records of 10 patients with DISH treated with tumour necrosis factor inhibitors (TNFi), will be retrospectively audited and will be compared with 13 DISH patients that are not treated with TNFi, and also compared with patients with 42 ankylosing spondylitis (AS) who will be identified from a national rheumatology database (Australian Rheumatology Association Database - ARAD)
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Intervention code [1]
298629
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Not applicable
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Comparator / control treatment
13 DISH patients that were not treated with TNFi will be compared as controls. They also met radiologic criteria for diagnosis and were identified using the same method as the treated DISH patients- that is physician recall and a word search of hospital clinic letters. The TNFi and control patients will also be compared with 42 AS patients identified from Australian Rheumatology Association Database (ARAD).
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Control group
Active
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Outcomes
Primary outcome [1]
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Bath Ankylosing Spondylitis Disease Activity Index scores will be used to assess response.
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Assessment method [1]
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Timepoint [1]
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5 years after diagnosis
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Secondary outcome [1]
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BASDAI score
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Assessment method [1]
337502
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Timepoint [1]
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9 years after diagnosis
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Eligibility
Key inclusion criteria
Radiological criteria for DISH were applied. Patients were classified on the basis described by Fornasier, Littlejohn and Urowitz (Fornasier V, Littlejohn G, Urowitz M, Keystone E, Smythe H. Spinal entheseal new bone formation: the early changes of spinal diffuse idiopathic skeletal hyperostosis. J Rheum 1983;10:939-47). They were also evaluated for characteristic changes of an inflammatory sacro-iliitis.
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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
Those people without DISH.
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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
Both
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Statistical methods / analysis
Analysis of variance (ANOVA).
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
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Actual
8/05/2007
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Date of last participant enrolment
Anticipated
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Actual
14/12/2015
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Date of last data collection
Anticipated
1/12/2026
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Actual
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Sample size
Target
65
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Accrual to date
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Final
65
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Fremantle Hospital and Health Service - Fremantle
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Recruitment hospital [2]
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Fiona Stanley Hospital - Murdoch
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Recruitment postcode(s) [1]
16914
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6160 - Fremantle
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Recruitment postcode(s) [2]
16915
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6150 - Murdoch
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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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Dr Graeme Carroll
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Address [1]
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ArthroCare, 19A Guildford Rd, Mount Lawley, Western Australia, 6050
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Country [1]
297019
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Australia
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Primary sponsor type
Individual
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Name
Dr Graeme Carroll
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Address
ArthroCare, 19A Guildford Rd, Mount Lawley, Western Australia, 6050
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
296316
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Other collaborator category [1]
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Other Collaborative groups
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Name [1]
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Australian Rheumatology Association
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Address [1]
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145 Macquarie Street
SYDNEY NSW 2000
Tel: (+61 2) 9252 2356
Fax: (+61 2) 9252 2328
email:
[email protected]
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Country [1]
279678
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Australia
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Ethics approval
Ethics application status
Not required
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Ethics committee name [1]
298204
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Ethics committee address [1]
298204
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Ethics committee country [1]
298204
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Date submitted for ethics approval [1]
298204
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Approval date [1]
298204
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Ethics approval number [1]
298204
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Summary
Brief summary
Diffuse idiopathic skeletal hyperostosis (DISH), is a skeletal disorder for which, apart from non-steroidal anti-inflammatory drugs and analgesics, there is no effective pharmacological treatment. The aim of this retrospective/prospective data audit is to determine the effect of tumour necrosis factor inhibitors in clinically active DISH patients. This will be achieved by the comparison of changes in pain and function in people with DISH that are treated with tumour necrosis factor inhibitor (TNFi) to similar people with DISH that are not treated with TNFi, with people with ankylosing spondylitis, over time.
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Trial website
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Trial related presentations / publications
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Public notes
This retrospective audit has identified people with DISH and will examine their results from 8/05/2007 until present day with the anticipation that these people will be followed until 1/12/2026. Ethics approval was not required according to the WA Health Research Governance Policy and Procedures: 3.2.3 Exemption from Ethical and Scientific Review In accordance with the National Statement (Chapter 5.1), WA Health provides the discretion to exempt from ethical review research that: is negligible risk research; and involves the use of existing collections of data or records that contain only nonidentifiable data about human beings. In our case: • The manuscript does not report on primary research. Participants were not recruited for study, but rather were evaluated and in some cases treated empirically in the context of clinical service provision. All data analysed were collected as part of routine diagnosis and patient care. • Patients were diagnosed and treated in accordance with national guidelines. The tests and procedures performed (as well as recording all other variables included in our analysis) were routine and essential for confirming diagnosis and classifying patients. The imaging and other investigations had been performed as part of routine care. They were not done as an add-on for purposes of research. • The paper does not report on the use of experimental or new protocols. The outcomes of observation and in some cases empirical “off label” therapies was a variation of an accepted treatment protocol. • The audit was not set up as a study or research project, but as a review of treatment practices and outcomes. Hence we did not seek/obtain ethical approval for a study. • Our analysis looked retrospectively at outcomes for a cohort of patients treated or observed over an extensive period of time. This was done internally as part of an audit/evaluation, with a view to improving quality of care. Ref: Department of Health. (2012). WA Health Research Governance Policy and Procedures, Research Development Unit, Department of Health, Perth.
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Contacts
Principal investigator
Name
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Prof Graeme Carroll
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Address
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ArthroCare
19A Guildford Rd, Mount Lawley, Western Australia, 6050
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Country
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Australia
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Phone
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+61892716306
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Fax
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+61893703957
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Email
76326
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[email protected]
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Contact person for public queries
Name
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Graeme Carroll
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Address
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ArthroCare
19A Guildford Rd, Mount Lawley, Western Australia, 6050
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Country
76327
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Australia
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Phone
76327
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+61892716306
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Fax
76327
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+61893703957
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Email
76327
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[email protected]
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Contact person for scientific queries
Name
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Graeme Carroll
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Address
76328
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ArthroCare
19A Guildford Rd, Mount Lawley, Western Australia, 6050
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Country
76328
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Australia
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Phone
76328
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+61892716306
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Fax
76328
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+61893703957
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Email
76328
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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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