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Trial registered on ANZCTR
Registration number
ACTRN12619001083189
Ethics application status
Approved
Date submitted
19/07/2019
Date registered
6/08/2019
Date last updated
10/08/2022
Date data sharing statement initially provided
6/08/2019
Date results provided
2/03/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
A study comparing the changes in lung function following the use of salbutamol and symbicort in adults with asthma
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Scientific title
Bronchodilation following repeated administration of budesonide/formoterol vs salbutamol in adult asthma: A randomised, open-label, cross-over study
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Secondary ID [1]
298116
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None
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Universal Trial Number (UTN)
U1111-1229-6923
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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:
Asthma
312646
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Condition category
Condition code
Respiratory
311141
311141
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0
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Asthma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention drug schedule: Budesonide/formoterol 200µg/6µg per actuation from the Turbuhaler, 1 actuation at 30 minute intervals for 4 doses over 90 minutes, followed by 2 actuations on 3 occasions at 20 minute intervals for 1 hour, followed by 2 actuations at 7 hours.
The total duration of administration will be 7 hours.
The intervention will take place at the Medical Research Institute of New Zealand (MRINZ) facility. The study drugs will be administered by a study investigator and therefore there is no need to monitor adherence.
An actuation is defined as an 'inhalation or puff from an inhaler'.
Due to the cross over design, there will be a minimum washout period of 7 days.
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Intervention code [1]
314340
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Treatment: Drugs
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Comparator / control treatment
Salbutamol 100µg per actuation from the MDI (Metered Dose Inhaler) and spacer inhaled in a single maximal breath. 2 actuations at 30 minute intervals for 4 doses over 90 minutes, followed by salbutamol 2.5mg via nebuliser on 3 occasions at 20 minute intervals for 1 hour, followed by salbutamol 2.5mg via nebuliser at 7 hours. Prior to leaving the study site, this group will receive 12 actuations of Budesonide 200µg via Turbuhaler.
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Control group
Active
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Outcomes
Primary outcome [1]
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Magnitude of bronchodilation at 180 mins as measured by FEV1
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Assessment method [1]
319923
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Timepoint [1]
319923
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180 minutes post-intervention commencement
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Secondary outcome [1]
369878
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Magnitude of bronchodilation over time as measured by FEV1 using Spirometry
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Assessment method [1]
369878
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Timepoint [1]
369878
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FEV1 at 30 min intervals for 4 hours, then hourly to 8 hours post-intervention commencement
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Secondary outcome [2]
369879
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Levels of airway inflammation over time as measured by FeNO
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Assessment method [2]
369879
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Timepoint [2]
369879
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FeNO at 30 min intervals for 4 hours, then hourly to 8 hours post-intervention commencement
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Secondary outcome [3]
369880
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Relief of breathlessness as measured by the Modified Borg Score
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Assessment method [3]
369880
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Timepoint [3]
369880
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At 30 minute intervals for 4 hours, then hourly to 8 hours post-intervention commencement
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Secondary outcome [4]
369883
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Changes in serum potassium following treatment using blood sampling
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Assessment method [4]
369883
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Timepoint [4]
369883
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At 0, 3 and 8 hours post-intervention commencement
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Secondary outcome [5]
369884
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To determine changes in blood eosinophil count following treatment using blood sampling
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Assessment method [5]
369884
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Timepoint [5]
369884
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At 0, 3 and 8 hours post-intervention commencement
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Secondary outcome [6]
369885
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Changes in heart rate following treatment using an ECG
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Assessment method [6]
369885
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Timepoint [6]
369885
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At 0, 3 and 8 hours post-intervention commencement
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Secondary outcome [7]
373015
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Changes in QTc following treatment using an ECG
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Assessment method [7]
373015
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Timepoint [7]
373015
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At 0, 3 and 8 hours post-intervention commencement
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Eligibility
Key inclusion criteria
Doctor diagnosis of asthma.
Age 16 to 65 years.
SABA monotherapy or SABA with regular ICS therapy, or regular ICS/LABA treatment
FEV1 40 to 70% predicted as per GLI 2012 criteria
Change in FEV1 post 400µg salbutamol via MDI through a spacer >12% increase from baseline, and >200ml
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Minimum age
16
Years
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Maximum age
65
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
Other significant respiratory disorder
Other significant cardiovascular disorder such as history of arrhythmia including atrial fibrillation and supraventricular tachycardia
Current or recent respiratory tract infection in last 4 weeks
Current use of other asthma medications including LAMAs, theophylline, oral corticosteroids, biologics, sodium cromoglycate or nedocromil sodium
Asthma exacerbation requiring oral steroids in last 6 weeks
Current smoker or smoking history with >10 pack year history
QTCF > 430ms for men and > 450ms for women
Pregnant, or planning a pregnancy, or breast feeding
Allergy to investigational products, including previous adverse effects following administration of similar doses to those used in the study
Current use of beta-blockers
Any other condition which, at the investigator’s discretion, is believed may present a safety risk or impact the feasibility of the study or the study results.
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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)
Following the screening process, eligible participants who have given written consent to be enrolled in the study will be randomised 1:1 to one of the treatment arms. The allocations will be concealed and a participant’s randomisation outcome will only be released at the time of randomisation. Allocation was by central randomisation done by a computer.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
The randomisation method will involve a computer-generated sequence supplied by the study statistician, independent of the investigators. The sequence will be uploaded into the Research Electronic Data Capture (REDCap) system by an individual who is otherwise uninvolved in study processes.
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Masking / blinding
Open (masking not 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 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Update
A mixed linear model will be used with the baseline FEV1, treatment allocation, and treatment order as fixed effects; and participant treated as a random effect to take into account the cross-over design. For the FEV1 at other measurement times a time by treatment interaction will be fitted and if statistically significant individual time-wise comparisons will be estimated between treatments. A similar statistical method will be utilised for analysing the secondary variables: modified Borg score, heart rate and QTC, blood eosinophil and potassium levels.
Data for FeNO will be analysed on the logarithm transformed scale based on our previous experience with the skew distribution of this variable and that normality assumptions were better met on the logarithm transformed scale, interpreted as the ratio of geometric means.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
7/08/2019
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Actual
18/09/2019
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Date of last participant enrolment
Anticipated
9/03/2020
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Actual
18/10/2020
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Date of last data collection
Anticipated
27/03/2020
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Actual
1/11/2020
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Sample size
Target
39
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Accrual to date
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Final
39
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Recruitment outside Australia
Country [1]
21447
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New Zealand
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State/province [1]
21447
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Wellington
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Funding & Sponsors
Funding source category [1]
302649
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Commercial sector/Industry
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Name [1]
302649
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AstraZeneca
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Address [1]
302649
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Level 5,
15 Hopetoun St,
Freemans Bay,
Auckland
1011
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Country [1]
302649
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New Zealand
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Primary sponsor type
Other
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Name
Medical Research Institute of New Zealand
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Address
Medical Research Institute of New Zealand
Level 7, CSB Building,
Wellington Hospital,
Newtown
Wellington 6021
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Country
New Zealand
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Secondary sponsor category [1]
302567
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None
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Name [1]
302567
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Address [1]
302567
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Country [1]
302567
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
303273
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Health and Disability Ethics Committees
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Ethics committee address [1]
303273
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Ministry of Health Health and Disability Ethics Committees PO Box 5013 Wellington 6140
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Ethics committee country [1]
303273
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New Zealand
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Date submitted for ethics approval [1]
303273
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15/05/2019
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Approval date [1]
303273
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09/07/2019
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Ethics approval number [1]
303273
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19/NTB/83
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Summary
Brief summary
Update Currently, when someone goes to the Emergency Department with an asthma attack, they are given are medication called salbutamol (Ventolin). Salbutamol is a rescue inhaler which opens up the airways to make breathing easier. This study looks at what would happen if a different inhaler is used instead of salbutamol. This other combined inhaler is named Symbicort. It contains budesonide (an inhaled steroid medication) and formoterol (a long-acting medicine that opens your airways). This inhaler is currently used by many people with asthma as a preventative inhaler. This means it is used on a daily basis to prevent asthma attacks. In this study, we are looking to see if Symbicort could be used as a rescue inhaler as well, like salbutamol. Participants will first attend a screening visit to decide if they are eligible to take part. If found to be eligible, they then be requested to attend TWO intervention visits upto 4 weeks apart. Participants will receive salbutamol during one visit and Symbicort during the other, in a random order. Both the participant and the study doctor will know which group they are allocated to. During the Intervention visits, participants will undergo spirometry and FeNO testing. They will also have blood samples taken and ECGs done. They will also be asked to rate their levels of breathlessness on a scoring system.
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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
93090
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Prof Richard Beasley
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Address
93090
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Medical Research Institute of New Zealand
Private Bag 7902, Wellington 6242
Level 7, CSB Building,
Wellington Hospital,
Newtown
Wellington 6021
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Country
93090
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New Zealand
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Phone
93090
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+6448050238
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Fax
93090
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Email
93090
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[email protected]
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Contact person for public queries
Name
93091
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Richard Beasley
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Address
93091
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Medical Research Institute of New Zealand
Private Bag 7902, Wellington 6242
Level 7, CSB Building,
Wellington Hospital,
Newtown
Wellington 6021
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Country
93091
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New Zealand
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Phone
93091
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+6448050238
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Fax
93091
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Email
93091
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[email protected]
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Contact person for scientific queries
Name
93092
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Richard Beasley
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Address
93092
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Medical Research Institute of New Zealand
Private Bag 7902, Wellington 6242
Level 7, CSB Building,
Wellington Hospital,
Newtown
Wellington 6021
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Country
93092
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New Zealand
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Phone
93092
0
+6448050238
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Fax
93092
0
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Email
93092
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
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What data in particular will be shared?
Individual participant data that underlie the results reported in this article, after de-identification (text, tables, figures, and appendices).
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When will data be available (start and end dates)?
One year after publication until a minimum of 5 years after publication.
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Available to whom?
Researchers who provide a methodologically sound proposal that has been approved by the study steering committee.
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Available for what types of analyses?
To achieve the aims outlined in the approved proposal.
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How or where can data be obtained?
Through a signed data access agreement. The agreement can be obtained by emailing the Principal Investigator:
[email protected]
.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
2497
Ethical approval
377508-(Uploaded-26-07-2019-06-43-11)-Study-related document.pdf
3278
Informed consent form
377508-(Uploaded-18-11-2019-06-32-56)-Study-related document.pdf
3279
Study protocol
377508-(Uploaded-18-11-2019-06-34-14)-Study-related document.pdf
5837
Statistical analysis plan
[email protected]
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