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Trial registered on ANZCTR
Registration number
ACTRN12621000220864
Ethics application status
Approved
Date submitted
4/11/2020
Date registered
3/03/2021
Date last updated
30/03/2022
Date data sharing statement initially provided
3/03/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
Autologous Protein Solution in the management of knee osteoarthritis
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Scientific title
The effect of Autologous Protein Solution on patient reported outcomes in knee osteoarthritis
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Secondary ID [1]
302512
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none
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Universal Trial Number (UTN)
U1111-1259-4651
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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:
Osteoarthritis
319374
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Condition category
Condition code
Musculoskeletal
317384
317384
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0
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Osteoarthritis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The intervention is an intra-articular injection of "autologous protein solution" produced from a patient's own blood via a provided centrifuge kit that involves separating and then concentrating the blood products.
60mls of blood is drawn from the patient. The resultant injection is approximately 3mls. This is injected in to the affected knee, immediately after it is drawn and processed (which takes about 20 minutes) using ultrasound guidance to confirm intra-articular placement, by one of the study doctors. It is a single administration
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Intervention code [1]
318829
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Treatment: Other
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Comparator / control treatment
Intra-articular saline injection
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Control group
Placebo
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Outcomes
Primary outcome [1]
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WOMAC score
The first primary outcome will be osteoarthritis severity as rated by the overall WOMAC score between the two groups at each time period
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Assessment method [1]
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Timepoint [1]
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1,3,6 and 12 months
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Primary outcome [2]
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Koos pain subscore
The second primary outcome will be osteoarthritis pain severity as rated by the KOOS pain subscore score between the two groups at each time period
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Assessment method [2]
326309
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Timepoint [2]
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1,3,6 and 12 months
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Primary outcome [3]
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KOOS ADL function subscore
The third primary outcome will be osteoarthritis functional impariment as rated by the KOOS ADL function score between the two groups at each time period
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Assessment method [3]
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Timepoint [3]
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1, 3, 6, and 12 months
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Secondary outcome [1]
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KOOS symptoms subscore
Osteoarthritis symptoms as rated by the KOOS symptoms subscore will be a secondary outcome.
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Assessment method [1]
387899
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Timepoint [1]
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1, 3, 6 and 12 months
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Secondary outcome [2]
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VAS pain score
Osteoarthritis pain as rated by a VAS pain score will be a secondary outcome
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Assessment method [2]
387900
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Timepoint [2]
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1, 3, 6 and 12 months
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Secondary outcome [3]
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Adverse events
The most common adverse event expected in transient joint pain/swelling after the injection. There is also the possibility of bruising from the taking of blood. The risk of introducing infection in to the joint (i.e. causing septic arthritis) is very low but is present and the patients will be informed of this and what to look out for.
Adverse events will be patient self reported - they will be asked to remain at the clinic for 30 minutes following the injection and report any symptoms prior to leaving, and advised to call the research assistant at any time if they observe an adverse event or have any concerns. They will also be asked at the time of the follow up surveys if they have noted any adverse events.
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Assessment method [3]
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Timepoint [3]
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At the time of injection, 1, 3, 6 and 12 months
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Secondary outcome [4]
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WOMAC pain subscore will be assessed as a secondary outcome (WOMAC overall score will be assessed as a primary outcome
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Assessment method [4]
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Timepoint [4]
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1, 3, 6 and 12 months
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Secondary outcome [5]
391006
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Functional deficit from osteoarthritis will be assessed by WOMAC function subscore as a secondary outcome (WOMAC overall score will be assessed as a primary outcome)
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Assessment method [5]
391006
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Timepoint [5]
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1 ,3, 6 and 12 months
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Secondary outcome [6]
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VAS function score
VAS function score will be assessed as a secondary outcome to reflect functional impairment from arthritis
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Assessment method [6]
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Timepoint [6]
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1, 3, 6 and 12 months
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Eligibility
Key inclusion criteria
Unilateral knee osteoarthritis
Kellgren-Lawrence grade 2-3
Failed at least one non-operative management
BMI <40
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Minimum age
21
Years
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Maximum age
80
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
Active infection
Osteoarthritis in the contralateral knee
Diagnosis other than osteoarthritis (e.g. inflammatory arthritis, gout, paget's disease, etc) in the affected knee
Other cause for pain as judged by the investigator (e.g. hip, spine pathology, acute injury)
Presence of surgical implants in the affected knee
Arthroscopic surgery on the affected knee within 6 months
Steroid injection in the affected knee within 3 months
Oral steroids within 2 weeks, or other systemic immunosuppressants within 6 weeks
Planned surgery on the affected knee
Local anaesthetic allergy
Current treatment for leakaemia or other malignancy
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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)
Sealed opaque envelope
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Simple randomisation using a randomisation table created by computer software
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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
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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/efficacy
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Statistical methods / analysis
Statistical analysis will involve comparing the baseline demographics and radiographic severity between the two groups to ensure they are equal, using Chi-squared tests for absolute variables (gender, Kellgren-Lawrence classification of severity) and Independent T-test for continuous variables (age). We will use paired T-test to compare scores over the different timeframes within each cohort, and independent T-test to compare results between the two cohorts to determine if the APS injection is statistically superior to saline
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
22/03/2021
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Actual
11/06/2021
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Date of last participant enrolment
Anticipated
1/06/2022
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Actual
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Date of last data collection
Anticipated
1/06/2023
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Actual
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Sample size
Target
50
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Accrual to date
32
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Final
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Recruitment outside Australia
Country [1]
23089
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New Zealand
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State/province [1]
23089
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Funding & Sponsors
Funding source category [1]
306947
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Charities/Societies/Foundations
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Name [1]
306947
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Northland Orthopaedic Research Trust
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Address [1]
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15 Kensington Avenue
Kensington
Whangarei
0112
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Country [1]
306947
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New Zealand
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Primary sponsor type
Government body
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Name
Northland DHB
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Address
Maunu Road
Private Bag 9742
Whangarei
0148
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Country
New Zealand
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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]
307715
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Country [1]
307715
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
307087
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Health and Disability Ethics Committee
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Ethics committee address [1]
307087
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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]
307087
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New Zealand
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Date submitted for ethics approval [1]
307087
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18/11/2020
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Approval date [1]
307087
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16/12/2020
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Ethics approval number [1]
307087
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20/CEN/264
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Summary
Brief summary
Pain and disability from knee osteoarthritis is a significant source of morbidity in the population. Intra-articular steroid, hyaluronic acid and platelet-rich protein have all been investigated for treatment of osteoarthitis. The autologous protein solution was developed as a biologic therapy that concentrates specific anti-inflammatory cytokines (particularly interleukin-1 receptor antagonist and soluble tumour necrosis factor-receptor I and II) as well as growth factors. Pre-clinical studies demonstrated high concentrations of these anti-inflammatory mediators, and low concentration of pro-inflammatory cytokines in the autologous protein solution. They demonstrated inhibition of MMP production (protease involved in cartilage degradation) and reduced cartilage breakdown products in vitro. An animal study demonstrated reduced lameness in horses. Small human trials have demonstrated an acceptable safety profile and improved patient reported outcome scores. We plan to assess the effect of a single APS injection on knee pain and function compared to placebo at 1, 3, 6 and 12 months
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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
105986
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Dr Marla Ross
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Address
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PO Box 1936
Shortland Street
Auckland
New Zealand
OR
Whangarei Hospital, Maunu Road, Private bag 9742, Whangarei 0148
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Country
105986
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New Zealand
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Phone
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+64 21847165
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Fax
105986
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Email
105986
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[email protected]
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Contact person for public queries
Name
105987
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Marla Ross
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Address
105987
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PO Box 1936
Shortland Street
Auckland
New Zealand
OR
Whangarei Hospital, Maunu Road, Private bag 9742, Whangarei 0148
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Country
105987
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New Zealand
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Phone
105987
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+64 21847165
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Fax
105987
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Email
105987
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[email protected]
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Contact person for scientific queries
Name
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Marla Ross
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Address
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PO Box 1936
Shortland Street
Auckland
New Zealand
OR
Whangarei Hospital, Maunu Road, Private bag 9742, Whangarei 0148
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Country
105988
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New Zealand
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Phone
105988
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+64 21847165
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Fax
105988
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Email
105988
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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)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
9623
Study protocol
380732-(Uploaded-04-11-2020-14-50-42)-Study-related document.docx
9624
Informed consent form
380732-(Uploaded-15-12-2020-08-25-53)-Study-related document.docx
9625
Ethical approval
380732-(Uploaded-25-02-2021-14-20-22)-Study-related document.pdf
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