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Trial registered on ANZCTR
Registration number
ACTRN12621001268831
Ethics application status
Approved
Date submitted
23/10/2020
Date registered
20/09/2021
Date last updated
23/09/2022
Date data sharing statement initially provided
20/09/2021
Type of registration
Prospectively registered
Titles & IDs
Public title
The effect of tocotrienol-rich vitamin E (Tocovid Suprabio) compared to tocopherol on diabetic microvascular complications: A double-blinded placebo controlled, multicentre clinical trial
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Scientific title
The Effect of Lower-dose 100mg and 200mg Tocotrienol-rich Vitamin E (Tocovid Suprabio®) and 200IU Alpha-Tocopherol on Diabetic Microvascular Complications in Patients with Diabetes
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Secondary ID [1]
302579
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Nil known
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Universal Trial Number (UTN)
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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:
Diabetes Mellitus
319457
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Diabetic Nephropathy
319464
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Diabetic Retinopathy
319465
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Diabetic Neuropathy
319466
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Condition category
Condition code
Metabolic and Endocrine
317430
317430
0
0
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Diabetes
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Renal and Urogenital
317431
317431
0
0
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Other renal and urogenital disorders
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Eye
317432
317432
0
0
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Diseases / disorders of the eye
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Neurological
317433
317433
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1: 100mg tocotrienol-rich Vitamin E from palm oil
Dose: 100mg once daily
Duration: 24 weeks
Mode of administration: Oral capsule
Active ingredients:
1) d-Alpha Tocotrienol 30.76mg
2) d-Gamma-Tocotrienol 56.40mg
3) d-Delta-Tocotrienol 12.84mg
4) d-Alpha-Tocopherol 45.80IU
5) Plant Squalene 25.64mg
6) Phytosterol Complex 10.24mg
7) Phytocarotenoid Complex 180.00ug
Arm 2: 200mg tocotrienol-rich Vitamin E from palm oil
Dose: 200mg once daily
Duration: 24 weeks
Mode of administration: Oral capsule
Active ingredients:
1) d-Alpha-Tocotrienol 61.52mg
2) d-Gamma-Tocotrienol 112.80mg
3) d-Delta-Tocotrienol 25.68mg
4) d-Alpha-Tocopherol 91.60IU
5) Plant Squalene 51.28mg
6) Phytosterol Complex 20.48mg
7) Phytocarotenoid Complex 360.00ug
Arm 3: Alpha-tocopherol
Dose: 200IU once daily
Duration: 24 weeks
Mode of administration: Oral capsule
Active ingredients: d-Alpha-Tocopherol 200IU
Adherence will be assessed by counting the remaining capsules brought back by the participants during the follow-up visits. In addition, the plasma Vitamin E levels will be measured to assess adherence of the participants.
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Intervention code [1]
318866
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Treatment: Drugs
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Intervention code [2]
318869
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Prevention
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Comparator / control treatment
This is a placebo controlled clinical trial. Each placebo capsule is made up of pure palm oil.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Changes in nerve conduction parameters as assessed by nerve conduction study
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Assessment method [1]
325468
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Timepoint [1]
325468
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Baseline, and 2, 4, 8, 12, and 24 (primary endpoint) weeks post-intervention commencement
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Primary outcome [2]
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Change in kidney function as assessed by serum creatine level
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Assessment method [2]
327606
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Timepoint [2]
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Baseline, and 2, 4, 8, 12, and 24 (primary endpoint) weeks post-intervention commencement
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Primary outcome [3]
327607
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Change in kidney function as assessed by eGFR
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Assessment method [3]
327607
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Timepoint [3]
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Baseline, and 2, 4, 8, 12, and 24 (primary endpoint) weeks post-intervention commencement
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Secondary outcome [1]
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This is a primary outcome:
Changes in retinal microhaemorrhages by means of fundal photography
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Assessment method [1]
388056
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Timepoint [1]
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Baseline, and 2, 4, 8, 12, and 24 (primary endpoint) weeks post-intervention commencement
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Secondary outcome [2]
388057
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This is a primary outcome:
Changes in macular edema by means of fundal photography
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Assessment method [2]
388057
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Timepoint [2]
388057
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Baseline, and 2, 4, 8, 12, and 24 (primary endpoint) weeks post-intervention commencement
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Secondary outcome [3]
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Levels of vitamin E measured using high-performance liquid chromatograph (HPLC)
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Assessment method [3]
395936
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Timepoint [3]
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Baseline, and 2, 4, 8, 12, and 24 (primary endpoint) weeks post-intervention commencement
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Eligibility
Key inclusion criteria
1) Subject, or legal representative, has voluntarily signed and dated an Informed Consent Form.
2) Subject is 30-75 years of age at the initial Screening visit.
3) Subject has type 2 diabetes mellitus (T2DM) with stable glucose control (not more than 10% change in HbA1c levels over the last 2 months) and the HbA1c range should be within 6-9%.
4) If a subject has hypertension, he/she must have a stable blood pressure control for the past 2 months with not more than 10% change and the blood pressure (BP) range should be less than 145/90 mmHg.
5) Subject has at least one of the following symptoms of diabetic peripheral neuropathy:
(a) Reduction in nerve conduction velocity (defined by baseline conduction velocity less than 40m/s)
(b) Reduction in negative to peak (NP) and peak to peak (PP) amplitude
(c) Abnormality found in clinical assessment (Eg: pain, light, touch, temperature, position sense, vibration and reflexes)
6) Subject has either one of the following or both:
(a) Inactive diabetic retinopathy as assessed by retinal photography
(b) Mild to moderate nephropathy which is defined by urine albumin-to-creatinine ratio (UACR) of greater than 20 mg/g or eGFR between 30 to 60 ml/min/bsa (Stage 3 chronic kidney disease (CKD))
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Minimum age
30
Years
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Maximum age
75
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
1) Subject is pregnant during screening OR planning to be pregnant OR not on contraception
2) Subject has urine protein greater than150 g/L during screening
3) Subject has current urinary tract infection during screening (symptomatic or definitively
on urine dipstick: presence of pyuria, nitrites and red blood cells)
4) Subject has known non-diabetic kidney disease, such as kidney stones, etc.
5) Subject has a corrected visual acuity of less than 20/200
6) Subject with eye diseases such as media opacity, amblyopic and glaucoma
7) Subject on anti-epileptic or sedative medications
8) Subject has acute or severe chronic illness such as acute coronary syndrome, active
tuberculosis, and previous or current history of cancer, liver or inflammatory disease,
etc.
9) Subject is taking other water-soluble antioxidants for the past 2 weeks or fat-soluble
antioxidants for the past 1 month
10) Subject is a heavy smoker (equal to 20 sticks/day) or has stopped smoking for less than 1 month
11) Subject has elevated liver enzymes (serum ALT and/or serum AST greater than 3x the upper limit of normal)
12) Subject with severely deranged renal profile. (Stage 5 CKD; eGFR less than or equal to 15 ml/min/bsa)
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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)
Allocation will be concealed by numbered containers.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Stratified allocation will be employed in the study. The participants will be stratified according to their gender, duration of diabetes mellitus and glycemic control as assessed by HbA1c levels. Allocation of subjects will be done by simple randomisation using a randomisation table created by computer software (i.e. computerised sequence).
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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 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/11/2022
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Actual
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Date of last participant enrolment
Anticipated
31/08/2023
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Actual
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Date of last data collection
Anticipated
31/12/2024
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Actual
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Sample size
Target
200
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
23067
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Malaysia
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State/province [1]
23067
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Thomson Hospital, Kota Damansara, Selangor
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Country [2]
23068
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Malaysia
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State/province [2]
23068
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Johor Bahru, Johor
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Funding & Sponsors
Funding source category [1]
307011
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University
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Name [1]
307011
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Monash University Malaysia
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Address [1]
307011
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Jalan Lagoon Selatan,
Bandar Sunway,
47500 Subang Jaya,
Selangor
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Country [1]
307011
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Malaysia
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Funding source category [2]
307028
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Commercial sector/Industry
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Name [2]
307028
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HOVID Berhad
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Address [2]
307028
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121, Jalan Tunku Abdul Rahman,
30010 Ipoh,
Perak
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Country [2]
307028
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Malaysia
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Funding source category [3]
308663
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Government body
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Name [3]
308663
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Malaysian Palm Oil Board (MPOB)
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Address [3]
308663
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No. 6, Persiaran Institusi, Bandar Baru Bangi,
43000 Kajang, Selangor, Malaysia.
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Country [3]
308663
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Malaysia
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Primary sponsor type
University
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Name
Monash University Malaysia
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Address
Jalan Lagoon Selatan,
Bandar Sunway,
47500 Subang Jaya,
Selangor
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Country
Malaysia
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Secondary sponsor category [1]
307579
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Commercial sector/Industry
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Name [1]
307579
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HOVID Berhad
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Address [1]
307579
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121, Jalan Tunku Abdul Rahman,
30010 Ipoh,
Perak
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Country [1]
307579
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Malaysia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
307142
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Monash University Human Research Ethics Committee (MUHREC)
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Ethics committee address [1]
307142
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Monash Research Office, 26 Sports Walk, Monash University, Wellington Road, Clayton VIC 3800
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Ethics committee country [1]
307142
0
Australia
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Date submitted for ethics approval [1]
307142
0
03/01/2018
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Approval date [1]
307142
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12/02/2018
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Ethics approval number [1]
307142
0
12090
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Summary
Brief summary
The overarching aim of the research is to establish the potential mechanisms of action(s) of increasing doses tocotrienol-rich Vitamin E on diabetes and its diabetes microvascular complications, namely nephropathy, retinopathy and neuropathy. In this study, we aim to establish the potential renal-, retinal- and/or neuro-protective role(s) of increasing doses of tocotrienol-rich Vitamin E by measuring the renal, retinal and nerve parameters respectively. In addition, we focus on investigating the mechanisms by which tocotrienol-rich Vitamin E improves nerve function, protects the retina and gives renal protection. We will also look into the superiority of tocotrienol-rich Vitamin E to natural alpha-tocopherol (200IU) in showing beneficial effects on the diabetic complications. This is a prospective, multi-centered, randomized, double-blinded, placebo-controlled study involving patients with type 2 diabetes mellitus with reasonable glycaemic control (HbA1c between 6.0 - 9.0%) and diabetic neuropathy as assessed by nerve conduction study. Subjects in interventional groups will receive one of the following treatments: 100mg of tocotrienol-rich Vitamin E, 200mg of tocotrienol-rich Vitamin E or 200IU of alpha-tocopherol once per day for 24 weeks. The control arm will receive matching placebo once per day for 24 weeks. All study subjects will be followed up at 2, 4, 8, 12, and 24 weeks throughout the double-blinded treatment period. Study subjects will be asked to return 3 months after treatment cessation to monitor for adverse events. The detail timeline of the study will be provided in the relevant section below. The improvement of the microvascular complications will be assessed by respective parameters as follows: (i) Nephropathy: UACR & eGFR (ii) Retinopathy: Intraretinal hemorrhages & macular edema by means of fundal photography (iii) Peripheral Neuropathy: Nerve conduction study parameters
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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
106182
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Prof Khalid Abdul Kadir
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Address
106182
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Monash University Malaysia Clinical Research Centre
No. 20 & 22, Jalan PJS 11/5,
Bandar Sunway,
46150 Petaling Jaya,
Selangor
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Country
106182
0
Malaysia
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Phone
106182
0
+6035519779
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Fax
106182
0
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Email
106182
0
[email protected]
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Contact person for public queries
Name
106183
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Khalid Abdul Kadir
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Address
106183
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Monash University Malaysia Clinical Research Centre
No. 20 & 22, Jalan PJS 11/5,
Bandar Sunway,
46150 Petaling Jaya,
Selangor
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Country
106183
0
Malaysia
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Phone
106183
0
+6035519779
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Fax
106183
0
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Email
106183
0
[email protected]
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Contact person for scientific queries
Name
106184
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Khalid Abdul Kadir
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Address
106184
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Monash University Malaysia Clinical Research Centre
No. 20 & 22, Jalan PJS 11/5,
Bandar Sunway,
46150 Petaling Jaya,
Selangor
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Country
106184
0
Malaysia
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Phone
106184
0
+6035519779
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Fax
106184
0
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Email
106184
0
[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
9511
Study protocol
380781-(Uploaded-22-10-2020-20-40-24)-Study-related document.pdf
9512
Informed consent form
380781-(Uploaded-22-10-2020-14-08-43)-Study-related document.pdf
9513
Ethical approval
The ethics approval has been obtained on the 26th ...
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More Details
]
380781-(Uploaded-15-09-2021-14-20-40)-Study-related document.pdf
9514
Other
Explanatory Statement
380781-(Uploaded-22-10-2020-14-09-02)-Study-related document.pdf
13216
Other
Please find the revised English Explanatory Statem...
[
More Details
]
380781-(Uploaded-15-09-2021-14-28-13)-Study-related document.pdf
13217
Other
Please find the revised Malay Explanatory Statemen...
[
More Details
]
380781-(Uploaded-15-09-2021-14-33-09)-Study-related document.pdf
13218
Other
The amended study protocol which was approved by M...
[
More Details
]
380781-(Uploaded-15-09-2021-14-40-40)-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