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Trial registered on ANZCTR
Registration number
ACTRN12622000914763
Ethics application status
Approved
Date submitted
19/06/2022
Date registered
27/06/2022
Date last updated
19/10/2023
Date data sharing statement initially provided
27/06/2022
Type of registration
Prospectively registered
Titles & IDs
Public title
Orally Administered Faecal Microbial Transplantation in the Management of Immune Checkpoint Inhibitor Associated Colitis
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Scientific title
Orally Administered Faecal Microbial Transplantation in the Management of Immune Checkpoint Inhibitor Associated Colitis - A randomised control trial to assess safety and preliminary efficacy
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Secondary ID [1]
307386
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None
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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:
Immune Checkpoint inhibitor Colitis
326698
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Condition category
Condition code
Cancer
323945
323945
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0
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Other cancer types
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Orally administered encapsulated lyophilised faecal microbiota transplantation(FMT) administered daily over a period of 7 days. Given the nature of FMT, the "dose" of FMT will vary.
Participants will be contacted throughout the trial period to check compliance and for further reminders and arranged unused product return.
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Intervention code [1]
323821
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Treatment: Other
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Comparator / control treatment
Placebo capsules will consist of microcrystalline cellulose which is encapsulated, in line with the encapsulation process used for the active FMT treatment
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Control group
Placebo
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Outcomes
Primary outcome [1]
331744
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Percentage of patients in clinical remission as determined by stool count. through a patient diary
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Assessment method [1]
331744
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Timepoint [1]
331744
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1 week following commencement of FMT or placebo
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Secondary outcome [1]
410977
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Percentage of patients in clinical remission as determined by the stool count through a patient diary
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Assessment method [1]
410977
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Timepoint [1]
410977
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Week 2, 4, 8 and 12 following commencement of FMT or placebo
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Secondary outcome [2]
410978
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Percentage of patients in clinical response as determined by the stool count through a patient diary
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Assessment method [2]
410978
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Timepoint [2]
410978
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Week 1,2,4,8 and 12 following commencement of FMT or placebo
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Secondary outcome [3]
410979
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Percentage of patients on corticosteroids assessed through a study-specific questionnaire and medical records
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Assessment method [3]
410979
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Timepoint [3]
410979
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Week 2,4,6 and 12 following commencement of FMT or placebo
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Secondary outcome [4]
410980
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Median duration of corticosteroids assessed through a study-specific questionnaire and medical records
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Assessment method [4]
410980
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Timepoint [4]
410980
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Week 12 following commencement of FMT or placebo
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Secondary outcome [5]
410981
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Cumulative dose of corticosteroids assessed through a study-specific questionnaire and medical records
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Assessment method [5]
410981
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Timepoint [5]
410981
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Week 12 following commencement of FMT or placebo
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Secondary outcome [6]
410982
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Percentage of patients able to recommence immunotherapy assessed through a study-specific questionnaire and medical records
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Assessment method [6]
410982
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Timepoint [6]
410982
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Week 12 following commencement of FMT or placebo
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Secondary outcome [7]
410983
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Change in disease activity determined by blood and stool biomarkers (C-reactive protein, faecal calprotectin)
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Assessment method [7]
410983
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Timepoint [7]
410983
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Week 1, 2,4,8 and 12 following commencement of FMT or placebo
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Secondary outcome [8]
410984
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Rates of adverse events assessed through study-specific questionnaire, clinical examination and medical records.. Examples of possilbe adverse events include gastrointestinal upset, worsening colitis, transient fevers and very low risk of transmissible infection,
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Assessment method [8]
410984
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Timepoint [8]
410984
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Week 1,2,4,8 and 12 following commencement of FMT or placebo
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Secondary outcome [9]
410985
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Change in patient reported outcomes assessed using PRO-2 score through a study-specific questionnaire
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Assessment method [9]
410985
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Timepoint [9]
410985
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Week 1,2,4,8 and 12 following commencement of FMT or placebo
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Eligibility
Key inclusion criteria
• Grade 2 or more diarrhoea (greater than 4 bowel actions more than baseline)
• Last dose of checkpoint inhibitor within 4 months of symptom onset
Either
• No response to oral glucocorticoids
OR
• Steroid intolerant
OR
• Recurrence of symptoms during or following corticosteroid wean
Or
• Recurrent episode of immune checkpoint inhibitor colitis.
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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
-Infective colitis
-Inflammatory bowel disease
-Previous colectomy
-Significant medical comorbidity
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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)
Through central randomisation by computer generated list.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Pre-established computer generated randomisation list.
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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
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
Based on previous studies using FMT in the treatment of ICI colitis and allowing for 10% drop out,s ample size calculated as 46 patients across FMT and placebo groups
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/12/2022
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Actual
11/09/2023
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Date of last participant enrolment
Anticipated
1/06/2024
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Actual
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Date of last data collection
Anticipated
1/09/2024
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Actual
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Sample size
Target
46
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Accrual to date
2
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
22587
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St Vincent's Hospital (Darlinghurst) - Darlinghurst
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Recruitment postcode(s) [1]
37841
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2010 - Darlinghurst
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Funding & Sponsors
Funding source category [1]
311663
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Hospital
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Name [1]
311663
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St Vincent's Hospital Sydney
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Address [1]
311663
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390 Victoria St, Darlinghurst, NSW, 2010
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Country [1]
311663
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Australia
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Primary sponsor type
Hospital
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Name
St Vincent's Hospital Sydney
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Address
390 Victoria St, Darlinghurst, NSW, 2010
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Country
Australia
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Secondary sponsor category [1]
313115
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None
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Name [1]
313115
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Address [1]
313115
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Country [1]
313115
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
311120
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St Vincent's Hospital HREC
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Ethics committee address [1]
311120
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St Vincent’s Hospital Translational 97-105 Boundary Street Darlinghurst NSW 2010
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Ethics committee country [1]
311120
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Australia
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Date submitted for ethics approval [1]
311120
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09/06/2022
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Approval date [1]
311120
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20/07/2022
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Ethics approval number [1]
311120
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Summary
Brief summary
Cancer immunotherapy with immune checkpoint inhibitors (ICI) have revolutionised the treatment and outcomes for multiple cancers in the past 10 years leading to sustained remission and cure in some patients even when diagnosed with advanced disease. However, immune mediated side effects are common including diarrhoea and colitis which can affect up to 40% of patients who take ICI's. This study aims to assess whether a short course (7 days) of oral treatment with faecal microbiota transplantation (FMT) therapy has any impact upon ICI colitis symptoms in patients who are affected by this. Who is it for? You may be eligible for this study if you are an adult aged 18 years or older, you have experienced diarrhoea from your ICI and your last dose was within 4 months of symptom onset. Participants who are steroid intolerant, have had no response to oral glucocorticoids, have had recurrence of symptoms during or following corticosteroid wean or have had recurrent episodes of immune checkpoint inhibitor colitis will be considered for inclusion. Study details All participants who choose to enrol in this study will be randomly allocated by chance (similar to flipping a coin) to either the FMT group or a placebo group. Both groups will be asked to take FMT capsules each day for 7 days, and to keep a diary of their bowel movements for up to 12 weeks after enrolling in the study. Participants will also be asked to provide stool and blood samples throughout the study and may also require a colonoscopy. The overall participation will be 12 weeks. It is hoped this research will demonstrate that it is safe and effective to use orally administered FMT to treat ICI colitis in cancer patients who have been taking immune checkpoint inhibitors. If FMT is successful, this may lead to a reduction in overall corticosteroid use, hospitalisation and an early resumption of their cancer immunotherapy for affected patients.
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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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Dr Craig Haifer
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Address
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Gastroenterology Department,
St Vincent's Hospital
390 Victoria St
Darlinghurst, NSW, 2010
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Country
120006
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Australia
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Phone
120006
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+61 2 83822061
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Fax
120006
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Email
120006
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[email protected]
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Contact person for public queries
Name
120007
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Craig Haifer
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Address
120007
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Gastroenterology Department,
St Vincent's Hospital
390 Victoria St
Darlinghurst, NSW, 2010
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Country
120007
0
Australia
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Phone
120007
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+61 2 83822061
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Fax
120007
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Email
120007
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[email protected]
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Contact person for scientific queries
Name
120008
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Craig Haifer
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Address
120008
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Gastroenterology Department,
St Vincent's Hospital
390 Victoria St
Darlinghurst, NSW, 2010
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Country
120008
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Australia
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Phone
120008
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+61283822061
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Fax
120008
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Email
120008
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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
Data will be analysed as a group
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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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