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Trial registered on ANZCTR
Registration number
ACTRN12608000567325
Ethics application status
Approved
Date submitted
28/10/2008
Date registered
12/11/2008
Date last updated
12/11/2008
Type of registration
Retrospectively registered
Titles & IDs
Public title
Management of subclinical Cushing's syndrome in adrenal incidentalomas
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Scientific title
Surgical versus conservative management for subclinical Cushing's syndrome in adrenal incidentalomas.
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Universal Trial Number (UTN)
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Trial acronym
No acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Subclinical Cushing's syndrome in adrenal incidentalomas
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Condition category
Condition code
Metabolic and Endocrine
4092
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0
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Metabolic disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Laparoscopic adrenal surgery. This involves the removal of the adrenal gland by laparoscopic instruments via a transperitoneal lateral approach. This is the only surgical procedure we perform in this trial
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Intervention code [1]
3619
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Treatment: Surgery
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Comparator / control treatment
The participants in the control group have subclinical Cushing's syndrome in adrenal incidentalomas and they continue to receive conservative treatment for this condition. At the entry in the study, all patients in the conservarive group are in medical treatment that is different for each clinical disease. Patients with subclinical Cushing's syndrome presenting diabetes mellitus are in antidiabetic medication (oral antidiabetic medication or insulin) and they continue to have their therapy; patients with subclinical Cushing's syndrome presenting arterial hypertension are in antihypertensive treatment and they continue to have their therapy;patients with subclinical Cushing's syndrome presenting hypertriglyceridemia are in statin therapy and they continue to have their therapy. The study will continue enough to have a mean follow-up of 7 years for each enrolled patient.
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Control group
Active
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Outcomes
Primary outcome [1]
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Clinical outcome of subclinical Cushing's syndrome patients who underwent adrenalectomy versus those managed conservatively measured with laboratory test and clinical parameters.
Diabetes mellitus is measured with plasma concentration of fasting glucose (normal, < 110 mg/dL); arterial hypertension with systolic and diastolic values of blood pressure (normal, systolic < 150 mmHg; diastolic < 90 mmHg); obesity with body mass index (BMI) calculated as weight in kilograms divided per height in meter squared; osteoporosis by measuring the bone mineral density (BMD), i.e. the amount of calcium in bone regions, evaluated by dual energy x-ray absorptiometry (DEXA).
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Assessment method [1]
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Timepoint [1]
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All participants in the surgical group are assessed 6 and 12 months after surgery and then yearly by two experienced endocrinologists to monitor any improvements in clinical symptoms, laboratory findings and comorbidities.
All participants in the control group are assessed yearly during the follow-up period by two experienced endocrinologists to monitor any improvements in clinical symptoms, laboratory findings and comorbidities.
The study will continue enough to have a mean follow-up of 7 years for each enrolled patient.
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Secondary outcome [1]
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Perioperative death
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Assessment method [1]
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Timepoint [1]
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Death within 30 days after surgery
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Eligibility
Key inclusion criteria
No clinical signs of cortisol excess and failure to suppress serum cortisol using the dexamathasone test
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Minimum age
No limit
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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
Adrenal mass > 3.5 cm in diameter
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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 envelopes
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Patients were assigned to surgical or observation by sequentially following a list of randomly generated binary digits by a computer program
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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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
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/05/1991
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
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Italy
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State/province [1]
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Country [2]
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Italy
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State/province [2]
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Padova
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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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Antonio Toniato, MD
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Address [1]
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Via N. Giustiniani, 2
Padova
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Country [1]
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Italy
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Primary sponsor type
Individual
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Name
Antonio Toniato, M.D.
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Address
Via N. Giustiniani, 2
Padova
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Country
Italy
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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]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Ethics Committee of the University of Padua, School of Medicine
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Ethics committee address [1]
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Via N. Giustiniani,2 Padova
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Ethics committee country [1]
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Italy
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Date submitted for ethics approval [1]
6157
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Approval date [1]
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12/02/1991
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Ethics approval number [1]
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91/562
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Summary
Brief summary
We compared the clinical outcome of patients with subclinical Cushing’s syndrome due to an adrenal incidentaloma randomly assigned to undergo surgery (n = 23) or close follow-up (n = 22). Laparoscopic adrenalectomy was more beneficial than conservative management for subclinical Cushing’s syndrome patients complying with our selection criteria.
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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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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Antonio Toniato, M.D.
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Address
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Via N. Giustiniani,2
Padova
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Country
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Italy
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Phone
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39.049.8212258
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Antonio Toniato, M.D.
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Address
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Via N. Giustiniani,2
Padova
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Country
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Italy
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Phone
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39.049.8212258
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Fax
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Email
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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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