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Trial registered on ANZCTR
Registration number
ACTRN12605000244606
Ethics application status
Approved
Date submitted
22/08/2005
Date registered
31/08/2005
Date last updated
18/05/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
Open Label Extension of a Clinical Trial of Intravitreal Triamcinolone for Diabetic Macular Oedema (TDMX study)
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Scientific title
An open Label Extension of the phase II/III clinical trial of intravitreal triamcinolone on the effects and safety of clinically significant diabetic macular oedema that persists after laser treatment
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Universal Trial Number (UTN)
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Trial acronym
TDMX study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Diabetic Macular Oedema
331
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Condition category
Condition code
Metabolic and Endocrine
380
380
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Diabetes
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Eye
381
381
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0
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Diseases / disorders of the eye
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Results from our own randomised clinical trial, combined with anecdotal reports from other groups, suggests that intravitreal triamcinolone safely improves vision and reduces swelling for up to 2 years in most eyes with diabetic macular oedema which persists or recurs despite laser treatment. There are no data on longer term efficacy and safety. We will conduct an open-label extension of a prospective, single centre, double-masked, placebo-controlled clinical trial of IVTA for diabetic macular oedema that persists or recurs after laser treatment. Sixty four of the originally enrolled 69 (93%) eyes are available to be followed. Triamcinolone (0.1 ml Kenacort 40, 40mg/ml triamcinolone acetate, Bristol-Myers Squibb pharmaceuticals, Australia) will be injected into the vitreous in eyes which have persistent macular oedema (>250 micron) AND visual acuity of 6/9 or worse. Treatment will be withheld at the investigator’s discretion if 2 previous injections have failed to significantly (50 micron) reduce macular oedema. The duration of the patient follow-up is 3 years and the duration of the entire study is 4 years.
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Intervention code [1]
225
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Treatment: Drugs
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Comparator / control treatment
Placebo
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Increase of >=5 letters at the 5-year study visit on a LogMAR chart compared with (a) the initial baseline level and (b) the level at the 2-year study visit.
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Assessment method [1]
438
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Timepoint [1]
438
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At baseline, 2 years and 5 years.
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Primary outcome [2]
439
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Incidence of moderate or severe adverse events over the 3 years of the open-label extension
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Assessment method [2]
439
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Timepoint [2]
439
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at baseline, 2 years and 5 years
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Secondary outcome [1]
967
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Change in macular thickness by OCT.
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Assessment method [1]
967
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Timepoint [1]
967
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up to 5 years follow up
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Secondary outcome [2]
968
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Any change in visual acuity.
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Assessment method [2]
968
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Timepoint [2]
968
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up to 5 years follow up
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Secondary outcome [3]
969
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Number of laser treatments required.
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Assessment method [3]
969
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Timepoint [3]
969
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up to 5 years follow up
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Eligibility
Key inclusion criteria
All patients at the conclusion of the TDMO study. Currently we are still following 64 of the 69 (93%) eyes that were initially entered into the TDMO study that had reduced vision from diabetic macular oedema at baseline.
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Minimum age
Not stated
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Maximum age
Not stated
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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
Uncontrolled glaucoma; Loss of vision due to other causes (e.g. age related macular degeneration, myopic macular degeneration);known allergies to triamcinolone acetate; patient is already receiving systemic steroid treatment; intercurrent severe disease such as septicemia; any condition which would affect follow-up or photographic documentation (e.g. geographical, psycho-social, media opacities).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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
Single group
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Other design features
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Phase
Phase 2 / Phase 3
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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
11/04/2005
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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
64
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Funding & Sponsors
Funding source category [1]
435
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Government body
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Name [1]
435
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Applied for NHMRC project grant 2006 (#402573)
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Address [1]
435
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Australia
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Country [1]
435
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Australia
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Funding source category [2]
4974
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Government body
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Name [2]
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NHMRC project grant 402573
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Address [2]
4974
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Australia
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Country [2]
4974
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Australia
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Primary sponsor type
Individual
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Name
Professor Mark Gillies
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Address
Save Sight Institute
Department of Clinical Ophthalmology and Eye Health
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Country
Australia
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Secondary sponsor category [1]
353
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None
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Name [1]
353
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No
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Address [1]
353
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Country [1]
353
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
1404
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SESIAHS Northern Network Human Research Ethics Committee
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Ethics committee address [1]
1404
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NSW Australia
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Ethics committee country [1]
1404
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Australia
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Date submitted for ethics approval [1]
1404
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Approval date [1]
1404
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01/10/2004
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Ethics approval number [1]
1404
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05/272
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Summary
Brief summary
We will conduct an open-label extension of a prospective, single centre, double-masked, placebo-controlled clinical trial of IVTA for diabetic macular oedema that persists or recurs after laser treatment. Sixty four of the originally enrolled 69 (93%) eyes are available to be followed. The primary outcome measures will be an increase of =5 letters at the 5-year study visit on a LogMAR chart compared with (a) the initial baseline level and (b) the level at the 2-year study visit. The incidence of moderate or severe adverse events over the 3 years of the open-label extension will also be a primary outcome. Secondary outcomes will include change in macular thickness by OCT, any change in visual acuity and number of laser treatments required. Standardised protocols have been developed for intravitreal injection, macular laser treatment, refraction and measurement of visual acuity. Treatment with triamcinolone will be offered to all patients, whether they previously received placebo or active treatment, on exit from the TDMO study. IVTA will be administered in the clinic under local anaesthesia. Treatments will be given at least 6 months apart according to prospectively identified criteria that take into account the previous and current visual acuity and macular thickness measured by OCT. The safety data will be monitored 6 monthly by an independent Safety Monitoring Committee.
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Trial website
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Trial related presentations / publications
1. Larsson J, Kifley A, ZhuM, Want JJ, Mitchell P, Sutter FKP, Gillies MC. Rapid reduction of hard exudates in eyes with diabetic retinopathy after intravitreal triamcinolone - Data from a randomized, placebo controlled clinical trial. Acta Ophthalmologica in press, acceptance date: Feb 4 2008 (IF:1.458) 2. Gillies MC, Islam FM, Zhu M, Larsson J, Wong TY. Efficacy and safety of multiple intravitreal triamcinolone injections for refractory diabetic macular oedema. Br J Ophthalmol. 2007; 91:1323-6. (IF:2.524) 3. Gillies MC, Sutter FK, Simpson JM, Larsson J, Ali H, Zhu M. Intravitreal triamcinolone for refractory diabetic macular oedema: two-year results of a double-masked, placebo-controlled, randomized clinical trial. Ophthalmology. 2006;113:1533-8. (IF:4.031) 4. Gillies MC, Simpson JM, Gaston C, Hunt G, Ali H, Zhu M, Sutter FKP. 5-year results of a randomized clinical trial with open label extension of intravitreal triamcinolone for refractory diabetic macular edema. Ophthalmology, In Press accepted 16.1.09.
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Public notes
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Contacts
Principal investigator
Name
35885
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Address
35885
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Country
35885
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Phone
35885
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Fax
35885
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Email
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Contact person for public queries
Name
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Dr Christine Gaston
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Address
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Save Sight Institute
Department of Clinical Ophthalmology and Eye Health
University of Sydney
Sydney/Sydney Eye Hospital Campus
GPO Box 4337
NSW 2001
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Country
9414
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Australia
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Phone
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+61 2 93827309
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Fax
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+61 2 93827318
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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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Professor Mark Gillies
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Address
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Save Sight Institute
Department of Clinical Ophthalmology and Eye Health
University of Sydney
Sydney/Sydney Eye Hospital Campus
GPO Box 4337
NSW 2001
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Country
342
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Australia
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Phone
342
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+61 2 93827309
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Fax
342
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+61 2 93827318
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Email
342
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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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