Please note that the copy function is not enabled for this field.
If you wish to
modify
existing outcomes, please copy and paste the current outcome text into the Update field.
LOGIN
CREATE ACCOUNT
MY TRIALS
LOGIN
CREATE ACCOUNT
MY TRIALS
REGISTER TRIAL
FAQs
HINTS AND TIPS
DEFINITIONS
Register a trial
The ANZCTR website will be unavailable from 1pm until 3pm (AEDT) on Wednesday the 30th of October for website maintenance. Please be sure to log out of the system in order to avoid any loss of data.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been endorsed by the ANZCTR. Before participating in a study, talk to your health care provider and refer to this
information for consumers
Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT01483560
Registration number
NCT01483560
Ethics application status
Date submitted
23/11/2011
Date registered
1/12/2011
Titles & IDs
Public title
REducing With MetfOrmin Vascular Adverse Lesions in Type 1 Diabetes (REMOVAL)
Query!
Scientific title
Phase 3 Study of Metformin in Adults With Type 1 Diabetes
Query!
Secondary ID [1]
0
0
2011-000300-18
Query!
Secondary ID [2]
0
0
GN10DI406
Query!
Universal Trial Number (UTN)
Query!
Trial acronym
REMOVAL
Query!
Linked study record
Query!
Health condition
Health condition(s) or problem(s) studied:
Diabetes Mellitus, Type 1
0
0
Query!
Condition category
Condition code
Metabolic and Endocrine
0
0
0
0
Query!
Diabetes
Query!
Intervention/exposure
Study type
Interventional
Query!
Description of intervention(s) / exposure
Treatment: Drugs - Metformin
Treatment: Drugs - Placebo
Experimental: Metformin - Oral Metformin (as Glucophage 500mg x 2 bd) titrated from initial 500mg to target 2000mg daily
Placebo comparator: Placebo -
Treatment: Drugs: Metformin
3 years treatment duration
Treatment: Drugs: Placebo
3 years duration
Query!
Intervention code [1]
0
0
Treatment: Drugs
Query!
Comparator / control treatment
Query!
Control group
Query!
Outcomes
Primary outcome [1]
0
0
Change in Averaged Mean Far Wall Common Carotid Artery Intima-media Thickness (cIMT)
Query!
Assessment method [1]
0
0
Progression of averaged mean far wall common carotid artery intima media thickness IMT (mean cIMT) measured using B mode ultrasonography with a 7.0 MHz or higher broadband linear array transducer and concurrent recording of 3-lead electrocardiogram (ECG). Longitudinal images of the common carotid artery will be obtained at anterior, lateral and posterior angles at baseline, 12, 24 and 36 months using Meijer's arc to standardize the transducer angle.
Query!
Timepoint [1]
0
0
0, 12 months, 24 months, 36 months
Query!
Secondary outcome [1]
0
0
Change in HbA1c
Query!
Assessment method [1]
0
0
Measured in accredited local laboratories participating in DCCT-aligned quality control programmes.
Query!
Timepoint [1]
0
0
Baseline, Year 3
Query!
Secondary outcome [2]
0
0
Change in LDL Cholesterol
Query!
Assessment method [2]
0
0
mmol/L Centrally assayed at the University of Glasgow
Query!
Timepoint [2]
0
0
Baseline, Year 3
Query!
Secondary outcome [3]
0
0
Change in Estimated Glomerular Filtration Rate
Query!
Assessment method [3]
0
0
Number of participants developing new microalbuminuria; change in absolute concentration Calculated using the MDRD equation1 based on creatinine measured in accredited local laboratories
Query!
Timepoint [3]
0
0
Baseline, Year 1, Year 2, Year 3
Query!
Secondary outcome [4]
0
0
Number of Participants With Retinopathy and at Least a 2 Stage Progression in Retinopathy From Baseline to 36 Months
Query!
Assessment method [4]
0
0
Two color 45° field retinal photographs (fields 1 and 2) from each eye at 0 and 36 months graded at the University of Wisconsin Ocular Epidemiology Reading Center (OERC) using the modified Airlie House classification scheme and the Early Treatment Diabetic Retinopathy Severity scale.
Query!
Timepoint [4]
0
0
Baseline, Year 3
Query!
Secondary outcome [5]
0
0
Change in Weight
Query!
Assessment method [5]
0
0
Measured at sites using calibrated weighing scales
Query!
Timepoint [5]
0
0
Baseline, Year 1, Year 2, Year 3
Query!
Secondary outcome [6]
0
0
Change in Insulin Dose
Query!
Assessment method [6]
0
0
Units/ kg body weight Extracted by study nurses from the Study Diary and reported on the study CRF using dedicated fields
Query!
Timepoint [6]
0
0
Baseline, Year 1, Year 2, Year 3
Query!
Secondary outcome [7]
0
0
Change in Endothelial Function
Query!
Assessment method [7]
0
0
In some centres (Arbitrary units) Reactive Hyperaemia Index using the ENDOPAT device (Itamar, Israel)
Query!
Timepoint [7]
0
0
Baseline, Year 1, Year 3
Query!
Eligibility
Key inclusion criteria
* Type 1 Diabetes for five years or more*
* Age 40 years or above
* 7.0 =< HbA1c <10.0% (53 - 86 mmol/mol)
AND 3 or more of the following ten CardioVascular Disease (CVD) risk factors:
* BMI >27 kg/m^2
* Current HbA1c >8.0% (64 mmol/mol)
* Known CVD/peripheral vascular disease
* Current smoker
* Estimated glomerular filtration rate (eGFR) <90 ml/min per 1.73 m^3
* Confirmed micro- or macroalbuminuria [according to local assays and reference ranges]
* Hypertension (BP >=140/90 millimeters of mercury (mmHg) or established on antihypertensive treatment)
* Dyslipidaemia [total cholesterol >=5.0 mmol/L (200 mg/dL);OR HDL cholesterol <1.20 mmol/L (46mg/dL) [MEN]; OR <1.30 mmol/L (50 mg/dL) [WOMEN]; or triglycerides >=1.7 mmol/L (150mg/dL); or established on lipid-lowering treatment)]
* Strong family history of CVD (at least one parent, biological aunt/ uncle, or sibling with myocardial infarction or stroke aged <60 years)
* Duration of diabetes > 20 years
Query!
Minimum age
40
Years
Query!
Query!
Maximum age
No limit
Query!
Query!
Sex
Both males and females
Query!
Can healthy volunteers participate?
No
Query!
Key exclusion criteria
* eGFR < 45 ml/min/1.73m2
* woman of childbearing age not on effective contraception
* Pregnancy and/or lactation
* Acute coronary syndrome or Stroke/Transient Ischaemic Attack within the last three months
* NYHA stage 3 or 4 heart failure
* Significant hypoglycaemia unawareness
* Impaired cognitive function/ unable to give informed consent
* Previous carotid surgery/ inability to capture adequate carotid images
* Estimated glomerular filtration < 45ml/min/1.73m^2 (MDRD)
* Gastroparesis
* History of lactic acidosis
* Other contraindications to metformin (hepatic impairment, known hypersensitivity to metformin, acute illness such as dehydration, severe infection, shock, acute cardiac failure or suspected tissue hypoxia)
* Any coexistent life threatening condition including prior diagnosis of cancer within two years
* History of alcohol problem or drug abuse
Query!
Study design
Purpose of the study
Treatment
Query!
Allocation to intervention
Randomised controlled trial
Query!
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Query!
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Query!
Masking / blinding
Blinded (masking used)
Query!
Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people analysing the results/data
Query!
Query!
Query!
Query!
Intervention assignment
Parallel
Query!
Other design features
Query!
Phase
Phase 3
Query!
Type of endpoint/s
Query!
Statistical methods / analysis
Query!
Recruitment
Recruitment status
Completed
Query!
Data analysis
Query!
Reason for early stopping/withdrawal
Query!
Other reasons
Query!
Date of first participant enrolment
Anticipated
Query!
Actual
1/12/2011
Query!
Date of last participant enrolment
Anticipated
Query!
Actual
Query!
Date of last data collection
Anticipated
Query!
Actual
18/04/2017
Query!
Sample size
Target
Query!
Accrual to date
Query!
Final
493
Query!
Recruitment in Australia
Recruitment state(s)
Query!
Recruitment hospital [1]
0
0
Royal Melbourne Hospital - Melbourne
Query!
Recruitment hospital [2]
0
0
St Vincent's Hospital - Melbourne
Query!
Recruitment hospital [3]
0
0
Royal Prince Albert Hospital - Sydney
Query!
Recruitment postcode(s) [1]
0
0
- Melbourne
Query!
Recruitment postcode(s) [2]
0
0
- Sydney
Query!
Recruitment outside Australia
Country [1]
0
0
Canada
Query!
State/province [1]
0
0
Ontario
Query!
Country [2]
0
0
Canada
Query!
State/province [2]
0
0
Ottawa
Query!
Country [3]
0
0
Denmark
Query!
State/province [3]
0
0
Gentofte
Query!
Country [4]
0
0
Netherlands
Query!
State/province [4]
0
0
Maastricht
Query!
Country [5]
0
0
United Kingdom
Query!
State/province [5]
0
0
Aberdeen
Query!
Country [6]
0
0
United Kingdom
Query!
State/province [6]
0
0
Ayr
Query!
Country [7]
0
0
United Kingdom
Query!
State/province [7]
0
0
Bristol
Query!
Country [8]
0
0
United Kingdom
Query!
State/province [8]
0
0
Dundee
Query!
Country [9]
0
0
United Kingdom
Query!
State/province [9]
0
0
Durham
Query!
Country [10]
0
0
United Kingdom
Query!
State/province [10]
0
0
Edinburgh
Query!
Country [11]
0
0
United Kingdom
Query!
State/province [11]
0
0
Exeter
Query!
Country [12]
0
0
United Kingdom
Query!
State/province [12]
0
0
Glasgow
Query!
Country [13]
0
0
United Kingdom
Query!
State/province [13]
0
0
Gloucester
Query!
Country [14]
0
0
United Kingdom
Query!
State/province [14]
0
0
Hull
Query!
Country [15]
0
0
United Kingdom
Query!
State/province [15]
0
0
Liverpool
Query!
Country [16]
0
0
United Kingdom
Query!
State/province [16]
0
0
London
Query!
Country [17]
0
0
United Kingdom
Query!
State/province [17]
0
0
Manchester
Query!
Country [18]
0
0
United Kingdom
Query!
State/province [18]
0
0
Newcastle
Query!
Country [19]
0
0
United Kingdom
Query!
State/province [19]
0
0
Plymouth
Query!
Country [20]
0
0
United Kingdom
Query!
State/province [20]
0
0
Salford
Query!
Funding & Sponsors
Primary sponsor type
Other
Query!
Name
University of Glasgow
Query!
Address
Query!
Country
Query!
Other collaborator category [1]
0
0
Other
Query!
Name [1]
0
0
NHS Greater Glasgow and Clyde
Query!
Address [1]
0
0
Query!
Country [1]
0
0
Query!
Other collaborator category [2]
0
0
Other
Query!
Name [2]
0
0
Juvenile Diabetes Research Foundation
Query!
Address [2]
0
0
Query!
Country [2]
0
0
Query!
Other collaborator category [3]
0
0
Other
Query!
Name [3]
0
0
Imperial College London
Query!
Address [3]
0
0
Query!
Country [3]
0
0
Query!
Other collaborator category [4]
0
0
Other
Query!
Name [4]
0
0
University of Wisconsin, Madison
Query!
Address [4]
0
0
Query!
Country [4]
0
0
Query!
Other collaborator category [5]
0
0
Other
Query!
Name [5]
0
0
University of Dundee
Query!
Address [5]
0
0
Query!
Country [5]
0
0
Query!
Other collaborator category [6]
0
0
Commercial sector/industry
Query!
Name [6]
0
0
Merck Serono S.A., Geneva
Query!
Address [6]
0
0
Query!
Country [6]
0
0
Query!
Other collaborator category [7]
0
0
Commercial sector/industry
Query!
Name [7]
0
0
Itamar-Medical, Israel
Query!
Address [7]
0
0
Query!
Country [7]
0
0
Query!
Other collaborator category [8]
0
0
Other
Query!
Name [8]
0
0
University of Western Ontario, Canada
Query!
Address [8]
0
0
Query!
Country [8]
0
0
Query!
Other collaborator category [9]
0
0
Other
Query!
Name [9]
0
0
University of Melbourne
Query!
Address [9]
0
0
Query!
Country [9]
0
0
Query!
Other collaborator category [10]
0
0
Other
Query!
Name [10]
0
0
Steno Diabetes Center Copenhagen
Query!
Address [10]
0
0
Query!
Country [10]
0
0
Query!
Other collaborator category [11]
0
0
Other
Query!
Name [11]
0
0
Maastricht University Medical Center
Query!
Address [11]
0
0
Query!
Country [11]
0
0
Query!
Ethics approval
Ethics application status
Query!
Summary
Brief summary
The trial is conducted in the United Kingdom (UK), Australia, Canada, Denmark and the Netherlands. The aim is to test whether 3 years treatment with metformin added to titrated insulin therapy (towards target HbA1c 7.0%/53 mmol/mol) reduces atherosclerosis, as measured by progression of carotid intima-media thickness (cIMT), in adults with confirmed type 1 diabetes aged 40 years and over at increased risk for cardiovascular disease.
Query!
Trial website
https://clinicaltrials.gov/study/NCT01483560
Query!
Trial related presentations / publications
Petrie JR, Chaturvedi N, Ford I, Brouwers MCGJ, Greenlaw N, Tillin T, Hramiak I, Hughes AD, Jenkins AJ, Klein BEK, Klein R, Ooi TC, Rossing P, Stehouwer CDA, Sattar N, Colhoun HM; REMOVAL Study Group. Cardiovascular and metabolic effects of metformin in patients with type 1 diabetes (REMOVAL): a double-blind, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol. 2017 Aug;5(8):597-609. doi: 10.1016/S2213-8587(17)30194-8. Epub 2017 Jun 11. Erratum In: Lancet Diabetes Endocrinol. 2017 Aug;5(8):e5. doi: 10.1016/S2213-8587(17)30229-2. Lancet Diabetes Endocrinol. 2017 Nov;5(11):e7. doi: 10.1016/S2213-8587(17)30340-6.
Query!
Public notes
Query!
Contacts
Principal investigator
Name
0
0
John Petrie, Prof
Query!
Address
0
0
University of Glasgow
Query!
Country
0
0
Query!
Phone
0
0
Query!
Fax
0
0
Query!
Email
0
0
Query!
Contact person for public queries
Name
0
0
Query!
Address
0
0
Query!
Country
0
0
Query!
Phone
0
0
Query!
Fax
0
0
Query!
Email
0
0
Query!
Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
Yes
Query!
What data in particular will be shared?
Site specific participant data will be made available to the site PIs later in 2017, after the main publications.
Query!
When will data be available (start and end dates)?
Query!
Available to whom?
Query!
Available for what types of analyses?
Query!
How or where can data be obtained?
Query!
What supporting documents are/will be available?
No Supporting Document Provided
Type
Other Details
Attachment
Study protocol
https://cdn.clinicaltrials.gov/large-docs/60/NCT01483560/Prot_000.pdf
Statistical analysis plan
https://cdn.clinicaltrials.gov/large-docs/60/NCT01483560/SAP_001.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT01483560