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Trial registered on ANZCTR
Registration number
ACTRN12611001270909
Ethics application status
Approved
Date submitted
13/09/2011
Date registered
12/12/2011
Date last updated
12/12/2011
Type of registration
Retrospectively registered
Titles & IDs
Public title
BOTOX for vocal cord dysfunction in severe asthma
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Scientific title
Botulinum Toxin to treat vocal cord dysfunction in severe asthma
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Secondary ID [1]
263028
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Nil
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Universal Trial Number (UTN)
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Trial acronym
VCD BOTOX
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Severe asthma
270755
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Vocal cord Dysfunction
278898
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Condition category
Condition code
Respiratory
270935
270935
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0
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Asthma
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Botulinium Toxin 3 units (1.5 units to each thyro-arytenoid muscle = 0.1ml total volume) will be injected into the thyroarytenoid muscle (vocal cord) localised by using Electromyography.
Percutaneous transcricothyroid injection is the method of injection to be used.
Treatment will occur on one occasion only for the purpose of this study.
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Intervention code [1]
269372
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Treatment: Drugs
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Comparator / control treatment
Placebo - normal saline = 0.1ml total volume, will be injected into the thyroarytenoid muscle (vocal cord) localised by using Electromyography.
Percutaneous transcricothyroid injection is the method of injection to be used.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Primary outcome measure for first hypothesis is RATIO (vocal cord diameter:tracheal diameter) using 320-slice CT scan of the larynx, adjusted for baseline
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Assessment method [1]
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Timepoint [1]
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Measured at 4 weeks
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Primary outcome [2]
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Asthma Control Test (ACT)
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Assessment method [2]
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Timepoint [2]
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performed 4 weekly over 6 months, adjusted for baseline
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Primary outcome [3]
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Pre-bronchodilator FEV1
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Assessment method [3]
279606
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Timepoint [3]
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Performed 4 weekly over 6 months adjusted for baseline
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Secondary outcome [1]
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Changes in BORG score
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Assessment method [1]
294015
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Timepoint [1]
294015
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Assessed weekly for 4 weeks, then monthly to 6 months
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Secondary outcome [2]
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Asthma Control Questionnaire
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Assessment method [2]
294016
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Timepoint [2]
294016
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Assessed weekly for 4 weeks, then monthly to 6 months
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Secondary outcome [3]
294017
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Daily Symptom scores and Peak Flow reading
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Assessment method [3]
294017
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Timepoint [3]
294017
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Performed daily by the patient for 24 weeks
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Secondary outcome [4]
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Changes in FEV1
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Assessment method [4]
294018
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Timepoint [4]
294018
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Assessed weekly for 4 weeks, then monthly to 6 months
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Secondary outcome [5]
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Voice related Quality of Life score (VRQoL)
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Assessment method [5]
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Timepoint [5]
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Assessed weekly for 4 weeks, then monthly to 6 months
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Eligibility
Key inclusion criteria
Asthma confirmed by airway reversibility (FEV1 >12% and 200mls) OR airway hyperreponsiveness;
Subjects with clinical features of severe refractory asthma;
Subjects with well documented requirement for regular treatment with high dose ICS;
Subjects with well documented requirement for controller medication in addition to high dose ICS;
Evidence of optimal medication use;
Sub-optimally controlled asthma, as indicated by ACT score <15;
Post-bronchodilator FEV1 >40% predicted;
VCD demonstrated by 320-slice CT larynx (RATIO below LLN during either inspiration or expiration;
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Minimum age
18
Years
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Maximum age
65
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
Other significant respiratory disorder;
Known vocal cord pathology or diagnosed voice condition other than VCD;
Known brain or brainstem cancer, or head and neck cancer;
Known neurological disorders or neuromuscular disorders;
Pregnancy
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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)
Once patients are successfully screened and eligibility confirmed, they are randomised to receive medication/placebo assigned to the subject from a central computer-based randomisation program.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation to active (BOTOX) or control (saline) intervention will be performed by an unblinded pharmacist, using a computer-based minimisation algoithm (Woolcock Institute of Medical Research), with stratification according to whether the patient has or has not received speech therapy for VCD and FEV1 <80% predicted.
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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
Phase 4
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Type of endpoint/s
Safety/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
1/11/2011
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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
46
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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]
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Self funded/Unfunded
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Name [1]
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
Individual
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Name
Prof Philip Bardin
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Address
Southern Health, Monash Medical Centre, Respiratory and Sleep Medicine
246 Clayton Rd
Clayton
VIC, 3168
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
268862
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Address [1]
268862
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Country [1]
268862
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Southern Health HREC A
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Ethics committee address [1]
271799
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Research Directorate Monash Medical Centre 246 Clayton Rd Clayton, VIC, 3168
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Ethics committee country [1]
271799
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Australia
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Date submitted for ethics approval [1]
271799
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Approval date [1]
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25/05/2011
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Ethics approval number [1]
271799
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11006A
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Summary
Brief summary
Asthma is a common condition and severe and difficult-to-treat in up to 5-20% of patients. Vocal cord dysfunction (VCD) is a disorder characterised by inappropriate closure of the vocal cords during respiration. Numerous asthmatics have VCD co-existing with asthma. Recent studies have detected VCD in as many as 50% of cases with Difficult-To-Treat-Asthma. Botulinium Toxin has been shown to effectively reverse the detrimental effects of VCD. This study looks at two hypotheses: 1. That in patients with VCD and DTTA, botulinium toxin treatment reduces VCD compared with saline control; 2. That in patients with VCD and DTTA, botulinium toxin treatment is associated with improvement in symptom-based, but not physiological, measures of asthma control, compared with saline control.
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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
33145
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Country
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Phone
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Fax
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Email
33145
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Contact person for public queries
Name
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Professor Philip Bardin
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Address
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Monash Medical Centre
Department of Respiratory and Sleep Medicine
246 Clayton Rd
Clayton, VIC, 3168
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Country
16392
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Australia
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Phone
16392
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+61 3 9594 2281
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Fax
16392
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+61 3 9594 7877
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Email
16392
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[email protected]
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Contact person for scientific queries
Name
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Prof Philip Bardin
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Address
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Monash Medical Centre
Department of Respiratory and Sleep Medicine
246 Clayton Rd
Clayton, VIC, 3168
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Country
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Australia
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Phone
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+61 3 9594 2281
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Fax
7320
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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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