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Trial registered on ANZCTR
Registration number
ACTRN12612000206820
Ethics application status
Approved
Date submitted
5/02/2012
Date registered
20/02/2012
Date last updated
27/07/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
ROBUST- Reduction Of exacerbations in Bronchiectasis USing Tiotropium
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Scientific title
A multi-centre, double-blind, randomised, placebo-controlled crossover study of tiotropium treatment in adult patients with stable, non-cystic fibrosis bronchiectasis
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Secondary ID [1]
279876
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None
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Universal Trial Number (UTN)
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Trial acronym
ROBUST- Reduction Of exacerbations in Bronchiectasis USing Tiotropium
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Non-cystic Bronchiectasis
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Condition category
Condition code
Respiratory
285958
285958
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0
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Other respiratory disorders / diseases
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Inhaled Tiotropium or placebo 18 microgram daily for 6 months with a washout period of 4 weeks then crossover to the opposite arm of treatment for another 6 months.
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Intervention code [1]
284200
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Treatment: Drugs
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Comparator / control treatment
Placebo will be manufactured identical to tiotropium but without the active ingredients.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Event-based exacerbation frequency- ascertained using data from the daily diary card kept by participants and clinical assessment during follow up visits.
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Assessment method [1]
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Timepoint [1]
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week 0-26 ; week 30 to 54
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Secondary outcome [1]
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Symptom-based exacerbation frequency - ascertained using data from the daily diary card kept by participants and clinical assessment during follow up visits.
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Assessment method [1]
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Timepoint [1]
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week 0-26 ; week 30 to 54
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Secondary outcome [2]
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Time to first exacerbation - ascertained using data from the daily diary card kept by participants and clinical assessment during follow up visits.
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Assessment method [2]
295903
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Timepoint [2]
295903
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week 0-26 ; week 30 to 54
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Secondary outcome [3]
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Health-related quality of life measured by changes in health questionnaires
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Assessment method [3]
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Timepoint [3]
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At week "0", "26", "30" and "56"
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Secondary outcome [4]
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Change in Forced vital capacity (FVC) - measured by performing forced spirometry at protocol required follow up visits.
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Assessment method [4]
295905
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Timepoint [4]
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At screening, week"0", "4", "13", "26", "30", "34", "43" and "56"
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Secondary outcome [5]
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Change in Exercise capacity measured by 6 minutes walk test
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Assessment method [5]
295906
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Timepoint [5]
295906
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At screening, week "0", "26", "30" and "56"
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Secondary outcome [6]
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Change in markers of airway inflammation - by comparing sputum analysis results on sputum samples collected at baseline and end of treatment for each treatment period.
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Assessment method [6]
295907
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Timepoint [6]
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At screening, week"26", "30" and "56"
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Secondary outcome [7]
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Cost and cost effectiveness of tiotropium treatment - cost analysis from participants daily diary card recording visits to General Practitioners or other Health providers.
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Assessment method [7]
295908
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Timepoint [7]
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At week"0", "4", "13", "26", "30", "34", "43" and "56"
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Secondary outcome [8]
295909
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Adverse events such as dry mouth, dry skin, blurred vision and difficulty in passing urine will be assessed at every follow up clinic visits.
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Assessment method [8]
295909
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Timepoint [8]
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At week"0", "4", "13", "26", "30", "34", "43" and "56"
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Secondary outcome [9]
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Airway function measured by FEV1 changes
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Assessment method [9]
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Timepoint [9]
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At screening, week"0", "4", "13", "26", "30", "34", "43" and "56"
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Eligibility
Key inclusion criteria
- adult patients
- able to provide written informed consent
- confirmed diagnosis of bronchiectasis by high resolution CT scan
- FEV1/FVC ratio < 70%
- History of at least one pulmonary exacerbation requiring antibiotic treatment in the past 12 months
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Minimum age
18
Years
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Maximum age
80
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
Smoking history of > 20 pack years
Primary diagnosis of asthma defined as 1 or more admissions to hospital in the past year with a primary discharge diagnosis of asthma or a history of more courses of oral steroids than antibiotics in the past year
Continuous antibiotic therapy
Known adverse reaction to tiotropium
Cystic fibrosis
Hypogammaglobulinaemia
Allergic BronchoPulmonary Aspergillosis
History of non-tuberculous mycobacterial infection (treated or untreated)
Bronchiectasis exacerbation or respiratory infection requiring oral or intravenous antibiotic within 6 weeks before randomisation
Use of oral corticosteroid medication at unstable doses (i.e. less than six weeks on a stable dose) or at doses more than or equal to 10 mg/day
Unstable or life threatening cardiac arrhythmia or cardiac arrhythmia requiring intervention or a change in drug therapy within the past year
Any other serious co-existing illness that precludes patients from the study
Narrow-angle glaucoma
Symptomatic prostatic hyperplasia or bladder-neck obstruction (patients whose symptoms are controlled on treatment may be included)
Inability to complete HRQL questionnaires
Female patients who are pregnant or breast feeding
Known non-compliance with medications and follow ups
Patients taking tiotropium (can be included if they are willing to withhold tiotropium for two weeks prior to randomisation and throughout the whole duration of the study)
Patients who are unable or unwilling to stop ipratropium (Atrovent inhaler). A salbutamol inhaler may be substituted for the ipratropium inhaler
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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)
Allocation is concealed, all study personnel and participants are "blinded" and randomisation is sequential using the number on the study drug packs.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be stratified by centres (there are a total of 3 centres) with an equal allocation of patients within centre to each group using random permuted blocks. The computer-generated randomisation numbers will generate a drug kit code that is to be assigned as subject numbers at each site.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
NA
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Phase
Not Applicable
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Type of endpoint/s
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
5/03/2012
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Actual
14/03/2012
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Date of last participant enrolment
Anticipated
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Actual
13/05/2015
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Date of last data collection
Anticipated
13/05/2016
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Actual
4/05/2016
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Sample size
Target
90
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Accrual to date
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Final
90
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Country [2]
4108
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New Zealand
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State/province [2]
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Hamilton
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Health Research Council
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Address [1]
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Level 3 - ProCARE Building, 110 Stanley Street (access via Grafton Mews), Auckland 1010
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Country [1]
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New Zealand
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Primary sponsor type
Government body
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Name
Health Research Council
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Address
Level 3 - ProCARE Building, 110 Stanley Street (access via Grafton Mews), Auckland 1010
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
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NA
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Address [1]
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NA
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Country [1]
283557
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
286642
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Northern Y Regional Ethics Committee
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Ethics committee address [1]
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c/- Ministry of Health PO Box 1031 Hamilton 3240 New Zealand
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Ethics committee country [1]
286642
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New Zealand
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Date submitted for ethics approval [1]
286642
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10/10/2011
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Approval date [1]
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19/12/2011
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Ethics approval number [1]
286642
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NTY/11/10/104
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Summary
Brief summary
The study aims to assess the effect of tiotropium compared with placebo in adult patients with non-cystic bronchiectasis with airflow obstruction. The primary aim is to assess whether tiotropium reduces event-based exacerbation frequency. And the secondary aims are whether tiotropium increases time to first exacerbation, improves lung function, reduces symptom-based exacerbation, improves quality of life, reduces airway inflammation, reduces bacterial infection and improves exercise capacity and forced vital capacity.
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Trial website
NA
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Trial related presentations / publications
NA
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Public notes
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Contacts
Principal investigator
Name
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Dr Conroy Wong
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Address
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C/- Respiratory department
Middlemore Hospital
100 Hospital Rd
Papatoetoe
Auckland 2015
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Country
33736
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New Zealand
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Phone
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+ 64 9 2760000
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Dr Conroy Wong
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Address
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Respiratory Services, Middlemore Hospital
Hospital Road, Otahuhu
Auckland 1640
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Country
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New Zealand
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Phone
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0064 9 276 0000
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Fax
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0064 9 2709737
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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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Dr Conroy Wong
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Address
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Respiratory Services, Middlemore Hospital
Hospital Road, Otahuhu
Auckland 1640
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Country
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New Zealand
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Phone
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0064 9 276 0000
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Fax
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0064 9 2709737
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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
Source
Title
Year of Publication
DOI
Embase
Tiotropium treatment for bronchiectasis: a randomised, placebo-controlled, crossover trial.
2022
https://dx.doi.org/10.1183/13993003.02184-2021
N.B. These documents automatically identified may not have been verified by the study sponsor.
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