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Trial registered on ANZCTR
Registration number
ACTRN12613000356763
Ethics application status
Approved
Date submitted
28/03/2013
Date registered
4/04/2013
Date last updated
7/12/2020
Date data sharing statement initially provided
7/12/2020
Date results provided
7/12/2020
Type of registration
Prospectively registered
Titles & IDs
Public title
Rapid Administration of iron Polymaltose whilst In the operating Department for patients with iron deficiency
The RAPID Study
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Scientific title
A study evaluating the effects of rapid iron polymaltose infusion during general anaesthesia in patients with iron deficiency.
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Secondary ID [1]
282201
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nil
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Universal Trial Number (UTN)
U1111-1141-1370
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Trial acronym
The RAPID study
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Iron deficiency
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Condition category
Condition code
Blood
289070
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0
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Anaemia
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Blood
289071
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0
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Other blood disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intravenous iron polymaltose infusion, dose of 500 - 1000mg (based on body weight and anaemia) over 15 min.
Administration occurs any time after 15min from the start of anaesthesia.
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Intervention code [1]
286814
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Treatment: Drugs
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Comparator / control treatment
Nil
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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The proportion of patients with systolic BP less than 80mmHg during iron infusion compoared to the proportion of patients with systolic BP less than 80mmHg in the first 15 min after induction of anaesthesia. Statistical comparison using fishers exact test.
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Assessment method [1]
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Timepoint [1]
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First 15 min after induction of anaesthesia compared to 30min period around iron infusion (15min during and 15min after)
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Secondary outcome [1]
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Absolute difference in systolic blood pressure change during iron infusion compared to after induction of anaesthesia. Statistical analysis using t-test to compare measured difference.
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Assessment method [1]
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Timepoint [1]
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First 15 min after induction of anaesthesia compared to 30min period around iron infusion (15min during and 15min after)
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Eligibility
Key inclusion criteria
Female Hb < 120 g/L and ferritin < 100
Male Hb < 130 g/L and ferritin < 100
Iron deficiency alone ferritin < 30
Undergoing general anaesthesia for a procedure
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Minimum age
18
Years
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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
- Pregnancy
- Iron overload (haemochromatosis or haemosiderosis) or ferritin > 100
- Clinically significant renal or liver disease
- Chronic polyarthritis
- Active infection
- Allergy / intolerance to iron polymaltose
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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)
Not applicable
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Not applicable
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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 4
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
We are planning a study of independent cases and controls with 1 control(s) per case. Prior data indicate that the failure rate (incidence of hypotension after induction) among controls is 0.2. If the true failure rate ( incidence of hypotension during iron infusion) for experimental subjects is 0.04, we will need to study 85 experimental subjects and 85 control subjects to be able to reject the null hypothesis that the failure rates for experimental and control subjects are equal with probability (power) 0.85. The Type I error probability associated with this test of this null hypothesis is 0.05. We will use a continuity-corrected chi-squared statistic or Fisher’s exact test to evaluate this null hypothesis.
Calculated Sample Size = 85
To adjust for dropouts, failed data collection, or optimistic sample size assumptions we aim to recruit 100 patients.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
28/03/2013
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Actual
1/07/2013
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Date of last participant enrolment
Anticipated
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Actual
1/12/2015
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Date of last data collection
Anticipated
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Actual
1/04/2016
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Sample size
Target
100
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Accrual to date
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Final
100
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Fremantle Hospital and Health Service - Fremantle
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Recruitment hospital [2]
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King Edward Memorial Hospital - Subiaco
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Recruitment postcode(s) [1]
6632
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6008 - Subiaco
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Recruitment postcode(s) [2]
6633
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6160 - Fremantle
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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]
286967
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Primary sponsor type
Individual
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Name
Dr Roger M Browning
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Address
Department of Anaesthesia and Pain Medicine
King Edward Memorial Hospital for Women
374 Bagot Road, Subiaco
Western Australia 6008
Australia
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Country
Australia
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Secondary sponsor category [1]
285758
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None
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Name [1]
285758
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Address [1]
285758
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Country [1]
285758
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Other collaborator category [1]
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Individual
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Name [1]
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Dr Ed O'Loughlin
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Address [1]
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Department of Anaesthesia and Pain Medicine
Fremantle Hospital
Alma St, Fremantle
Western Australia 6969
Australia
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Country [1]
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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South Metropolitan Health Service Human Research Ethics Committee
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Ethics committee address [1]
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Human Research Ethics Committee South Metropolitan Area Health Service Demountable 3, G Block, Fremantle Hospital PO Box 480, Fremantle, WA 6959
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
289016
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Approval date [1]
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22/10/2012
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Ethics approval number [1]
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12/201
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Summary
Brief summary
The RAPID Study – Lay Description Rapid Administration of iron Polymaltose whilst In the operating Department Background, aims & objectives We aim to show that giving intravenous iron polymaltose over 15 minutes to patients who are under general anaesthesia is safe and not associated with a significant incidence of low blood pressure or other adverse effects. Anaemia and iron deficiency are very common in surgical patients, a recent audit at KEMH showed an incidence of around 18%. In patients undergoing surgery it has been linked with an increased risk of needing a blood transfusion, slower recovery from surgery and an increase in postoperative complications. Patient often suffer from decreased energy, fatigue and poor ability to concentrate, all of which will affect their quality of life. Iron polymaltose is an intravenous iron medication commonly used to correct anaemia and iron deficiency. It has been used in Australia for over 40 years, has a very good safety record and about 4-500 women a year receive iron polymaltose at KEMH currently. It is usually administered as a slow infusion over 1.5 – 2.5 hours in a general ward setting. Common adverse effects can include headache, nausea, flushing and muscle cramps all of which are not as relevant to patients whilst they are under general anaesthesia. Low blood pressure can occur less commonly. Serious adverse events such as anaphylaxis are extremely rare and are not related to the speed at which iron polymaltose is given. Oral iron tablets are not effective in many patients for a number of reasons. It would labour intensive, expensive and inconvenient to bring all these patients back to a ward for a 1-2 hour infusion of iron polymaltose after surgery. Many other intravenous iron preparations, with similar pharmacological properties, have been shown to be safe when given over similar short periods of time and we believe this will be the case with iron polymaltose too. Some anaesthetists (in Australia and NZ) have already administered iron polymaltose in this manner with no anecdotal reports of any problems, however we believe it warrants formal evaluation. Study Population 100 Adult patients with anaemia or iron deficiency, undergoing general anaesthesia. Study Design and Methods Prospective, interventional study. Patients will act as their own controls. Temporary low blood pressure is quite common after the initial injection of anaesthetic medications used to start a patients general anaesthetic. We think that the proportion of patients with low blood pressure following iron polymaltose administration will be significantly less than this. We estimate we would need 83 patients, but because we anticipate some dropouts, or incomplete data we aim to recruit 100 (across both sites). Because anaemia is so common we think we should be able to get this many patients in 12 months or less. Outcomes Primary outcome will be the incidence of significant low blood pressure following the administration of iron polymaltose (definition = systolic BP less than 80). Secondary outcomes, will be the incidence of all adverse effects as ascertained by questionnaire 2 hours and 2 days after surgery.
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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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Dr Roger Browning
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Address
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Department of Anaesthesia and Pain Medicine
King Edward Memorial Hospital for Women
374 Bagot Road, Subiaco
Western Australia 6008
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Country
38806
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Australia
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Phone
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+61 (08) 9340 2222
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Fax
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+61 (08) 9340 2227
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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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Roger Browning
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Address
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Department of Anaesthesia and Pain Medicine
King Edward Memorial Hospital for Women
374 Bagot Road, Subiaco
Western Australia 6008
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Country
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Australia
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Phone
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+61 (08) 9340 2222
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Fax
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+61 (08) 9340 2227
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Email
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[email protected]
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Contact person for scientific queries
Name
38808
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Roger Browning
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Address
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Department of Anaesthesia and Pain Medicine
King Edward Memorial Hospital for Women
374 Bagot Road, Subiaco
Western Australia 6008
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Country
38808
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Australia
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Phone
38808
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+61 (08) 9340 2222
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Fax
38808
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+61 (08) 9340 2227
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Email
38808
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
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No/undecided IPD sharing reason/comment
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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
Efficacy and safety of ultra rapid iron polymaltose infusion during general anaesthesia.
2017
https://dx.doi.org/10.1177/0310057x1704500307
N.B. These documents automatically identified may not have been verified by the study sponsor.
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