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Trial registered on ANZCTR
Registration number
ACTRN12616001248459
Ethics application status
Approved
Date submitted
23/01/2015
Date registered
7/09/2016
Date last updated
7/09/2016
Type of registration
Retrospectively registered
Titles & IDs
Public title
The use of metformin in patients with moderate to severe renal failure and type 2 diabetes
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Scientific title
A pharmacokinetic study of metformin in patients with stable stage 4 chronic kidney disease and type 2 diabetes
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Secondary ID [1]
286011
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Nil Known
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Universal Trial Number (UTN)
U1111-1166-3205
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Type 2 Diabetes mellitus
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Chronic Kidney Disease
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Condition category
Condition code
Metabolic and Endocrine
294274
294274
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0
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Diabetes
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Renal and Urogenital
299916
299916
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0
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Kidney disease
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention: Low dose metformin of 250mg, 500mg and 1000mg per day. Patients in cohort 1 will take 250mg dose. When this cohort has completed treatment cohort 2 will commence. Patients in cohort 2 will take a 500mg dose. After completion of cohort 2, patients in cohort 3 will commence and take the 1000mg dose.
Duration: 4 weeks
Method of administration: Oral
Adherence monitoring: Pill count and drug plasma level monitoring
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Intervention code [1]
290990
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Treatment: Drugs
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Comparator / control treatment
Active
Participants to remain on current diabetic medication as per standard care
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Control group
Active
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Outcomes
Primary outcome [1]
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Trough metformin serum concentrations using high performance liquid chromatography (HPLC)
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Assessment method [1]
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Timepoint [1]
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Weekly levels for 4 weeks
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Secondary outcome [1]
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Single dose pharmacokinetic profile for metformin in patients with stage 4 chronic kidney disease using HPLC assay to measure serum metformin concentrations at 0, 2, 4, 6 ,8 and 24 hours.
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Assessment method [1]
312457
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Timepoint [1]
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Day 4 at 0, 2, 4, 6 ,8 and 24 hours.
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Secondary outcome [2]
312458
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72 hour continuous capillary glucose monitoring using an implanted Continuous Glucose Control Monitoring System (CGMS) with the sensor inserted subcutaneously into the abdominal wall.
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Assessment method [2]
312458
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Timepoint [2]
312458
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Day 1-3 and Day 29-31
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Secondary outcome [3]
312459
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Hemoglobin A1c serum assay
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Assessment method [3]
312459
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Timepoint [3]
312459
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Day 1 and Day 32
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Secondary outcome [4]
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Serum lactate levels
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Assessment method [4]
312460
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Timepoint [4]
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Day 1, 11, 18, 25, 32
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Secondary outcome [5]
312461
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Serum bicarbonate levels
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Assessment method [5]
312461
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Timepoint [5]
312461
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Day 1, 11, 18, 25, 32
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Secondary outcome [6]
312462
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Venous pH via venous blood gas
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Assessment method [6]
312462
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Timepoint [6]
312462
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Day 1, 11, 18, 25, 32
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Eligibility
Key inclusion criteria
1. Type 2 diabetes for at least 2 years
2. Haemoglobin A1c between 6 and 11%
3. Stable stage 4 chronic kidney disease as defined by estimated glomerular filtration rate of 15-29mls/1.73m2.
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Minimum age
30
Years
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Maximum age
75
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
1. Current treatment with metformin
2. Previous intolerance to metformin
3. Body mass greater than 160kg
4. Severe COPD as evidenced by hospitalization for decompensation within 6 months of randomization, chronic treatment with oral steroids
5. Unstable CHF needing frequent hospitalisations or frequent adjustment of heart failure medications
6. Significant IHD with acute coronary event, and/or CABG, and/or PCI in the previous 60 days.
7. Severe liver disease with icterus and plasma bilirubin greater than or equal to 60 micrommol/L, plasma transaminase greater than 3-fold upper limit of normal, albumin less than 25 g/L or coagulopathy.
8. Haemoglobin less tha 100 g/L or platelet count less than 80,000/mm3
9. Gastrointestinal bleeding in the previous 60 days
10. Unstable angina or planned for invasive cardiac investigations in the next 6 months
11. Malignancy other than basal cell carcinoma.
12. Any other disease or condition which in the opinion of the investigator could make them unsuitable for entry.
13. Pregnant, nursing a child, or planning a pregnancy at the time of this study
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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
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 1
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Type of endpoint/s
Pharmacokinetics
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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
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Actual
7/05/2012
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Date of last participant enrolment
Anticipated
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Actual
3/03/2014
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Date of last data collection
Anticipated
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Actual
3/04/2014
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Sample size
Target
18
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Accrual to date
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Final
18
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Recruitment outside Australia
Country [1]
6603
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New Zealand
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State/province [1]
6603
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Middlemore Clinical Trials
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Address [1]
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Middlemore Clinical trials
Esme Green Building
Middlemore Hospital
Hospital Rd
Papatoetoe, Auckland 2025
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Country [1]
290601
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New Zealand
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Primary sponsor type
Individual
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Name
Dr Ajith Dissanayake
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Address
Department of Medicine
Middlemore Hospital
Hospital Rd
Papatoetoe, Auckland 2025
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Country
New Zealand
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Secondary sponsor category [1]
289290
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Individual
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Name [1]
289290
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Dr Christopher Hood
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Address [1]
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Renal Department
Middlemore Hospital
Hospital Rd
Papatoetoe, Auckland 2025
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Country [1]
289290
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Northern X Regional Ethics Committee, Health and Disability Ethics Committees
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Ethics committee address [1]
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Private Bag 92522 Wellesley Street Auckland 1141
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
292237
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Approval date [1]
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19/12/2011
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Ethics approval number [1]
292237
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NTX/11/12/112
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Summary
Brief summary
The primary goal of this study was to establish if treatment with low dose metformin in patients with stage 4 chronic kidney disease would produce safe and therapeutic serum levels of metformin. Metformin is widely acknowledged to be the first choice treatment for type 2 diabetes mellitus but fears around accumulation in patients with kidney disease have limited it's use in this patient group. Our aim is to investigate the use of low dose metformin in this group by showing predictable, stable and safe drug levels with low dose treatment.
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Trial website
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Trial related presentations / publications
Manuscript in preparation
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Public notes
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Contacts
Principal investigator
Name
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Dr Christopher Hood
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Address
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Middlemore Hospital Private Bag 93311 Otahuhu Auckland 1640
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Country
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New Zealand
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Phone
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+64 9 276 0000
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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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Christopher Hood
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Address
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Middlemore Hospital Private Bag 93311 Otahuhu Auckland 1640
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Country
54247
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New Zealand
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Phone
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+64 9 276 0000
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Fax
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Email
54247
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[email protected]
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Contact person for scientific queries
Name
54248
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Christopher Hood
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Address
54248
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Middlemore Hospital Private Bag 93311 Otahuhu Auckland 1640
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Country
54248
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New Zealand
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Phone
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+64 9 276 0000
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Fax
54248
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Email
54248
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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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