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Trial registered on ANZCTR
Registration number
ACTRN12624000701527
Ethics application status
Approved
Date submitted
4/04/2024
Date registered
4/06/2024
Date last updated
4/06/2024
Date data sharing statement initially provided
4/06/2024
Type of registration
Retrospectively registered
Titles & IDs
Public title
Botulinum Toxin A in Abdominal Hernia Repair
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Scientific title
The efficacy of Botulinum Toxin A (BTA) as an Adjunct
to Surgical Repair of Large Ventral Hernia in Adults, A Randomised Controlled Trial
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Secondary ID [1]
296858
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None
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Universal Trial Number (UTN)
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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:
Massive ventral hernia
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Condition category
Condition code
Surgery
325294
325294
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0
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Surgical techniques
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Oral and Gastrointestinal
330528
330528
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Musculoskeletal
330529
330529
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Botulinum toxin type A - 200 units in 200mL of saline for injection into abdominal wall musculature once, at 4-6 weeks before surgery. Adherence is considered as positive when participant has received all injections.
The injection points will be three evenly spaced spots along the front side of the body between the bottom edge of the ribs and the top of the hip bone on each side. A total of six injections will be administered by the investigator general surgeon.
Completion of the intervention will be noted on the participant case report form.
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Intervention code [1]
324893
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Treatment: Drugs
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Comparator / control treatment
Normal saline - 200 units for injection into abdominal wall musculature once, at 4-6 weeks before surgery. Adherence is considered as positive when participant has received all injections.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Hernia recurrence as assessed by the Principal Investigator by physical assessment (height and weight, abdominal examination) and imaging studies (computed tomography (CT)).
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Assessment method [1]
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Timepoint [1]
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1 month after surgery, 3 months after surgery, 6 months after surgery, 12 months after surgery and 3 years after surgery and 5 years after surgery
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Secondary outcome [1]
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Pain as assessed by the 10-point pain Visual Analog Scale
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Assessment method [1]
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Timepoint [1]
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First five days post-operatively, and at 1 month after surgery, 3 months after surgery, 6 months after surgery, 12 months after surgery and 3 years after surgery and 5 years after surgery
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Secondary outcome [2]
433612
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Effect of hernia on quality of life will be assessed using the HerQles: Hernia related Quality of Life Survey.
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Assessment method [2]
433612
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Timepoint [2]
433612
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1 month after surgery, 3 months after surgery, 6 months after surgery, 12 months after surgery and 3 years after surgery and 5 years after surgery
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Secondary outcome [3]
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Effect of hernia on quality of life will be assessed using the SF-36: Short form 36 item survey.
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Assessment method [3]
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Timepoint [3]
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1 month after surgery, 3 months after surgery, 6 months after surgery, 12 months after surgery and 3 years after surgery and 5 years after surgery
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Secondary outcome [4]
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Effect of hernia on quality of life will be assessed using the PRO-VHR: Patient-reported outcomes for interventional trials assessing ventral hernia repair
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Assessment method [4]
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Timepoint [4]
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1 month after surgery, 3 months after surgery, 6 months after surgery, 12 months after surgery and 3 years after surgery and 5 years after surgery
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Eligibility
Key inclusion criteria
• Is greater than and equal to 18 years of ages at enrolment
• Has a large ventral hernia that requires surgical repair as determined by attendance of the Hepatobiliary and Upper Gastrointestinal Surgical Clinic
• Ability to understand study information in English
• Provide a signed and dated informed consent form
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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
• Emergency procedures
• Prisoners
• Hernia with defect greater than 14cm transversely or more than 50% loss of domain
• Known hypersensitivity to any ingredient in the formulation.
• Participants with myasthenia gravis or Eaton Lambert syndrome.
• Presence of infection at the proposed injection site(s).
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Study design
Purpose of the study
Prevention
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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)
Randomisation plan limited to study coordination team and pharmacy only. Central randomisation by computer is allocated to pharmacy.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
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Other design features
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Phase
Phase 4
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
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Actual
13/06/2023
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Date of last participant enrolment
Anticipated
31/12/2028
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Actual
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Date of last data collection
Anticipated
28/02/2034
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Actual
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Sample size
Target
168
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Accrual to date
11
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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St Vincent's Hospital (Melbourne) Ltd - Fitzroy
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Recruitment hospital [2]
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Epworth Eastern Hospital - Box Hill
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Recruitment hospital [3]
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Box Hill Hospital - Box Hill
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Recruitment hospital [4]
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Royal Melbourne Hospital - Royal Park campus - Parkville
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Recruitment postcode(s) [1]
39006
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3065 - Fitzroy
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Recruitment postcode(s) [2]
39007
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3128 - Box Hill
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Recruitment postcode(s) [3]
39008
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3052 - Parkville
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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St Vincent's Hospital Research Endowment Fund
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Address [1]
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41 Victoria Parade, Fitzroy Victoria 3070
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Country [1]
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Australia
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Funding source category [2]
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Hospital
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Name [2]
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Epworth Research Foundation
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Address [2]
312691
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89 Bridge Rd, Richmond VIC 3121
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Country [2]
312691
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Australia
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Primary sponsor type
Individual
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Name
Dr Mary Ann Johnson
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Address
41 Victoria ParadeFitzroy VIC 3070
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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]
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Address [1]
301116
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Country [1]
301116
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
302164
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St Vincent’s Hospital Human Research Ethics Committee
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Ethics committee address [1]
302164
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https://svhs.org.au/home/research-education/research-office
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Ethics committee country [1]
302164
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Australia
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Date submitted for ethics approval [1]
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11/01/2023
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Approval date [1]
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22/02/2023
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Ethics approval number [1]
302164
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Summary
Brief summary
Large ventral hernias are a source of significant morbidity and pose a considerable surgical challenge. A hernia is abdominal wall muscular defect, allowing protrusion of abdominal contents under the skin. Surgical repair brings the edges of the abdominal wall opening (muscle edges) together. BTA prevents the muscles from contracting (approx 3 months) and thus reduces the lateral pulling 'force' on the surgical repair of the hernia. The study aims to perform a double- blinded randomised placebo-controlled trial to evaluate the effectiveness of BTA as an adjunct to surgical hernia repair of large ventral hernias. Participants will be randomised into two groups: one group will receive BTA injections, the other normal saline injections, into abdominal musculature. All participants will then undergo a surgical hernia repair 4 to 6 weeks after the injections. 84 participants will be recruited to each group (total: 168 participants). Our hypothesis is that BTA can improve the success of hernia repair by better intra-operative closure, better post-operative recovery , reduced recurrence of a hernia and overall reduced health expenditure.
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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 Mary Ann Johnson
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Address
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St Vincent's Hospital Melbourne 41 Victoria ParadeFitzroy VIC 3065
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Country
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Australia
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Phone
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+61 3 98957606
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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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Mary Ann Johnson
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Address
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St Vincent's Hospital Melbourne 41 Victoria ParadeFitzroy VIC 3065
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Country
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Australia
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Phone
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+61 3 98957606
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
89348
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Mary Ann Johnson
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Address
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St Vincent's Hospital Melbourne 41 Victoria ParadeFitzroy VIC 3065
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Country
89348
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Australia
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Phone
89348
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+61 3 98957606
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Fax
89348
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Email
89348
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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)?
No
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No/undecided IPD sharing reason/comment
All data collected to be used in analysis will be de-identified in re-identifiable form for individual participants. The analysed data will be pooled, therefore no individually identifiable components will be apparent in the final demographic and statistical analysis. Only pooled data results will be presented or published. All study documents and findings will be regarded as highly confidential, and will not be disclosed without prior written approval from the investigator.
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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
No additional documents have been identified.
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