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Trial registered on ANZCTR
Registration number
ACTRN12619001370190
Ethics application status
Approved
Date submitted
27/08/2019
Date registered
8/10/2019
Date last updated
17/08/2022
Date data sharing statement initially provided
8/10/2019
Type of registration
Retrospectively registered
Titles & IDs
Public title
Treatment of Superficial Strawberry Birthmarks with Topical Timolol
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Scientific title
Topical Timolol Treatment of Superficial Proliferating Infantile Haemangioma assessing the effectiveness of 0.5% topical timolol gel in the treatment of
superficial IH.
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Secondary ID [1]
298995
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None
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Universal Trial Number (UTN)
U1111-12113953
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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:
Infantile Haemangioma
314001
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Condition category
Condition code
Skin
312390
312390
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0
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Dermatological conditions
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
This is an open labelled phase II study assessing the effectiveness of 0.5% topical timolol gel in the treatment of superficial infantile haemangiomas (IHs) .
Most IHs do not require active treatment as they involute spontaneously over time. However, up to 10-15% of IH require intervention during infancy because they cause complications, such as visual and airway obstruction, ulceration, bleeding, and permanent disfigurement. Following spontaneous involution, approximately 50% of the lesions will leave a blemish, and half of these will require treatment. Currently propanolol is the mainstay treatment of problematic IHs. We have demonstrated that oral propranolol at 1.5–2 mg/kg/day is an effective and safe treatment for problematic proliferating IH. However, many of the untreated IH can cause permanent cosmectic blemish, affecting the skin and/or leaving subcutaneous fatty residuum following spontaneous involution. Earlier treatment (during the early proliferative phase) has been shown to result in better outcomes and reduced short and long-term complications.
Parents/caregivers will be shown how to apply this gel to the IH.
1 drop morning and night applied topically to the IH.
Treatment will be increased to 1 drop three times a day, morning,noon and night, after 2 months if there is no improvement and there are no adverse effects.
Treatment is continued until complete resolution of the lesion occurs, there is no change in lesion size, colour or consistency after 3 months of continued use, until the patient reaches 12 months of age, or if any criteria for removal from the study are met.
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Intervention code [1]
315262
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Treatment: Drugs
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Comparator / control treatment
No control group
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Composite primary outcome
To assess the effectiveness of 0.5% topical timolol gel in the treatment of infantile haemangioma using an Analogue scale 0-10.
Before and after treatment photographs will be evaluated by an independent panel using an analogue scale of 0 (no improvement and/or deterioration) to 10 (excellent improvement).
Similarly, the parents/caregivers will be asked to evaluate the results of the treatment using this analogue scale.
Treatment failure will be defined as:
• A score of “0” on the analogue scale above
• Cessation of the growth of the lesion without regression in size, or improvement in consistency or colour
• Continued growth of the lesion
• Development of ulceration of the lesion or worsening of ulceration
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Assessment method [1]
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Timepoint [1]
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Baseline at first clinic appointment.
4 weeks after commencement of treatment
12 weeks after commencement of treatment
24 weeks after commencement of treatment
52 weeks primary endpoint
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Primary outcome [2]
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Possible adverse effect. decreased heart rate and blood pressure. Assessed at clinic appointments using digital sphygmomanometer.
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Assessment method [2]
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Timepoint [2]
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Heart rate and blood pressure measured pre-commencement of treatment.
1 hour post treatment commencement
1 month after commencement of treatment
3 m0nths after commencement of treatment
6 months after commencement of treatment
12 months primary endpoint
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Secondary outcome [1]
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Nil
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Assessment method [1]
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Timepoint [1]
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Nil
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Eligibility
Key inclusion criteria
Infants referred with a superficial IH(s) in the cosmetic sensitive areas (face and neck), perineum, buttock and axilla, who are not suitable for oral propranolol treatment.
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Minimum age
1
Months
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Maximum age
10
Months
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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
• Premature infants (less than 6 weeks corrected gestational age)
• IH on or near mucosal surface such as the eye, mouth and anus
• Any single lesion larger than 90mm² (e.g., 3x3cm)
• Multifocal IHs with a total surface area of more than 90mm²
• IH with ulceration >1x1cm
• IH with thickness >3mm
• Subcutaneous IH
• Any infants with contraindication to ß-blocker use, e.g.:
o Cardiac disease including: 2nd or 3rd degree atrioventricular heart block, bradycardia, cardiac failure, cardiogenic shock and congenital heart disease
o Congenital hyperthyroidism
o Hypersensitivity to any components of the medication
• Weight <3.5kg
• >10 months old
• Premature infants with a history of apnoea or chronic lung disease
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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
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 2
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Type of endpoint/s
Safety/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
31/08/2018
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Date of last participant enrolment
Anticipated
5/04/2023
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Actual
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Date of last data collection
Anticipated
7/06/2023
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Actual
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Sample size
Target
50
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Accrual to date
22
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Final
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Recruitment outside Australia
Country [1]
21761
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New Zealand
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State/province [1]
21761
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Funding & Sponsors
Funding source category [1]
303533
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Other Collaborative groups
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Name [1]
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Gillies McIndoe Research Institute
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Address [1]
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Gillies McIndoe Research Institute
PO Box 7184
Newtown
Wellington
6242
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Country [1]
303533
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New Zealand
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Primary sponsor type
Other Collaborative groups
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Name
Gillies McIndoe Research Institute
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Address
Gillies McIndoe Research Institute
PO Box 7184
Newtown
Wellington
6242
New Zealand
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Country
New Zealand
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Secondary sponsor category [1]
303599
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None
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Name [1]
303599
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Address [1]
303599
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Country [1]
303599
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Central Health and Ethics Disability Committee
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Ethics committee address [1]
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Ministry of Health PO box 5013 Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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11/04/2018
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Approval date [1]
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07/06/2018
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Ethics approval number [1]
304060
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18/CEN/67
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Summary
Brief summary
Most IHs do not require active treatment as they involute spontaneously over time. Up to 10-15% of IHs are problematic and require intervention during infancy- with the mainstay treatment being oral propanolol. Complications of propranolol treatment of IH have been reported in up to 31% of patients in a large meta-analysis, and therefore its use is restricted to problematic IHs. However, following spontaneous involution, many of the IH lesions can cause permanent cosmetic blemish, Timolol maleate is a topical ß-blocker that has been used for the treatment of glaucoma in the paediatric population for over 30 years. Research is yet to define the optimal duration of topical treatment of IH, with studies treating patients from 24 weeks up to 10 months, or until satisfactory improvement was noted. The best outcomes for topical timolol appears to be in patients with superficial IH who used the 0.5% timolol solution for a period of at least three months.This study investigates the efficacy of 0.5% topical timolol gel for the treatment of superficial IHs.
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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 Swee Tan
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Address
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Gillies McIndoe Research Institute
PO Box 7184
Newtown
Wellington
6242
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Country
95686
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New Zealand
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Phone
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+64 216 31000
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Fax
95686
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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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Ruth Watson-Black
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Address
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Gillies McIndoe Research Institute
PO Box 7184
Newtown
Wellington
6242
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Country
95687
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New Zealand
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Phone
95687
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+64277460776
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Fax
95687
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Email
95687
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[email protected]
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Contact person for scientific queries
Name
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Swee Tan
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Address
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Gillies McIndoe Research Institute
PO Box 7184
Newtown
Wellington
6242
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Country
95688
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New Zealand
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Phone
95688
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+64 216 31000
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Fax
95688
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Email
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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)?
Yes
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What data in particular will be shared?
All de-identified data collected during the trial will be shared.
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When will data be available (start and end dates)?
Data will be available after publication of the outcomes (and any protection of IP). No specific end date of when data will be shared has been decided as yet.
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Available to whom?
Researchers in Infantile Haemangioma (IH)
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Available for what types of analyses?
No restrictions on analyses are predicted.
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How or where can data be obtained?
Requests are made to the Principal Investigator via email or website
https://www.gmri.org/ or
[email protected]
Dr Swee Tan
Gillies McIndoe Research Institute
PO Box 7184
Newtown
Wellington
6242
New Zealand
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
3988
Study protocol
[email protected]
378157-(Uploaded-12-08-2019-11-12-08)-Study-related document.docx
3989
Ethical approval
[email protected]
378157-(Uploaded-12-08-2019-11-12-42)-Study-related document.pdf
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.
Download to PDF