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Trial registered on ANZCTR
Registration number
ACTRN12623000435684
Ethics application status
Approved
Date submitted
17/04/2023
Date registered
28/04/2023
Date last updated
15/09/2024
Date data sharing statement initially provided
28/04/2023
Type of registration
Prospectively registered
Titles & IDs
Public title
VITA-AMP - a pilot randomised controlled trial of vitamin supplementation in people following diabetes-related minor amputation of the lower limb.
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Scientific title
VITA-AMP - a pilot randomised controlled trial of the effect of vitamin supplementation on wound area in people following diabetes-related minor amputation of the lower limb.
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Secondary ID [1]
309376
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NIL
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Universal Trial Number (UTN)
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Trial acronym
VITA-AMP
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Diabetes-related foot disease
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Condition category
Condition code
Metabolic and Endocrine
326520
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0
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Diabetes
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Subjects allocated to the intervention arm will be administered oral capsules with Vitamin C 1000mg and Zinc picolinate 25mg daily for 28 days. Adherence will be monitored with a count of returned capsules at 28 days.
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Intervention code [1]
325809
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Treatment: Drugs
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Comparator / control treatment
Subjects allocated to the placebo arm will be administered placebo capsules containing an inactive comparator, daily for 28 days. Placebo medication will be a commercial placebo from Optima Ovest, Perth, Western Australia
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Percentage change in wound area measured by Silhouette from baseline to 12 weeks.
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Assessment method [1]
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Timepoint [1]
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12 weeks from initiating treatment
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Secondary outcome [1]
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Proportion of completely healed DFUs at 12 weeks by clinical assessment.
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Assessment method [1]
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Timepoint [1]
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At conclusion of study
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Secondary outcome [2]
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A composite outcome of any of the following: minor limb amputation, major limb amputation or death within 12 weeks from clinical assessment and audit of hospital records
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Assessment method [2]
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Timepoint [2]
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12 weeks from initiating treatment
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Eligibility
Key inclusion criteria
i) Age greater than or equal to 18years
ii) Diabetes (type 1 or 2) defined according to international consensus guidelines
iii) Admission to Fiona Stanley Hospital, Royal Perth Hospital, Sir Charles Gairdner Hospital or Albany Hospital under the inpatient high-risk foot team service or attending outpatient clinic with a DFU.
iv) Current inpatient admission or outpatient within 7 days of a minor amputation or debridement
v) Competent and willing to provide informed consent
vi) Able and willing to be followed up at 4 and 12 weeks
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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
i) Not competent to provide informed consent i.e. cognitive impairment, significant psychiatric illness, non-english speaking or other
ii) Women of reproductive age i.e. less than 45 years
iii) Already on VitC and/or zinc supplements or taken within 4 weeks of enrolment
iv) Known VitC and/or zinc deficiencies
v) Unlikely to be accessible for follow-up visit over the next 12 weeks
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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)
Randomisation of study supplements will be conducted by the Clinical Trials Pharmacist at Fiona Stanley Hospital. The randomisation schedule will be prepared using SealedEnvelope.com. This list will be provided to the manufacturer (off site) in order to create blinded, subject specific kits. Study supplements and placebo will be identical in appearance and non-identifiable.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Permuted block randomisation in variable block sizes will be conducted by the Fiona Stanley Hospital Clinical Trials Pharmacist and both participants and study investigators will be blinded to the intervention. The randomisation schedule will be prepared using SealedEnvelope.com. This list will be provided to the manufacturer in order to create blinded, subject specific kits.
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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
Parallel
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Other design features
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Phase
Phase 3
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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
27/09/2023
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Actual
27/09/2023
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Date of last participant enrolment
Anticipated
30/04/2025
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Actual
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Date of last data collection
Anticipated
30/01/2025
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Actual
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Sample size
Target
100
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Accrual to date
34
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Recruitment hospital [1]
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Fiona Stanley Hospital - Murdoch
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Recruitment hospital [2]
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Sir Charles Gairdner Hospital - Nedlands
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Recruitment hospital [3]
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Royal Perth Hospital - Perth
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Recruitment hospital [4]
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Albany Hospital - Albany
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Recruitment postcode(s) [1]
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6150 - Murdoch
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Recruitment postcode(s) [2]
40047
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6009 - Nedlands
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Recruitment postcode(s) [3]
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6000 - Perth
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Recruitment postcode(s) [4]
40049
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6330 - Albany
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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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National Health and Medical Research Council (MRFF Investigator Grant held by Laurens Manning)
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Address [1]
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16 Marcus Clarke St,
Canberra
ACT 2601
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
South Metropolitan Health Service - Fiona Stanley Fremantle Hospitals Group
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Address
Fiona Stanley Hospital, Murdoch Drive, Murdoch WA 6150
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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]
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Country [1]
315355
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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 (EC00265)
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Ethics committee address [1]
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Level 2, Education Building, Fiona Stanley Hospital 14 Barry Marshall Parade MURDOCH Western Australia 6150
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
312752
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Approval date [1]
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27/02/2023
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Ethics approval number [1]
312752
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Summary
Brief summary
Diabetes-related foot ulcers (DFU) are a common and burdensome condition. Established interventions to promote DFU healing include local wound care, debridement, pressure offloading, management of infection and revascularisation. Despite this, the condition still accounts for significant morbidity and mortality in the community and further improvements in ulcer healing and overall outcomes in patients is essential. Recent studies have suggested that patients with type 2 diabetes mellitus are at risk of nutritional deficiencies due to high calorie yet low quality diets, poor food choices and/or restrictive eating (2). Nutrients such as Vitamin C (VitC), Vitamin A (VitA) and zinc are essential in wound healing by stimulating epithelialisation and cellular proliferation. Deficiencies in these micronutrients are common amongst people with diabetes and DFU but data regarding the effect of supplementation is limited. Our team is currently recruiting to a double-blinded randomised controlled trial of multivitamins in patients with chronic foot ulcers (VITAFOOT). However following minor amputations, patients are ineligible for recruitment for VITAFOOT, yet presumably are also at similar risk of micronutrient deficiencies. To complement VITAFOOT, in this pilot randomised controlled trial, we aim to recruit 100 adult patients at Fiona Stanley, Royal Perth, Sir Charles Gairdner or Albany Hospital with a DFU within 7 days of a minor amputation or debridement. Subjects can be either hospitalised or attending the outpatient high risk foot clinic. We will then compare 28 days of oral supplementation of VitC and zinc with placebo in a pilot randomised controlled trial. Subjects will be followed up at 4 and 12 weeks to assess wound healing, as measured using ARANZ Medical Silhouette™ wound measurement camera. Our primary outcome is to prove that micronutrient supplementation with VitC and zinc will result in greater reduction in wound area from baseline to 12 weeks (ie percentage change in wound area measured by Silhouette wound camera at 12 weeks). Secondary outcomes include: i) the percentage of completely healed DFUs at 12 weeks (ie percentage of patients with completely healed DFU at 12 weeks in intervention vs control group) ii) minor or major lower limb amputation or death at 12 weeks and iii) wound healing trajectory over 12 weeks (measured using total % area change from baseline). The following are not prespecified secondary outcomes but will also be reported i) baseline prevalence of VitC and zinc deficiencies in people with DFU, ii) adverse effects associated with micronutrient supplementation and placebo iv) baseline prevalence of anaemia, absolute iron deficiency and functional iron deficiency.
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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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A/Prof Laurens Manning
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Address
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Fiona Stanley Hospital
11 Robin Warren Drive
MURDOCH Western Australia 6150
Australia
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Country
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Australia
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Phone
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+61 8 6151 1156
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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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Alana Di Giacomo
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Address
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Alana Di Giacomo
Fiona Stanley Hospital
11 Robin Warren Drive
MURDOCH Western Australia 6150
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Country
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Australia
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Phone
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+61 8 6151 1145
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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
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Laurens Manning
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Address
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Fiona Stanley Hospital
11 Robin Warren Drive
MURDOCH Western Australia 6150
Australia
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Country
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Australia
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Phone
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+61 8 6151 1156
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Fax
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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)?
No
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No/undecided IPD sharing reason/comment
No informed consent to share data.
Maintaining patient confidentiality: As this study is small, the data (relating to age and amputation) may be re-identifiable by participants or other interested parties.
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What supporting documents are/will be available?
No Supporting Document Provided
Doc. No.
Type
Citation
Link
Email
Other Details
Attachment
18909
Study protocol
[email protected]
385680-(Uploaded-24-07-2023-13-04-37)-Study-related document.doc
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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