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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT00994903
Registration number
NCT00994903
Ethics application status
Date submitted
13/10/2009
Date registered
14/10/2009
Date last updated
2/12/2013
Titles & IDs
Public title
Simvastatin in Colorectal Surgery
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Scientific title
Prospective, Double-Blinded, Multi-Centred, Randomised Controlled Trial of Perioperative Simvastatin Use in Elective Colorectal Surgery
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Secondary ID [1]
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StatCol
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Universal Trial Number (UTN)
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Trial acronym
StatCol
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Intestinal Neoplasm
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Perioperative Care
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Condition category
Condition code
Cancer
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Bowel - Back passage (rectum) or large bowel (colon)
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Cancer
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Bowel - Small bowel (duodenum and ileum)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Drugs - Simvastatin
Treatment: Drugs - Placebo
Placebo comparator: Placebo - Placebo tablets (Inert calcium lactate)
Experimental: Simvastatin - 40mg of Simvastatin given 3-7 days pre-op and continued till 14 days post-op
Treatment: Drugs: Simvastatin
40mg orally, given 3-7 days pre-op and continued till 14 days post-op
Treatment: Drugs: Placebo
Placebo (Inert calcium lactate) tablets 3-7 days pre-op to 14 days post-op (as per experimental arm)
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Total complications
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Assessment method [1]
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Complications pre-defined and graded by the Clavien-Dindo classification
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Timepoint [1]
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Up to post-operative day 30
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Secondary outcome [1]
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Peritoneal Cytokines
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Assessment method [1]
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Timepoint [1]
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Postoperative Day 1
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Secondary outcome [2]
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Serum cytokines
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Assessment method [2]
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Timepoint [2]
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Post-operative Day 1
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Secondary outcome [3]
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Change in serum C-reactive protein (CRP)
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Assessment method [3]
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Timepoint [3]
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Baseline and Postoperative Day 1, 2 and 3
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Secondary outcome [4]
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Change in functional recovery
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Assessment method [4]
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Timepoint [4]
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Baseline and Postoperative Day 1, 3, 7, 14, and 30
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Eligibility
Key inclusion criteria
Inclusion criteria:
* Consecutive consenting patients undergoing elective colectomy, rectal resection, and reversal of Hartmann's procedure at Middlemore Hospital, Manukau Surgery Centre, Auckland City Hospital, and North Shore Hospital.
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Minimum age
18
Years
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Maximum age
90
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
Exclusion criteria:
* Acute presentation
* Already taking statins or other lipid-lowering medication
* Known adverse reaction to statins
* Hepatic dysfunction
* Moderate to severe renal dysfunction
* Previous history of rhabdomyolysis
* On contraindicated medication
* Pregnancy
* Breastfeeding
* Patient choice.
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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)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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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
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/10/2011
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/09/2013
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Sample size
Target
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Accrual to date
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Final
132
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Recruitment in Australia
Recruitment state(s)
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Funding & Sponsors
Primary sponsor type
Other
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Name
University of Auckland, New Zealand
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Counties Manukau Health
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Address [1]
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Country [1]
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Other collaborator category [2]
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Government body
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Name [2]
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Waitemata District Health Board
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Address [2]
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Country [2]
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Other collaborator category [3]
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Government body
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Name [3]
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Auckland District Health Board
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Address [3]
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Country [3]
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Ethics approval
Ethics application status
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Summary
Brief summary
Statins (HMG-CoA reductase inhibitors) are a widely used class of cholesterol-lowering drugs that have an established role in the medical management of cardiovascular disease. Their benefits have also been shown in the surgical setting with decreased cardiovascular complications and lower perioperative mortality following cardiac and vascular surgery. There is now considerable evidence showing statins have useful pleiotropic properties that extend beyond cholesterol lowering, including anti-inflammatory, anti-oxidant, immunomodulatory and fibrinolytic effects. Growing evidence suggests these effects may be useful in attenuating the proinflammatory and metabolic stress response to surgery and the benefit of statins may extend to other surgical settings such as abdominal surgery. Laboratory studies demonstrate the surgically-relevant benefits of statins and show they decrease peritoneal inflammation, reduce the severity of intestinal ischaemia-reperfusion injury, improve survival in models of abdominal sepsis, decrease the formation of postoperative intraperitoneal adhesions and improve the healing of colonic anastomoses. Retrospective clinical studies show statins improve outcomes in sepsis, reduce the postoperative systemic inflammatory response syndrome (SIRS) and are associated with decreased rates of surgical wound infections and postoperative respiratory complications following various non-cardiac general surgical procedures. However, no prospective studies have specifically evaluated the perioperative use of statins in abdominal surgery. Using colorectal surgery as a model for major abdominal surgery, the investigators will conduct a randomised controlled trial evaluating the effect of perioperative statin use on postoperative morbidity, local and systemic inflammatory response, and functional recovery after surgery.
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Trial website
https://clinicaltrials.gov/study/NCT00994903
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Trial related presentations / publications
Singh PP, Lemanu DP, Soop M, Bissett IP, Harrison J, Hill AG. Perioperative Simvastatin Therapy in Major Colorectal Surgery: A Prospective, Double-Blind Randomized Controlled Trial. J Am Coll Surg. 2016 Aug;223(2):308-320.e1. doi: 10.1016/j.jamcollsurg.2016.04.004. Epub 2016 Apr 13.
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Public notes
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Contacts
Principal investigator
Name
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Andrew G Hill, MBChB MD FRACS
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Address
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University of Auckland, New Zealand
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
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
No documents have been uploaded by study researchers.
Results not provided in
https://clinicaltrials.gov/study/NCT00994903
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