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Trial registered on ANZCTR
Registration number
ACTRN12607000560493
Ethics application status
Approved
Date submitted
23/10/2007
Date registered
1/11/2007
Date last updated
25/02/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
A randomised placebo-controlled study of lovastatin in children with neurofibromatosis type 1
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Scientific title
A prospective randomized placebo-controlled study to evaluate the effect of lovastatin on neuropsychological function in children with neurofibromatosis type 1
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Secondary ID [1]
288620
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Nil Known
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Universal Trial Number (UTN)
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Trial acronym
STAtin Randomised Study: STARS
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Neurofibromatosis type 1
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Neuropsychological impairment
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Condition category
Condition code
Human Genetics and Inherited Disorders
2546
2546
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0
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Other human genetics and inherited disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
We will evaluate the efficacy of lovastatin, a 3-hydroxy-3-methylglutaryl-Coenzyme A reductase (HMG-CoA reductase) inhibitor, on visual spatial learning and sustained attention. Children in the treatment condition will initally take a titrated dose of lovastatin (20mg/day) for 2 weeks, followed by 40mg of lovastatin once per day for 14 weeks.
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Intervention code [1]
2172
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Treatment: Drugs
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Comparator / control treatment
A placebo pill that is designed to be indistinguishable from lovastatin. It is plausible and ethical to employ a placebo as no standard therapy with established efficacy is withheld.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Visuospatial learning: Mean Total Errors Adjusted score on the "Paired Associate Learning" subtest from the Cambridge Neuropsychological Test Automated Battery (CANTAB).
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Assessment method [1]
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Timepoint [1]
3329
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Primary outcome [2]
3330
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Sustained attention: Mean score on "Score!" subtest of the Test of Everyday Attention for Children (TEA-Ch).
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Assessment method [2]
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Timepoint [2]
3330
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Secondary outcome [1]
5540
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Mean Total Errors from the "Spatial Working Memory" subtest from the CANTAB
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Assessment method [1]
5540
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Timepoint [1]
5540
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Secondary outcome [2]
5541
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Problems solved in minimum moves from the "Stockings of Cambridge" subtest from the CANTAB
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Assessment method [2]
5541
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Timepoint [2]
5541
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Secondary outcome [3]
5542
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The "Stop Signal Task" from the CANTAB
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Assessment method [3]
5542
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Timepoint [3]
5542
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Secondary outcome [4]
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"Motor Screening" from the CANTAB
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Assessment method [4]
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Timepoint [4]
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Secondary outcome [5]
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Judgement of Line Orientation
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Assessment method [5]
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Timepoint [5]
5752
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Secondary outcome [6]
5753
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Total words on the "Controlled Oral Word Association Test".
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Assessment method [6]
5753
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Timepoint [6]
5753
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Secondary outcome [7]
5754
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Attention Score from the "Sky Search" subtest from the TEA-Ch
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Assessment method [7]
5754
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Timepoint [7]
5754
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Secondary outcome [8]
5755
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Dual Task Decrement from the "Sky Search DT" subtest from the TEA-Ch
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Assessment method [8]
5755
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Timepoint [8]
5755
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Secondary outcome [9]
5756
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Total Correct and Timing Score from the "Creature Counting" subtest from the TEA-Ch
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Assessment method [9]
5756
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Timepoint [9]
5756
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Secondary outcome [10]
5757
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Conners' Continuous Performance Test - II
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Assessment method [10]
5757
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Timepoint [10]
5757
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Secondary outcome [11]
5758
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Questionnaires: Conners ADHD/DSM-IV Scales (CADS; Parent Report); Behavior Rating Inventory of Executive Function (Parent Form), Behavior Assessment System for Children - II (Parent Report & Self Report), The Pediatric Quality of Life Scale (Parent Report & Self Report).
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Assessment method [11]
5758
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Timepoint [11]
5758
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Baseline, post-treatment (16 weeks after commencement of intervention) and 8 weeks after cessation of intervention.
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Eligibility
Key inclusion criteria
1. Males or females aged between 8-15 years of age who meet National Institutes of Health (NIH) diagnostic criteria for neurofibromatosis type 1 (NF1). 2. Full scale intellectual quotient (IQ) of 70 or above. 3. Cognitive impairment defined as having a score of at least 1 standard deviation or more below the normative mean on one or more of the primary outcome measures.
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Minimum age
8
Years
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Maximum age
15
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. Full scale IQ score less than 70.
2. Individuals with insufficient English to complete the assessments.
3. Participants taking stimulant medication or Straterra, as it is unclear whether lovastatin and ADHD medication utilise similar biological pathways, possibly leading to an interaction between the two medications
4. Participants on psychotropic or antiepileptic medication
5. Participants with intracranial pathology such as epilepsy, diagnosed head injury, hydrocephalus or progressive intracranial tumors (children with asymptomatic or static lesions will be eligible).
6. Participants who are pregnant or breastfeeding.
7. Participants with a clinically significant unrelated illness, which in the judgement of the principle or associate investigator, would compromise the participant's ability to tolerate the medication or potentially interfere with the participant's ability to participate in the required testing.
8. Children with very low LDL cholesterol levels pre-treatment (1 mmol/L). LDL levels within the normal range are required pre-treatment as lovastatin has been shown to lower levels of LDL cholesterol by approximately 30%.
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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)
If the potential participant and his/her family are interested in participating in the study, they will undergo a screening assessment to determine eligability.
Once enrolled, participants will be allocated to a treatment condition by contacting the holder of the allocation schedule who is at a central administration site. Allocation will be concealed from clinical centre personnel(except pharmacy).
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be by permuted block.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
An interim analysis will be conducted when there are 30 participants in each treatment arm. This analysis will be conducted to internally validate the adequacy of the sample size and to recalculate the sample size required if the treatment difference is smaller than expected. If the treatment effect is smaller than expected, large numbers of participants will be required to show that the treatment effect is statistically significant. However, if the treatment difference is larger than expected, it is usual to maintain the initial sample size calculation to ensure precision around the estimates. For example, a large effect size that occurs when the sample size is small may be an early random event.
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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
Completed
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Date of first participant enrolment
Anticipated
1/07/2009
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Actual
1/07/2009
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Date of last participant enrolment
Anticipated
1/05/2014
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Actual
1/05/2014
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
142
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Accrual to date
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Final
146
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment postcode(s) [1]
455
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2145
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Recruitment outside Australia
Country [1]
589
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United States of America
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State/province [1]
589
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45229
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Country [2]
590
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United States of America
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State/province [2]
590
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63110
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Country [3]
591
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United States of America
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State/province [3]
591
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84132
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Country [4]
592
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United States of America
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State/province [4]
592
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02115
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Country [5]
593
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United States of America
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State/province [5]
593
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19104
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Country [6]
594
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United States of America
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State/province [6]
594
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60637
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Country [7]
595
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United States of America
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State/province [7]
595
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35294
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Country [8]
596
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United States of America
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State/province [8]
596
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20010
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Funding & Sponsors
Funding source category [1]
2693
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Other
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Name [1]
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US Army Medical Research and Materiel Command
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Address [1]
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504 Scott Street
Fort Detrick, Maryland, 51702-5012
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Country [1]
2693
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United States of America
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Primary sponsor type
Individual
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Name
Prof Kathryn North
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Address
Murdoch Childrens Research Institute
Flemington Road Parkville
VIC 3052 Australia
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Country
Australia
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Secondary sponsor category [1]
2437
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Individual
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Name [1]
2437
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Dr Jonathan Payne
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Address [1]
2437
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Neurogenetics Research Unit
The Children's Hospital at Westmead,
Locked Bag 4001, Westmead, 2145
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Country [1]
2437
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Australia
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Secondary sponsor category [2]
2440
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Individual
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Name [2]
2440
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Dr Belinda Barton
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Address [2]
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Children's Hospital Education Research Institute
The Children's Hosptial at Westmead,
Locked Bag 4001, Westmead, 2145
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Country [2]
2440
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
4613
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Royal Alexandra Hospital for Children Ethics Committee
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Ethics committee address [1]
4613
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Ethics committee country [1]
4613
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Australia
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Date submitted for ethics approval [1]
4613
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26/09/2007
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Approval date [1]
4613
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18/12/2008
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Ethics approval number [1]
4613
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07/CHW/13
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Summary
Brief summary
Children with neurofibromatosis type 1 (NF1) frequently demonstrate impairments in attention and visuospatial learning. Despite the significant negative impact of this disorder on cognitive functioning, no studies have examined the effects of interventions on the cognitive functioning of children with NF1. Mice mutated at the NF1 gene provide a useful experimental model to study the biological basis of cognitive deficits in NF1 as they exhibit cognitive impairments that appear to mimic those displayed in children with NF1. Recent evidence has shown that the pharmacological agent lovastatin can reverse attention and learning deficits in NF1 mice. Lovastatin has a 20 year history as in treating hyperlipidemia and Phase I data in children with NF1 suggests that it is safe and tolerable. We intend to conduct a multi-centre, randomised trial examining the efficacy of lovastatin in children with NF1. There will be two treatment groups: one on lovastatin and the other a placebo control. The primary aim will be to establish whether lovastatin significantly improves visuospatial learning and/or sustained attention in children with NF1. Secondary aims include examining the effect of lovastatin on measures of executive function, behaviour and quality of life, as well as further evaluating the toxicity and tolerability of lovastatin in children with NF1.
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Trial website
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Trial related presentations / publications
Nil
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Public notes
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Contacts
Principal investigator
Name
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Prof Kathryn North
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Address
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Murdoch Childrens Research Institute
Flemington Road PARKVILLE VIC 3052
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Country
28027
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Australia
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Phone
28027
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+61 3 8341 6226
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Fax
28027
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Email
28027
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[email protected]
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Contact person for public queries
Name
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Dr Jonathan Payne
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Address
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Neurogenetics Research Unit
The Children's Hospital at Westmead
Locked Bag 4001, Westmead, 2145
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Country
11184
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Australia
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Phone
11184
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+61 2 9845 3698
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Fax
11184
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Email
11184
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[email protected]
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Contact person for scientific queries
Name
2112
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Prof Kathryn North
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Address
2112
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Murdoch Childrens Research Institute
Flemington Road PARKVILLE VIC 3052
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Country
2112
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Australia
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Phone
2112
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+61 2 9845 1903
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Fax
2112
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Email
2112
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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
Source
Title
Year of Publication
DOI
Embase
Randomized placebo-controlled study of lovastatin in children with neurofibromatosis type 1.
2016
https://dx.doi.org/10.1212/WNL.0000000000003435
N.B. These documents automatically identified may not have been verified by the study sponsor.
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