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Trial registered on ANZCTR
Registration number
ACTRN12607000546459
Ethics application status
Approved
Date submitted
19/10/2007
Date registered
23/10/2007
Date last updated
7/11/2018
Date data sharing statement initially provided
7/11/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Beta-blockade to reduce energy expenditure in cirrhosis
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Scientific title
A randomized pilot study to assess efficacy of beta-blockade for reducing energy expenditure in patients with liver cirrhosis.
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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:
Liver cirrhosis
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Condition category
Condition code
Other
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0
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Conditions of unknown or disputed aetiology (such as chronic fatigue syndrome/myalgic encephalomyelitis)
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Randomized, double-blind, crossover trial of nadolol vs placebo; 2 phases of 3 months each with 2-week washout. Nadolol will be commenced at 40mg daily, increasing to 80mg after 1 week. Nadolol and placebo will be dispensed in a form that is indistinguishable. Patients will be re-assessed at 2 weeks after beginning each 3-month phase and, if necessary, the dose of nadolol adjusted to achieve a target resting pulse rate of 60 beats per minute or a 20% reduction in baseline resting pulse rate. This adjustment will be made by an unblinded third-party clinician who is not involved with end-point measurements. The patients and investigators will remain blinded to the treatment allocation.
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Intervention code [1]
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Treatment: Drugs
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Comparator / control treatment
Placebo (sugar pill).
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Change in resting energy expenditure (measured by Deltatrac metabolic monitor)after 3-months treatment (with appropriate adjustment for change in metabolising mass of the body).
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Assessment method [1]
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Timepoint [1]
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Beginning and end of each 3-month phase.
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Secondary outcome [1]
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Total body protein (measured by in vivo prompt-gamma neutron activation analysis).
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Assessment method [1]
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Timepoint [1]
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Beginning and end of each 3-month phase.
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Secondary outcome [2]
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Quality of life (Short Form 36).
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Assessment method [2]
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Timepoint [2]
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Beginning and end of each 3-month phase.
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Secondary outcome [3]
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Skeletal muscle function (grip strength by Lafayette dynamometer and respiratory muscle strengthby Validyne pressure transducer).
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Assessment method [3]
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Timepoint [3]
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Beginning and end of each 3-month phase.
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Eligibility
Key inclusion criteria
Liver cirrhosis, no contra-indications to beta-blockers (history of bronchospasm, severe peripheral vascular disease, complete heart block, previous intolerance to b-blockers, brittle diabetes characterised by recurrent hypoglycaemia), clinically stable and no major complication of liver disease within 1 month of entry, age over 18 years and ability to give informed consent.
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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
Patients requiring primary prophylaxis with beta-blockers, pregnancy, hepatocellular carcinoma, listed for liver transplantation at the time of enrolment.
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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)
Allocation by sequentially numbered sealed envelope.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Cumputer-generated randomization sequence.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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
1/12/2007
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Actual
1/08/2008
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Date of last participant enrolment
Anticipated
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Actual
19/08/2009
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Date of last data collection
Anticipated
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Actual
3/03/2010
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Sample size
Target
24
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Accrual to date
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Final
23
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
628
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Auckland
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Address [1]
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Private Bag 92019
Auckland
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Country [1]
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New Zealand
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Primary sponsor type
Individual
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Name
Associate Professor Lindsay Plank
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Address
Department of Surgery
University of Auckland
Private Bag 92019
Auckland
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Country
New Zealand
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Secondary sponsor category [1]
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Individual
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Name [1]
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Professor John McCall
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Address [1]
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New Zealand Liver Transplant Unit
Auckland City Hospital
Park Road
Auckland
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Country [1]
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New Zealand
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Other collaborator category [1]
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Individual
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Name [1]
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Associate Professor Edward Gane
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Address [1]
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New Zealand Liver Transplant Unit
Auckland City Hospital
Park Road
Auckland
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Country [1]
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Ethics committee address [1]
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Ethics committee country [1]
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Date submitted for ethics approval [1]
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16/10/2007
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Approval date [1]
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24/01/2008
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Ethics approval number [1]
4644
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Ethics committee name [2]
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Ethics committee address [2]
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Ethics committee country [2]
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Date submitted for ethics approval [2]
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Approval date [2]
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Ethics approval number [2]
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Summary
Brief summary
Liver cirrhosis is associated with significant changes in energy metabolism and body composition. Increased resting energy expenditure (REE) is commonly found and is an independent predictor of reduced survival. Short-term intravenous infusion of beta-blockers can reduce REE in cirrhotic patients indicating the potential for long-term beta-blockade to modulate the metabolic and nutritional consequences of cirrhosis. We hypothesised that oral beta-blockade over the longer term will reduce REE. The present randomised, placebo-controlled pilot study aims to determine if 3-month treatment with oral beta-blockers can reduce REE in cirrhotic patients. A positive result from this study would provide a strong rationale for further investigation of their potential for improving survival and reducing the demand for liver transplantation.
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Trial website
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Trial related presentations / publications
Lee WG, McCall JL, Gane EJ, Murphy R, Plank LD. Oral ß-blockade in relation to energy expenditure in clinically stable patients with liver cirrhosis: a double-blind randomized cross-over trial. Metabolism 2012; 61; 1547-1553. doi:10.1016/j.metabol.2012.04.001.
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Public notes
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Contacts
Principal investigator
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 public queries
Name
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Associate Professor Lindsay Plank
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Address
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Department of Surgery
University of Auckland
Private Bag 92019
Auckland
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Country
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New Zealand
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Phone
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+64 9 3074935
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Fax
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+64 9 3779656
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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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Associate Professor Lindsay Plank
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Address
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Department of Surgery
University of Auckland
Private Bag 92019
Auckland
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Country
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New Zealand
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Phone
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+64 9 3074935
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Fax
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+64 9 3779656
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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)?
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No/undecided IPD sharing reason/comment
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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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