Reduction of blood loss in pediatric surgical procedures around the hip - A trial with tranexamic acid

2024-516324-34-01 Therapeutic use (Phase IV) Ongoing, recruiting

Start 17 Apr 2023 · Status Ongoing, recruiting · 1 EU/EEA countries · 1 sites

Overview

Sponsor-declared trial summary

Phase Therapeutic use (Phase IV)
Status Ongoing, recruiting
Participants planned 180
Countries 1
Sites 1

Slipped capital femoral epiphysis (SCFE)

To evaluate (reduction of) intraoperative blood-loss with and without pre-operative TXA administration, in children undergoing a proximal femoral and/or pelvic osteotomy (PFPO). Primary research question: Is pre-operative TXA administration associated with reduced intraoperative blood loss, compared to placebo, in chi…

Key facts

Sponsor
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Participant type
Pediatric, Patients
Age range
0-17 years
Gender
Male and Female
Therapeutic area
Diseases [C] - Musculoskeletal Diseases [C05]
Trial duration
17 Apr 2023 → ongoing
Decision date (initial)
2024-11-21
Transition trial
Yes
Low-intervention
No
Rare-disease indication
No
Vulnerable population
Yes

External identifiers

EU CT number
2024-516324-34-01
EudraCT number
2022-002384-30

Trial design

CTIS Part I — objectives, methods, condition coding

Main objective

Scope: Safety, Efficacy, Prophylaxis

To evaluate (reduction of) intraoperative blood-loss with and without pre-operative TXA administration, in children undergoing a proximal femoral and/or pelvic osteotomy (PFPO).

Primary research question:
Is pre-operative TXA administration associated with reduced intraoperative blood loss, compared to placebo, in children undergoing a proximal femoral and/or pelvic osteotomy for DDH or other indications?

Secondary objectives 4

  1. Does pre-operative tranexamic acid (TXA) administration lead to a reduced number of patients with severe intraoperative blood loss (>500 ml, >20 ml/kg (severe), or > 35 ml/kg (massive)), compared to placebo?
  2. Does pre-operative TXA administration lead to shorter procedure time and hospital stay, compared to placebo?
  3. Does pre-operative TXA administration lead to a lower decrease in post-operative Hb, compared to placebo?
  4. What patient (e.g. demographics) and treatment characteristics (e.g. type of osteotomy, location, procedure time), besides TXA, are associated with intraoperative blood loss?

Conditions and MedDRA coding

Slipped capital femoral epiphysis (SCFE)

Study design 1 period

#TitleAllocationBlindingRoles blindedArms
1 Data collection and analysis
The period between the first inclusion and the end of the data analysis
Randomised Controlled Double [{"id":93314,"code":5,"name":"Carer"},{"id":93311,"code":2,"name":"Investigator"},{"id":93313,"code":4,"name":"Analyst"},{"id":93312,"code":3,"name":"Monitor"},{"id":93310,"code":1,"name":"Subject"}]

Regulatory references

Scientific advice from competent authorities
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Plan to share IPD
No
EU CT numberTitleSponsor
2024-516324-34-00 Reduction of blood loss in pediatric osteotomies around the hip - A randomized placebo-controlled trial with tranexamic acid Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)

Eligibility criteria

Principal inclusion / exclusion criteria as submitted by sponsor

Inclusion criteria 4

  1. Proximal femoral and/or pelvic osteotomy/ies
  2. 1-18 years old
  3. Any indication for surgery
  4. Performed at our institution

Exclusion criteria 7

  1. Contraindications for TXA
  2. Active use of alternative (anti)fibrinolytics
  3. Diagnosed bleeding or coagulation disorder
  4. Medical history of thromboembolic complications
  5. Use of hormonal contraception
  6. Insufficient Dutch language skills of the patient and/or caretakers
  7. No informed consent

Endpoints

Primary and secondary outcome measures (English text)

Primary endpoints 1

  1. Estimated intraoperative blood loss (ml/kg)

Secondary endpoints 10

  1. Baseline demographic data
  2. Indication for surgery
  3. Prior surgery at same site
  4. Treatment characteristics
  5. Operative time
  6. Eventual additional antifibrinolytic agents administered during surgery (including TXA)
  7. Blood transfusions
  8. Pre- and postoperative blood values, including Hb
  9. Complications
  10. Duration of hospital stay

Investigational products

Investigational medicinal products (IMPs), comparators, placebo, auxiliary

Test 1

Tranexamic Acid

SUB11214MIG · Substance

Active substance
Tranexamic Acid
Pharmaceutical form
SOLUTION FOR INFUSION
Route of administration
INTRAVENOUS BOLUS USE
Max daily dose
25 mg/kg milligram(s)/kilogram
Max total dose
25 mg/kg milligram(s)/kilogram
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Placebo 1

Saline

SUB20722 · Substance

Active substance
Saline
Pharmaceutical form
SOLUTION FOR INJECTION
Route of administration
INTRAVENOUS INJECTION
Max daily dose
40 Other
Max total dose
40 Other
Max treatment duration
1 Day(s)
Authorisation status
Authorised
ATC code
- — -
Marketing authorisation
-
Paediatric formulation
No
Orphan designation
No
Modified vs. Marketing Authorisation
No

Sponsors and contacts

Sponsor organisations, regulatory contacts, third parties

Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)

Sponsor organisation
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Address
Dr. Molewaterplein 40
City
Rotterdam
Postcode
3015 GD
Country
Netherlands

Scientific contact point

Organisation
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Contact name
J.J. Tolk

Public contact point

Organisation
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Contact name
J.J. Tolk

Locations

1 EU/EEA country · 1 investigational sites

By country

CountryMS statusPlanned subjectsSites
Netherlands Ongoing, recruiting 180 1
Rest of world 0

Investigational sites

Netherlands

1 site · Ongoing, recruiting
Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC)
Department of Orthopaedics and Sports Medicine, Dr. Molewaterplein 40, 3015 GD, Rotterdam

Country notifications

Trial-start, recruitment-start, end and early-termination notifications submitted per Member State

Country Trial startTrial end Recruitment startRecruitment end Early termination
Netherlands 2023-04-17 2023-04-17

Results and documents

Annex IV summary of results, Annex V layperson summary, and all documents registered in CTIS for this trial

Documents 7 files

Public protocol annexes, IB summaries, regulatory submissions and post-authorisation documents registered in CTIS.

TypeTitleVersion
Protocol (for publication) D1_Protocol NL81872 078 22 3
Recruitment arrangements (for publication) K1_Recruitment arrangements 1
Subject information and informed consent form (for publication) L1_SIS and ICF 1-11 yo 2
Subject information and informed consent form (for publication) L1_SIS and ICF 12-15 yo 2
Subject information and informed consent form (for publication) L1_SIS and ICF 16-18 yo 2
Subject information and informed consent form (for publication) L1_SIS and ICF Adults 2
Summary of Product Characteristics (SmPC) (for publication) E2_SmPC Tranexamic Acid 1

Application history

1 submissions — initial application plus substantial / non-substantial modifications

#TypeCodeSubmittedReference MSConclusionDecision date
1 INITIAL IN 2024-10-16 Netherlands Acceptable
2024-11-21
2024-11-21