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腹主动脉瘤的非侵入性治疗临床试验(N-TA(3)CT):一项IIb期、安慰剂对照、双盲、随机临床试验的设计,该试验旨在研究强力霉素对减小小腹主动脉瘤生长的作用。

Non-invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial (N-TA(3)CT): Design of a Phase IIb, placebo-controlled, double-blind, randomized clinical trial of doxycycline for the reduction of growth of small abdominal aortic aneurysm.

作者信息

Baxter B Timothy, Matsumura Jon, Curci John, McBride Ruth, Blackwelder William C, Liu Xinggang, Larson LuAnn, Terrin Michael L

机构信息

University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE 68198, United States.

University of Wisconsin, Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, United States.

出版信息

Contemp Clin Trials. 2016 May;48:91-8. doi: 10.1016/j.cct.2016.03.008. Epub 2016 Mar 25.

Abstract

OBJECTIVES

The Non-Invasive Treatment of Abdominal Aortic Aneurysm Clinical Trial (N-TA(3)CT) is a Phase IIb randomized, placebo-controlled clinical trial, testing doxycycline (100mg bid) for inhibition of growth in the greatest transverse, orthogonal diameter of small abdominal aortic aneurysms (AAA).

METHODS

We will enroll 258 patients, ≥55years of age who have AAA, men: 3.5-5.0cm and women: 3.5-4.5cm on CT scans confirmed centrally. The primary outcome is growth in maximal transverse, orthogonal diameter from baseline to 24-month follow-up. Secondary analyses address doxycycline effects on clinical events, aneurysm volume, and biomarkers. Primary analysis will be performed according to the principle of intention-to-treat accounting for death and ruptures by use of normal scores in analysis of covariance. At the time of the data file reported, 200 subjects have been randomized. We started enrollment in mid-2013 and will complete enrollment by mid-2016.

RESULTS

Participant average age=70.9years, (SD=7.6years) and maximum transverse diameter=4.3cm for men (SD=0.4) and 4.0cm for women (SD=0.3).

CONCLUSION

N-TA(3)CT is a critical experiment to determine whether doxycycline reduces growth of small AAA and systemic markers of inflammation previously seen in bench experiments and observational human studies to be associated with AAA growth. Our patient population baseline measurements agree with the design assumptions supporting our expectation of 90% power or greater to reject a null hypothesis in favor of an alternative hypothesis when growth is reduced by at least 40%.

REGISTRATION

clinicaltrials.gov #NCT01756833.

摘要

目的

腹主动脉瘤无创治疗临床试验(N-TA(3)CT)是一项IIb期随机、安慰剂对照临床试验,旨在测试强力霉素(100mg,每日两次)对抑制小腹主动脉瘤(AAA)最大横向、正交直径生长的作用。

方法

我们将招募258名年龄≥55岁的AAA患者,男性在CT扫描上确诊的瘤体大小为3.5 - 5.0cm,女性为3.5 - 4.5cm。主要结局是从基线到24个月随访期间最大横向、正交直径的生长情况。次要分析涉及强力霉素对临床事件、动脉瘤体积和生物标志物的影响。主要分析将根据意向性治疗原则进行,在协方差分析中使用正态分数考虑死亡和破裂情况。在报告数据文件时,已有200名受试者被随机分组。我们于2013年年中开始招募,将于2016年年中完成招募。

结果

参与者平均年龄 = 70.9岁(标准差 = 7.6岁),男性最大横向直径 = 4.3cm(标准差 = 0.4),女性为4.0cm(标准差 = 0.3)。

结论

N-TA(3)CT是一项关键试验,用于确定强力霉素是否能减少小AAA的生长以及先前在实验室实验和人体观察性研究中发现的与AAA生长相关的全身炎症标志物。我们患者群体的基线测量结果与设计假设相符,这支持了我们的预期,即当生长减少至少40%时,有90%或更高的把握度拒绝零假设而支持备择假设。

注册信息

clinicaltrials.gov #NCT01756833

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