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    EudraCT Number:2018-002636-25
    Sponsor's Protocol Code Number:NBF_HK_03_2018
    National Competent Authority:Denmark - DHMA
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2018-08-27
    Trial results View results
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    A. Protocol Information
    A.1Member State ConcernedDenmark - DHMA
    A.2EudraCT number2018-002636-25
    A.3Full title of the trial
    Highdose Steroid for High Pain Responders undergoing Total Hip-arthroplasty - A randomized doubleblindet controlled trial.
    Højdosis steroid til High Pain Responders der opereres med Total Hoftealloplastik - Et randomiseret, dobbeltblindet kontrolleret studie.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Highdose steroids in a High Pain Responder-group undergoing total hip-replacement surgery - A lottery-based doubleblindet controlled trial.

    Højdosis steroid til en High Pain Responder-gruppe der opereres med Total hofte-protese - Et lodtrækningsbaseret, dobbeltblindet kontrolleret forsøg.
    A.4.1Sponsor's protocol code numberNBF_HK_03_2018
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorAnaesthesia Department, Hvidovre Hospital, Capital Region of Denmark.
    B.3.1 and B.3.2Status of the sponsorNon-Commercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportClinic of Pathophysiology, University of copenhagen
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAnaesthesia Department, Hvidovre Hospital, Capital Region of Denmark.
    B.5.2Functional name of contact pointResearch group
    B.5.3 Address:
    B.5.3.1Street AddressKettegård Alle 30
    B.5.3.2Town/ cityHvidovre
    B.5.3.3Post code2650
    B.5.4Telephone number+4538623862
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D. name Dexa-ratiopharm
    D. of the Marketing Authorisation holderRatiopharm GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous bolus use (Noncurrent)
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.1CAS number 312-93-6
    D.3.9.3Other descriptive nameDEXAMETHASONE PHOSPHATE
    D.3.9.4EV Substance CodeSUB01612MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D. cell therapy medicinal product No
    D. therapy medical product No
    D. Engineered Product No
    D. ATIMP (i.e. one involving a medical device) No
    D. on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Perioperative management of total hip-arthroplasty because of hip-osteoarthritis
    Perioperativ optimering af total hoftealloplastik på baggrund af slidgigt i hofte.
    E.1.1.1Medical condition in easily understood language
    Management of total hip-replacement surgery because of hip-osteoarthritis
    Perioperativ optimering af udskiftning af hofte på baggrund af slidgigt i hofte.
    E.1.1.2Therapeutic area Diseases [C] - Musculoskeletal Diseases [C05]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10020096
    E.1.2Term Hip arthroplasty
    E.1.2System Organ Class 10042613 - Surgical and medical procedures
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level LLT
    E.1.2Classification code 10054711
    E.1.2Term Postoperative pain
    E.1.2System Organ Class 100000004863
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level LLT
    E.1.2Classification code 10049475
    E.1.2Term Chronic pain
    E.1.2System Organ Class 100000004867
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To investigate the effect of high dose steroids on the amount of patients with VAS >30 in a 5-meter walktest, 24 hours postoperatively efter total
    hip-arthroplasty in a High Pain responder cohort.
    At undersøge effekten af højdosis steroid på andelen af patienter med VAS >30 ved en 5 meter gangtest 24 timer postoperativt efter Total hoftealloplastik i en High Pain Responder kohorte.
    E.2.2Secondary objectives of the trial
    To investigate the reasons for resumed hospitalization in the days after total hip-arthroplasty.
    At undersøge årsager til fortsat indlæggelse i dagene efter total hoftealloplastik.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    - Age between 40 and 90.
    - Booked for unilateral hip-arthroplasty.
    - Is able to take part in the investigation(selfreporting of pain and nausea/vomitting)
    - Understands Danish or English, or has a translator available.
    - Chronic opioid-user with >29 mg morfine/day or equivalent other opioids and/or Pain Catastrophizing Scale-score of >20.
    - Signatured written consent.
    - Alder mellem 40 og 90 år.
    - Booket til hoftealloplastik unilateralt.
    - Kan medvirke til undersøgelsen (selvrapportere smerter/kvalme).
    - Forstår dansk/engelsk, eller har tolk under indlæggelse.
    - Fast opioid-bruger svarende til >29 mg morfin/dag eller tilsvarende i morfinækvivalenter og/eller PCS score >20.
    - Underskrevet skriftligt samtykke.
    E.4Principal exclusion criteria
    - Insulin-dependent diabetes melitus.
    - Ongoing treatment with systemic glucocorticoids or immunesuppressing treatment(apart from inhaled glucocorticoids).
    - Pregnancy/Breastfeeding
    - Allergies for the investigational drug.
    - A history of schizophrenia or bipolar diseases, or patients with permanent use of antipsychotic medication.
    - Insulinbehandlet DM
    - Aktuel behandling m. systemisk glukokortikoid eller immunsupressiv behandling (fraset inhalationssteroid).
    - Graviditet/amning.*
    - Allergi overfor undersøgelsesmedicin.
    - Personer som lider af skizofreni eller bipolær sygdom, samt personer som tager fast antipsykotika.
    E.5 End points
    E.5.1Primary end point(s)
    The amount of patients with VAS>30 in a 5 meter walk test 24 hours postoperatively after total hip-arthroplasty.
    Andelen af patienter med VAS >30 ved en 5 meter gangtest 24 timer postoperativt efter total hoftealloplastik.
    E.5.1.1Timepoint(s) of evaluation of this end point
    24 hour postoperatively
    24 timer postoperativt.
    E.5.2Secondary end point(s)
    - Pain upon rest and in a 5-meter walking test 4, 24 and 48 hours postoperatively, and filling out a 7 day pain-diary.
    - Acummulated painscore 0-48 hours postoperatively in rest and walking.
    - Duration of stay in PACU.
    - Length of stay in hospital.
    - "Why still in hospital"-registration at 9 hours postoperatively and 2 times daily the next 3 days.
    - Assesment of Opioid-related sideeffects (OR-SDS).
    - PONV after hip-arthroplasty.
    - The need for, and amount of rescue analgetics during the perioperative, postoperative and reconvalescense phase until day 7.
    - The need for, and amount of rescue antiemetics during the perioperative, postoperative and reconvalescense phase until day 7.
    - The influence on the inflammatory response expressed by C-reactive protein(CRP), analysed preoperatively and 24 og 48 hours after surgery.
    - Quality of sleep, VAS.
    - Morbidity and mortality(30 and 90 days).
    - Smerter ved hvile og ved 5-meter gangtest til tiden 4 timer postoperativt, samt efter 24 og 48 timer samt 1 uges smertedagbog.
    - Kummuleret smertescore 0-48 timer v. hvile og gang.
    - Indlæggelsesvarighed på PACU
    - Indlæggelsesvarighed total (Length of stay, LOS).
    - Why still in hospital? Til tiden 9 timer + 2 x dagligt efterfølgende 3 dage (09.00 og 14.00)
    - Vurdering af Opioid-relaterede bivirkninger(OR-SDS)
    - Post-operative Quality of Recovery Scale(PQRS)
    - PONV efter TKA.
    - Analgetika behov udover standard under operation, i opvågningsfase, samt på sengeafdeling dag 0-5 og i hjemmet indtil dag 7.
    - Antiemetika behov udover standard medicinering under hele forløb.
    - Påvirkning af det inflammatoriske respons udtrykt ved C-reaktivt protein(CRP), målt præoperativt og 24 og 48 timer postoperativt.
    - Undersøgelse af søvnkvalitet.
    - Morbiditet og mortalitet (30 og 90 dage).
    E.5.2.1Timepoint(s) of evaluation of this end point
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy No
    E.6.4Safety No
    E.6.5Efficacy No
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E. trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) Yes
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E. description
    Sammenlignet med sig selv, lavere dosis(normal dosis).
    Against itself, lower dose(normal dose)
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned2
    E.8.5The trial involves multiple Member States No
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 40
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 120
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state160
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2018-10-10
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-10-23
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2021-03-01
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