Clinical Trial With Catheter Locking TauroSept® (Taurolidine 2%) or Saline Solution 0,9%

NCT ID: NCT01826526

Last Updated: 2016-12-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

105 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-06-30

Study Completion Date

2016-11-30

Brief Summary

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The purpose of this study is to determine if TauroSept® taurolidine 2% is more efficient than saline solution 0.9% as a catheter lock solution in preventing catheter related blood stream infections in patients with home parenteral nutrition.

Detailed Description

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Home Parenteral Nutrition has become a mainstay in the support of patients with chronic intestinal failure. It requires the presence of a central venous catheter to assure adequate venous access. Catheter Related BloodStream Infections (CRBSIs) are frequent. Most CRBSIs originate from contamination of the catheter hub and subsequent growth of microorganisms embedded within the biofilm that rapidly develops on the inner catheter surface. The best preventive measure against the development of CRBSIs is observation of strict hygiene guidelines when inserting and manipulating a central venous catheter and in addition to this the instillation of antimicrobial solutions like TauroSept® or saline solution 0.9% into the catheter lumen (antimicrobial lock). This measure is currently widely used in clinical practice.

Conditions

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Catheter Related Blood Stream Infections

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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TauroSept®

5 ml of TauroSept® will be instilled into the catheter (CVAD) each time after total parenteral nutrition (TPN) has been completed. The frequency of administration depends on the schedule of HPN. It varies between twice per week and once daily.

The duration of TauroSept® administration in this trial will be 12 months.

Group Type ACTIVE_COMPARATOR

TauroSept®

Intervention Type DEVICE

5 ml of TauroSept® will be instilled into the catheter (CVAD) each time after total parenteral nutrition (TPN) has been completed. The frequency of administration depends on the schedule of HPN. It varies between twice per week and once daily.

The duration of TauroSept® administration in this trial will be 12 months.

Saline solution 0.9%

5 ml of saline will be instilled into the catheter (CVAD) each time after total parenteral nutrition (TPN) has been completed. The frequency of administration depends on the schedule of HPN. It varies between twice per week and once daily.

The duration of saline administration in this trial will be 12 months.

Group Type PLACEBO_COMPARATOR

TauroSept®

Intervention Type DEVICE

5 ml of TauroSept® will be instilled into the catheter (CVAD) each time after total parenteral nutrition (TPN) has been completed. The frequency of administration depends on the schedule of HPN. It varies between twice per week and once daily.

The duration of TauroSept® administration in this trial will be 12 months.

Interventions

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TauroSept®

5 ml of TauroSept® will be instilled into the catheter (CVAD) each time after total parenteral nutrition (TPN) has been completed. The frequency of administration depends on the schedule of HPN. It varies between twice per week and once daily.

The duration of TauroSept® administration in this trial will be 12 months.

Intervention Type DEVICE

Other Intervention Names

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Taurolidine 2%

Eligibility Criteria

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Inclusion Criteria

* Benign underlying disease leading to long-term intestinal failure who will receive HPN and/or fluids (saline and/or glucose) at least 2 times /week over a subcutaneously tunnelled single-lumen Central Venous Catheter (CVC) (Hickman/Broviac or subcutaneous port) for at least one year

1. Patient receives a new single lumen central vascular access device for HPN (new patient starting HPN or patient already on HPN) allocation to Group I = new catheter group\] or
2. Patient is already on HPN for ≥1 year prior to trial inclusion and has a CRBSI rate (bacterial and/or yeast infections) of \>0.3/year and a catheter that has been in place for ≥6 months (allocation to Group II = high risk group). (Previous salvage of this catheter by line-lock antibiotics or other therapeutic interventions is not an exclusion criterion as long as this has been performed at least two months before enrolment in the trial)
* Estimated life expectancy ≥1 year
* Male or female patient aged 18 - 80 years
* Patient is fully able to understand the nature of the proposed intervention and gives written informed consent before entering the trial.

Exclusion Criteria

* cannot be expected to comply with the trial plan (substance abuse, mental condition)
* has significant cardiovascular disease such as unstable angina, acute myocardial infarction or recent cerebral vascular accident (within 6 weeks); a cardiac rhythm which in the investigators judgment may result in significant hemodynamic effects
* has a known hypersensitivity/allergy to taurolidine 2% or saline solution 0.9% and/or their excipients.
* is pregnant, lactating, or nursing.
* has a current bloodstream infection
* has any clinically significant abnormalities in blood coagulation requiring intervention
* has received thrombolytic therapy in the 6 weeks prior to insertion (aspirin 80-325 mg daily is acceptable).
* has received an investigational drug within 30 days of trial entry
* has an antibiotic coated, silver impregnated or antimicrobial cuff catheter
* has received a Taurolidine lock previously
* has compromised skin integrity, including any infection at the insertion site
* has received parenteral or oral antibiotic therapy \<2months prior trial inclusion
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Geistlich Pharma AG

INDUSTRY

Sponsor Role collaborator

Geert Wanten

OTHER

Sponsor Role lead

Responsible Party

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Geert Wanten

MD, PhD, MSc

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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University Hospital Copenhagen Rigshospitalet

Copenhagen, , Denmark

Site Status

University Clinic Münster

Münster, , Germany

Site Status

Rabin Medical Center

Petah Tikva, , Israel

Site Status

University of Bologna Center for Chronic Intestinal Failure Department of Gastroenterology and Internal Medicine

Bologna, , Italy

Site Status

Department of Gastroenterology and Hepatology clinical ward

Nijmegen, , Netherlands

Site Status

St Mark's Hospital

Harrow, Middlesex, United Kingdom

Site Status

University College Hospital

London, , United Kingdom

Site Status

Countries

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Denmark Germany Israel Italy Netherlands United Kingdom

References

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Bisseling TM, Willems MC, Versleijen MW, Hendriks JC, Vissers RK, Wanten GJ. Taurolidine lock is highly effective in preventing catheter-related bloodstream infections in patients on home parenteral nutrition: a heparin-controlled prospective trial. Clin Nutr. 2010 Aug;29(4):464-8. doi: 10.1016/j.clnu.2009.12.005. Epub 2010 Jan 12.

Reference Type RESULT
PMID: 20061070 (View on PubMed)

Wouters Y, Theilla M, Singer P, Tribler S, Jeppesen PB, Pironi L, Vinter-Jensen L, Rasmussen HH, Rahman F, Wanten GJA. Randomised clinical trial: 2% taurolidine versus 0.9% saline locking in patients on home parenteral nutrition. Aliment Pharmacol Ther. 2018 Aug;48(4):410-422. doi: 10.1111/apt.14904. Epub 2018 Jul 5.

Reference Type DERIVED
PMID: 29978597 (View on PubMed)

Tribler S, Brandt CF, Fuglsang KA, Staun M, Broebech P, Moser CE, Scheike T, Jeppesen PB. Catheter-related bloodstream infections in patients with intestinal failure receiving home parenteral support: risks related to a catheter-salvage strategy. Am J Clin Nutr. 2018 May 1;107(5):743-753. doi: 10.1093/ajcn/nqy010.

Reference Type DERIVED
PMID: 29722835 (View on PubMed)

Other Identifiers

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TCL-0112

Identifier Type: -

Identifier Source: org_study_id