'Palliative-D' Vitamin D to Palliative Cancer Patients

NCT ID: NCT03038516

Last Updated: 2020-09-11

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

PHASE2

Total Enrollment

244 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-11-01

Study Completion Date

2020-06-09

Brief Summary

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To test the hypothesis that vitamin D treatment during 12 weeks to palliative cancer patients can decrease opioid consumption, fatigue and infectious burden and increase quality of life.

Detailed Description

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PROTOCOL IDENTITY AND OBJECTIVES: EudraCT Number 2017-000268-14 Protocol Title: Vitamin D supplementation to palliative cancer patients - A double blind, randomised controlled trial. Acronym: "Palliative-D" Trial Objectives: To test the hypothesis that vitamin D treatment during 12 weeks to palliative cancer patients can decrease opioid consumption, fatigue and infectious burden and increase quality of life.

INVESTIGATIONAL MEDICINAL PRODUCTS (IMP): Test ProductDetremin, MA holder Renapharma; Pharmaceutical Form: Oil Route of Administration: Oral route

METHODOLOGY Trial Design: Double-blind, parallel randomised and placebo controlled trial Dose/Duration 4000 IU/day for 12 weeks

Primary Endpoint:

The decline of opioid-consumption during 12 weeks in the vitamin D group compared to the placebo group, based on 3 measurements with 4 weeks intervals.

Secondary end Points:

1. Decline in antibiotic consumption
2. Improvement in quality of life
3. Improvement in fatigue
4. Vitamin D levels in serum after 12 weeks
5. Association between opioid dose and genetic polymorphism in genes involved in the effect and metabolism of vitamin D in the body.

Efficacy Parameters:

Opioid dose, translated to fentanyl per hour measured at baseline and at week 4,8 and 12.

Antibiotic consumption expressed as % of days with antibiotics during the last 4 weeks measured at baseline and at week 4, 8 and 12.

Quality of Life measured with EORTC-QLQ-C15-PAL at baseline and after 12 weeks. Fatigue measured with EORTC-QLQ-C15-PAL at baseline and after 12 weeks. 25-hydroxyvitamin D levels in blood at baseline and after 12 weeks. ESAS (Edmonton Symptom Assessment Scale ) measured at baseline and at week 4, 8 and 12.

Safety Parameters: S-calcium will be controlled in all subjects at baseline, at week 4, 8 and 12 and U-calcium in selected cases Power: The least clinically meaningful effect is estimated to be a 20% decline in opioid dose compared to the placebo. To obtain this result with 80% power the number of patients is estimated to be 127 in each arm i.e. 254 patients in total. This includes a drop-out of 25% per group.

Statistical Analyse plan: The primary endpoint will be analysed using linear regression, using bias corrected and accelerated bootstrap confidence intervals, while controlling for baseline measure of opioid dose (similar to ANCOVA). Adjustment for other background variables - such as vitamin D-level at baseline, gender and age - will be made in a secondary analysis to gain efficiency. The continuous secondary endpoints will be analysed using the same method as the primary endpoint .

POPULATION OF TRIAL SUBJECTS Number of Subjects: 254 (127 vitamin D and 127 placebo) Description of Trial Subjects: Palliative Cancer Patients (any cancer form) with a life expectancy of more than 3 months.

TRIAL TIMETABLE First Subject In Aug 2017 Last Subject In Sept 2019 (25 months to include participants) Last Subject Out Dec 2019 End of intervention Dec 2019 End of follow up Dec2019 End of Trial: Dec 2020

Conditions

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Vitamin D Deficiency

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Vitamin D

Cholecalciferol (Detremin) solved in MIGLYOL® 812

Group Type ACTIVE_COMPARATOR

Cholecalciferol

Intervention Type DRUG

To test the hypothesis that vitamin D treatment during 12 weeks to palliative cancer patients is superior to placebo in decreasing opioid consumption, fatigue and infectious burden and increase quality of life.

Placebo

MIGLYOL® 812

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DEVICE

To test the hypothesis that placebo is inferior to vitamin D treatment during 12 weeks to palliative cancer patients in decreasing opioid consumption,

Interventions

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Cholecalciferol

To test the hypothesis that vitamin D treatment during 12 weeks to palliative cancer patients is superior to placebo in decreasing opioid consumption, fatigue and infectious burden and increase quality of life.

Intervention Type DRUG

Placebo

To test the hypothesis that placebo is inferior to vitamin D treatment during 12 weeks to palliative cancer patients in decreasing opioid consumption,

Intervention Type DEVICE

Other Intervention Names

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Detremin MIGLYOL® 812

Eligibility Criteria

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Inclusion Criteria

1. Patients admitted to ASIH Stockholm Södra or Stockholms Sjukhem.
2. Incurable cancer patients with any type of cancer. They could have ongoing oncological treatment but only with palliative intention. No patients with ongoing oncological treatment with curative intended treated will be included.
3. The life expectancy should be at least 3 months according to the clinical assessment of the study physician at the screening visit.
4. The patient should have no cognitive failure, being able to comprehend oral and written information about the study.
5. 25 OHD \< 50 nmol/L.
6. Men and women aged ≥18
7. Signed 'informed consent'

Exclusion Criteria

1. Ongoing vitamin D supplementation at the time for inclusion.
2. Serum level of 25-OH vitamin D3 \>50 nmol/L
3. Known sarkoidosis
4. Treatment with tiazides or digoxin or digitoxin
5. Primary hyperparathyroidism
6. Hypercalcaemia (verified by a laboratory result younger than 2 month)
7. Plans to leave the Stockholm county within 12 weeks of inclusion
8. History of kidney stones
9. Taking part of another clinical study involving drugs
10. Hypersensitivity to cholecalciferol and/or any of the excipients
11. Other criteria that could jeopardize the study or its intention as judged by the investigator
12. Not being able to perform EORTC-QLQ-C15-PAL or ESAS
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Region Stockholm

OTHER_GOV

Sponsor Role lead

Responsible Party

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Linda Björkhem-Bergman

MD, PhD, Assoc Prof, Senior Consultant

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Linda Björkhem-Bergman, Assoc Prof

Role: PRINCIPAL_INVESTIGATOR

Stockholm Läns Landsting

Locations

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ASIH Stockholm Norr

Solna, Stockholm County, Sweden

Site Status

ASIH Stockholm Södra

Älvsjö, , Sweden

Site Status

Stockholms Sjukhem ASIH

Stockholm, , Sweden

Site Status

Countries

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Sweden

References

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Goodrose-Flores C, Bonn SE, Klasson C, Frankling MH, Lagerros YT, Bjorkhem-Bergman L. Appetite and its association with mortality in patients with advanced cancer - a Post-hoc Analysis from the Palliative D-study. BMC Palliat Care. 2023 Oct 26;22(1):159. doi: 10.1186/s12904-023-01287-1.

Reference Type DERIVED
PMID: 37880704 (View on PubMed)

Klasson C, Helde-Frankling M, Sandberg C, Nordstrom M, Lundh-Hagelin C, Bjorkhem-Bergman L. Vitamin D and Fatigue in Palliative Cancer: A Cross-Sectional Study of Sex Difference in Baseline Data from the Palliative D Cohort. J Palliat Med. 2021 Mar;24(3):433-437. doi: 10.1089/jpm.2020.0283. Epub 2020 Sep 16.

Reference Type DERIVED
PMID: 32936046 (View on PubMed)

Other Identifiers

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Palliative-D

Identifier Type: -

Identifier Source: org_study_id

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