{"id":41779,"date":"2018-04-04T21:32:30","date_gmt":"2018-04-04T20:32:30","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=41779"},"modified":"2018-04-17T08:56:42","modified_gmt":"2018-04-17T07:56:42","slug":"nick-devito-and-ben-goldacre-unreported-clinical-trial-of-the-week-nct03115177","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2018\/04\/04\/nick-devito-and-ben-goldacre-unreported-clinical-trial-of-the-week-nct03115177\/","title":{"rendered":"Unreported clinical trial of the week: antibiotics to reduce propionibacterium acnes in shoulder arthroplasty (NCT03115177)"},"content":{"rendered":"<p class=\"standfirst\">Every week this new series will uncover an unreported clinical trial<\/p>\n<p><!--more--><\/p>\n<p dir=\"ltr\"><strong>Nicholas J DeVito and Ben Goldacre<\/strong><\/p>\n<p><strong>Background<\/strong><\/p>\n<p dir=\"ltr\">The US FDA Amendments Act (FDAAA 2007) requires certain clinical trials to report their results onto ClinicalTrials.gov within one year of completion. Our <a href=\"https:\/\/fdaaa.trialstracker.net\/\" target=\"_blank\" rel=\"noopener\">FDAAA TrialsTracker<\/a> shows all individual trials that <a href=\"https:\/\/www.biorxiv.org\/content\/early\/2018\/03\/12\/266452.full.pdf\" target=\"_blank\" rel=\"noopener\">breach<\/a> this legal requirement. Once a week, we write about one unreported clinical trial: you can read more background <a href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/03\/29\/it-is-time-to-fix-the-problem-of-unreported-clinical-trials\/\" target=\"_blank\" rel=\"noopener\">here<\/a>.<\/p>\n<p dir=\"ltr\"><strong>Trial NCT03115177<\/strong><\/p>\n<p dir=\"ltr\">The week\u2019s unreported trial is \u201cCan Addition of Doxycycline Perioperatively Reduce Propionibacterium Acnes in Shoulder Arthroplasty?\u201d (<a href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT03115177\" target=\"_blank\" rel=\"noopener\">NCT03115177<\/a>). This study enrolled 56 participants, 40 to 90 years old, undergoing shoulder replacement (primary total shoulder arthroplasty). Patients were randomised to receive either cefazolin (the current antibiotic standard of care) or cefazolin plus doxycycline during surgery. The primary outcome was cultures showing presence of Propionibacterium acnes (P. acnes), a bacterium that can cause complications with shoulder procedures. The trial was not blinded. The completion date is given as February 2017.<\/p>\n<p dir=\"ltr\"><strong>Discussion<\/strong><\/p>\n<p dir=\"ltr\">Shoulder replacements are common, with <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4492145\/\" target=\"_blank\" rel=\"noopener\">66,485 operations in the US 2011<\/a>, and incidence rising in the <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27608744\" target=\"_blank\" rel=\"noopener\">US<\/a>, <a href=\"https:\/\/aoanjrr.sahmri.com\/documents\/10180\/181963\/Demographics%20and%20Outcomes%20of%20Shoulder%20Arthroplasty\" target=\"_blank\" rel=\"noopener\">Australia<\/a>, and <a href=\"http:\/\/www.njrcentre.org.uk\/njrcentre\/Portals\/0\/Documents\/England\/PPG\/09736%20NJR%20PPG%20-%20SHOULDERS%202018%20SPREADS.pdf?ver=2018-02-08-112730-050\" target=\"_blank\" rel=\"noopener\">UK<\/a>. Infection after shoulder surgery is one of the most common complications, with prevalence reported at <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4596192\/\" target=\"_blank\" rel=\"noopener\">0-4%, and P. acnes the most common cause<\/a>. <a href=\"http:\/\/www.jsesopenaccess.org\/article\/S2468-6026(17)30001-3\/pdf\" target=\"_blank\" rel=\"noopener\">One recent study<\/a> estimated the cost of two-stage reimplantation following an infected shoulder arthroplasty at $35,824. Knowing whether a commonly used drug, such as doxycycline, can help prevent infections following shoulder replacement could therefore be very valuable for orthopedic surgeons, patients, and health services around the world. The FDAAA requires researchers to post results directly into <a href=\"http:\/\/clinicaltrials.gov\/\" target=\"_blank\" rel=\"noopener\">clinicaltrials.gov<\/a>: however, <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=Allison+Rao\" target=\"_blank\" rel=\"noopener\">searching<\/a> <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/?term=NCT03115177+OR+(Doxycycline+AND+Arthroplasty)\" target=\"_blank\" rel=\"noopener\">Pubmed<\/a> and <a href=\"https:\/\/scholar.google.co.uk\/scholar?hl=en&amp;as_sdt=0%2C5&amp;q=NCT03115177+OR+%28Doxycycline+AND+shoulder+Arthroplasty%29+&amp;btnG=\" target=\"_blank\" rel=\"noopener\">Google Scholar<\/a> also found no publications related to this study.<b><\/b><\/p>\n<p dir=\"ltr\"><strong>Conclusion<\/strong><\/p>\n<p dir=\"ltr\">This unreported trial was sponsored by Rush University Medical Center in Chicago, USA. The PI is Dr. Allison Rao who took responsibility for the registry information. We hope the investigators will share the results of this trial soon.<\/p>\n<p><em><b><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/ben_goldacre.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-41742\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/ben_goldacre.jpg\" alt=\"\" width=\"160\" height=\"160\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/ben_goldacre.jpg 160w, https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/ben_goldacre-150x150.jpg 150w\" sizes=\"auto, (max-width: 160px) 100vw, 160px\" \/><\/a>Ben Goldacre <\/b>is a doctor, author, and director of the EBM DataLab at the University of Oxford. He co-founded the AllTrials campaign for trials transparency.<b><\/b><\/em><\/p>\n<p><strong>Competing interests:<\/strong>\u00a0BG has received research funding from the Laura and John Arnold Foundation, the Wellcome Trust, the Oxford Biomedical Research Centre, the NHS National Institute for Health Research School of Primary Care Research, the Health Foundation, and the World Health Organization; he also receives personal income from speaking and writing for lay audiences on the misuse of science. ND is employed on BG&#8217;s LJAF grant.<\/p>\n<div>\n<div>\n<p><em><strong><span class=\"il\"><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/nick_de_vito.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-41743\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/nick_de_vito.png\" alt=\"\" width=\"160\" height=\"160\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/nick_de_vito.png 160w, https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/nick_de_vito-150x150.png 150w\" sizes=\"auto, (max-width: 160px) 100vw, 160px\" \/><\/a><\/span><\/strong><\/em><\/p>\n<p>&nbsp;<\/p>\n<p><em><strong><span class=\"il\">Nicholas<\/span>\u00a0J DeVito<\/strong> is a researcher at the EBM Datalab at the University of Oxford.<\/em><\/p>\n<\/div>\n<div>\n<p><b>Competing interests:\u00a0<\/b>ND is employed on BG&#8217;s LJAF grant.<\/p>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Every week this new series will uncover an unreported clinical trial [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/04\/04\/nick-devito-and-ben-goldacre-unreported-clinical-trial-of-the-week-nct03115177\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":39227,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18897],"tags":[],"class_list":["post-41779","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-unreported-trial-of-the-week"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - 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