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The IVCare Adaptive Platform Trial

7. května 2026 aktualizováno: The University of Queensland

Comparative Effectiveness of Interventions to Prevent Infections and Other Complications Arising From Central Venous Access Devices: the IVCare Adaptive Platform Trial.

The IVCare trial is a multicentre adaptive platform study evaluating interventions to prevent infections and other complications associated with central venous access devices (CVADs) in patients with newly inserted or existing devices. The study is organised into domains addressing different aspects of CVAD care and includes patient groups referred to as strata. Domains, strata and interventions may change over time as the study progresses. IVCare also includes an observational cohort study in which patients with CVADs are followed to assess CVAD care practices, infections, and other CVAD-related complications across health services.

The trial starts with two domains. The Connectors/Caps Domain compares antimicrobial chlorhexidine-containing connectors and caps with standard-of-care connectors and caps used in Australian hospitals. In the cancer stratum, participants are randomised to receive either InVision-Plus CS® or standard-of-care connectors/caps. In the kidney disease stratum, participants are randomised to receive either ClearGuard™ HD or standard-of-care connectors/caps. Following a predefined stopping decision for ClearGuard™ HD in the kidney disease stratum, Tego™ will be introduced and evaluated in this group.

The Securement Domain compares the effectiveness of SecurAcath®, a subcutaneous anchor securement system, with standard-of-care securement methods used in Australian hospitals. Participants in both the cancer and kidney disease strata are randomised to receive either SecurAcath® or standard-of-care securement.

Přehled studie

Detailní popis

Participants who have or require a CVAD, including a peripherally inserted central catheter (PICC), non-tunnelled or tunnelled central venous catheter (CVC), or totally implanted venous access port, are eligible for the IVCare trial. Participation in the observational cohort is a core component of trial participation and occurs for all enrolled participants. Participation in intervention domains is optional. Participants may be enrolled in more than one intervention domain concurrently.

Each domain has its own inclusion and exclusion criteria in addition to core eligibility requirements. Participants will be followed for up to 180 days from enrolment into the observational cohort or randomisation to one or more interventions.

Participants who complete follow-up in the observational cohort and/or one or more intervention domains may be eligible for re-entry, provided they meet eligibility criteria.

There is no fixed sample size for this adaptive platform trial. Recruitment into each domain will be guided by pre-specified interim analyses of accumulating data using Bayesian methods. Predefined decision rules will determine adaptations, including early stopping for futility, non-inferiority, or superiority of interventions within each domain.

Typ studie

Intervenční

Zápis (Odhadovaný)

2500

Fáze

  • Nelze použít

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

  • Dítě
  • Dospělý
  • Starší dospělý

Přijímá zdravé dobrovolníky

Ne

Popis

Core inclusion Criteria:

  • The patient has or requires a CVAD, including a PICC, a non-tunnelled or tunnelled CVC, or a totally implanted venous access port.
  • Patient is less than 18 years old and paediatric recruitment has not been approved at the site.

Securement Domain exclusion criteria:

  • Central line-associated bloodstream infection (CLABSI) currently suspected associated with any vascular access device (peripheral or central) that is in situ.
  • CLABSI diagnosed from any vascular access device currently in situ within the past 7 days or being actively treated with antimicrobials.
  • Participants with an estimated life expectancy of <30 days OR who have commenced a documented end-of-life, terminal-care, or comfort-care pathway.
  • Participants who have previously been randomised for the same CVAD.
  • Participants who have been randomised three times.
  • SecurAcath® cannot be applied in accordance with manufacturer instructions and local policy.
  • The participant has compromised skin integrity at the current or intended insertion site, including active infection, inflammation, erosion, ulceration, or pre-existing exit-site injury.

Connectors/Caps Domain exclusion criteria:

  • Central line-associated bloodstream infection (CLABSI) currently suspected associated with any vascular access device (peripheral or central) that is in situ.
  • CLABSI diagnosed within the past 14 days or CLABSI being actively treated with antimicrobials, associated with any vascular access device currently in situ.
  • Participants with an estimated life expectancy of <30 days OR who have commenced a documented end-of-life, terminal-care, or comfort-care pathway.
  • Participants who have previously been randomised for the same CVAD.
  • Participants who have been randomised three times.
  • Known or suspected hypersensitivity or a confirmed allergy to chlorhexidine or silver-containing products.

Cancer stratum inclusion criteria:

  • Confirmed diagnosis of a solid tumour OR
  • Confirmed diagnosis of a haematological malignancy. OR
  • Bone marrow failure syndrome requiring systemic therapy, immunosuppression, or haematopoietic stem cell transplantation.

Kidney stratum exclusion criteria:

• Confirmed diagnosis of kidney disease.

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Prevence
  • Přidělení: Randomizované
  • Intervenční model: Paralelní přiřazení
  • Maskování: Žádné (otevřený štítek)

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Aktivní komparátor: Connectors/Caps Domain - Standard of care
Any needle-free or closed-system connector or cap that does not contain antimicrobial agents and does not incorporate specific infection-prevention design features.
Experimentální: Connectors/Caps Domain - InVision-Plus CS® for the cancer stratum
InVision-Plus CS® is a needleless intravenous (IV) connector system intended for use in IV and blood administration sets without the use of needles, thereby reducing the risk of needle-stick injuries during use. The device incorporates antimicrobial agents, including silver and chlorhexidine, designed to reduce microbial colonisation on treated surfaces, including the septum and fluid path.
Experimentální: Connectors/Caps Domain - ClearGuard™ HD for the kidney stratum
The ClearGuard™ HD cap is designed for use with haemodialysis catheters. It attaches to compatible catheter hubs to maintain a closed system between dialysis sessions. The cap is coated with chlorhexidine, which is intended to reduce microbial colonisation at the catheter hub interface.
Experimentální: Connectors/Caps Domain - Tego™ for the kidney stratum
Tego™ is a needle-free capping device that closes the end of a catheter, creating a mechanically and microbiologically closed system when attached to the catheter hub.
Aktivní komparátor: Securement Domain - Standard of care
Basic securement using sterile tape/adhesion fixation device and a simple transparent dressing, without antimicrobial, antiseptic, or engineered stabilization features.
Experimentální: Securement Domain - SecurAcath®
SecurAcath® is a subcutaneous catheter securement system. The device utilises a small anchor (securement feet) placed just beneath the skin at the catheter insertion site and then attached to the catheter shaft. It mechanically stabilises the catheter, reducing movement and migration.

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Central Line-Associated Bloodstream Infection (CLABSI)
Časové okno: Up to 180 days
Laboratory confirmed bloodstream infection associated with the study central venous access device (CVAD), with no other source for the infection, consistent with core criteria of the Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) from January 2026
Up to 180 days

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Positive blood cultures
Časové okno: Up to 180 days
Any positive blood culture classified as contaminant, CLABSI, non-CLABSI primary bloodstream infection, mucosal barrier injury laboratory-confirmed bloodstream infection (MBI-LCBI), or secondary bloodstream infection, consistent with the CDC NHSN criteria from January 2026
Up to 180 days
Catheter-related infection
Časové okno: 180 days
Catheter-related infection consistent with the Catheter Related Infection definitions (CRI1, CRI2, and CRI3) from the European Centre for Disease Prevention and Control (ECDC) version 1.02 from 2015
180 days
Central Venous Catheter (CVC) exit site infection
Časové okno: Up to 180 days
CVC exit site infection consistent with the Infectious Diseases Society of America (IDSA) guidelines from 2009
Up to 180 days
Pocket site infection
Časové okno: Up to 180 days
Pocket site infection consistent with the IDSA guidelines from 2009
Up to 180 days
CVAD failure
Časové okno: Up to 180 days
CVAD failure defined as a composite measure of CLABSI and any other infectious or non-infectious complication leading to CVAD removal.
Up to 180 days
CVAD complications not requiring removal
Časové okno: Up to 180 days
CVAD complications not requiring removal, defined as a composite measure of any complication not requiring CVAD removal.
Up to 180 days
CVAD insertion complications
Časové okno: Up to 180 days
CVAD insertion complications, defined as a composite measure of any insertion complications.
Up to 180 days
Health-related quality of life
Časové okno: Up to 180 days
Assessed using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire
Up to 180 days
Patients' experiences of care
Časové okno: Up to 180 days
Assessed using the Australian Hospital Patient Experience Question Set (AHPEQS)
Up to 180 days
CVAD-related Serious Adverse Events (SAEs)
Časové okno: Up to 180 days
Any SAE considered related or possible related to the CVAD.
Up to 180 days
Intervention-related SAEs
Časové okno: Up to 180 days
Any SAE considered related or possibly related to an intervention within the Connectors/Caps or the Securement domain.
Up to 180 days
Unanticipated Serious Adverse Device Effect (USADEs)
Časové okno: Up to 180 days
Any SAE which meets the definition of an USADE.
Up to 180 days

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Odhadovaný)

1. prosince 2026

Primární dokončení (Odhadovaný)

1. prosince 2031

Dokončení studie (Odhadovaný)

1. prosince 2031

Termíny zápisu do studia

První předloženo

7. května 2026

První předloženo, které splnilo kritéria kontroly kvality

7. května 2026

První zveřejněno (Aktuální)

14. května 2026

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

14. května 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

7. května 2026

Naposledy ověřeno

1. května 2026

Více informací

Termíny související s touto studií

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Ano

produkt vyrobený a vyvážený z USA

Ano

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