Multicentre, randomised, open-label, non-inferiority trial comparing the effectiveness and safety of ductal lavage versus oral corticosteroids for idiopathic granulomatous mastitis: a study protocol

Introduction The ideal treatment for idiopathic granulomatous mastitis (IGM) remains unclear. In a prospective, single-centre, pilot study, we reported that ductal lavage treatment for non-lactational mastitis patients had a 1-year clinical complete response (cCR) rate of >90%, without any si...

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Main Authors: Jian Zhang, Fengxi Su, Tingting Hu, Shunrong Li, Heng Huang, Hui Huang, Luyuan Tan, Yanbo Chen, Heran Deng, Jiannan Wu, Liling Zhu, Kai Chen
Format: Article
Language:English
Published: BMJ Publishing Group 2020-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/10/e036643.full
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author Jian Zhang
Fengxi Su
Tingting Hu
Shunrong Li
Heng Huang
Hui Huang
Luyuan Tan
Yanbo Chen
Heran Deng
Jiannan Wu
Liling Zhu
Kai Chen
author_facet Jian Zhang
Fengxi Su
Tingting Hu
Shunrong Li
Heng Huang
Hui Huang
Luyuan Tan
Yanbo Chen
Heran Deng
Jiannan Wu
Liling Zhu
Kai Chen
author_sort Jian Zhang
collection DOAJ
description Introduction The ideal treatment for idiopathic granulomatous mastitis (IGM) remains unclear. In a prospective, single-centre, pilot study, we reported that ductal lavage treatment for non-lactational mastitis patients had a 1-year clinical complete response (cCR) rate of >90%, without any significant adverse events. Thus, in this multicentre, randomised, open-label, non-inferiority trial, we will aim to compare the effectiveness and safety of ductal lavage vs oral corticosteroids as the first-line treatment for patients with IGM.Methods and analysis The trial will be conducted at the Breast Tumor Center of Sun Yat-sen Memorial Hospital in China and at least at one participating regional centre. We plan to recruit 140 eligible IGM patients who will be randomised into the ductal lavage group or oral corticosteroid group with a 1:1 ratio. The patients in the oral corticosteroid group will receive Methylprednisolone or prednisone for 6 months. The patients in the ductal lavage group will receive ductal lavage and breast massage, as previously reported. All the participants will be followed up at the clinic for 1 year post randomisation. The primary endpoint of this trial will be the 1-year cCR rate, and the secondary endpoints will include the time to cCR, treatment failure rate, relapse rate and protocol compliance rate. The trial was designed to determine whether ductal lavage is non-inferior to oral corticosteroids (1-year cCR rate assumed to be 90%), with a non-inferiority margin of 15%.Ethics and dissemination The ethics committee of Sun Yat-sen Memorial Hospital at Sun Yat-sen University approved the study (2018-Lun-Shen-Yan-No. 30). The results of the trial will be communicated to the participating primary care practices, published in international journals and presented at international clinical and scientific conferences.Trial registration number ClinicalTrials.gov Registry (NCT03724903); Pre-results.
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spelling doaj-art-d0b0a5feb87f4875bcb090873cbb68242025-08-20T02:11:41ZengBMJ Publishing GroupBMJ Open2044-60552020-10-01101010.1136/bmjopen-2019-036643Multicentre, randomised, open-label, non-inferiority trial comparing the effectiveness and safety of ductal lavage versus oral corticosteroids for idiopathic granulomatous mastitis: a study protocolJian Zhang0Fengxi Su1Tingting Hu2Shunrong Li3Heng Huang4Hui Huang5Luyuan Tan6Yanbo Chen7Heran Deng8Jiannan Wu9Liling Zhu10Kai Chen112 Guangdong Provincial Key Laboratory of Digestive Cancer Research, Sun Yat-sen University, Shenzhen, Guangdong, ChinaBreast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaXiangyang Central Hospital, Xiangyang, Hubei, ChinaBreast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Mammary Surgery, Lianjiang People’s Hospital, Zhanjiang, Guangdong, ChinaDepartment of Mammary Surgery, Maternity and Child Health Care Hospital of Jiangmen, Jiangmen, Guangdong, ChinaBreast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of orthopedics, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaBreast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, ChinaDepartment of Emergence, Hubei Province Women and Children Hospital, Wuhan, Hubei, ChinaBreast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, Chinaassociate professorIntroduction The ideal treatment for idiopathic granulomatous mastitis (IGM) remains unclear. In a prospective, single-centre, pilot study, we reported that ductal lavage treatment for non-lactational mastitis patients had a 1-year clinical complete response (cCR) rate of >90%, without any significant adverse events. Thus, in this multicentre, randomised, open-label, non-inferiority trial, we will aim to compare the effectiveness and safety of ductal lavage vs oral corticosteroids as the first-line treatment for patients with IGM.Methods and analysis The trial will be conducted at the Breast Tumor Center of Sun Yat-sen Memorial Hospital in China and at least at one participating regional centre. We plan to recruit 140 eligible IGM patients who will be randomised into the ductal lavage group or oral corticosteroid group with a 1:1 ratio. The patients in the oral corticosteroid group will receive Methylprednisolone or prednisone for 6 months. The patients in the ductal lavage group will receive ductal lavage and breast massage, as previously reported. All the participants will be followed up at the clinic for 1 year post randomisation. The primary endpoint of this trial will be the 1-year cCR rate, and the secondary endpoints will include the time to cCR, treatment failure rate, relapse rate and protocol compliance rate. The trial was designed to determine whether ductal lavage is non-inferior to oral corticosteroids (1-year cCR rate assumed to be 90%), with a non-inferiority margin of 15%.Ethics and dissemination The ethics committee of Sun Yat-sen Memorial Hospital at Sun Yat-sen University approved the study (2018-Lun-Shen-Yan-No. 30). The results of the trial will be communicated to the participating primary care practices, published in international journals and presented at international clinical and scientific conferences.Trial registration number ClinicalTrials.gov Registry (NCT03724903); Pre-results.https://bmjopen.bmj.com/content/10/10/e036643.full
spellingShingle Jian Zhang
Fengxi Su
Tingting Hu
Shunrong Li
Heng Huang
Hui Huang
Luyuan Tan
Yanbo Chen
Heran Deng
Jiannan Wu
Liling Zhu
Kai Chen
Multicentre, randomised, open-label, non-inferiority trial comparing the effectiveness and safety of ductal lavage versus oral corticosteroids for idiopathic granulomatous mastitis: a study protocol
BMJ Open
title Multicentre, randomised, open-label, non-inferiority trial comparing the effectiveness and safety of ductal lavage versus oral corticosteroids for idiopathic granulomatous mastitis: a study protocol
title_full Multicentre, randomised, open-label, non-inferiority trial comparing the effectiveness and safety of ductal lavage versus oral corticosteroids for idiopathic granulomatous mastitis: a study protocol
title_fullStr Multicentre, randomised, open-label, non-inferiority trial comparing the effectiveness and safety of ductal lavage versus oral corticosteroids for idiopathic granulomatous mastitis: a study protocol
title_full_unstemmed Multicentre, randomised, open-label, non-inferiority trial comparing the effectiveness and safety of ductal lavage versus oral corticosteroids for idiopathic granulomatous mastitis: a study protocol
title_short Multicentre, randomised, open-label, non-inferiority trial comparing the effectiveness and safety of ductal lavage versus oral corticosteroids for idiopathic granulomatous mastitis: a study protocol
title_sort multicentre randomised open label non inferiority trial comparing the effectiveness and safety of ductal lavage versus oral corticosteroids for idiopathic granulomatous mastitis a study protocol
url https://bmjopen.bmj.com/content/10/10/e036643.full
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