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Cerebral PalsyPhase 3TABLONCT07672158

Tranexamic Acid to Reduce Blood Loss After Varus Derotation Osteotomy

A Phase 3 study testing Tranexamic Acid (IV) in people with Cerebral Palsy and Hip Surgery Corrective, run by Murdoch Childrens Research Institute at 1 site in Australia.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
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Trial summary

TABLO (Tranexamic Acid to reduce Blood Loss after varus derotation Osteotomy) is a clinical trial of postoperative tranexamic acid vs placebo in non-ambulatory children with cerebral palsy (CP) undergoing reconstructive hip surgery. Read more about this study

Who is it for?
Ages 4 to 16 years
What is being tested?
Tranexamic Acid (IV)
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
52 participants
Where
1 siteAustralia
Study dates
Nov 2026to Jun 2029
Phase
Phase 3
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 4 to 16 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Children (aged 4 to 16 years)
  • Diagnosis of cerebral palsy (CP). CP is an umbrella term under which many specific diagnoses are captured, and the clinical team at the study institution operates a comprehensive referral network to ensure patients with any relevant diagnoses are included.
  • Gross Motor Function Classification System (GMFCS) levels IV and V, with substantial hip displacement (>40% migration percentage per Australian Hip Surveillance Guidelines (Wynter M, Gibson N, Kentish M, Love S, Thomason P, Willoughby K, et al. Australian hip surveillance guidelines for children with cerebral palsy 2014. Australian Academy of Cerebral Palsy and Developmental Medicine. 2014.)), who are on the waitlist for bilateral proximal femoral varus derotational osteotomy (VDRO) +/- unilateral or bilateral pelvic osteotomy.

Who cannot join

  • Haematological disorder (defined as an active genetic or acquired bleeding disorder)
  • Known hypersensitivity to tranexamic acid (TXA)
  • Children with promyelocytic leukaemia being treated with oral tretinoin will be excluded from the trial because combination with TXA has resulted in fatal thrombotic complications
  • Known coagulation defect
  • Known renal disorder (moderate to severe as per study institution guidelines)

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Erich Rutz, MD, PhD contact

+61 9345 7645

erich.rutz@rch.org.au

Daniel Gould, MD, PhD contact

+61 9345 7645

daniel.gould@unimelb.edu.au

Australia1 site
  • The Royal Children's Hospital

    Melbourne, Victoria, 3052

Other trials in Australia

About this study

Official title: Postoperative Continuous Intravenous Tranexamic Acid Infusion to Reduce Blood Loss in Non-Ambulatory Children With Cerebral Palsy Following Bilateral Bony Hip Reconstructive Surgery: A Phase III Parallel-Group Randomised Placebo-Controlled Trial

TABLO (Tranexamic Acid to reduce Blood Loss after varus derotation Osteotomy) is a clinical trial of postoperative tranexamic acid vs placebo in non-ambulatory children with cerebral palsy (CP) undergoing reconstructive hip surgery.

Improving surgical outcomes is a high priority in this patient population given the high risk of bleeding and the diminished capacity for these children to withstand substantial blood loss. Preliminary data from the study institution indicates that approximately one third of these patients receive transfusion of blood products in the postoperative period. There is growing evidence that hidden blood loss occurring in the postoperative period is substantial and can potentially be attenuated with the administration of Tranexamic Acid (TXA). However, trials on postoperative TXA have been carried out exclusively in adult surgical populations.

Read the detailed description

TABLO (Tranexamic Acid to reduce Blood Loss after varus derotation Osteotomy) is a parallel-group randomised placebo-controlled trial of postoperative tranexamic acid vs placebo in children with CP undergoing bilateral varus derotational osteotomy (VDRO) surgery. The allocation ratio is 1:1 (placebo: intervention), and the trial will be powered to detect a difference in postoperative blood loss calculated using a haemoglobin mass loss formula. Improving perioperative outcomes is a high priority in this patient population given the high risk of bleeding from this surgical intervention and the reduced physiological reserve in these children. Preliminary data from the study institution indicates that approximately one third of these patients receive transfusion of blood products in the postoperative period. There is growing evidence that hidden blood loss occurring in the postoperative period is substantial and can potentially be attenuated with the administration of Tranexamic Acid (TXA). However, trials on postoperative TXA have been carried out exclusively in adult surgical populations. This is an embedded superiority randomised placebo-controlled patient-/treating team-/assessor-blinded trial comparing tranexamic acid with placebo in reducing blood loss following bilateral bony hip reconstructive surgery in non-ambulatory children with cerebral palsy. Primary objective: to evaluate the impact of postoperative continuous intravenous TXA infusion, compared with placebo in the form of normal saline, on blood loss in non-ambulatory children with cerebral palsy undergoing bilateral VDRO surgery with or without pelvic osteotomy. Secondary objectives: to investigate the safety and tolerability of postoperative tranexamic acid in children with CP undergoing bilateral VDRO surgery with or without pelvic osteotomy, and to evaluate the health economic impact of postoperative tranexamic acid in children with cerebral palsy undergoing bilateral VDRO surgery with or without pelvic osteotomy. To the best of the study team's knowledge this will be the first randomised controlled trial to investigate postoperative intravenous TXA in a paediatric surgical population. Trial population: Non-ambulant children with cerebral palsy undergoing bilateral VDRO surgery with or without pelvic osteotomy. Planned sample size is 52 participants (26 in each group: placebo and intervention). Study setting: Single site electronic medical record (EMR) embedded trial in the software platform EpicTM at The Royal Children's Hospital (RCH). Trial intervention: after cessation of the intraoperative tranexamic acid infusion, and once the patient has been transferred to the recovery bay, the postoperative infusion will commence comprising 10mg/kg/hr intravenous TXA for 24 hours. Placebo: equivalent volume of visually identical normal saline will be infused at the same rate as the TXA. Recruitment: It is anticipated that recruitment will commence in June 2026 and cease August 2028, with the last participant completing 6-month follow up period by April 2029. Participant duration: It is anticipated that duration of participation will be approximately four to six months. The time between initial identification as potentially eligible to date of surgery is three months maximum, length of stay is approximately seven days, and post-operative follow-up is 6 months.

Being tested
Tranexamic Acid (IV), Placebo
Keywords
Cerebral Palsy, Hip surgery, Tranexamic Acid, Blood Loss, Orthopaedics
Medical subject headings
Cerebral Palsy, Blood Loss, Surgical, Hemorrhage

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Tranexamic Acid (IV)Drug

    Once the patient has been transferred to recovery after surgery, the postoperative infusion will commence comprising 10mg/kg/hr intravenous tranexamic acid for 24 hours.

  • PlaceboDrug

    The control group will receive placebo in the form of normal saline. The volume administered will be identical to that of TXA intervention arm, and the infusion rate will be the same.

Study groups in NCT07672158
Study groupRoleWhat they receive
Tranexamic acid postoperative continuous infusion armExperimentalOnce the patient has been transferred to recovery after surgery, the postoperative infusion will commence comprising 10mg/kg/hr intravenous tranexamic acid for 24 hours.
Receives: Drug: Tranexamic Acid (IV)
Normal saline postoperative continuous infusion armPlacebo comparatorThe control group will receive placebo in the form of normal saline, which is physically identical to tranexamic acid and has been used in previous randomised placebo-controlled trials of tranexamic acid.
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Mean change between treatment arms in postoperative haemoglobin mass loss, measured on postoperative day 5 or day of discharge (whichever is earlier) and estimated using the HAEmoglobin Mass loss DuRing the periOperative Period (HAEMDROP) formula

    HAEMDROP formula:

    mHb_loss = BV*(Hb_initial - Hb_final) + (TV * 200), where:

    • mHb_loss = Haemoglobin (Hb) mass loss in grams (g)
    • BV = Blood volume of the patient in litres (L). For paediatric patients, blood volume is ~75ml/kg.
    • Hb_initial = Hb at the start of the period of interest (in grams per litre (g/L)).
    • Hb_final = Hb at the end of the period of interest (in grams per litre (g/L)).
    • VT = volume (in L) of packed red blood cells transfused between Hb_initial and Hb_final.
    • - 200 = 200g/L, the average haemoglobin level in a unit of blood. Multiplying this by the VT gives the haemoglobin mass transfused (in grams)

    Measured: Day of surgery (within 15 minutes of the end of surgery), Day 5 or day of discharge (whichever is earlier)

Secondary outcomes (9)
  1. Number of clinically significant seizures

    Seizures experienced between Day of surgery until Day 5 post-operatively which:

    • are more frequent or more severe than the participant's pre-admission baseline.
    • necessitate additional clinical monitoring or intervention, as per institutional guidelines, beyond what is expected from the participant's pre-admission baseline seizure management.
    • seizures which require the administration of rescue medications which deviates from what is typical for the participant at baseline.

    Measured: Day of surgery until Day 5 post-operatively

  2. Duration of hospital stay

    Total duration of hospital stay, in calendar days, from date of admission (= day zero) to date of discharge.

    Measured: Date of surgery, date of discharge from hospital which will be an anticipated average of 8.28 days

  3. Duration of paediatric intensive care unit admission

    The occurrence and duration of both planned and unplanned admission to the paediatric intensive care (PICU) unit during the participant's post-operative inpatient period.

    Measured: Date of PICU admission through to date of discharge from PICU which will be an anticipated average of 26.5 hours

  4. Volume of packed red blood cells transfused

    Volume of packed red blood cells transfused during the period over which the primary outcome is measured (from end of operation to postoperative day 5 inclusive).

    Measured: From end of operation to postoperative day 5 or day of discharge (whichever comes first)

  5. Incidence of surgical wound infections - superficial incisional surgical site infection

    Surgical site infection event defined in accordance with the Centers for Disease Control and Prevention (CDC)'s National Healthcare Safety Network (NHSN) criteria

    Measured: Day of surgery through to 30 days following surgery

  6. Incidence of surgical wound infections - deep incisional surgical site infection

    Surgical site infection event defined in accordance with the Centers for Disease Control and Prevention (CDC)'s National Healthcare Safety Network (NHSN) criteria

    Measured: Day of surgery through to 90 days following surgery

  7. Incidence of venous thromboembolism events requiring treatment

    Incidence of venous thromboembolism requiring anticoagulant treatment in accordance with study institution guidelines will be captured.

    Measured: Day of surgery through to Day 5 post-surgery

  8. Changes in in quality of life, measured in quality-adjusted life years (QALYs)

    The EuroQol 5 dimensions (EQ-5D) by proxy will be completed by participants' parent/guardian. The EQ-5D is numbered from 0 to 100, where 100 means the best health you can imagine and 0 means the worst health you can imagine. From this, QALYs will be calculated and compared between intervention and control groups.

    Measured: Preoperatively, 3 months postoperatively, 6 months postoperatively

  9. Changes in quality of life

    Changes in quality of life will be captured by the CP-CHILD (caregiver) questionnaire, which measures:

    Social wellbeing \& acceptance, Feelings about functioning, Participation \& physical health, Emotional wellbeing \& self-esteem, Access to services, Pain \& impact of disability, Family health

    Measured: Preoperatively, 3 months postoperatively, 6 months postoperatively

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Jun 2026
  2. Study startNov 2026 (estimated)
  3. Primary completionDec 2028 (estimated)
  4. Study completionJun 2029 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
52 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07672158
Sponsor's protocol ID
tablotrialvdrocprchmcri2025123
Acronym
TABLO
Status last verified
Jun 2026
First submitted
10 Jun 2026
Last updated
14 Oct 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The anonymised data set collected for the analysis of this trial will be made available 12 months following analysis and publication of the primary outcome. This includes data collected for the primary outcome and each secondary outcome.

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Tranexamic Acid (IV) in people with Cerebral Palsy and Hip Surgery Corrective, run by Murdoch Childrens Research Institute at 1 site in Australia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 14 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Australia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Erich Rutz, MD, PhD (+61 9345 7645, erich.rutz@rch.org.au), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Mean change between treatment arms in postoperative haemoglobin mass loss, measured on postoperative day 5 or day of discharge (whichever is earlier) and estimated using the HAEmoglobin Mass loss DuRing the periOperative Period (HAEMDROP) formula (time frame: Day of surgery (within 15 minutes of the end of surgery), Day 5 or day of discharge (whichever is earlier)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 14 Oct 2026; AzTrials last refreshed its copy on 26 Oct 2026.

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