Representativeness of Honeypot Trial Participants to Australasian PD Patients

Abstract

Background The HONEYPOT trial failed to establish the superiority of exit-site application of Medihoney compared with nasal mupirocin prophylaxis for the prevention of peritonitis in peritoneal dialysis (PD) patients. This study aimed to assess the representativeness of the patients in the HONEYPOT trial to the Australian and New Zealand PD population. Methods This study compared baseline characteristics of the 371 PD patients in the HONEYPOT trial with those of 6,085 PD patients recorded on the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Results Compared with the PD population, the HONEYPOT sample was older (standardized difference [ d] = 0.19, p = 0.003), more likely to be treated with automated PD ( d = 0.58, p < 0.001), had higher residual renal function ( d = 0.26, p < 0.001) and a higher proportion of participants with end-stage kidney disease due to polycystic kidney disease ( d = 0.17) and lower proportion due to diabetes ( d = -0.17) and glomerulonephritis ( d = -0.18) ( p < 0.001), and lower proportions of indigenous people ( d = -0.17, p < 0.001), current smokers ( d = -0.10, p < 0.001), and people with prior histories of hemodialysis ( d = -0.16, p < 0.001), diabetes mellitus ( d = -0.18, p < 0.001), and coronary artery disease ( d = -0.15, p < 0.001). Conclusions HONEYPOT trial participants tended to be healthier than the Australian and New Zealand PD patient population. Although the differences between the groups were generally modest, it is possible that their cumulative effect may have had some impact on external generalizability, which is not an uncommon occurrence in clinical trials.