Ursodiol for Treating Parenteral Nutrition Associated Cholestasis in Neonates (URSONEONAT)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
This is the first randomised controlled study that address the question of the role of ursodiol as treatment of cases of PNAC.
It includes all neonates with stratification of less than and equal to 32 weeks or more than 32 weeks of gestation.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 3
Contacts and Locations
Study Locations
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Quebec
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Montréal, Quebec, Canada, H3T 1C5
- CHU Sainte-Justine
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Child
- Adult
- Older Adult
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Preterm or in-term newborns hospitalized in neonatal care units at CHU Sainte-Justine between October 1st 2008 and October 1st 2011.
- Must be receiving parenteral nutrition (either partial or total) at the diagnosis of cholestasis.
- Parental Consent must be obtained.
Exclusion Criteria:
- Active urinary tract infection
- Presence of clinical signs(acholic stool) of or ultrasound evidence of biliary tract anomalies.
- Positive TORCH infections(Toxoplasmosis, Other infections, Rubella, Cytomegalovirus, Herpes simplex virus)
- Known short bowel syndrome
- Known congenital hypothyroidism
- Known genetic disorders associated with cholestasis like galactosemia, phenylcytonuria, antitrypsin 1 deficiency... etc
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Ursodiol
Participants assigned in this arm receive an ursodiol suspension at 20mg/ml.
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Ursodiol is given by mouth, three times a day from second value of elevated conjugated bilirubin (>33mmol/L) to the resolution of cholestasis (conjugated bilirubin <34mmol/L) If Nil per os, 3,3mg/kg/dose is given. If Nil per os is required (e.g. pre-surgery, or necrotizing enterocolitis), none is given. If enteral feeding is under 100mL/kg/day, 6,7 mg/kg/day is given. If enteral feeding exceeds 100mL/kg/day, 10 mg/kg/day is given.
Other Names:
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Placebo Comparator: placebo
A placebo suspension that looks like the ursodiol suspension used.
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Placebo given in the same amount that ursodiol would be given, depending on enteral feeding and weight.
It is also given three times a day, until cholestasis resolution.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Length of parenteral nutrition associated cholestasis (in days)
Time Frame: at the end of cholestasis (when conjugated bilirubin < 34 mmol/L) average of 4 weeks.
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at the end of cholestasis (when conjugated bilirubin < 34 mmol/L) average of 4 weeks.
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Peak value of biomarkers associated with cholestasis (Gamma-glutamyl transpeptidase, Alkaline phosphatase, conjugated bilirubin)
Time Frame: at least once a week, during cholestasis
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at least once a week, during cholestasis
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1- Other hepatic marker (Aspartate transaminase, alanine transaminase, albumin blood level)
Time Frame: at least once a week, during cholestasis
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at least once a week, during cholestasis
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Length required to minimal enteral feeding (120mL/kg/day) measured in days.
Time Frame: From birth to outcome (usually less than 21 days)
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From birth to outcome (usually less than 21 days)
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Weight gain (in g/kg/day)
Time Frame: From birth to resolution of cholestasis (very varuiable but usually less than 3 months)
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From birth to resolution of cholestasis (very varuiable but usually less than 3 months)
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Adverse effects linked to ursodiol
Time Frame: From beginning to the end of the medication (average 4 weeks)
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From beginning to the end of the medication (average 4 weeks)
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Ibrahim Mohamed, MB ChB, DIS P, St. Justine's Hospital
- Study Director: Josianne Malo, B.Pharm, M.Sc., St. Justine's Hospital
Publications and helpful links
General Publications
- Al-Hathlol K, Al-Madani A, Al-Saif S, Abulaimoun B, Al-Tawil K, El-Demerdash A. Ursodeoxycholic acid therapy for intractable total parenteral nutrition-associated cholestasis in surgical very low birth weight infants. Singapore Med J. 2006 Feb;47(2):147-51.
- Arslanoglu S, Moro GE, Tauschel HD, Boehm G. Ursodeoxycholic acid treatment in preterm infants: a pilot study for the prevention of cholestasis associated with total parenteral nutrition. J Pediatr Gastroenterol Nutr. 2008 Feb;46(2):228-31. doi: 10.1097/MPG.0b013e3181560524.
- Chen CY, Tsao PN, Chen HL, Chou HC, Hsieh WS, Chang MH. Ursodeoxycholic acid (UDCA) therapy in very-low-birth-weight infants with parenteral nutrition-associated cholestasis. J Pediatr. 2004 Sep;145(3):317-21. doi: 10.1016/j.jpeds.2004.05.038.
- Venigalla S, Gourley GR. Neonatal cholestasis. Semin Perinatol. 2004 Oct;28(5):348-55. doi: 10.1053/j.semperi.2004.09.008.
- McKiernan PJ. Neonatal cholestasis. Semin Neonatol. 2002 Apr;7(2):153-65. doi: 10.1053/siny.2002.0103.
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- RC:127
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