Intratracheal Budesonide/Surfactant Prevents BPD

May 25, 2023 updated by: Taipei Medical University

Routine Administration of Surfactant/Budesonide to Prevent BPD in VLBW With RDS-A Double Blind Study

A double-blind study includes: 1) birth Wt 500-1499 gm, 2) respiratory distress shortly after birth and requires resuscitation 3) failure to NCPAP within 4 hrs after birth, defined as: a) FIO2 ≥ 0.30, pressure > 5cmH2O b) severe retraction c) apnea d) PCO2 ≥ 60 mmHg. Exclusion criteria: 1) lethal cardiopulmonary status 2) severe congenital anomalies.

Given the COVID19 pandemics, the recruitment became difficult. Under the consideration of scientific and practical consideration, we therefore determine to have a sample of 300, (150 in each group), fulfill the criteria of type I error 0.05, type II error 0.10, power 90% and with an expectation of 30 % improvement of primary outcome (from 60 % in control group to 40 % in the intervention group as original presumed).Appropriate amount of placebo will be used as it does not affect the biophysical property of curosurf (PAS abstract 2017 San Francisco). Primary outcome of study is death or BPD defined by NICHD criteria. Follow up study of neuromotor and cognitive function and pulmonary states will be done at 1-2 years of corrected age.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

A double-blind study will be conducted in 7 tertiary centers. Inclusion criteria are: 1) birth Wt 500-1499 gm, 2) respiratory distress shortly after birth and requires resuscitation 3) failure to NCPAP within 4 hrs after birth, defined as: a) FIO2 ≥ 0.30, pressure > 5cmH2O b) severe retraction c) apnea d) PCO2 ≥ 60 mmHg. Exclusion criteria: 1) lethal cardiopulmonary status 2) severe congenital anomalies.

The initial sample size was determined based on the expectation of 30% improvement of the primary outcome (BPD/death) in the intervention group (Curosurf + budesonide) (40%), as compared to control group (Curosurf +saline placebo) (60%), specifying a type I error of 0.05 and type II error 0.20. The total number needed was 240 (120 in each group). The study was started in June 2019 before the pandemic of COVID19 and the study went on smoothly in 2019. Because of the smooth enrollment of the patients in 2019, we decided to increase the ability of the study for detecting the intervention effect through increasing the power from 80 % to 90 % (type II error from 0.2 to 0.1 and type I error decreased from 0.05 to 0.02). The total sample size required was estimated to be 350 (170 in each group). Given the COVID19 pandemics, the recruitment became difficult. Under the consideration of scientific and practical consideration, we therefore determine to have a sample of 300, (150 in each group), fulfill the criteria of type I error 0.05, type II error 0.10, power 90% and with an expectation of 30 % improvement of primary outcome (from 60 % in control group to 40 % in the intervention group as original presumed). The changes in sample size had been approved by independent monitoring committee. We expect that the study will be completed in September 2022.

The sample will be stratified based on birth weight (500-749 grams, 750-999 grams and 1000-1499 grams), the presence of clinical chorioamnionitis or not, and site of study.

Study Type

Interventional

Enrollment (Actual)

310

Phase

  • Phase 4

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

  • Name: Chung M. Chen, MD., PhD.
  • Phone Number: 3715 886-2-27372181
  • Email: cmchen@tmu.edu.tw

Study Locations

      • Taipei, Taiwan
        • National Taiwan University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

30 minutes to 4 hours (Child)

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • 1) birth Wt 500-1499 gm, 2) respiratory distress shortly after birth and requires resuscitation, 3) failure to NCPAP within 4 hrs after birth, defined as: a) FIO2 ≥ 0.30, pressure > 5 cmH2O b) severe retraction c) apnea d) PCO2 ≥ 60 mmHg.

Exclusion Criteria:

  • 1) lethal cardiopulmonary status, 2) severe congenital anomalies.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Experimental
Curosurf + budesonide
Intra-tracheal instillation of a combination of budesonide/surfactant in preterm infants with RDS to prevent BPD
Other Names:
  • pulmicort
Placebo Comparator: Placebo
Curosurf + saline
Intra-tracheal instillation of a combination of saline/surfactant in preterm infants with RDS to prevent BPD
Other Names:
  • sodium chloride

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
incidence of death or BPD
Time Frame: 6 months
Primary outcome of study is death or BPD defined by NICHD criteria.
6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Tsu F Yeh, M.D., Ph.D., Maternal Child Health Research Center, Taipei Medical University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

July 1, 2019

Primary Completion (Actual)

June 30, 2022

Study Completion (Actual)

June 30, 2022

Study Registration Dates

First Submitted

September 5, 2017

First Submitted That Met QC Criteria

September 6, 2017

First Posted (Actual)

September 7, 2017

Study Record Updates

Last Update Posted (Actual)

May 30, 2023

Last Update Submitted That Met QC Criteria

May 25, 2023

Last Verified

June 1, 2022

More Information

Terms related to this study

Other Study ID Numbers

  • N201705026

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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