Extremely Low Gestatonal Age Infants' Paracetamol Study (Paras)
Extremely Low Gestational Age Infants' Paracetamol Study: a Randomized Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The purpose of this randomized, placebo-controlled, double-blind, phase 2, one center clinical trial is to study the efficacy and safety of early (< 96 h) intravenous paracetamol in prophylactic closure of ductus arteriosus in extremely premature (gestational age <28+0 wk, ELGA) or low birth weight (<1000 g, ELBW) infants. The infants born extremely preterm or low birth weight are a focus of the study, since a small phase 2 study on paracetamol failed to demonstrate contraction of ductus arteriosus.
In the investigator's previous cohort of ELGA/ELBW infants, the numbers of patients who needed any therapies for patent ductus arteriosus (PDA) were 29 (23%) in the paracetamol exposed group, and 90 (54%) in the control group. As demonstrated in a phase 2 study, the early paracetamol treatment induced the closure of ductus arteriosus: the mean (SD) ductal closure age was 177 (338) h in the whole paracetamol group. However, in the subgroup of ELGA infants born before 28 gestation weeks (n=14), the mean (SD) ductal closure ages in the paracetamol and placebo groups were 491 (504) h and 858 (719) h, respectively.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
- Phase 1
Contacts and Locations
Study Contact
Study Contact
- Name: Outi Aikio, MD, PhD
- Phone Number: +35883155810
- Email: outi.aikio@pohde.fi
Study Contact Backup
- Name: Tiina Ukkonen, MD
- Phone Number: +358 8 315 4386
- Email: tiina.ukkonen@pohde.fi
Study Locations
-
-
-
Oulu, Finland, 90014
- Department of Pediatrics, Oulu University Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Premature infants born before 28+0 gestation weeks and/or birth weight less than 1000g
Exclusion Criteria:
- Severe malformation or suspected chromosomal defect or other very severe life-threatening disease (e.g. very severe birth asphyxia or persistent pulmonary hypertension, etc.)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Prevention
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Paracetamol
Paracetamol 10 mg/mL infusion solution, intravenous loading dose 20 mg/kg, followed by maintenance dose 7.5 mg/kg every 6 h up to 9 days
|
Intravenous paracetamol solution for infusion
Other Names:
|
|
Placebo Comparator: Placebo
0.45% sodium chloride (NaCl) solution, equal amounts in mL as would have been given the experimental drug
|
Half physiological saline solution as the non-active placebo solution
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Ductal closure
Time Frame: Neonatal intensive care unit (NICU) treatment period up to 13 weeks
|
Postnatal age of the observed closure of ductus arteriosus
|
Neonatal intensive care unit (NICU) treatment period up to 13 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Near-infrared spectroscopy values
Time Frame: Study drug period up to 10 days
|
Near-infrared spectroscopy values
|
Study drug period up to 10 days
|
|
Paracetamol serum levels
Time Frame: Study drug period up to 10 days
|
Paracetamol serum levels
|
Study drug period up to 10 days
|
|
Paracetamol side effects
Time Frame: Neonatal intensive care unit (NICU) treatment period up to 13 weeks
|
Any observed or detected paracetamol side effects
|
Neonatal intensive care unit (NICU) treatment period up to 13 weeks
|
|
PDA
Time Frame: Neonatal intensive care unit (NICU) treatment period up to 13 weeks
|
Open ductus arteriosus without any traditional PDA therapies
|
Neonatal intensive care unit (NICU) treatment period up to 13 weeks
|
|
PDA, treated
Time Frame: Neonatal intensive care unit (NICU) treatment period up to 13 weeks
|
The need for PDA therapies (ibuprofen, paracetamol, ligation)
|
Neonatal intensive care unit (NICU) treatment period up to 13 weeks
|
|
Ventilatory assist
Time Frame: Neonatal intensive care unit (NICU) treatment period up to 13 weeks
|
The duration of any ventilation assist, days
|
Neonatal intensive care unit (NICU) treatment period up to 13 weeks
|
|
Complications of prematurity
Time Frame: The first hospitalization period up to 19 weeks
|
The long term complications of prematurity (moderate-to-severe bronchopulmonary dysplasia (BPD), intraventricular hemorrhage gr 2-4, moderate to severe necrotizing enterocolitis, retinopathy of prematurity (ROP) needing therapy)
|
The first hospitalization period up to 19 weeks
|
|
Long term morbidity
Time Frame: The first hospitalization period up to 19 weeks
|
Other long-term morbidity
|
The first hospitalization period up to 19 weeks
|
|
Mortality
Time Frame: The first hospitalization period up to 19 weeks
|
Mortality
|
The first hospitalization period up to 19 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Outi Aikio, MD, PhD, Oulu University Hospital
Publications and helpful links
General Publications
- Juujarvi S, Saarela T, Hallman M, Aikio O. Intravenous paracetamol was associated with closure of the ductus arteriosus in extremely premature infants. Acta Paediatr. 2018 Apr;107(4):605-610. doi: 10.1111/apa.14137. Epub 2017 Nov 17.
- Harkin P, Harma A, Aikio O, Valkama M, Leskinen M, Saarela T, Hallman M. Paracetamol Accelerates Closure of the Ductus Arteriosus after Premature Birth: A Randomized Trial. J Pediatr. 2016 Oct;177:72-77.e2. doi: 10.1016/j.jpeds.2016.04.066. Epub 2016 May 20.
- Harma A, Aikio O, Hallman M, Saarela T. Intravenous Paracetamol Decreases Requirements of Morphine in Very Preterm Infants. J Pediatr. 2016 Jan;168:36-40. doi: 10.1016/j.jpeds.2015.08.003. Epub 2015 Aug 29.
- Aikio O, Harkin P, Saarela T, Hallman M. Early paracetamol treatment associated with lowered risk of persistent ductus arteriosus in very preterm infants. J Matern Fetal Neonatal Med. 2014 Aug;27(12):1252-6. doi: 10.3109/14767058.2013.854327. Epub 2013 Oct 31.
Study record dates
Study Major Dates
Study Start (Actual)
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 (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
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
- 39/2018
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Prematurity; Extreme
-
NCT05827250RecruitingPremature Birth | Prematurity | Premature Lungs | Prematurity; Extreme
-
NCT02782637CompletedComplications | Extreme Prematurity
-
NCT04121897CompletedParent-Child Relations | Parents | Extreme Prematurity
-
NCT04074525CompletedPregnancy Preterm | Birth, Preterm | Extreme Prematurity
-
NCT07616778RecruitingInfant, Extremely Premature | Intensive Care, Neonatal | Neonatal and Perinatal Conditions | Extreme Prematurity - Less Than 28 Weeks
-
NCT01773746TerminatedExtreme Prematurity - Less Than 28 Weeks
-
NCT03635944CompletedGrowth Retardation | Prematurity; Extreme
-
NCT01378273CompletedExtreme Prematurity
Clinical Trials on Paracetamol 10mg/mL infusion solution
-
NCT01938261CompletedComplication of Prematurity | Persistent Ductus Arteriosus | Pain or Discomfort in Intensive Care of Preterm Infants
-
NCT03648437TerminatedPatent Ductus Arteriosus
-
NCT05914649RecruitingPostural Orthostatic Tachycardia Syndrome | Post Acute Sequelae of SARS CoV 2 Infection
-
NCT03428230Completed
-
NCT07520487Recruiting
-
NCT04778904Completed
-
NCT05293158Not yet recruiting
-
NCT05170269TerminatedCongenital Cytomegalovirus Infection
-
NCT05868876Recruiting
-
NCT04675021Completed