Gastrointestinal Dysmotility on Aspiration Risk
The Impact of Upper Gastrointestinal Dysmotility on Aspiration-associated Symptoms
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Contact
Study Contact
- Name: Rachel Rosen, MD
- Phone Number: 617-355-0897
- Email: rachel.rosen@childrens.harvard.edu
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02115
- Recruiting
- Boston Children's Hospital
-
Contact:
- Rachel Rosen Principal Investigator
- Phone Number: 6173556055
- Email: rachel.rosen@childrens.harvard.edu
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- are 5-21 years of age;
- receive >90% of their calories by enteral tube (i.e., patients take no food or drink by mouth);
- are determined to be at high risk for aspiration pneumonia based on evidence of impaired airway protective mechanisms, documented by aspiration on video fluoroscopic swallow study;
- have static neurologic impairment, defined as functional and/or intellectual impairment that results from a chronic neurologic or related diagnosis (e.g., cerebral palsy) with no prospect of progression for at least one year;
have chronic respiratory symptoms, defined as coughing, choking, or need for oral suctioning a minimum of three times per week during the prior four weeks.
-
Exclusion Criteria:
- have progressive neurologic impairment;
- have a history of prior intact Nissen fundoplication;
- are currently taking oral or inhaled antibiotics, including prophylactic antibiotics;
- are currently taking or have taken in the last four weeks acid suppression (H2 antagonist or PPI); or
- are fed by gastrojejunostomy rather than by gastrostomy. -
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Arm 1
Patients will be undergo 1 week observation period followed by 4 weeks of prucalopride followed by 1 weeks of a wash out followed by 4 weeks of famotidine
|
Prucalopride 0.04 mg/kg/day
Famotidine 0.4 mg/kg/day
|
|
Experimental: Arm 2
Patients will be undergo 1 week observation period followed by 4 weeks of famotidine followed by 1 weeks of a wash out followed by 4 weeks of prucalopride
|
Prucalopride 0.04 mg/kg/day
Famotidine 0.4 mg/kg/day
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Pediatric Cough Quality of Life Questionnaire
Time Frame: 4 weeks
|
Comparison of the mean difference in the Pediatric Cough Quality of Life Questionnaire (range: 7 to 189, lower scores=more symptom impairment) between baseline and 4 week scores between Arm 1 and Arm 2
|
4 weeks
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Gastric emptying outcomes
Time Frame: 4 weeks
|
Comparison of within-patient differences in gastric residuals by nuclear scintigraphy
|
4 weeks
|
|
Total Peds-GI QL score
Time Frame: 8 weeks
|
Comparison of the mean difference in total Peds-GI QL scores (range: 0-100, lower=worse symptoms) between famotidine and prucalopride periods
|
8 weeks
|
|
Aspiration symptoms
Time Frame: 4 weeks
|
Comparison of the mean difference in the number of coughing or choking episodes per week during the fourth week of treatment
|
4 weeks
|
|
Microbiome
Time Frame: 8 weeks
|
Comparison of within-patient differences in microbiome diversity and abundance between baseline and after each medication period
|
8 weeks
|
|
Pneumonias
Time Frame: 10 weeks
|
Comparisons in the number of aspiration pneumonias between each treatment period
|
10 weeks
|
|
Esophageal reflux events
Time Frame: 4 weeks
|
Comparison of within-patient differences in post-prandial reflux events by nuclear scintigraphy
|
4 weeks
|
Collaborators and Investigators
Sponsor
Sponsor
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
Additional Relevant MeSH Terms
- Respiratory Tract Infections
- Infections
- Respiratory Tract Diseases
- Digestive System Diseases
- Gastrointestinal Diseases
- Lung Diseases
- Esophageal Diseases
- Pneumonia
- Deglutition Disorders
- Gastroesophageal Reflux
- Pneumonia, Aspiration
- Esophageal Motility Disorders
- Sulfur Compounds
- Organic Chemicals
- Heterocyclic Compounds, 1-Ring
- Heterocyclic Compounds
- Thiazoles
- Azoles
- Famotidine
- prucalopride
Other Study ID Numbers
Other Study ID Numbers
- IRB-P00038381
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
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