- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03456336
Management of the PDA Trial (PDA)
Management of the Patent Ductus Arteriosus in Premature Infants Trial (PDA Trial)
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a pragmatic randomized multicenter, effectiveness study comparing active treatment of a symptomatic patent ductus arteriosus (sPDA) to expectant management. We hypothesize in premature infants with a sPDA, expectant management reduces the incidence proportion of death or BPD by 10% (from 50% to 40%) when compared to active treatment.
Participants with a sPDA allocated to the active treatment arm will receive intravenous administration of indomethacin or ibuprofen (depending on center preference). The decision to ligate will be left to the clinical team. Participants with a sPDA allocated to the expectant management arm will receive supportive care at the clinical team's discretion and will receive indomethacin/ibuprofen or ligation if the infant develops cardiopulmonary compromise. The decision to ligate will be left to the clinical team.
The primary endpoint for the study will be death or BPD (as assessed by the physiologic definition) at 36 weeks postmenstrual age (PMA).
Study Type
Enrollment (Estimated)
Phase
- Phase 3
Contacts and Locations
Study Contact
- Name: Abhik Das, PhD
- Phone Number: 301-230-4640
Study Contact Backup
- Name: Matthew Laughon, MD, MPH
- Phone Number: 984-974-5063
- Email: matt_laughon@med.unc.edu
Study Locations
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Alabama
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Birmingham, Alabama, United States, 35233
- Recruiting
- University of Alabama at Birmingham
-
Contact:
- Waldemar A. Carlo, MD
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Principal Investigator:
- Waldemar A. Carlo, MD
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California
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Palo Alto, California, United States, 94304
- Recruiting
- Stanford University
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Contact:
- Krisa P. Van Meurs, MD
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Principal Investigator:
- Krisa P. Van Meurs, MD
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San Diego, California, United States, 92123
- Recruiting
- Sharp Mary Birch Hospital for Women & Newborns
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Contact:
- Anup Katheria, MD
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Principal Investigator:
- Anup Katheria, MD
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Georgia
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Atlanta, Georgia, United States, 30303
- Recruiting
- Emory University
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Contact:
- David P Carlton, MD
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Principal Investigator:
- David P Carlton, MD
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Illinois
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Chicago, Illinois, United States, 60611
- Not yet recruiting
- Northwestern Lurie Children's Hospital of Chicago
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Contact:
- Aaron Hamvas, MD
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Principal Investigator:
- Aaron Hamvas, MD
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Iowa
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Iowa City, Iowa, United States, 52242
- Recruiting
- University of Iowa
-
Contact:
- Edward F. Bell, MD
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Principal Investigator:
- Edward F. Bell, MD
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Mississippi
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Jackson, Mississippi, United States, 39216
- Not yet recruiting
- University of Mississippi Medical Center - Children's of Mississippi
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Principal Investigator:
- Abhay Bhatt, MD
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Contact:
- Abhay Bhatt, MD
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New Mexico
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Albuquerque, New Mexico, United States, 87131
- Recruiting
- University of New Mexico
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Contact:
- Kristi L. Watterberg, MD
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Principal Investigator:
- Kristi L. Watterberg, MD
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New York
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Rochester, New York, United States, 14642
- Active, not recruiting
- University of Rochester
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North Carolina
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Durham, North Carolina, United States, 27710
- Recruiting
- Duke University
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Contact:
- C. Michael Cotten, MD
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Sub-Investigator:
- C. Michael Cotten, MD MHS
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Durham, North Carolina, United States, 27705
- Active, not recruiting
- RTI International
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Ohio
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Cincinnati, Ohio, United States, 45267
- Recruiting
- Cincinnati Children's Medical Center
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Contact:
- Brenda Poindexter, MD
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Principal Investigator:
- Brenda Poindexter, MD
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Cleveland, Ohio, United States, 44106
- Recruiting
- Case Western Reserve University, Rainbow Babies and Children's Hospital
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Contact:
- Michele C. Walsh, MD MS
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Principal Investigator:
- Michele C. Walsh, MD MS
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Columbus, Ohio, United States, 43205
- Active, not recruiting
- Research Institute at Nationwide Children's Hospital
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Pennsylvania
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Philadelphia, Pennsylvania, United States, 19104
- Recruiting
- University of Pennsylvania
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Contact:
- Eric Eichenwald, MD
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Principal Investigator:
- Eric Eichenwald, MD
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Rhode Island
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Providence, Rhode Island, United States, 02905
- Active, not recruiting
- Brown University - Women and Infants Hospital of Rhode Island
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Texas
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Dallas, Texas, United States, 75235
- Recruiting
- University of Texas Southwestern Medical Center at Dallas
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Contact:
- Myra Myckoff, MD
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Principal Investigator:
- Myra Wyckoff, MD
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Houston, Texas, United States, 77030
- Recruiting
- University of Texas Health Science Center at Houston
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Principal Investigator:
- Jon E. Tyson, MD MPH
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Contact:
- Jon E Tyson, MD MPH
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Utah
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Salt Lake City, Utah, United States, 84108
- Recruiting
- University of Utah
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Contact:
- Bradley Yoder, MD
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Principal Investigator:
- Bradley A. Yoder, MD
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Postnatal age 48 hours -21 days
- Infant 22 0/7 to 28 6/7 weeks gestation at birth
sPDA, as defined as:
- Mild, Moderate, or Severe Clinical Criteria with Small or Moderate size PDA on echocardiogram
- Mild or Moderate Clinical Criteria with Large PDA on echocardiogram
Exclusion Criteria:
- Cardiopulmonary compromise
- Known congenital heart disease (besides atrial septal defect or ventricular septal defect)
- Known pulmonary malformation (e.g. congenital lobar emphysema, congenital pulmonary adenomatous malformation)
- Any condition which, in the opinion of the investigator, would preclude enrollment
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Active Treatment Group
Infants assigned to the active treatment group will receive indomethacin or ibuprofen per their local site usual care dosing and schedule if the infant has a sPDA.
The choice of indomethacin or ibuprofen will be left to the center, however, infants may only receive one or the other.
|
Infants assigned to the active treatment group will receive indomethacin or ibuprofen per their local site usual care dosing and schedule if the infant has a sPDA.
The choice of indomethacin or ibuprofen will be left to the center, however, infants may only receive one or the other.
If the infant receives both, it will be considered a protocol violation.
|
Active Comparator: Expectant Management Group
Infants assigned to the expectant management group will receive indomethacin or ibuprofen if cardiopulmonary compromise occurs.
|
Infants assigned to the expectant management group will receive indomethacin or ibuprofen if cardiopulmonary compromise occurs.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Death or Bronchopulmonary Dysplasia (BPD) at 36 weeks PMA
Time Frame: birth to 36 week postmenstrual age
|
Death or BPD.
BPD will be defined by the physiologic definition.
|
birth to 36 week postmenstrual age
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mortality at 36 weeks PMA
Time Frame: birth to 36 week postmenstrual age
|
mortality assessed at 36 week postmenstrual age
|
birth to 36 week postmenstrual age
|
Mortality before discharge
Time Frame: birth to 120 days of life
|
mortality assessed prior to hospital discharge
|
birth to 120 days of life
|
Bronchopulmonary dysplasia - Physiological Test
Time Frame: birth to 36 week postmenstrual age
|
BPD defined by the physiologic test of oxygen therapy
|
birth to 36 week postmenstrual age
|
Bronchopulmonary dysplasia - NIH Consensus Definition
Time Frame: birth to 36 week postmenstrual age
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BPD defined by the NIH consensus definition of moderate or severe
|
birth to 36 week postmenstrual age
|
Necrotizing Enterocolitis (NEC) at 36 weeks PMA
Time Frame: birth to 36 weeks post menstrual age
|
Proven NEC, no surgery, Stages IIA, IIB, or IIIA AND proven, surgery, Stage IIIB
|
birth to 36 weeks post menstrual age
|
Retinopathy of Prematurity at 36 weeks PMA
Time Frame: birth to 36 weeks post menstrual age
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Stage 3 or worse in either eye AND as any intervention therapy-retinal ablation, scleral buckle/vitrectomy, avastin or other anti-VEGF drug
|
birth to 36 weeks post menstrual age
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Receipt of therapies designed to close the PDA
Time Frame: birth to 120 days
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Defined as ligation or cardiac catheterization
|
birth to 120 days
|
Weight at 36 weeks PMA
Time Frame: birth to 36 weeks post menstrual age
|
Weight assessed at 36 weeks post menstrual age
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birth to 36 weeks post menstrual age
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Height at 36 weeks PMA
Time Frame: birth to 36 weeks post menstrual age
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Height assessed at 36 weeks post menstrual age
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birth to 36 weeks post menstrual age
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Head Circumference at 36 weeks PMA
Time Frame: birth to 36 weeks post menstrual age
|
Head Circumference assessed at 36 weeks post menstrual age
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birth to 36 weeks post menstrual age
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Necrotizing Enterocolitis (NEC) at status (2 years)
Time Frame: 26 months corrected age
|
Proven NEC, no surgery, Stages IIA, IIB, or IIIA AND proven, surgery, Stage IIIB
|
26 months corrected age
|
Retinopathy of Prematurity at status (2 years)
Time Frame: 26 months corrected age
|
Stage 3 or worse in either eye AND as any intervention therapy-retinal ablation, scleral buckle/vitrectomy, avastin or other anti-VEGF drug
|
26 months corrected age
|
Weight at status (2 years)
Time Frame: 26 months corrected age
|
Weight assessed at status (2 years)
|
26 months corrected age
|
Height at status (2 years)
Time Frame: 26 months corrected age
|
Height assessed at status (2 years)
|
26 months corrected age
|
Head Circumference at status (2 years)
Time Frame: 26 months corrected age
|
Head Circumference assessed at status (2 years)
|
26 months corrected age
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Neurodevelopmental impairment (NDI) at status (2 years)
Time Frame: 26 months corrected age
|
Severe NDI will be defined by any of the following: a BSID III cognitive score < 70, Gross Motor Functional (GMF) Level of 3-5, blindness (<20/200 vision) or profound hearing loss (inability to understand commands despite amplification); moderate NDI will be defined as a BSID III cognitive score 70-84 and either a GMF level of 2 or a hearing deficit requiring amplification to understand commands or unilateral blindness; mild NDI will be defined by a cognitive score 70-84, or a cognitive score ≥ 85 and any of the following: presence of a GMF level 1 or hearing loss not requiring amplification.
Normal (no NDI) will be defined by a cognitive score ≥ 85 and absence of any neurosensory deficits.
|
26 months corrected age
|
Collaborators and Investigators
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Heart Diseases
- Cardiovascular Diseases
- Congenital Abnormalities
- Pregnancy Complications
- Obstetric Labor Complications
- Obstetric Labor, Premature
- Heart Defects, Congenital
- Cardiovascular Abnormalities
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Premature Birth
- Ductus Arteriosus, Patent
- Infant, Newborn, Diseases
Other Study ID Numbers
- NICHD-NRN-0059
- UG1HD112079 (U.S. NIH Grant/Contract)
- UG1HD112097 (U.S. NIH Grant/Contract)
- UG1HD112100 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
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.
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