- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05493540
Oral Ibuprofen Versus Placebo in Treatment of Patent Ductus Arteriosus (PDA)in Preterm Infants
Oral Ibuprofen Versus Placebo in Management of Patent Ductus Arteriosus in Preterm Infants: A Double Blind, Randomized Control Trial
The management options of Patent Ductus Arteriosus are still controversial and differ between centers. Recently, conservative management has been gaining interest as the evidence of benefit from medical treatment in terms of mortality and morbidity is lacking.
This study will compare oral ibuprofen (the standard treatment) with the conservative treatment, in terms of ductal closure and morbidity and mortality at discharge in preterm neonates less than 34 weeks.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
A double-blinded, randomized, placebo-control non-inferiority trial was conducted in the neonatal intensive care unit (NICU) of Ain Shams University children's hospital, Cairo, Egypt.
Informed consent was taken from the parents or legal guardians before enrolment, after fully explaining to them the nature of the study. The approval of the Research Ethics Committee at Ain Shams University was also obtained.
All preterm neonates less than 34 weeks were assessed in the first 48 hours by clinical and echocardiographic examination by a cardiologist to detect PDA and exclude any congenital heart disease.
All neonates meeting the inclusion criteria will be randomized into one of two groups:
Medical treatment group and Placebo group. Targeted neonatal Echo was repeated after 5 days of the start of medical treatment by a neonatologist or a cardiologist to assess PDA closure.
After 7 days of intervention, open-label is offered to all patients with the option of another course for patients in the medical treatment group and Rescue therapy in the Placebo group.
The short-term morbidity is documented.
Withdrawal and replacement of individual subjects:
- The attending physician can decide to withdraw a subject from the study for urgent medical reasons. If they wish, parents or caregivers can leave the study at any time for any reason.
- Infants who are withdrawn from the study will be managed according to NICU Protocols.
Study Type
Enrollment (Actual)
Phase
- Phase 2
Contacts and Locations
Study Locations
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Cairo, Egypt
- Faculty of Medicine Ain shams University
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Gestational age ≤ 34 weeks
- PDA Size > 1.5 mm and predominantly left-to-right shunt
- One of the following:
- Signs of Pulmonary overflow: Left atrium/Aortic diameter ratio (LA/Ao), Left Ventricular End Diastolic Diameter (LVEDD).
- Signs of Systemic Hypo perfusion: Absent or Reversed diastolic flow in the aorta, celiac/mesenteric, or Anterior Cerebral Artery (ACA)/ Middle Cerebral Artery (MCA)
Exclusion Criteria:
- Chromosomal anomaly
- Congenital heart defect, other than PDA and/or patent foramen ovale
- Congenital or acquired gastrointestinal anomaly
- Previous episodes of Necrotizing enterocolitis (NEC) or intestinal perforation
- Active bleeding, especially intracranial or gastrointestinal hemorrhage
- Contraindications to the use of ibuprofen
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Medical treatment Group
40 preterm neonates will receive Ibuprofen oral suspension
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The medical treatment group will receive oral Ibuprofen with conservative therapy in the form of fluid restriction, Positive End Expiratory Pressure (PEEP), and/or diuretics An additional course of Ibuprofen may be offered if there is:
Other Names:
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Placebo Comparator: Placebo Group
40 preterm neonates will receive oral placebo
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Placebo Group will receive Oral Placebo and Conservative therapy in the form of fluid restriction, PEEP, and/or diuretics An Open-label option might be offered if there are concerns by attending physicians over the poor patient condition that might be attributed to persistent PDA:
Rescue therapy in the form of a course of oral ibuprofen may be offered:
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of PDA Closure by Echocardiography
Time Frame: Hospital discharge (approximately 3 months unless death occurs first)
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Compare the incidence of PDA closure assessed by Echocardiography during hospitalization between the two groups
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Hospital discharge (approximately 3 months unless death occurs first)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of death during hospitalization
Time Frame: Hospital discharge (approximately 3 months unless death occurs first)
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Compare the incidence of death during hospitalization between the two groups
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Hospital discharge (approximately 3 months unless death occurs first)
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Incidence of Necrotizing Enterocolitis (NEC)
Time Frame: Hospital discharge (approximately 3 months unless death occurs first)
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Compare the incidence of NEC during hospitalization between the two groups by Bell's staging
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Hospital discharge (approximately 3 months unless death occurs first)
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Incidence of Bronchopulmonary dysplasia (BPD)
Time Frame: Hospital discharge (approximately 3 months unless death occurs first)
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Compare the Incidence of BPD (needing supplemental oxygen at 28 days of life) during hospitalization between the two groups
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Hospital discharge (approximately 3 months unless death occurs first)
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Incidence of Sepsis
Time Frame: Hospital discharge (approximately 3 months unless death occurs first)
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Compare the Incidence of sepsis during hospitalization between the two groups by positive blood culture.
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Hospital discharge (approximately 3 months unless death occurs first)
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Incidence of Intraventricular hemorrhage (IVH)
Time Frame: Hospital discharge (approximately 3 months unless death occurs first)
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Compare the Incidence of IVH during hospitalization between the two groups by transcranial ultrasound
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Hospital discharge (approximately 3 months unless death occurs first)
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Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Nada H Youssef, ain shams University
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimate)
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
- Premature Birth
- Ductus Arteriosus, Patent
- Physiological Effects of Drugs
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- Enzyme Inhibitors
- Analgesics
- Sensory System Agents
- Anti-Inflammatory Agents, Non-Steroidal
- Analgesics, Non-Narcotic
- Anti-Inflammatory Agents
- Antirheumatic Agents
- Cyclooxygenase Inhibitors
- Ibuprofen
Other Study ID Numbers
- MD 96 2020
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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