- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT06065215
Early-life MRI Biomarkers of Longer-term Respiratory Morbidity in Infants Born Extremely Preterm (EMBLEM) (EMBLEM)
March 7, 2024 updated by: Sherri Katz, Children's Hospital of Eastern Ontario
Bronchopulmonary dysplasia (BPD) is a common, major complication of premature birth, associated with developmental and health consequences that continue into adulthood.
Prediction of who will have these problems is challenging using traditional definitions of disease.
It is believed that underdevelopment and injury occur in both lung tissue and the blood vessels in the lungs, with a sophisticated interplay between them that contributes to lung disease seen in prematurity.
New magnetic resonance imaging (MRI) techniques can delineate tissue structure with unprecedented granularity, assessing lung tissue, blood vessels, and their interplay.
The ability to identify, at an early stage, those infants destined for chronic lung disease with greater certainty will be useful in counseling families and critical for the effective introduction of promising new BPD therapies.
319 infants born less than 29 weeks gestation will be recruited from 4 centres, including 5 babies who received stem cell therapy in a clinical trial.
Babies will be evaluated at 36 weeks post-conception with lung MRI, oscillometry (lung function), echocardiogram (heart ultrasound), and oscillometry.
Lung health will be assessed every 3 months by phone questionnaire and chart review.
At 18-21 months post-conception, babies will undergo neurodevelopmental assessment and lung function testing.
The investigators will look at how well baseline MRI markers predict subsequent lung health and development, independently and combined with echocardiogram, lung ultrasound, and traditional markers of BPD.
The investigators anticipate that these new MRI markers will measure lung health safely and longitudinally in babies born extremely preterm.
By identifying predictors of longer-term lung disease, clinicians will be able to allocate resources to babies at the highest risk of severe disease.
Further, The investigators envision that MRI will help identify babies who would benefit most from interventions like stem cell therapy and be useful for evaluation of future treatments.
Study Overview
Status
Recruiting
Conditions
Study Type
Observational
Enrollment (Estimated)
319
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
- Name: Sherri Katz
- Phone Number: (613) 737-7600
- Email: skatz@cheo.on.ca
Study Locations
-
-
Ontario
-
Ottawa, Ontario, Canada, K1H 8L1
- Recruiting
- The Children's Hospital of Eastern Ontario
-
Contact:
- Sherri Katz, Clinical Study Lead
- Phone Number: 2956 (613) 737-7600
- Email: skatz@cheo.on.ca
-
Toronto, Ontario, Canada, M5G 1X5
- Recruiting
- Mount Sinai Hospital
-
Contact:
- Adel Mohamed, Site Lead
- Phone Number: 7396 416-586-4800
- Email: adel.mohamed@sinaihealth.ca
-
-
Quebec
-
Montréal, Quebec, Canada, H4A 3J1
- Recruiting
- Montreal Children's Hospital
-
Contact:
- Gabriel Altit, Co-Site Lead
- Email: gabriel.altit@mcgill.ca
-
Contact:
- Larry Lands, Co-Site Lead
- Email: larry.lands@mcgill.ca
-
Montréal, Quebec, Canada, H3T 1C5
- Active, not recruiting
- CHU-Sainte Justine
-
-
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
- Child
Accepts Healthy Volunteers
No
Sampling Method
Non-Probability Sample
Study Population
Babies will be recruited from four Canadian tertiary care pediatric centers: Children's Hospital of Eastern Ontario (CHEO), Ottawa, ON; Mount Sinai Hospital, Toronto, ON; Centre Hospitalier Universitaire Sainte-Justine, Montreal QC; and Montreal Children's Hospital, Montreal QC.
MRI will occur at each site except Mount Sinai, whose babies will undergo MRI at The Hospital for Sick Children, Toronto, ON.
Description
Inclusion Criteria:
- Infants born at <29 weeks gestation;
- currently <36 weeks PMA.
Exclusion Criteria:
- Known interstitial lung disease, congenital lung anomaly, ciliary dysfunction, immunodeficiency, cystic fibrosis, neuromuscular disease, or structural heart disease (other than atrial septal defect/hemodynamically insignificant ventricular septal defect/patent ductus arteriosus);
- genetic syndrome or congenital anomaly;
- contraindications for MRI or transport;
- invasive or non-invasive ventilation that cannot be safely removed for MRI;
- current respiratory infection;
- family cannot speak English/French;
- transferred to another hospital prior to baseline study visit
- not receiving follow-up at one of the study centres.
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
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Severe Post-prematurity Respiratory Disease (PRD)
Time Frame: The evaluation will be conducted at regular intervals of every 3 months, commencing at 36 weeks PMA and continuing until the child reaches 18 months corrected age
|
PRD will be defined based on the consensus definition of the Prematurity and Respiratory Outcomes Program.
This composite outcome characterizes clinically relevant persistent respiratory morbidity in early life.
It will be evaluated every 3 months from 36 weeks PMA to 18 months corrected age through parent questionnaire and chart review.
Severe PRD is defined as a positive response to any of the following: ≥2 respiratory-related hospitalizations, home oxygen at 3 months corrected age or any home respiratory support, systemic corticosteroid or pulmonary vasodilators after discharge home, chronic respiratory symptoms (cough without cold or wheeze at least once per week) despite concurrent inhaled corticosteroids in ≥ 2 questionnaires, or death secondary to a cardiopulmonary cause.
PRD has been used as a clinical outcome in cohort studies and an American Thoracic Society guideline on optimal neonatal care pathways and predictive perinatal characteristics.
|
The evaluation will be conducted at regular intervals of every 3 months, commencing at 36 weeks PMA and continuing until the child reaches 18 months corrected age
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Neurodevelopmental Impairment (NDI)
Time Frame: Neurodevelopmental impairment will be determined at the 18-21 months corrected age visit
|
Per the Canadian Neonatal Follow-Up Network protocol, NDI will be determined at the 18-21 months corrected age visit.
Children will be administered the Bayley Scales of Infant and Toddler Development, 4th edition (Bayley-4), assessing infant developmental functioning across five domains.
Cognition, language, and motor subtests are directly assessed by a blinded, trained assessor regarding neonatal history.
The social-emotional and adaptive behavior components are assessed via parental questionnaires.
The Bayley-4 yields standard mean scores of 100±15.
A pediatrician performs a neurological examination to identify signs of cerebral palsy and determine functional level using the Gross Motor Functional Classification System (GMFCS).
Visual and hearing function data are retrieved from the chart.
NDI will be defined as the presence of any of the following: Bayley-4 score <85, cerebral palsy with GMFCS ≥ 2, the requirement for hearing aids/cochlear implants, and bilateral blindness.
|
Neurodevelopmental impairment will be determined at the 18-21 months corrected age visit
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Collaborators
Investigators
- Principal Investigator: Sherri Katz, Children's Hospital of Eastern Ontario
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 (Estimated)
March 30, 2024
Primary Completion (Estimated)
June 30, 2027
Study Completion (Estimated)
June 30, 2027
Study Registration Dates
First Submitted
September 27, 2023
First Submitted That Met QC Criteria
September 27, 2023
First Posted (Actual)
October 3, 2023
Study Record Updates
Last Update Posted (Actual)
March 8, 2024
Last Update Submitted That Met QC Criteria
March 7, 2024
Last Verified
March 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 486713
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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