- ICH GCP
- Yhdysvaltain kliinisten tutkimusten rekisteri
- Kliininen tutkimus NCT01600430
Vitamin D Supplementation for Extremely Preterm Infants
Early Vitamin D Supplementation for Prevention of Respiratory Morbidity in Extremely Preterm Infants: A Randomized Clinical Trial
Tutkimuksen yleiskatsaus
Tila
Interventio / Hoito
Yksityiskohtainen kuvaus
After informed consent obtained, infants will be randomized using computer-generated stratified randomization codes by the pharmacy. Clinicians, researcher, and primary caregivers will be masked. Subjects will be randomly assigned to one of the treatment arms or to a placebo concurrent control.
Early vitamin D supplementation/placebo will be initiated within the first 7 days after birth. Premature infants will be randomized to receive one of the 3 fixed doses of vitamin D: either placebo (zero dose), 200 IU/day, or 800 IU/day. The supplementation will be started within 72 hours of enteral feeds being initiated and will continue until postnatal day 28. After this period of supplementation, routine supplementation will be conducted in all groups.
Remnant cord blood samples will be analyzed for vitamin D levels (serum hydroxyvitamin D [25(OH)D]. Two circulating vitamin D concentrations (25(OH)D concentrations) will be measured on postnatal days 14 and 28. Urine samples will be collected weekly, to determine calcium excretion if high serum calcium concentrations are found.
Supplementation will be discontinued and infant will exit the study if surgical necrotizing enterocolitis/bowel perforation is diagnosed, if 25 (OH)D concentrations >60ng/mL (>150nmol/L; potentially toxic) are detected or, if infant NPO for greater than 24 hours. If infant made briefly NPO (<24h) for feeding intolerance, suspected sepsis, hypotension,hemodynamically significant PDA, or respiratory difficulties, enteral vitamin D will not be discontinued.
All infants will be followed to discharge for primary, secondary outcomes as well as adverse events.
Opintotyyppi
Ilmoittautuminen (Todellinen)
Vaihe
- Vaihe 2
- Vaihe 3
Yhteystiedot ja paikat
Opiskelupaikat
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Alabama
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Birmingham, Alabama, Yhdysvallat, 35249
- University of Alabama at Birmingham
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
Hyväksyy terveitä vapaaehtoisia
Sukupuolet, jotka voivat opiskella
Kuvaus
Inclusion Criteria:
- Infants admitted to the Regional Newborn ICU of the University of Alabama with gestational age between 23-27 completed weeks
Exclusion Criteria:
- Major congenital/chromosomal anomalies
- Moribund infant with low likelihood of survival, in opinion of the clinical team
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Ennaltaehkäisy
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Nelinkertaistaa
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
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Active Comparator: Oral Vitamin D--200 IU/day
Cholecalciferol 200 IU given orally once per day
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200 IU/day given orally once per day as one of 4 doses of 0.5ml each given every 6 hours.
Other 3 doses will be placebo (sterile water).
Duration of 28 postnatal days
Muut nimet:
800 IU/day given orally per day as 4 doses of 200 IU/0.5ml each every 6 hours.
Duration of 28 postnatal days
Muut nimet:
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Placebo Comparator: Placebo
Identical-appearing treatment that does not contain the test drug given orally four times per day.
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Sterile water 0.5ml given orally every 6 hours.
Duration of 28 postnatal days
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Active Comparator: Oral Vitamin D--800 IU/day
Cholecalciferol 800 IU given orally once per day
|
200 IU/day given orally once per day as one of 4 doses of 0.5ml each given every 6 hours.
Other 3 doses will be placebo (sterile water).
Duration of 28 postnatal days
Muut nimet:
800 IU/day given orally per day as 4 doses of 200 IU/0.5ml each every 6 hours.
Duration of 28 postnatal days
Muut nimet:
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Total number of days alive and off respiratory support in the first 28 days
Aikaikkuna: 28 days
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The total number of days alive and off respiratory support.
Respiratory support is defined as need of supplemental oxygen and/or positive pressure ventilation to maintain normal target oxygen saturations (88-95%).
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28 days
|
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Serum vitamin D concentration
Aikaikkuna: Day after birth 28
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Serum vitamin D levels determined by enzyme immunoassay obtained from whole blood (remnant sample or obtained during clinical blood draw)
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Day after birth 28
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Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Number of sepsis episodes treated with antibiotics for at least 5 days
Aikaikkuna: Participants will be followed for the duration of hospital stay, an expected average of 4 months
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Number of episodes of culture proven or clinically suspected sepsis episodes treated with antibiotics for at least 5 days
|
Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
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Sepsis
Aikaikkuna: Participants will be followed for the duration of hospital stay, an expected average of 4 months
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Culture proven or culture negative clinically treated course consistent with sepsis
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Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
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Need for supplemental oxygen at 36 weeks of corrected age (Physiologic definition)
Aikaikkuna: 36 weeks gestational age corrected
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A physiologic oxygen challenge test will be administered to infants from 36.0 weeks gestation to 37.0 weeks gestation to determine a need for supplemental oxygen to keep saturation levels between 88-95%.
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36 weeks gestational age corrected
|
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Duration of mechanical ventilation after randomization
Aikaikkuna: Participants will be followed for the duration of hospital stay, an expected average of 4 months
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Counted as number of days on which an infant is on mechanical ventilation for any part of a calendar day
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Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
|
Days alive and off mechanical ventilation in the first 28 days after birth
Aikaikkuna: 28 days
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Counted as days alive without mechanical ventilation for any part of a day
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28 days
|
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Number of re-intubation events
Aikaikkuna: Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
Counted as number of reintubations for purposes of respiratory support
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Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
|
Death
Aikaikkuna: Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
Cardiorespiratory failure
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Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
|
Surgical necrotizing enterocolitis or intestinal perforation
Aikaikkuna: Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
Radiographic documentation of pneumatosis or intestinal perforation or treatment course for clinical necrotizing enterocolitis per Bell's stage greater than 1.
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Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
|
25(OH)D concentrations >60ng/ml (150 nmol/L)
Aikaikkuna: 14 postnatal (+/- 2 days)
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Vitamin D measurement per blood obtained either centrally or by heel stick.
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14 postnatal (+/- 2 days)
|
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25(OH)D concentrations >60ng/ml (150 nmol/L)
Aikaikkuna: 28 days postnatal age (+/- 3 days)
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Vitamin D measurement per blood obtained either centrally or by heel stick.
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28 days postnatal age (+/- 3 days)
|
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Serum calcium level
Aikaikkuna: Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
Serum calcium measurement per blood obtained either centrally or by heel stick, performed for clinical care.
High serum calcium level is greater than 3 mmol/l of total calcium or total calcium of >12 mg/dL, or ionized calcium >2 mml/L.
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Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
|
Urine calcium level
Aikaikkuna: Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
Calcium measurement per urine, random sampling.
High level (>95%tile) urine calcium to creatinine ratio is >3.8 mmol/mmol.
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Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
|
Meningitis
Aikaikkuna: Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
Culture proven or culture negative clinically treated course consistent with meningitis
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Participants will be followed for the duration of hospital stay, an expected average of 4 months
|
Muut tulostoimenpiteet
Tulosmittaus |
Aikaikkuna |
|---|---|
|
Death or Neurodevelopmental Impairment
Aikaikkuna: Birth to 22-26 months of age
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Birth to 22-26 months of age
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Yhteistyökumppanit ja tutkijat
Sponsori
Yhteistyökumppanit
Tutkijat
- Opintojohtaja: Ariel A. Salas, MD, University of Alabama at Birmingham
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- Huey SL, Acharya N, Silver A, Sheni R, Yu EA, Pena-Rosas JP, Mehta S. Effects of oral vitamin D supplementation on linear growth and other health outcomes among children under five years of age. Cochrane Database Syst Rev. 2020 Dec 8;12(12):CD012875. doi: 10.1002/14651858.CD012875.pub2.
- Fort P, Salas AA, Nicola T, Craig CM, Carlo WA, Ambalavanan N. A Comparison of 3 Vitamin D Dosing Regimens in Extremely Preterm Infants: A Randomized Controlled Trial. J Pediatr. 2016 Jul;174:132-138.e1. doi: 10.1016/j.jpeds.2016.03.028. Epub 2016 Apr 11.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus
Ensisijainen valmistuminen (Todellinen)
Opintojen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Arvio)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Avainsanat
Muita asiaankuuluvia MeSH-ehtoja
- Hengityselinten sairaudet
- Keuhkosairaudet
- Vauva, vastasyntynyt, sairaudet
- Ravitsemushäiriöt
- Avitaminoosi
- Puutostaudit
- Aliravitsemus
- Raskauden komplikaatiot
- Synnytystyön komplikaatiot
- Synnytystyö, ennenaikainen
- Keuhkovaurio
- Vauva, Keskoset, Sairaudet
- Hengityslaitteen aiheuttama keuhkovaurio
- D-vitamiinin puutos
- Ennenaikainen Synnytys
- Bronkopulmonaalinen dysplasia
- Huumeiden fysiologiset vaikutukset
- Mikroravinteet
- Luutiheyden säilyttämisaineet
- Kalsiumia säätelevät hormonit ja aineet
- D-vitamiini
- Kolekalsiferoli
- Vitamiinit
- Ergokalsiferolit
Muut tutkimustunnusnumerot
- UAB Neo 006
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