Phosphate in Acute Pancreatitis (PPP)
Phosphate in Acute Pancreatitis (PPP)
The goal of this study is to learn if phosphate administration works to treat acute pancreatitis in adults presenting to the emergency department at Duke University Hospital. The main questions it aims to answer are:
- Does having low phosphate levels increase the risk of acute pancreatitis and can giving phosphate through an IV make the illness less severe?
- Is phosphate therapy practical to use, and what is the appropriate dose?
- Is this study achievable, and how can the results help design a future randomized controlled trial to assess safety and effectiveness?
Participants will:
- Receive standard of care or intravenous (IV) phosphate during their hospital stay
- Have blood samples collected during admission to monitor phosphorus levels
- Complete follow-up assessments after hospital admission to evaluate how severe the illness is and the effects of phosphate supplementation
調査の概要
詳細な説明
This prospective, two-phase pilot clinical trial will enroll 100 adult emergency department patients with acute pancreatitis (50 per phase) at Duke University Hospital.
Phase one will consist of an observational control group receiving usual care, with serum phosphorus collected throughout the emergency department visit and hospitalization to examine how phosphorus levels change over time and relate to disease severity and clinical outcomes.
Phase two will include a treatment group receiving continuous intravenous sodium phosphate or potassium phosphate infusions to maintain high-normal serum phosphorus levels (4.0-4.5 mg/dL) during the first 72 hours of hospitalization. Phosphate dosing requirements will be determined and compared across varying levels of disease severity to assess whether more severe illness is associated with greater supplementation needs.
Overall, the study will characterize phosphorus dynamics in acute pancreatitis, evaluate the feasibility and dosing of phosphate repletion, and generate preliminary data to inform the design of a future randomized controlled trial assessing the safety and efficacy of phosphate therapy.
研究の種類
入学 (推定)
段階
- フェーズ2
連絡先と場所
研究連絡先
- 名前:Samuel Francis, MD
- 電話番号:919-684-5537
- メール:samuel.francis@duke.edu
研究場所
-
-
North Carolina
-
Durham、North Carolina、アメリカ、27710
- 募集
- Duke University Medical Center
-
コンタクト:
- Lezly Collins
- メール:lezly.collins@duke.edu
-
主任研究者:
- Samuel Francis, MD
-
-
参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Age 18 years or older
- Presenting to the emergency department (ED) with acute pancreatitis meeting 2 or more characteristics of: (1) typical, persistent, severe upper abdominal pain, (2) lipase or amylase levels at least three times greater than the upper limit of normal, and/or (3) characteristic findings on abdominal imaging)
- Trial treatment can be initiated within 24 hours of hospital admission
- Consent can be obtained from the patient or their legal representative
Exclusion Criteria:
Contraindications to injectable phosphate including:
- Hyperkalemia
- Hypercalcemia or significant hypocalcemia
- Severe renal impairment (eGFR <30 mL/min/1.73m2) or end-stage renal disease
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 主な目的:処理
- 割り当て:非ランダム化
- 介入モデル:並列代入
- マスキング:なし(オープンラベル)
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
|
介入なし:Standard of Care Observational Phase
During the first year of enrollment, 50 control group participants will be enrolled in an observational phase and receive usual care only with fluid resuscitation at the discretion of the clinical team.
Serum phosphorus levels will be checked every 6 hours and additional blood samples will be collected daily to monitor patients' lab values during their hospital stay.
|
|
|
実験的:Phosphate Treatment Phase
During the second year of enrollment, 50 treatment group participants will be enrolled and receive usual care plus continuous sodium phosphate or potassium phosphate (in the case of hypernatremia) which will be delivered by continuous peripheral intravenous infusion at a rate of 30 mmol every 6 hours, as long as serum phosphorus levels are ≤ 4.0 mg/dL.
Phosphate infusion will be initiated as soon as possible after patient enrollment and continued for a maximum duration of 72 hours or until patient discharge from the hospital, whichever occurs sooner.
Serum phosphorus levels will be checked every 6 hours, and the infusion will be paused until the next recheck if the level rises >4.0 mg/dL.
Additional blood samples will be collected daily to monitor patients' lab values during their hospital stay.
|
The treatment is administered via continuous peripheral intravenous infusion at a rate of 30 mmol every 6 hours, provided serum phosphorus levels remain at or below 4.0 mg/dL; it begins upon patient enrollment and continues for up to 72 hours.
他の名前:
This treatment will be used in case of hypernatremia.
The treatment is administered via continuous peripheral intravenous infusion at a rate of 30 mmol every 6 hours, provided serum phosphorus levels remain at or below 4.0 mg/dL; it begins upon patient enrollment and continues for up to 72 hours.
他の名前:
|
この研究は何を測定していますか?
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Serum Phosphorus Levels
時間枠:During hospitalization, up to approximately 7 days
|
Serum phosphorus levels measured in a control (observational) group of patients with acute pancreatitis.
This will be determined utilizing the Revised Atlanta Classification.
|
During hospitalization, up to approximately 7 days
|
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Disease Severity as measured by the Revised Atlanta Classification (RAC)
時間枠:During hospitalization, up to approximately 7 days
|
The RAC is categorized into three levels based on the absence or presence of organ failure and local or systemic complications: Mild = No organ failure and no local or systemic complications, Moderately Severe = Transient organ failure (resolving within 48 hours) OR local/systemic complications without persistent organ failure, Severe = Persistent organ failure (lasting more than 48 hours) that can involve a single or multiple organ systems.
|
During hospitalization, up to approximately 7 days
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Dosing Requirements
時間枠:During the first 72 hours of hospital admission and phosphate administration
|
Determine the dosing requirements of phosphate treatment in a treatment group of patients with acute pancreatitis to maintain a high-normal phosphorus level (4.0-4.5 mg/dL) during their emergency department (ED) and hospital stay, with serum phosphorus levels being measured every 6 hours.
|
During the first 72 hours of hospital admission and phosphate administration
|
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Feasibility as measured by the proportion of treatment-group participants receiving at least one infusion
時間枠:Up to 3 months post-discharge
|
Based on the prospective phosphate supplementation phase, determine the feasibility of developing a randomized controlled trial to assess safety and efficacy of phosphate treatment in patients with acute pancreatitis.
|
Up to 3 months post-discharge
|
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Feasibility as measured by the proportion of treatment-group participants completing treatment
時間枠:Up to 3 months post-discharge
|
Based on the prospective phosphate supplementation phase, determine the feasibility of developing a randomized controlled trial to assess safety and efficacy of phosphate treatment in patients with acute pancreatitis.
|
Up to 3 months post-discharge
|
協力者と研究者
スポンサー
捜査官
- 主任研究者:Samuel Francis, MD、Duke University Hospital
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (推定)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
- Pro00120087
- 1R01DK142980-01A1 (米国 NIH グラント/契約)
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
米国で製造され、米国から輸出された製品。
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