- ICH GCP
- Реестр клинических исследований США
- Клиническое испытание 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
Обзор исследования
Статус
Подробное описание
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.
Тип исследования
Регистрация (Действительный)
Фаза
- Фаза 2
- Фаза 3
Контакты и местонахождение
Места учебы
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Alabama
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Birmingham, Alabama, Соединенные Штаты, 35249
- University of Alabama at Birmingham
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Критерии участия
Критерии приемлемости
Возраст, подходящий для обучения
Принимает здоровых добровольцев
Полы, имеющие право на обучение
Описание
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
Учебный план
Как устроено исследование?
Детали дизайна
- Основная цель: Профилактика
- Распределение: Рандомизированный
- Интервенционная модель: Параллельное назначение
- Маскировка: Четырехместный
Оружие и интервенции
Группа участников / Армия |
Вмешательство/лечение |
|---|---|
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Активный компаратор: 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
Другие имена:
800 IU/day given orally per day as 4 doses of 200 IU/0.5ml each every 6 hours.
Duration of 28 postnatal days
Другие имена:
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Плацебо Компаратор: 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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Активный компаратор: Oral Vitamin D--800 IU/day
Cholecalciferol 800 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
Другие имена:
800 IU/day given orally per day as 4 doses of 200 IU/0.5ml each every 6 hours.
Duration of 28 postnatal days
Другие имена:
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Что измеряет исследование?
Первичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
|
Total number of days alive and off respiratory support in the first 28 days
Временное ограничение: 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
Временное ограничение: 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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Вторичные показатели результатов
Мера результата |
Мера Описание |
Временное ограничение |
|---|---|---|
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Number of sepsis episodes treated with antibiotics for at least 5 days
Временное ограничение: 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
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Participants will be followed for the duration of hospital stay, an expected average of 4 months
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Sepsis
Временное ограничение: 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)
Временное ограничение: 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
Временное ограничение: 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
|
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Days alive and off mechanical ventilation in the first 28 days after birth
Временное ограничение: 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
Временное ограничение: Participants will be followed for the duration of hospital stay, an expected average of 4 months
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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
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Death
Временное ограничение: Participants will be followed for the duration of hospital stay, an expected average of 4 months
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Cardiorespiratory failure
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Participants will be followed for the duration of hospital stay, an expected average of 4 months
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Surgical necrotizing enterocolitis or intestinal perforation
Временное ограничение: Participants will be followed for the duration of hospital stay, an expected average of 4 months
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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
|
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25(OH)D concentrations >60ng/ml (150 nmol/L)
Временное ограничение: 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)
Временное ограничение: 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
Временное ограничение: Participants will be followed for the duration of hospital stay, an expected average of 4 months
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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
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Urine calcium level
Временное ограничение: Participants will be followed for the duration of hospital stay, an expected average of 4 months
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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
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Meningitis
Временное ограничение: 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 meningitis
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Participants will be followed for the duration of hospital stay, an expected average of 4 months
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Другие показатели результатов
Мера результата |
Временное ограничение |
|---|---|
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Death or Neurodevelopmental Impairment
Временное ограничение: Birth to 22-26 months of age
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Birth to 22-26 months of age
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Соавторы и исследователи
Соавторы
Следователи
- Директор по исследованиям: Ariel A. Salas, MD, University of Alabama at Birmingham
Публикации и полезные ссылки
Общие публикации
- 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.
Даты записи исследования
Изучение основных дат
Начало исследования
Первичное завершение (Действительный)
Завершение исследования (Действительный)
Даты регистрации исследования
Первый отправленный
Впервые представлено, что соответствует критериям контроля качества
Первый опубликованный (Оценивать)
Обновления учебных записей
Последнее опубликованное обновление (Действительный)
Последнее отправленное обновление, отвечающее критериям контроля качества
Последняя проверка
Дополнительная информация
Термины, связанные с этим исследованием
Ключевые слова
Дополнительные соответствующие термины MeSH
- Заболевания дыхательных путей
- Легочные заболевания
- Младенец, Новорожденный, Болезни
- Расстройства питания
- Авитаминоз
- Дефицитные заболевания
- Недоедание
- Осложнения беременности
- Осложнения акушерских родов
- Акушерские роды, преждевременные роды
- Травма легких
- Младенец, Преждевременно, Заболевания
- Повреждение легких, вызванное вентилятором
- Дефицит витамина D
- Преждевременные роды
- Бронхолегочная дисплазия
- Физиологические эффекты лекарств
- Микроэлементы
- Агенты сохранения плотности костей
- Кальций-регулирующие гормоны и агенты
- Витамин Д
- Холекальциферол
- Витамины
- Эргокальциферолы
Другие идентификационные номера исследования
- UAB Neo 006
Эта информация была получена непосредственно с веб-сайта clinicaltrials.gov без каких-либо изменений. Если у вас есть запросы на изменение, удаление или обновление сведений об исследовании, обращайтесь по адресу register@clinicaltrials.gov. Как только изменение будет реализовано на clinicaltrials.gov, оно будет автоматически обновлено и на нашем веб-сайте. .