A Multi-center Trial to Determine if Curosurf® Reduces the Duration of Mechanical Ventilation in Infants 24+0 to 29+6 Weeks Gestational Age
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Purpose
The purpose of this study is to see if a medication called Curosurf can reduce the length of time that small premature babies with Respiratory Distress Syndrome (immature lungs) or RDS, stay on the ventilator, as compared to the standard medication called BLES. Curosurf is a medication that is already licensed in other countries around the world but is not licensed as yet, in Canada.
Babies born between 24 and 30 weeks of gestation frequently need respiratory support after birth, including being placed on a breathing machine or respirator. The most common reason is Respiratory Distress Syndrome (RDS) whereby immature lungs don't produce enough surfactant, a soapy like substance that helps the air sacs open and close. The current standard treatment is a surfactant called BLES. As Curosurf is less viscous and more potent (therefore requiring a smaller dose), the investigators hypothesize that it will lead to quicker removal from the respirator.
Babies in this study will have a 50/50 chance of receiving either Curosurf or BLES and the investigators will monitor their progress during their Neonatal Intensive Care Unit admission.
The study is taking place in Canada. The goal is to enroll 88 babies. There are no extra tests (blood tests or X-Rays) or return visits to the hospital for the purposes of this study
| Condition | Intervention | Phase |
|---|---|---|
|
Respiratory Distress Syndrome |
Drug: Curosurf-Group1 |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | A Randomized, Controlled, Partially Double-blinded, Phase 3, Multi-center Trial to Determine if Curosurf® Reduces the Duration of Mechanical Ventilation in Infants 24+0 to 29+6 Weeks Gestational Age |
- The primary objective of the study is to compare between the two groups, the number of subjects alive and extubated at 48 hours post surfactant administration. Extubation [ Time Frame: 48 hours ] [ Designated as safety issue: Yes ]
- rate on ventilator ≤40 per minute and
- mean airway pressure ≤ 10 cm H20 and
- fi02 ≤ 30%
- To compare the duration of respiratory support, extubation failure rates, need for additional surfactant doses, adverse events (during and following administration), survival and pulmonary morbidities during hospital admission between the two groups. [ Time Frame: 36 weeks GA ] [ Designated as safety issue: Yes ]1. Extubation failure
- Curosurf-01 [ Time Frame: 36 weeks GA ] [ Designated as safety issue: Yes ]2. Duration of first intubation (in hours/days)
- Curosurf-01 [ Time Frame: 36 weeks GA ] [ Designated as safety issue: Yes ]3. Total duration of respiratory support (ventilator and nCPAP) and total number of days of oxygen requirement
- Curosurf-01 [ Time Frame: 36 weeks GA ] [ Designated as safety issue: Yes ]4. Number of doses of surfactant received
- Curosurf-01 [ Time Frame: 36 weeks GA ] [ Designated as safety issue: Yes ]5. Adverse events during or after administration of surfactant
- Curosurf-01 [ Time Frame: 36 Weeks GA ] [ Designated as safety issue: Yes ]6. Bronchopulmonary dysplasia, defined as oxygen or respiratory support requirement at 36 weeks corrected GA
- Curosurf-01 [ Time Frame: 36 weeks GA ] [ Designated as safety issue: Yes ]7. Mortality prior to discharge
| Estimated Enrollment: | 88 |
| Study Start Date: | January 2013 |
| Estimated Study Completion Date: | December 2014 |
| Estimated Primary Completion Date: | June 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Curosurf (Group 1)
Surfactant(Curosurf in this arm) is given for treatment of RDS after the diagnosis has been made by the Neonatologist. The treatment dose for Curosurf® is 2.5 ml/kg (200mg/kg) for the first dose and 1.25 ml/kg (100mg/kg) for repeat doses, given by endotracheal method. There is a maximum of 3 doses in the study.
|
Drug: Curosurf-Group1
Maximum of 3 doses are administered to infants diagnosed with RDS, as per the standard surfactant policy of the NICU.
|
|
Active Comparator: BLES (Group 2)
Surfactant(BLES in this arm) is given for treatment of RDS after the diagnosis has been made by the Neonatologist. For BLES the recommended dose is 5 ml/kg. given by endotracheal method. There is a maximum of 3 doses in the study.
|
Drug: Curosurf-Group1
Maximum of 3 doses are administered to infants diagnosed with RDS, as per the standard surfactant policy of the NICU.
|
Eligibility| Ages Eligible for Study: | 24 Weeks to 29 Weeks |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Infants born between 24+0 and 29+6 weeks gestational age, admitted to the study centers
- Infants with RDS requiring intubation and surfactant therapy within 48 hours after birth
Exclusion Criteria:
- Any infant more than 48 hours of age
- Any infant with a pulmonary hemorrhage
- Any infant with life-threatening congenital anomaly or one that is considered non-viable
- Any infant on a high frequency ventilator
- Any infant known to require early intubation and ventilation for surgical treatment of a congenital anomaly
- Any infant with anomalies of the upper or lower airway or mandible precluding use of nCPAP
- Any infant born after prolonged premature rupture of membranes (<22 weeks GA or >14 days prior to delivery)
- A parent/LAR who is incapable of, or unwilling, to give consent
- Participation in another clinical trial of any placebo, drug, biological, or device conducted under the provisions of a protocol
- Any other reason as deemed significant by the Investigator
Contacts and Locations| Contact: Brigitte Lemyre, MD | 6137378899 ext 71882 | blemyre@ottawahospital.on.ca |
| Contact: Lynne Cullen, RN | 6137377600 ext 3782 | lcullen@cheo.on.ca |
| Canada, Ontario | |
| The Ottawa Hospital | Not yet recruiting |
| Ottawa, Ontario, Canada, K1H8L6 | |
| Contact: Lynne Cullen, RN 6137377600 ext 3782 lcullen@cheo.on.ca | |
| Contact: Samantha Somers, BA 6137377600 ext 2794 ssomers@cheo.on.ca | |
| Principal Investigator: Brigitte Lemyre, MD | |
| Principal Investigator: | Brigitte Lemyre, MD | OHRI |
More Information
Additional Information:
No publications provided
| Responsible Party: | Ottawa Hospital Research Institute |
| ClinicalTrials.gov Identifier: | NCT01709409 History of Changes |
| Other Study ID Numbers: | Curosurf-01 |
| Study First Received: | October 12, 2012 |
| Last Updated: | October 16, 2012 |
| Health Authority: | Canada: Health Canada |
Keywords provided by Ottawa Hospital Research Institute:
|
Prematurity |
Additional relevant MeSH terms:
|
Respiratory Distress Syndrome, Newborn Respiratory Distress Syndrome, Adult Lung Diseases Respiratory Tract Diseases Respiration Disorders Infant, Premature, Diseases |
Infant, Newborn, Diseases Poractant alfa Pulmonary Surfactants Respiratory System Agents Therapeutic Uses Pharmacologic Actions |
ClinicalTrials.gov processed this record on May 16, 2013