Efficacy of Erythropoietin to Improve Survival and Neurological Outcome in Hypoxic Ischemic Encephalopathy (Neurepo)
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Purpose
The purpose of this study is to determine the efficacy of high dose Erythropoietin to improve survival and neurologic outcome in asphyxiated term newborn undergoing cooling.
| Condition | Intervention | Phase |
|---|---|---|
|
Hypoxic Ischemic Encephalopathy |
Drug: Erythropoietin Beta Drug: Placebo |
Phase 3 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Treatment |
| Official Title: | Phase III Study of Efficacy of High Dose Erythropoietin to Prevent Hypoxic-ischemic Encephalopathy Sequelea in Term Newborn |
- Survival without neurologic sequelea [ Time Frame: at 24 months ] [ Designated as safety issue: Yes ]
- Mortality rates [ Time Frame: Within 24 months ] [ Designated as safety issue: Yes ]
- Rate of moderate and severe sequelae [ Time Frame: at 24 months ] [ Designated as safety issue: No ]Mental Developemental index (Brunet Lezine Test), motor, visual and hearing impairment
- Aspect of brain lesions on MRI [ Time Frame: at day 6 and day 12 after birth ] [ Designated as safety issue: No ]Brain MRI performed between day 6 and day 12 after birth
- Tolerance of treatment [ Time Frame: at 24 months ] [ Designated as safety issue: Yes ]
| Estimated Enrollment: | 330 |
| Study Start Date: | December 2012 |
| Estimated Study Completion Date: | December 2016 |
| Estimated Primary Completion Date: | December 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Erythropoietin beta
1000 to 1500 U/kg/dose X 3 every 24 hours
|
Drug: Erythropoietin Beta
Erythopoietin intravenous injection (5000 U/ 0.3 ml)1000 to 1500 U/kg/dose X 3 given every 24 hours with the first dose within 12 hours of delivery
|
|
Placebo Comparator: Placebo
0.2 ml saline solution X 3 given every 24 hours
|
Drug: Placebo
Other Name: 0.2 ml saline solution X 3 given every 24 hours with the first dose within 12 hours of delivery
|
Detailed Description:
Hypoxic-ischemic encephalopathy remains the main cause of death or long term neurologic impairments in neonates. Yet, therapies for birth asphyxia are currently limited. Hypothermia when applied within 6 hours after birth demonstrate partial improvement in outcome of newborns specially those with moderate form. Erythropoietin and its receptors are upregulated after brain injury in ischemic conditions. Systemically administered erythropoietin is neuroprotective in animal models of birth asphyxia. To date, one study demonstrate improvement neurologic outcome in asphyxiated term newborn under erythropoietin treatment but no reports evaluating beneficial of erythropoietin associated with cooling. This is a large randomised controlled trial to evaluate the efficacy of high dose erythropoietin on outcome at two years of asphyxiated term newborns undergoing cooling.
Eligibility| Ages Eligible for Study: | up to 12 Hours |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Term or near-term newborn (> = 36 weeks agestational age)
- Moderate to severe encephalopathy
- undergoing moderate controlled hypothermia started within 6 hours after delivery
- Beneficiary of social security plan
- Informed consent parental authority
Exclusion Criteria:
- Impossibility of getting controlled hypothermia before H6
- Infant older than 12 hours of age
- Chromosomal or significant congenital abnormality
- Predictable surgery in the first 3 days of life
- Uncontrolled collapse
- Haemorrhagic syndrome unchecked
- Head trauma with or without skull fracture
Contacts and Locations| Contact: Juliana Patkai, MD, PhD | + 33 1 58 41 54 12 | juliana.patkai@cch.aphp.fr |
| Contact: Laurence Lecomte, PhD | : +33 1 71 19 64 94 | laurence.lecomte@nck.aphp.fr |
| France | |
| Cochin Hospital | Not yet recruiting |
| Paris, France, 75014 | |
| Contact: Juliana Patkai, PhD + 33 1 58 41 54 12 Juliana.patkai@cch.aphp.fr | |
| Sub-Investigator: Juliana Patkai, MD, PhD | |
| Principal Investigator: | Juliana Patkai, MD, PhD | Cochin Hospital |
More Information
Publications:
| Responsible Party: | Assistance Publique - Hôpitaux de Paris |
| ClinicalTrials.gov Identifier: | NCT01732146 History of Changes |
| Other Study ID Numbers: | 110111 |
| Study First Received: | November 19, 2012 |
| Last Updated: | November 19, 2012 |
| Health Authority: | France: Ministry of Health |
Keywords provided by Assistance Publique - Hôpitaux de Paris:
|
Hypoxic Ischemic Encephalopathy Term neonate Neuroprotection Erythropoeitin |
Additional relevant MeSH terms:
|
Brain Ischemia Ischemia Brain Damage, Chronic Delirium Encephalitis Hepatic Encephalopathy Neurotoxicity Syndromes Hypoxia-Ischemia, Brain Cerebrovascular Disorders Brain Diseases Central Nervous System Diseases Nervous System Diseases Vascular Diseases Cardiovascular Diseases Pathologic Processes |
Confusion Neurobehavioral Manifestations Neurologic Manifestations Signs and Symptoms Delirium, Dementia, Amnestic, Cognitive Disorders Mental Disorders Central Nervous System Viral Diseases Virus Diseases Central Nervous System Infections Liver Failure Hepatic Insufficiency Liver Diseases Digestive System Diseases Brain Diseases, Metabolic Metabolic Diseases |
ClinicalTrials.gov processed this record on June 18, 2013