Erythropoietin in Premature Infants to Prevent Encephalopathy
Palabras clave
Abstracto
Descripción
EPO has been safely used for prevent preterm anemia and recent studies have shown the neuro-protective effect. Our hypothesis is that EPO could prevent preterm brain injury and reduce the rate of premature death and disability from encephalopathy. The aims of this study include: to investigate the safety and efficacy of EPO by using 1000u/kg higher than the dose of anemia treatment (250u/kg); to evaluate the effect of EPO on neurodevelopment in preterm infants; to detect biological and imaging indicators of EPO. Eligible premature infants will be enrolled in this double-blind, placebo-controlled randomized trial from the neonatal neurological intensive care unit (NNICU) at 7 Children's Hospital in 6 provinces of China. Subjects will be enrolled within the first 24 hours of life and randomly assigned to receive Epo or saline vehicle placebo. Standard NICU care will be provided to all subjects. Pharmacokinetic data, serial brain electrophysiologic and imaging exams, circulating inflammatory mediators, biomarkers and complications like polycythemia, neutropenia, thrombocytopenia, hypertension, sepsis, hemorrhage, seizure, necrotizing enterocolitis (NEC), persistent ductus arterious (PDA), apnea of prematurity, pulmonary haemorrhage, pulmonary hypertension, Prolonged blood coagulation time, retinopathy of prematurity (ROP), cardiac arrhythmia, major venous thrombosis, Renal failure treated with dialysis, pneumonia, pulmonary airleak and chronic lung disease will be collected at established time points during the study period. At 18 months corrected age, subjects will undergo a neurodevelopmental evaluation assessing for cerebral palsy, Bayley Scores of Mental Development Index (MDI) use.
fechas
| Verificado por última vez: | 01/31/2020 |
| Primero enviado: | 09/03/2015 |
| Inscripción estimada enviada: | 09/13/2015 |
| Publicado por primera vez: | 09/14/2015 |
| Última actualización enviada: | 02/18/2020 |
| Última actualización publicada: | 02/20/2020 |
| Fecha de inicio real del estudio: | 09/07/2015 |
| Fecha estimada de finalización primaria: | 12/29/2020 |
| Fecha estimada de finalización del estudio: | 12/29/2020 |
Condición o enfermedad
Intervención / tratamiento
Drug: Erythropoietin
Drug: Normal saline
Fase
Grupos de brazos
| Brazo | Intervención / tratamiento |
|---|---|
| Experimental: Erythropoietin Epo is administered 1000 U/kg, iv in 48 hours after premature birth, and at 48 hours interval for 3 doses per week. After 6 doses, Subcutaneously 3 doses per week until at corrected age of 34 weeks. | Drug: Erythropoietin Epo is administered 1000 U/kg, iv in 48 hours after premature birth, and at 48 hours interval for 3 doses per week. After 6 doses, subcutaneously 400 U/Kg per injection and 3 doses per week until at corrected age of 34 weeks. |
| Placebo Comparator: Normal saline Normal saline is administered 5ml, iv at 3 to 6 hours after premature birth, and at 48 hours interval for 3 doses per week. After 6 doses, Subcutaneously 3 doses per week until at corrected age of 34 weeks. | Drug: Normal saline Normal saline is administered 5ml, iv at 3 to 6 hours after premature birth, and at 48 hours interval for 3 doses per week. After 6 doses, Subcutaneously 3 doses per week until at corrected age of 34 weeks. |
Criterio de elegibilidad
| Sexos elegibles para estudiar | All |
| Acepta voluntarios saludables | si |
| Criterios | Inclusion Criteria: 1. Birthweight less or equal 1500 grams 2. Less than 32 weeks gestation at birth 3. Less than 48 hours of life at time of enrollment 4. Written informed consent of parent or guardian Exclusion Criteria: 1. Intrauterine Growth Retardation 2. Severe Congenital Anomalies adversely affecting life expectancy or neurodevelopment 3. Genetic Metabolic Diseases 4. Seizures within first 24 hours of life 5. Severe neutropenia (ANC < 500 cells/microL) within first 24 hours of life 6. Polycythemia (Hct > 65%) within first 24 hours of life 7. Thrombocytopenia (platelets < 50K cells/microL) within first 24 hours of life 8. Hypertension (SBP > 100mmHg) without vasopressor support within first 24 hours of life 9. Microcephaly 10. Grade III-IV intracranial hemorrhage Termination 1. Required by parent or guardian; 2. Polycythemia through blood transfusion can not be relieved 3. Oliguria（<0.5mL/kg/h for at least 24 hours） 4. Progression of azotemia 5. Pulmonary hypertension or Cardiac arrhythmia |
Salir
Medidas de resultado primarias
1. Neurodevelopment(Bayley Scores) [At corrected age of 18 months]
2. Neurological Evaluation(GMFM-88 Scores) [At corrected age of 18 months]
Medidas de resultado secundarias
1. Brain Structural Alterations(MRI) [At corrected age of 9 months]
2. Brain Structural Alterations(MRI) [At corrected age of 18 months]
3. Intracranial Hemorrhage(MRI) [At corrected age of 9 months]
4. Intracranial Hemorrhage(MRI) [At corrected age of 18 months]
5. Brain Parenchyma Alterations(MRI) [At corrected age of 9 months]
6. Brain Parenchyma Alterations(MRI) [At corrected age of 18 months]
7. Somatosensory Evoked Potential [At corrected age of 9 months]
8. Somatosensory Evoked Potential [At corrected age of 18 months]
9. Visual Evoked Potential [At corrected age of 9 months]
10. Visual Evoked Potential [At corrected age of 18 months]
11. Brain Stem Auditory Evoked Potential [At corrected age of 9 months]
12. Brain Stem Auditory Evoked Potential [At corrected age of 18 months]
13. Incidence of complication [During treament period (in 34 weeks)]
14. SDF-1 in Serum [At 34 weeks]
15. TNF-alpha in Serum [At 34 weeks]
16. IL-1 in Serum [At 34 weeks]
