Effect of Vitamin A in the Treatment of Neonatal Sepsis and Necrotizing Enterocolitis

NCT ID: NCT00707785

Last Updated: 2013-09-25

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

424 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-12-31

Study Completion Date

2012-06-30

Brief Summary

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The purpose of the study is to determine whether vitamin A can improve survival and facilitate recovery from sepsis and necrotizing enterocolitis in hospitalized neonates.

Detailed Description

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Sepsis and necrotizing enterocolitis (NEC) are leading causes of morbidity and mortality in neonates. Studies have shown that early reversal of the signs associated with severe disease is an important prognostic factor during acute illness. Vitamin A deficiency is widespread among children, including neonates, in developing countries. Vitamin A plays an important role in mediating immune responses and in maintaining epithelial integrity. For this reason vitamin A supplementation during the acute phase of neonatal infection could work synergistically with present antibiotic regimens in promoting early reversal of signs associated with adverse outcome and shorten the total duration of clinical illness. The purpose of the proposed hospital-based clinical trial is to evaluate the efficacy of vitamin A supplementation on reducing the morbidity and mortality among neonates hospitalized with sepsis (n=366) and NEC(n=150). Enrolled subjects will be randomized at the time of hospitalization to receive one dose of either 50,000 IU of vitamin A or placebo at enrollment, in addition to standard antibiotic therapy. We will compare the proportion of treatment failures in sepsis patients, the frequency of disease progression and mortality in NEC patients, and the time to clinical recovery and discharge between treatment groups. In addition, the study will determine whether vitamin A reduces pro-inflammatory cytokine levels; elevated host inflammatory cytokines are thought to contribute to the severity of both conditions. If vitamin A is found to be efficacious in the treatment of sepsis and NEC it could present a needed cost-effective approach to decreasing the global morbidity, mortality and the economic cost associated with neonatal sepsis and NEC in the developing world.

Conditions

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Sepsis Necrotizing Enterocolitis Meningitis Pneumonia

Keywords

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vitamin A Treatment neonates newborn sepsis necrotizing enterocolitis meningitis pneumonia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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1

Sepsis - vitamin A

Group Type EXPERIMENTAL

Vitamin A

Intervention Type DIETARY_SUPPLEMENT

50,000 IU of Vitamin A 50,000 IU of vegetable oil

2

Sepsis - placebo

Group Type PLACEBO_COMPARATOR

Vitamin A

Intervention Type DIETARY_SUPPLEMENT

50,000 IU of Vitamin A 50,000 IU of vegetable oil

3

NEC - vitamin A

Group Type EXPERIMENTAL

Vitamin A

Intervention Type DIETARY_SUPPLEMENT

50,000 IU of Vitamin A 50,000 IU of vegetable oil

4

NEC - Placebo

Group Type PLACEBO_COMPARATOR

Vitamin A

Intervention Type DIETARY_SUPPLEMENT

50,000 IU of Vitamin A 50,000 IU of vegetable oil

Interventions

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Vitamin A

50,000 IU of Vitamin A 50,000 IU of vegetable oil

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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Retinol

Eligibility Criteria

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Inclusion Criteria

* newborns less than 29 days with clinical sepsis

Exclusion Criteria

* healthy infants
* major congenital abnormalities
* known inborn error(s) of metabolism
* chronic disorders of other organs (e.g. cholestasis)
* definite or severe NEC (\> stage 2)
* congenital heart disease
* Infants receiving VA supplements
* Infants requiring mechanical ventilation
* Infant is unconscious
Minimum Eligible Age

1 Day

Maximum Eligible Age

28 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bill and Melinda Gates Foundation

OTHER

Sponsor Role collaborator

United States Agency for International Development (USAID)

FED

Sponsor Role collaborator

National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

NIH

Sponsor Role collaborator

Johns Hopkins University

OTHER

Sponsor Role lead

Responsible Party

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Christian Coles

Assistant Professor, Department of International Health

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Christian L Coles, PhD

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins Bloomberg School of Public Health

Locations

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Dhaka Shishu Hospital

Dhaka, , Bangladesh

Site Status

Countries

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Bangladesh

Other Identifiers

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1K01DK075478-01

Identifier Type: NIH

Identifier Source: secondary_id

View Link

H.22.05.12.20.A2

Identifier Type: -

Identifier Source: org_study_id