Ursodiol for Treating Parenteral Nutrition Associated Cholestasis in Neonates

NCT ID: NCT00846963

Last Updated: 2013-09-17

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

PHASE2/PHASE3

Total Enrollment

26 participants

Study Classification

INTERVENTIONAL

Study Start Date

2008-10-31

Study Completion Date

2013-03-31

Brief Summary

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The purpose of this study is to determine whether ursodiol is effective in the treatment of parenteral nutrition associated cholestasis in neonates.

Detailed Description

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This is the first randomised controlled study that address the question of the role of ursodiol as treatment of cases of PNAC.

It includes all neonates with stratification of less than and equal to 32 weeks or more than 32 weeks of gestation.

Conditions

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Cholestasis

Keywords

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parenteral nutrition associated cholestasis in neonates parenteral nutrition induced cholestasis in preterms Bile duct obstruction biliary stasis

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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Ursodiol

Participants assigned in this arm receive an ursodiol suspension at 20mg/ml.

Group Type EXPERIMENTAL

Ursodiol

Intervention Type DRUG

Ursodiol is given by mouth, three times a day from second value of elevated conjugated bilirubin (\>33mmol/L) to the resolution of cholestasis (conjugated bilirubin \<34mmol/L) If Nil per os, 3,3mg/kg/dose is given. If Nil per os is required (e.g. pre-surgery, or necrotizing enterocolitis), none is given.

If enteral feeding is under 100mL/kg/day, 6,7 mg/kg/day is given. If enteral feeding exceeds 100mL/kg/day, 10 mg/kg/day is given.

placebo

A placebo suspension that looks like the ursodiol suspension used.

Group Type PLACEBO_COMPARATOR

placebo

Intervention Type DRUG

Placebo given in the same amount that ursodiol would be given, depending on enteral feeding and weight. It is also given three times a day, until cholestasis resolution.

Interventions

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Ursodiol

Ursodiol is given by mouth, three times a day from second value of elevated conjugated bilirubin (\>33mmol/L) to the resolution of cholestasis (conjugated bilirubin \<34mmol/L) If Nil per os, 3,3mg/kg/dose is given. If Nil per os is required (e.g. pre-surgery, or necrotizing enterocolitis), none is given.

If enteral feeding is under 100mL/kg/day, 6,7 mg/kg/day is given. If enteral feeding exceeds 100mL/kg/day, 10 mg/kg/day is given.

Intervention Type DRUG

placebo

Placebo given in the same amount that ursodiol would be given, depending on enteral feeding and weight. It is also given three times a day, until cholestasis resolution.

Intervention Type DRUG

Other Intervention Names

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Urso ursodeoxycholic acid

Eligibility Criteria

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Inclusion Criteria

* Preterm or in-term newborns hospitalized in neonatal care units at CHU Sainte-Justine between October 1st 2008 and October 1st 2011.
* Must be receiving parenteral nutrition (either partial or total) at the diagnosis of cholestasis.
* Parental Consent must be obtained.

Exclusion Criteria

* Active urinary tract infection
* Presence of clinical signs(acholic stool) of or ultrasound evidence of biliary tract anomalies.
* Positive TORCH infections(Toxoplasmosis, Other infections, Rubella, Cytomegalovirus, Herpes simplex virus)
* Known short bowel syndrome
* Known congenital hypothyroidism
* Known genetic disorders associated with cholestasis like galactosemia, phenylcytonuria, antitrypsin 1 deficiency... etc
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Ibrahim Mohamed

OTHER

Sponsor Role lead

Responsible Party

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Ibrahim Mohamed

Assisstant professor of pediatrics

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Ibrahim Mohamed, MB ChB, DIS P

Role: PRINCIPAL_INVESTIGATOR

St. Justine's Hospital

Josianne Malo, B.Pharm, M.Sc.

Role: STUDY_DIRECTOR

St. Justine's Hospital

Locations

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CHU Sainte-Justine

Montreal, Quebec, Canada

Site Status

Countries

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Canada

References

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Al-Hathlol K, Al-Madani A, Al-Saif S, Abulaimoun B, Al-Tawil K, El-Demerdash A. Ursodeoxycholic acid therapy for intractable total parenteral nutrition-associated cholestasis in surgical very low birth weight infants. Singapore Med J. 2006 Feb;47(2):147-51.

Reference Type BACKGROUND
PMID: 16435058 (View on PubMed)

Arslanoglu S, Moro GE, Tauschel HD, Boehm G. Ursodeoxycholic acid treatment in preterm infants: a pilot study for the prevention of cholestasis associated with total parenteral nutrition. J Pediatr Gastroenterol Nutr. 2008 Feb;46(2):228-31. doi: 10.1097/MPG.0b013e3181560524.

Reference Type BACKGROUND
PMID: 18223390 (View on PubMed)

Chen CY, Tsao PN, Chen HL, Chou HC, Hsieh WS, Chang MH. Ursodeoxycholic acid (UDCA) therapy in very-low-birth-weight infants with parenteral nutrition-associated cholestasis. J Pediatr. 2004 Sep;145(3):317-21. doi: 10.1016/j.jpeds.2004.05.038.

Reference Type BACKGROUND
PMID: 15343182 (View on PubMed)

Venigalla S, Gourley GR. Neonatal cholestasis. Semin Perinatol. 2004 Oct;28(5):348-55. doi: 10.1053/j.semperi.2004.09.008.

Reference Type BACKGROUND
PMID: 15686266 (View on PubMed)

McKiernan PJ. Neonatal cholestasis. Semin Neonatol. 2002 Apr;7(2):153-65. doi: 10.1053/siny.2002.0103.

Reference Type BACKGROUND
PMID: 12208100 (View on PubMed)

Other Identifiers

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RC:127

Identifier Type: -

Identifier Source: org_study_id