Trial of Late Surfactant for Prevention of Bronchopulmonary Dysplasia

NCT ID: NCT01022580

Last Updated: 2021-05-13

Study Results

Results available

Outcome measurements, participant flow, baseline characteristics, and adverse events have been published for this study.

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Total Enrollment

511 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-01-31

Study Completion Date

2016-01-31

Brief Summary

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The purpose of this study is to determine if late doses of Infasurf surfactant given when patients are receiving inhaled nitric oxide will interact to improve surfactant function and increase survival without BPD in treated infants.

Detailed Description

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This is a multi-center, blinded, randomized controlled clinical trial to evaluate the effects of booster doses of exogenous surfactant (Infasurf®, calfactant) in addition to inhaled nitric oxide (iNO) on the outcome of survival without bronchopulmonary dysplasia (BPD, or chronic lung disease of prematurity, characterized by chronic lung dysfunction) at 36 weeks' post-menstrual age (PMA) in extremely low gestational age (ELGAN) infants that are at high risk of the development of BPD. This multi-center trial, with a planned enrollment of 524 infants, will also enable us to evaluate for any adverse effects of late surfactant treatment on short- and long-term outcomes, as we will be collecting data on effects of dosing of late surfactant, co-morbidities of prematurity and neurodevelopmental and pulmonary outcome at 1 year and 24 months corrected age. In addition, we will collect biological specimens for evaluation of the effects of late surfactant replacement therapy (administered as described in this trial) on surfactant function and inflammatory markers.

Conditions

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Bronchopulmonary Dysplasia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Infasurf surfactant (ONY, Inc.)

Infants already receiving inhaled nitric oxide will receive scheduled doses of late surfactant (Infasurf) on study days 0, 2, 4, 6 and 8.

Group Type ACTIVE_COMPARATOR

Infasurf surfactant (ONY, Inc.)

Intervention Type DRUG

Late doses of Infasurf 3ml/kg will be given to infants on study days 0, 2, 4, 6 and 8 as long as infant remains intubated.

Sham (No Treatment)

Infants already receiving inhaled nitric oxide will receive "Sham (no treatment)" doses on study days 0,2,4,6, and 8.

Group Type SHAM_COMPARATOR

Sham (No Treatment)

Intervention Type DRUG

Late doses of Sham (No treatment) will be given to infants on study days 0, 2, 4, 6 and 8 as long as infant remains intubated.

Interventions

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Infasurf surfactant (ONY, Inc.)

Late doses of Infasurf 3ml/kg will be given to infants on study days 0, 2, 4, 6 and 8 as long as infant remains intubated.

Intervention Type DRUG

Sham (No Treatment)

Late doses of Sham (No treatment) will be given to infants on study days 0, 2, 4, 6 and 8 as long as infant remains intubated.

Intervention Type DRUG

Other Intervention Names

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Treatment Control

Eligibility Criteria

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Inclusion Criteria

* \<=28 0/7 weeks gestational age
* Day of life 7-14
* Intubated and mechanically ventilated
* Plan to treat with inhaled nitric oxide

Exclusion Criteria

* Serious congenital malformations or chromosomal abnormalities
* Life expectancy \<7 days from enrollment
* Clinically unstable
* Less tha 48 hours since last dose surfactant
* Ability to obtain 36 week primary outcome information is unlikely
Minimum Eligible Age

7 Days

Maximum Eligible Age

14 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

Roberta Ballard

OTHER

Sponsor Role lead

Responsible Party

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Roberta Ballard

Professor of Pediatrics

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Roberta A Ballard, MD

Role: PRINCIPAL_INVESTIGATOR

University of California, San Francisco

Locations

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University of Arkansas - Arkansas Childrens Hospital

Little Rock, Arkansas, United States

Site Status

Alta Bates Medical Center

Berkeley, California, United States

Site Status

Oakland Children's Hospital

Oakland, California, United States

Site Status

University of California, San Francisco

San Francisco, California, United States

Site Status

Wolfson Children's Hospital and Shands HospitaL

Jacksonville, Florida, United States

Site Status

Florida Hospital for Children

Orlando, Florida, United States

Site Status

All Children's Hospital

St. Petersburg, Florida, United States

Site Status

Northwestern Memorial Hospital

Chicago, Illinois, United States

Site Status

Children's Memorial Hospital

Chicago, Illinois, United States

Site Status

Childrens Hospital and Clinics of Minnesota- Minneapolis

Minneapolis, Minnesota, United States

Site Status

University of Minnesota Medical School

Minneapolis, Minnesota, United States

Site Status

Children's Hospital and Clinics of Minnesota - St Paul

Saint Paul, Minnesota, United States

Site Status

Children's Mercy Hospital

Kansas City, Missouri, United States

Site Status

Women's and Children's Hospital of Buffalo

Buffalo, New York, United States

Site Status

Stony Brook University Medical Center

Stony Brook, New York, United States

Site Status

Wake Forest University- Forsyth Hospital and Brenner Hospital

Winston-Salem, North Carolina, United States

Site Status

Medical University of South Carolina(MUSC)

Charleston, South Carolina, United States

Site Status

UT Memphis- Memphis Medical Center

Memphis, Tennessee, United States

Site Status

UT Houston Health Science Center

Houston, Texas, United States

Site Status

Texas Children's Hospital

Houston, Texas, United States

Site Status

University of Washington, Seattle

Seattle, Washington, United States

Site Status

Countries

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United States

References

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Ballard RA, Truog WE, Cnaan A, Martin RJ, Ballard PL, Merrill JD, Walsh MC, Durand DJ, Mayock DE, Eichenwald EC, Null DR, Hudak ML, Puri AR, Golombek SG, Courtney SE, Stewart DL, Welty SE, Phibbs RH, Hibbs AM, Luan X, Wadlinger SR, Asselin JM, Coburn CE; NO CLD Study Group. Inhaled nitric oxide in preterm infants undergoing mechanical ventilation. N Engl J Med. 2006 Jul 27;355(4):343-53. doi: 10.1056/NEJMoa061088.

Reference Type BACKGROUND
PMID: 16870913 (View on PubMed)

Ballard PL, Merrill JD, Truog WE, Godinez RI, Godinez MH, McDevitt TM, Ning Y, Golombek SG, Parton LA, Luan X, Cnaan A, Ballard RA. Surfactant function and composition in premature infants treated with inhaled nitric oxide. Pediatrics. 2007 Aug;120(2):346-53. doi: 10.1542/peds.2007-0095.

Reference Type BACKGROUND
PMID: 17671061 (View on PubMed)

Truog WE, Ballard PL, Norberg M, Golombek S, Savani RC, Merrill JD, Parton LA, Cnaan A, Luan X, Ballard RA; Nitric Oxide (to Prevent) Chronic Lung Disease Study Investigators. Inflammatory markers and mediators in tracheal fluid of premature infants treated with inhaled nitric oxide. Pediatrics. 2007 Apr;119(4):670-8. doi: 10.1542/peds.2006-2683.

Reference Type BACKGROUND
PMID: 17403837 (View on PubMed)

Ballard RA, Keller RL, Black DM, Ballard PL, Merrill JD, Eichenwald EC, Truog WE, Mammel MC, Steinhorn RH, Rogers EE, Ryan RM, Durand DJ, Asselin JM, Bendel CM, Bendel-Stenzel EM, Courtney SE, Dhanireddy R, Hudak ML, Koch FR, Mayock DE, McKay VJ, O'Shea TM, Porta NF, Wadhawan R, Palermo L; TOLSURF Study Group. Randomized Trial of Late Surfactant Treatment in Ventilated Preterm Infants Receiving Inhaled Nitric Oxide. J Pediatr. 2016 Jan;168:23-29.e4. doi: 10.1016/j.jpeds.2015.09.031. Epub 2015 Oct 21.

Reference Type RESULT
PMID: 26500107 (View on PubMed)

Wai KC, Hibbs AM, Steurer MA, Black DM, Asselin JM, Eichenwald EC, Ballard PL, Ballard RA, Keller RL; Trial of Late Surfactant (TOLSURF) Study Group. Maternal Black Race and Persistent Wheezing Illness in Former Extremely Low Gestational Age Newborns: Secondary Analysis of a Randomized Trial. J Pediatr. 2018 Jul;198:201-208.e3. doi: 10.1016/j.jpeds.2018.02.032. Epub 2018 Apr 4.

Reference Type RESULT
PMID: 29627188 (View on PubMed)

Keller RL, Eichenwald EC, Hibbs AM, Rogers EE, Wai KC, Black DM, Ballard PL, Asselin JM, Truog WE, Merrill JD, Mammel MC, Steinhorn RH, Ryan RM, Durand DJ, Bendel CM, Bendel-Stenzel EM, Courtney SE, Dhanireddy R, Hudak ML, Koch FR, Mayock DE, McKay VJ, Helderman J, Porta NF, Wadhawan R, Palermo L, Ballard RA; TOLSURF Study Group. The Randomized, Controlled Trial of Late Surfactant: Effects on Respiratory Outcomes at 1-Year Corrected Age. J Pediatr. 2017 Apr;183:19-25.e2. doi: 10.1016/j.jpeds.2016.12.059. Epub 2017 Jan 16.

Reference Type RESULT
PMID: 28100402 (View on PubMed)

Wai KC, Keller RL, Lusk LA, Ballard RA, Chan DK; Trial of Late Surfactant (TOLSURF) Study Group. Characteristics of Extremely Low Gestational Age Newborns Undergoing Tracheotomy: A Secondary Analysis of the Trial of Late Surfactant Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. 2017 Jan 1;143(1):13-19. doi: 10.1001/jamaoto.2016.2428.

Reference Type DERIVED
PMID: 27583380 (View on PubMed)

Other Identifiers

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U01HL094338

Identifier Type: NIH

Identifier Source: secondary_id

View Link

H10842-33541-01A

Identifier Type: -

Identifier Source: org_study_id

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