Trial Outcomes & Findings for Neonatal Erythropoietin And Therapeutic Hypothermia Outcomes in Newborn Brain Injury (NEATO) (NCT NCT01913340)

NCT ID: NCT01913340

Last Updated: 2020-07-13

Results Overview

The investigators will monitor organ function and adverse events until hospital discharge from the neonatal intensive care unit

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

50 participants

Primary outcome timeframe

Participants will be followed for the duration of hospital stay, an expected average of 2 weeks

Results posted on

2020-07-13

Participant Flow

Participant milestones

Participant milestones
Measure
Erythropoietin
1000 U/kg/dose x 5 doses Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline
Normal saline: placebo: NS IV x 5 doses
Overall Study
STARTED
24
26
Overall Study
COMPLETED
21
20
Overall Study
NOT COMPLETED
3
6

Reasons for withdrawal

Reasons for withdrawal
Measure
Erythropoietin
1000 U/kg/dose x 5 doses Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline
Normal saline: placebo: NS IV x 5 doses
Overall Study
Death
2
5
Overall Study
Lost to Follow-up
1
1

Baseline Characteristics

missing data from 2 placebo subjects

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Erythropoietin
n=24 Participants
Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline
n=26 Participants
Normal saline: placebo: NS IV x 5 doses
Total
n=50 Participants
Total of all reporting groups
Age at randomization (hours)
13.3 hours
STANDARD_DEVIATION 6.1 • n=24 Participants • missing data from 2 placebo subjects
14.6 hours
STANDARD_DEVIATION 6.1 • n=24 Participants • missing data from 2 placebo subjects
13.9 hours
STANDARD_DEVIATION 6.1 • n=48 Participants • missing data from 2 placebo subjects
Age at 1st study drug (hours)
15.6 hours
STANDARD_DEVIATION 5.7 • n=24 Participants
17.2 hours
STANDARD_DEVIATION 6.1 • n=26 Participants
16.5 hours
STANDARD_DEVIATION 5.9 • n=50 Participants
Age, Continuous
29.4 years
STANDARD_DEVIATION 7.2 • n=24 Participants
29.7 years
STANDARD_DEVIATION 6.6 • n=26 Participants
29.5 years
STANDARD_DEVIATION 6.8 • n=50 Participants
Sex: Female, Male
Female
14 Participants
n=24 Participants
10 Participants
n=26 Participants
24 Participants
n=50 Participants
Sex: Female, Male
Male
10 Participants
n=24 Participants
16 Participants
n=26 Participants
26 Participants
n=50 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
5 Participants
n=24 Participants • Maternal Hispanic ethnicity provided
6 Participants
n=26 Participants • Maternal Hispanic ethnicity provided
11 Participants
n=50 Participants • Maternal Hispanic ethnicity provided
Ethnicity (NIH/OMB)
Not Hispanic or Latino
19 Participants
n=24 Participants • Maternal Hispanic ethnicity provided
20 Participants
n=26 Participants • Maternal Hispanic ethnicity provided
39 Participants
n=50 Participants • Maternal Hispanic ethnicity provided
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=24 Participants • Maternal Hispanic ethnicity provided
0 Participants
n=26 Participants • Maternal Hispanic ethnicity provided
0 Participants
n=50 Participants • Maternal Hispanic ethnicity provided
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=24 Participants • Maternal race provided
0 Participants
n=26 Participants • Maternal race provided
0 Participants
n=50 Participants • Maternal race provided
Race (NIH/OMB)
Asian
2 Participants
n=24 Participants • Maternal race provided
1 Participants
n=26 Participants • Maternal race provided
3 Participants
n=50 Participants • Maternal race provided
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=24 Participants • Maternal race provided
0 Participants
n=26 Participants • Maternal race provided
0 Participants
n=50 Participants • Maternal race provided
Race (NIH/OMB)
Black or African American
7 Participants
n=24 Participants • Maternal race provided
4 Participants
n=26 Participants • Maternal race provided
11 Participants
n=50 Participants • Maternal race provided
Race (NIH/OMB)
White
14 Participants
n=24 Participants • Maternal race provided
18 Participants
n=26 Participants • Maternal race provided
32 Participants
n=50 Participants • Maternal race provided
Race (NIH/OMB)
More than one race
0 Participants
n=24 Participants • Maternal race provided
0 Participants
n=26 Participants • Maternal race provided
0 Participants
n=50 Participants • Maternal race provided
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=24 Participants • Maternal race provided
3 Participants
n=26 Participants • Maternal race provided
4 Participants
n=50 Participants • Maternal race provided
Gestational age (weeks)
38.7 weeks
STANDARD_DEVIATION 1.9 • n=23 Participants • missing data in 1 Epo subject
38.7 weeks
STANDARD_DEVIATION 1.6 • n=26 Participants • missing data in 1 Epo subject
38.7 weeks
STANDARD_DEVIATION 1.7 • n=49 Participants • missing data in 1 Epo subject
Maternal education
High school or less
10 Participants
n=21 Participants • missing data in 3 Epo and 2 placebo subjects
10 Participants
n=24 Participants • missing data in 3 Epo and 2 placebo subjects
20 Participants
n=45 Participants • missing data in 3 Epo and 2 placebo subjects
Maternal education
Some college or university
5 Participants
n=21 Participants • missing data in 3 Epo and 2 placebo subjects
7 Participants
n=24 Participants • missing data in 3 Epo and 2 placebo subjects
12 Participants
n=45 Participants • missing data in 3 Epo and 2 placebo subjects
Maternal education
College graduate, or post-grad
6 Participants
n=21 Participants • missing data in 3 Epo and 2 placebo subjects
7 Participants
n=24 Participants • missing data in 3 Epo and 2 placebo subjects
13 Participants
n=45 Participants • missing data in 3 Epo and 2 placebo subjects
Birth weight (g)
3556 grams
STANDARD_DEVIATION 618 • n=24 Participants
3243 grams
STANDARD_DEVIATION 512 • n=26 Participants
3393 grams
STANDARD_DEVIATION 581 • n=50 Participants
Large for gestational age
6 Participants
n=24 Participants
1 Participants
n=26 Participants
7 Participants
n=50 Participants
Severe Sarnat encephalopathy
5 Participants
n=24 Participants
4 Participants
n=26 Participants
9 Participants
n=50 Participants
5 minute Apgar
0-3 (critically low)
11 Participants
n=23 Participants • missing data in 1 Epo and 1 placebo subject
14 Participants
n=25 Participants • missing data in 1 Epo and 1 placebo subject
25 Participants
n=48 Participants • missing data in 1 Epo and 1 placebo subject
5 minute Apgar
4-6 (below normal)
10 Participants
n=23 Participants • missing data in 1 Epo and 1 placebo subject
10 Participants
n=25 Participants • missing data in 1 Epo and 1 placebo subject
20 Participants
n=48 Participants • missing data in 1 Epo and 1 placebo subject
5 minute Apgar
7-10 (normal)
2 Participants
n=23 Participants • missing data in 1 Epo and 1 placebo subject
1 Participants
n=25 Participants • missing data in 1 Epo and 1 placebo subject
3 Participants
n=48 Participants • missing data in 1 Epo and 1 placebo subject
10 minute Apgar
0-3
5 Participants
n=21 Participants • missing data in 3 Epo and 1 placebo subject
7 Participants
n=25 Participants • missing data in 3 Epo and 1 placebo subject
12 Participants
n=46 Participants • missing data in 3 Epo and 1 placebo subject
10 minute Apgar
4-6
13 Participants
n=21 Participants • missing data in 3 Epo and 1 placebo subject
11 Participants
n=25 Participants • missing data in 3 Epo and 1 placebo subject
24 Participants
n=46 Participants • missing data in 3 Epo and 1 placebo subject
10 minute Apgar
7-10
3 Participants
n=21 Participants • missing data in 3 Epo and 1 placebo subject
7 Participants
n=25 Participants • missing data in 3 Epo and 1 placebo subject
10 Participants
n=46 Participants • missing data in 3 Epo and 1 placebo subject
Resuscitation > 10 minutes
21 Participants
n=24 Participants
21 Participants
n=26 Participants
42 Participants
n=50 Participants
Chest compressions
8 Participants
n=24 Participants
11 Participants
n=26 Participants
19 Participants
n=50 Participants
Lowest pH
6.9 pH
STANDARD_DEVIATION 0.2 • n=20 Participants • missing data from 4 Epo and 2 placebo subjects
7.0 pH
STANDARD_DEVIATION 0.2 • n=24 Participants • missing data from 4 Epo and 2 placebo subjects
6.9 pH
STANDARD_DEVIATION 0.2 • n=44 Participants • missing data from 4 Epo and 2 placebo subjects
aEEG severe abnormal background
7 Participants
n=22 Participants • missing data from 2 Epo and 2 placebo subjects
7 Participants
n=24 Participants • missing data from 2 Epo and 2 placebo subjects
14 Participants
n=46 Participants • missing data from 2 Epo and 2 placebo subjects
Maternal chorioamnionitis
4 Participants
n=24 Participants
3 Participants
n=26 Participants
7 Participants
n=50 Participants
Delivery mode
Spontaneous vaginal
5 Participants
n=24 Participants
9 Participants
n=26 Participants
14 Participants
n=50 Participants
Delivery mode
Vacuum or forceps
1 Participants
n=24 Participants
2 Participants
n=26 Participants
3 Participants
n=50 Participants
Delivery mode
Elective cesarean
1 Participants
n=24 Participants
0 Participants
n=26 Participants
1 Participants
n=50 Participants
Delivery mode
Emergency cesarean
17 Participants
n=24 Participants
15 Participants
n=26 Participants
32 Participants
n=50 Participants
Sentinel event
7 Participants
n=24 Participants
7 Participants
n=26 Participants
14 Participants
n=50 Participants

PRIMARY outcome

Timeframe: Participants will be followed for the duration of hospital stay, an expected average of 2 weeks

The investigators will monitor organ function and adverse events until hospital discharge from the neonatal intensive care unit

Outcome measures

Outcome measures
Measure
Erythropoietin
n=24 Participants
Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline
n=26 Participants
Normal saline: placebo: NS IV x 5 doses
Markers of Organ Function
Persistent pulmonary hypertension
5 participants
4 participants
Markers of Organ Function
Disseminated intravascular coagulation
3 participants
5 participants
Markers of Organ Function
Sepsis (positive blood culture and antibiotics >=7
0 participants
5 participants
Markers of Organ Function
Renal dysfunction (creatinine > 1.5)
4 participants
5 participants
Markers of Organ Function
Hypertension (requiring anti-hypertensive)
1 participants
0 participants
Markers of Organ Function
Polycythemia (requiring intervention)
0 participants
0 participants
Markers of Organ Function
Death during birth hospitalization
2 participants
5 participants
Markers of Organ Function
Cardiopulmonary collapse within 2 hours of drug
1 participants
0 participants
Markers of Organ Function
Thrombosis of major vessel
1 participants
1 participants
Markers of Organ Function
Unexpected event related to study drug
0 participants
0 participants
Markers of Organ Function
Liver dysfunction (ALT >100 IU/L)
10 participants
6 participants
Markers of Organ Function
Hypotension (requiring inotrope or vasopressor)
9 participants
12 participants
Markers of Organ Function
Thrombocytopenia (platelet < 100,000 per uL)
6 participants
10 participants

SECONDARY outcome

Timeframe: 12 months

The AIMS consists of 58 items, including 4 positions: prone (21 items), supine (9 items), sitting (12 items), \& standing (16 items). Each item is scored as 'observed' or 'not observed'. Total score range is 0-58, scored as percentile ranks after a raw score is obtained and plotted against age at testing, based on validated norms.

Outcome measures

Outcome measures
Measure
Erythropoietin
n=21 Participants
Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline
n=20 Participants
Normal saline: placebo: NS IV x 5 doses
Alberta Infant Motor Scale (AIMS)
53.5 percentile
Standard Deviation 5.2
42.8 percentile
Standard Deviation 19.3

OTHER_PRE_SPECIFIED outcome

Timeframe: 12 months

A 43-item questionnaire developed and standardized to assess the functional domains of self-care, motor function, communication and social cognition in young children. Self care sub-scale score range 17-68. Mobility score range is 9-36. Communication score range is 13-52. Social Cognition score range is 11-44. Total scale range is 50-200. Higher scores mean higher functioning. Lower scores mean lower functioning.

Outcome measures

Outcome measures
Measure
Erythropoietin
n=21 Participants
Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline
n=20 Participants
Normal saline: placebo: NS IV x 5 doses
Warner Initial Developmental Evaluation (WIDEA)
Total score (50-200)
122 units on a scale
Standard Deviation 14
110 units on a scale
Standard Deviation 31
Warner Initial Developmental Evaluation (WIDEA)
Self-care (17-68)
36.7 units on a scale
Standard Deviation 5.1
33.8 units on a scale
Standard Deviation 7.7
Warner Initial Developmental Evaluation (WIDEA)
Mobility (9-36)
28.6 units on a scale
Standard Deviation 3.8
23.8 units on a scale
Standard Deviation 8.9
Warner Initial Developmental Evaluation (WIDEA)
Communication (13-52)
28.2 units on a scale
Standard Deviation 5.1
25.5 units on a scale
Standard Deviation 8.8
Warner Initial Developmental Evaluation (WIDEA)
Social Cognition (11-44)
28.8 units on a scale
Standard Deviation 6.4
26.9 units on a scale
Standard Deviation 8.9

POST_HOC outcome

Timeframe: 6 months

A 43-item questionnaire developed and standardized to assess the functional domains of self-care, motor function, communication and social cognition in young children. Self care score range 7-28. Mobility score range is 9-36. Communication score range is 13-52. Social Cognition score range is 11-44. Higher the score means higher functioning. Lower scores means lower functioning.

Outcome measures

Outcome measures
Measure
Erythropoietin
n=21 Participants
Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline
n=21 Participants
Normal saline: placebo: NS IV x 5 doses
Warner Initial Developmental Evaluation (WIDEA) at 6 Months of Age
Mobility (9-36)
14.1 units on a scale
Standard Deviation 2.7
12.4 units on a scale
Standard Deviation 2.7
Warner Initial Developmental Evaluation (WIDEA) at 6 Months of Age
Communication (13-52)
16.4 units on a scale
Standard Deviation 3.2
15.3 units on a scale
Standard Deviation 2.8
Warner Initial Developmental Evaluation (WIDEA) at 6 Months of Age
Total score (50-200)
75.3 units on a scale
Standard Deviation 9.1
68.8 units on a scale
Standard Deviation 10.7
Warner Initial Developmental Evaluation (WIDEA) at 6 Months of Age
Self-care (7-28)
28.1 units on a scale
Standard Deviation 4.2
26.1 units on a scale
Standard Deviation 4.7
Warner Initial Developmental Evaluation (WIDEA) at 6 Months of Age
Social Cognition (11-44)
16.7 units on a scale
Standard Deviation 4.5
14.9 units on a scale
Standard Deviation 3.2

POST_HOC outcome

Timeframe: 12-months

Moderate to severe neurodevelopmental impairment at 12 months was defined as AIMS less than 5th percentile for age, or WIDEA more than 2 standard deviations below the mean based on normative data from typically developing infants at 12.9 months of age.

Outcome measures

Outcome measures
Measure
Erythropoietin
n=21 Participants
Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline
n=20 Participants
Normal saline: placebo: NS IV x 5 doses
Moderate to Severe Neurodevelopmental Impairment
2 Participants
5 Participants

POST_HOC outcome

Timeframe: 12-months

Outcome measures

Outcome measures
Measure
Erythropoietin
n=21 Participants
Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline
n=20 Participants
Normal saline: placebo: NS IV x 5 doses
Growth Parameters: Weight
9.9 kg
Standard Deviation 1.4
9.7 kg
Standard Deviation 1.2

POST_HOC outcome

Timeframe: 12-months

Outcome measures

Outcome measures
Measure
Erythropoietin
n=21 Participants
Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline
n=20 Participants
Normal saline: placebo: NS IV x 5 doses
Growth Parameters: Height
74.3 cm
Standard Deviation 3.2
71.7 cm
Standard Deviation 6.2

POST_HOC outcome

Timeframe: 12-months

Outcome measures

Outcome measures
Measure
Erythropoietin
n=21 Participants
Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline
n=20 Participants
Normal saline: placebo: NS IV x 5 doses
Growth Parameters: Head Circumference
45.7 cm
Standard Deviation 1.6
45.5 cm
Standard Deviation 2.1

POST_HOC outcome

Timeframe: neonatal hospitalization

Population: For subjects randomized to Erythropoietin, age at MRI was 5.6 days (SD 2.8) and subjects received 3.7 (SD 0.8) doses before MRI. For subjects randomized to placebo (normal saline), age at MRI was 4.9 days (SD 1.4) and subjects received 3.4 (SD 0.8) doses before MRI.

Outcome measures

Outcome measures
Measure
Erythropoietin
n=23 Participants
Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline
n=25 Participants
Normal saline: placebo: NS IV x 5 doses
Brain Injury, as Determined by Neonatal Brain MRI
Presence of brain injury: Brainstem
1 participants
4 participants
Brain Injury, as Determined by Neonatal Brain MRI
Presence of brain injury: Cerebellar
0 participants
5 participants
Brain Injury, as Determined by Neonatal Brain MRI
Presence of brain injury: >=2 regions injured
7 participants
14 participants
Brain Injury, as Determined by Neonatal Brain MRI
Global brain injury score: None (0)
8 participants
3 participants
Brain Injury, as Determined by Neonatal Brain MRI
Global brain injury score: Mild (1-11)
14 participants
11 participants
Brain Injury, as Determined by Neonatal Brain MRI
Global brain injury score: Moderate (12-31)
0 participants
6 participants
Brain Injury, as Determined by Neonatal Brain MRI
Global brain injury score: Severe (>=32)
1 participants
5 participants
Brain Injury, as Determined by Neonatal Brain MRI
Presence of brain injury: Subcortical
7 participants
17 participants
Brain Injury, as Determined by Neonatal Brain MRI
Presence of brain injury: Cortical
4 participants
9 participants
Brain Injury, as Determined by Neonatal Brain MRI
Presence of brain injury: White matter
12 participants
15 participants

Adverse Events

Erythropoietin - Infants

Serious events: 3 serious events
Other events: 17 other events
Deaths: 2 deaths

Normal Saline - Infants

Serious events: 6 serious events
Other events: 16 other events
Deaths: 5 deaths

Serious adverse events

Serious adverse events
Measure
Erythropoietin - Infants
n=24 participants at risk
Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline - Infants
n=26 participants at risk
Normal saline: placebo: NS IV x 5 doses
General disorders
Cardiopulmonary collapse within 2h of drug
4.2%
1/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
0.00%
0/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
Blood and lymphatic system disorders
Thrombosis of major vessel
4.2%
1/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
3.8%
1/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
General disorders
Unexpected event related to study drug
0.00%
0/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
0.00%
0/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
General disorders
Death during birth hospitalization
8.3%
2/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
19.2%
5/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.

Other adverse events

Other adverse events
Measure
Erythropoietin - Infants
n=24 participants at risk
Erythropoietin: 1000 U/kg/dose IV x 5 doses
Normal Saline - Infants
n=26 participants at risk
Normal saline: placebo: NS IV x 5 doses
Hepatobiliary disorders
Liver dysfunction (ALT >100 IU/L)
41.7%
10/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
23.1%
6/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
Vascular disorders
Hypotension (requiring inotrope or vasopressor)
37.5%
9/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
46.2%
12/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
Blood and lymphatic system disorders
Thrombocytopenia (platelet < 100,000 per uL)
25.0%
6/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
38.5%
10/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
Respiratory, thoracic and mediastinal disorders
Persistent pulmonary hypertension
20.8%
5/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
15.4%
4/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
Blood and lymphatic system disorders
Disseminated intravascular coagulation
12.5%
3/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
19.2%
5/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
Infections and infestations
Sepsis (positive blood culture and antibiotics >=7)
0.00%
0/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
19.2%
5/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
Renal and urinary disorders
Renal dysfunction (creatinine >1.5)
16.7%
4/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
19.2%
5/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
Vascular disorders
Hypertension (requiring anti-hypertensive)
4.2%
1/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
0.00%
0/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
Blood and lymphatic system disorders
Polycythemia (requiring intervention)
0.00%
0/24
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.
0.00%
0/26
Adverse Events were only monitored for infants. No Adverse Event data were collected for mothers.

Additional Information

Yvonne Wu, MD MPH

University of California San Francisco

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place