Effect of Feedings on Caffeine in Premature Infants

NCT ID: NCT02293824

Last Updated: 2017-09-13

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

Total Enrollment

50 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-12-31

Study Completion Date

2017-06-30

Brief Summary

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Almost all infants born \<29 weeks gestational age develop apnea of prematurity and are treated with caffeine. Type of diet and disease states may be significant contributors of variability in caffeine metabolism and pharmacokinetics (PK) in this population. This prospective, observational, open-label, opportunistic PK study will compare the population PK of caffeine between infants fed formula and infants fed exclusively breast milk; compare the activities of caffeine metabolizing enzymes between infants fed formula and infants fed exclusively breast milk; and determine the effect of hypoxia, hypotension, and infection on caffeine PK and metabolism in premature infants.

Detailed Description

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This study will use a consecutive patient sampling approach. All eligible participants admitted at each site will be approached. Caffeine and feedings will be administered per standard of care. Manipulations of caffeine dosing or feeding regimens will not be a part of this protocol. To minimize the amount of blood sampling, the investigators will use a sparse sampling methodology. Urine will be collected for analysis of caffeine and caffeine metabolite concentrations. Caffeine pharmacokinetics will be described by population pharmacokinetic analysis. Urinary concentrations of caffeine and its metabolites will be used to calculate metabolic ratios as markers of enzyme activity.

Conditions

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Apnea of Prematurity Premature Newborn Caffeine

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Premature infants

Premature infants \<29 weeks birth gestational age receiving caffeine per standard of care for the prevention or treatment of apnea of prematurity.

Caffeine

Intervention Type DRUG

Given per standard of care.

Interventions

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Caffeine

Given per standard of care.

Intervention Type DRUG

Other Intervention Names

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Caffeine Citrate Cafcit

Eligibility Criteria

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Inclusion Criteria

* Written informed consent from parent(s) or legal guardian(s)
* \<29 weeks birth gestational age
* Postnatal age ≤15 days
* Receiving caffeine (intravenous or oral) per standard of care for prevention or treatment of apnea of prematurity

Exclusion Criteria

* Known major congenital or chromosomal anomaly
Maximum Eligible Age

15 Days

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of North Carolina, Chapel Hill

OTHER

Sponsor Role collaborator

Duke University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Phillip B Smith, MD, MPH, MHS

Role: PRINCIPAL_INVESTIGATOR

Duke Clinical Research Institute

Locations

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North Carolina Children's Hospital

Chapel Hill, North Carolina, United States

Site Status

Duke University Medical Center

Durham, North Carolina, United States

Site Status

Countries

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United States

References

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Zhao J, Gonzalez F, Mu D. Apnea of prematurity: from cause to treatment. Eur J Pediatr. 2011 Sep;170(9):1097-105. doi: 10.1007/s00431-011-1409-6. Epub 2011 Feb 8.

Reference Type BACKGROUND
PMID: 21301866 (View on PubMed)

Di Fiore JM, Bloom JN, Orge F, Schutt A, Schluchter M, Cheruvu VK, Walsh M, Finer N, Martin RJ. A higher incidence of intermittent hypoxemic episodes is associated with severe retinopathy of prematurity. J Pediatr. 2010 Jul;157(1):69-73. doi: 10.1016/j.jpeds.2010.01.046. Epub 2010 Mar 20.

Reference Type BACKGROUND
PMID: 20304417 (View on PubMed)

Janvier A, Khairy M, Kokkotis A, Cormier C, Messmer D, Barrington KJ. Apnea is associated with neurodevelopmental impairment in very low birth weight infants. J Perinatol. 2004 Dec;24(12):763-8. doi: 10.1038/sj.jp.7211182.

Reference Type BACKGROUND
PMID: 15329741 (View on PubMed)

Clark RH, Bloom BT, Spitzer AR, Gerstmann DR. Reported medication use in the neonatal intensive care unit: data from a large national data set. Pediatrics. 2006 Jun;117(6):1979-87. doi: 10.1542/peds.2005-1707.

Reference Type BACKGROUND
PMID: 16740839 (View on PubMed)

Gal P. Caffeine Therapeutic Drug Monitoring Is Necessary and Cost-effective. J Pediatr Pharmacol Ther. 2007 Oct;12(4):212-5. doi: 10.5863/1551-6776-12.4.212. No abstract available.

Reference Type BACKGROUND
PMID: 23055855 (View on PubMed)

Blake MJ, Abdel-Rahman SM, Pearce RE, Leeder JS, Kearns GL. Effect of diet on the development of drug metabolism by cytochrome P-450 enzymes in healthy infants. Pediatr Res. 2006 Dec;60(6):717-23. doi: 10.1203/01.pdr.0000245909.74166.00. Epub 2006 Oct 25.

Reference Type BACKGROUND
PMID: 17065585 (View on PubMed)

Le Guennec JC, Billon B. Delay in caffeine elimination in breast-fed infants. Pediatrics. 1987 Feb;79(2):264-8.

Reference Type BACKGROUND
PMID: 3808800 (View on PubMed)

Xu H, Rajesan R, Harper P, Kim RB, Lonnerdal B, Yang M, Uematsu S, Hutson J, Watson-MacDonell J, Ito S. Induction of cytochrome P450 1A by cow milk-based formula: a comparative study between human milk and formula. Br J Pharmacol. 2005 Sep;146(2):296-305. doi: 10.1038/sj.bjp.0706319.

Reference Type BACKGROUND
PMID: 15997229 (View on PubMed)

Supnet MC, David-Cu R, Walther FJ. Plasma xanthine oxidase activity and lipid hydroperoxide levels in preterm infants. Pediatr Res. 1994 Sep;36(3):283-7. doi: 10.1203/00006450-199409000-00003.

Reference Type BACKGROUND
PMID: 7808822 (View on PubMed)

Hassoun PM, Yu FS, Cote CG, Zulueta JJ, Sawhney R, Skinner KA, Skinner HB, Parks DA, Lanzillo JJ. Upregulation of xanthine oxidase by lipopolysaccharide, interleukin-1, and hypoxia. Role in acute lung injury. Am J Respir Crit Care Med. 1998 Jul;158(1):299-305. doi: 10.1164/ajrccm.158.1.9709116.

Reference Type BACKGROUND
PMID: 9655743 (View on PubMed)

Related Links

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http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=fbcd234e-57e1-4da2-a96c-e3f7b7cf6ec0

Bedford Laboratories. CAFCIT (caffeine citrate) injection, CAFCIT (caffeine citrate) solution. 2013.

Other Identifiers

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Pro00058253

Identifier Type: -

Identifier Source: org_study_id

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