Phase 3 Study to Compare Safety and Efficacy of Smoflipid 20% to Intralipid 20% in Hospitalized Neonates and Infants

NCT ID: NCT02579265

Last Updated: 2022-01-05

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

204 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-12-31

Study Completion Date

2020-04-10

Brief Summary

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To show the superiority in safety of Smoflipid over Intralipid® as measured by the number of study patients in each treatment group with conjugated bilirubin exceeding 2 mg/dL during the first 28 days of study treatment, confirmed by a second sample collected 7 days after the first sample.

Detailed Description

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Conditions

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Hospitalized Neonates and Infants, Expected to Require Parenteral Nutrition for 28 Days

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Smoflipid 20%

Smoflipid is a lipid emulsion containing soybean oil, MCTs (medium-chain triglycerides), olive oil, and fish oil. Smoflipid belongs to the pharmacotherapeutic group: "Solutions for parenteral nutrition, fat emulsions".

Group Type EXPERIMENTAL

Smoflipid 20% (investigational lipid for parenteral nutrition)

Intervention Type DRUG

Dose: The targeted maximal dose is 3.0 g/kg/day. In patients already receiving parenteral nutrition (PN) before starting study treatment, the dose will either stay at 3.0 g/kg/day or be increased by 1.0 g/kg/day steps to a maximum of 3.0 g/kg/day.

Smoflipid 20% will be infused over 20 - 24 hours, as per hospital policy, at a weight based infusion rate.

Smoflipid 20% will be infused into a central or a peripheral vein.

Intralipid® 20%

Intralipid is a long-chain triglyceride emulsion derived from purified soybean oil and egg yolk phospholipids. Intralipid belongs to the pharmacotherapeutic group: "Solutions for parenteral nutrition, fat emulsions".

Group Type ACTIVE_COMPARATOR

Intralipid® 20%

Intervention Type DRUG

Dose: The targeted maximal dose is 3.0 g/kg/day. In patients already receiving parenteral nutrition (PN) before starting study treatment, the dose will either stay at 3.0 g/kg/day or be increased by 1.0 g/kg/day steps to a maximum of 3.0 g/kg/day.

Intralipid® 20% will be infused over 20 - 24 hours, as per hospital policy, at a weight based infusion rate.

Intralipid® 20% will be infused into a central or peripheral vein.

Interventions

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Smoflipid 20% (investigational lipid for parenteral nutrition)

Dose: The targeted maximal dose is 3.0 g/kg/day. In patients already receiving parenteral nutrition (PN) before starting study treatment, the dose will either stay at 3.0 g/kg/day or be increased by 1.0 g/kg/day steps to a maximum of 3.0 g/kg/day.

Smoflipid 20% will be infused over 20 - 24 hours, as per hospital policy, at a weight based infusion rate.

Smoflipid 20% will be infused into a central or a peripheral vein.

Intervention Type DRUG

Intralipid® 20%

Dose: The targeted maximal dose is 3.0 g/kg/day. In patients already receiving parenteral nutrition (PN) before starting study treatment, the dose will either stay at 3.0 g/kg/day or be increased by 1.0 g/kg/day steps to a maximum of 3.0 g/kg/day.

Intralipid® 20% will be infused over 20 - 24 hours, as per hospital policy, at a weight based infusion rate.

Intralipid® 20% will be infused into a central or peripheral vein.

Intervention Type DRUG

Other Intervention Names

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Smoflipid 20% (lipid injectable emulsion) Intralipid® 20% (a 20% intravenous fat emulsion)

Eligibility Criteria

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Inclusion Criteria

* Neonates and infants, expected to require parenteral nutrition (PN) for 28 days
* Postmenstrual age ≥ 24 weeks
* Birth weight ≥ 750g
* Gastroschisis, duodenal, jejunal or ileal atresia, volvulus, spontaneous intestinal perforation or necrotizing enterocolitis (Bell's stage 2B or higher)
* At least 80% of nutritional needs at baseline received by PN
* Signed and dated informed consent obtained from at least one parent or legal guardian

Exclusion Criteria

* Conjugated bilirubin \> 0.6 mg/dL
* Any known pre-, intra- or posthepatic complication increasing conjugated bilirubin levels \> 0.6, mg/dL during study participation
* Suspected liver disease or liver damage based on either aspartate aminotransferase (AST), alanine aminotransferase (ALT), or gamma-glutamyl transferase (GGT) exceeding 2.5x upper limit of normal range
* Active bloodstream infection demonstrated by positive blood culture at screening
* Cystic fibrosis
* Meconium ileus
* Serum triglyceride levels \> 250 mg/dL
* Cyanotic congenital heart defect
* Severe renal failure with serum creatinine \> 2.0 mg/dL
* History of shock requiring vasopressors
* Anasarca
* Extracorporeal Membrane Oxygenation (ECMO)
* Known inborn errors of metabolism
* Known congenital viral infection
* Unlikely to survive longer than 28 days
* Known hypersensitivity to fish-, egg-, soya- or peanut protein or to any of the active substances or excipients
Minimum Eligible Age

0 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Fresenius Kabi

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Steven A Abrams, MD

Role: PRINCIPAL_INVESTIGATOR

Dell Medical School at The University of Texas at Austin

Locations

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Lucile Packard Children's Hospital

Palo Alto, California, United States

Site Status

UC San Diego Medical Center

San Diego, California, United States

Site Status

Rady Children's Hospital San Diego

San Diego, California, United States

Site Status

Yale - New Haven Children's Hospital

New Haven, Connecticut, United States

Site Status

Ann & Robert H. Lurie Children's Hospital of Chicago

Chicago, Illinois, United States

Site Status

University of Nebraska Medical Center

Omaha, Nebraska, United States

Site Status

Mount Sinai Hospital

New York, New York, United States

Site Status

Steven & Alexandra Cohen Children's Medical Center of NY

New York, New York, United States

Site Status

The Children's Hospital at OU Medical Center

Oklahoma City, Oklahoma, United States

Site Status

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, United States

Site Status

Children's Hospital of Pittsburgh of UPMC

Pittsburgh, Pennsylvania, United States

Site Status

Vanderbilt Children's Hospital

Nashville, Tennessee, United States

Site Status

Texas Children's Hospital

Houston, Texas, United States

Site Status

Countries

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United States

References

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Abrams SA, Ernst KD, Weitkamp JH, Mascarenhas M, Anderson-Berry A, Rudolph J, Ling CY, Robinson DT, Shores D, Hair AB, Lai J, Lane B, McCallie KR, Levit O, Kim JH. Safety and Efficacy of a Composite Lipid Emulsion with Fish Oil in Hospitalized Neonates and Infants Requiring Prolonged Parenteral Nutrition - A Randomized, Double-Blind, Multicenter, Controlled Trial. J Nutr. 2024 Dec;154(12):3615-3625. doi: 10.1016/j.tjnut.2024.10.005. Epub 2024 Oct 5.

Reference Type DERIVED
PMID: 39374788 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

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SMOF-018-CP3

Identifier Type: -

Identifier Source: org_study_id

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