Efficacy and Safety of SmofKabiven Peripheral Versus Compounded Emulsion

NCT ID: NCT03792087

Last Updated: 2021-08-02

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

PHASE3

Total Enrollment

272 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-12-21

Study Completion Date

2018-12-30

Brief Summary

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The present protocol describes a randomized, open-labelled study in which either SmofKabiven Peripheral or a hospital compounded control Parenteral Nutrition (PN) regimen will be given to adult surgical patients for 5 consecutive days.

As serum prealbumin is a well-established surrogate efficacy parameter reflecting the patient´s nutritional status, the absolute change of the serum prealbumin level at the day of the final study visit compared to baseline will represent the primary efficacy parameter in the present study.

Detailed Description

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In addition, other variables will be assessed in this study, i.e., C-reactive Protein (CRP), free fatty acids, immunology parameters, taurine, comparison of the time required for Total Parenteral Nutrition (TPN) preparation of the two groups, the results of physical examination, vital signs, relevant nutrition- and safety-related laboratory parameters in venous blood and urine, the results of an Electrocardiography (ECG), and the number, severity, seriousness, clinical relevance, relatedness and outcome of Adverse Events (AEs). The aim of the planned study is to demonstrate that SmofKabiven Peripheral is not inferior to the comparative drug (compounded emulsion).

Conditions

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Parenteral Feeding Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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SmofKabiven Peripheral

Continuous intravenous Infusion for SmofKabiven Peripheral via peripheral or central venous access for 14-24 hours/day. Target dose 34.3 ml per kg body weight/day. Duration of treatment 5 consecutive days.

Group Type EXPERIMENTAL

SmofKabiven Peripheral

Intervention Type DRUG

Total Parenteral Nutrition

Hospital compounded emulsion

Continuous intravenous Infusion for Hospital compounded emulsion via peripheral or central venous access for 14-24 hours/day. Target dose 34.3 ml per kg body weight/day. Duration of treatment 5 consecutive days.

Group Type ACTIVE_COMPARATOR

Hospital compounded emulsion

Intervention Type DRUG

Total Parenteral Nutrition

Interventions

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SmofKabiven Peripheral

Total Parenteral Nutrition

Intervention Type DRUG

Hospital compounded emulsion

Total Parenteral Nutrition

Intervention Type DRUG

Other Intervention Names

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Study intervention Investigational Product Control Comparator

Eligibility Criteria

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Inclusion Criteria

1. Patient is scheduled to undergo elective abdominal surgery
2. Female or male patient, age between 18 and 75 years (inclusively)
3. Postoperatively, patient is expected to receive 100% of the total daily energy demand via PN for at least 5 consecutive days
4. Body Mass Index (BMI) ≥ 16 and ≤ 30 kg /m2, and actual body weight ≥ 40 kg
5. Patient is capable to give Informed Consent, agrees to participate in the study, and signs the Informed Consent Form

Exclusion Criteria

1. Patient has received PN or parenteral amino acids in the last 10 days before randomization (exception: administration of glucose will be allowed)
2. Severe liver insufficiency or AST, ALT or total bilirubin at least 1.5-times higher than the upper limit of normal range
3. International Normalised Ratio (INR) at least 1.5 times higher than the upper limit of normal range
4. Uncontrolled hyperglycaemia, fasting blood glucose \> 180 mg/ dl (10 mmol/L)
5. Severe renal impairment defined as serum creatinine value at least 1.5 times higher than the upper limit of normal range
6. Serious hyperlipidaemia (serum cholesterol and/or triglycerides and/or LDL-C level at least 1.5 times higher than the upper limit of normal range)
7. Inborn abnormality of amino acid metabolism
8. Present signs of acute pancreatitis, hypothyroidism or hyper-thyroidism as diagnosed clinically
9. Serum level of any of the electrolytes (sodium, potassium, magnesium, total calcium, chloride, phosphate) above the upper limit of the normal range
10. Known unstable metabolism (e.g., known metabolic acidosis)
11. Known hypersensitivity to fish-, egg-, soybean, or peanut protein or to any of the active substances or excipients of the study drugs
12. General contraindications to infusion therapy: acute pulmonary oedema, hyperhydration, and decompensated cardiac insufficiency /congestive heart failure
13. Unstable conditions (e.g., acute myocardial infarction, stroke, embolism, severe sepsis, shock)
14. Drug abuse and/or chronic alcoholism
15. Psychiatric diseases, epilepsy
16. Administration of growth hormones within the previous 4 weeks before surgery, or chronic maintenance therapy with systemic glucocorticoids 4 weeks before surgery
17. Participation in a clinical study with an investigational drug or an investigational medical device within one month prior to start of study or during study
18. Patient is pregnant or lactating and intends to continue breast-feeding
19. Development of intraoperative/ postoperative conditions (assessed after surgery and before enrollment of patients):

1. Intra-operative blood loss \> 1000ml;
2. Development of a condition in which PN is contraindicated;
3. Intra- or postoperative urine output \<0.5 ml/kg/h;
4. Need for postoperative haemo-filtration or dialysis;
5. Contraindication or inability to obtain peripheral or central venous catheter access;
6. Intra-operative decision on limited treatment, e.g. due to diagnosis of carcinomatosis;
7. Intra-operative severe complications including resuscitation, hemorrhagic and septic shock, acute single and multiple organ dysfunction including pulmonary, hepatic, and renal dysfunction prohibiting early postsurgical extubation, requiring liver-specific treatment and renal replacement therapy.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Parexel

INDUSTRY

Sponsor Role collaborator

Fresenius Kabi

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Wu Guohao, MD

Role: PRINCIPAL_INVESTIGATOR

Fudan University

Locations

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Beijing Friendship Hospital Capital Medical University

Beijing, , China

Site Status

Peking University People's Hospital

Beijing, , China

Site Status

The First Affiliated Hospital with Nanjing Medical University

Nanjing, , China

Site Status

The Affiliated Hospital of Qingdao University

Qingdao, , China

Site Status

Zhongshan Hospital, Fudan University

Shanghai, , China

Site Status

Countries

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China

References

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Calder PC. n-3 fatty acids, inflammation, and immunity--relevance to postsurgical and critically ill patients. Lipids. 2004 Dec;39(12):1147-61. doi: 10.1007/s11745-004-1342-z.

Reference Type BACKGROUND
PMID: 15736910 (View on PubMed)

Mayer K, Gokorsch S, Fegbeutel C, Hattar K, Rosseau S, Walmrath D, Seeger W, Grimminger F. Parenteral nutrition with fish oil modulates cytokine response in patients with sepsis. Am J Respir Crit Care Med. 2003 May 15;167(10):1321-8. doi: 10.1164/rccm.200207-674OC. Epub 2003 Feb 25.

Reference Type BACKGROUND
PMID: 12615625 (View on PubMed)

Novak TE, Babcock TA, Jho DH, Helton WS, Espat NJ. NF-kappa B inhibition by omega -3 fatty acids modulates LPS-stimulated macrophage TNF-alpha transcription. Am J Physiol Lung Cell Mol Physiol. 2003 Jan;284(1):L84-9. doi: 10.1152/ajplung.00077.2002. Epub 2002 Aug 30.

Reference Type BACKGROUND
PMID: 12388359 (View on PubMed)

Pluess TT, Hayoz D, Berger MM, Tappy L, Revelly JP, Michaeli B, Carpentier YA, Chiolero RL. Intravenous fish oil blunts the physiological response to endotoxin in healthy subjects. Intensive Care Med. 2007 May;33(5):789-797. doi: 10.1007/s00134-007-0591-5. Epub 2007 Mar 22.

Reference Type BACKGROUND
PMID: 17377770 (View on PubMed)

Xiong J, Zhu S, Zhou Y, Wu H, Wang C. Regulation of omega-3 fish oil emulsion on the SIRS during the initial stage of severe acute pancreatitis. J Huazhong Univ Sci Technolog Med Sci. 2009 Feb;29(1):35-8. doi: 10.1007/s11596-009-0107-3. Epub 2009 Feb 18.

Reference Type BACKGROUND
PMID: 19224159 (View on PubMed)

Helmut Grimm, A balanced lipid emulsion-A new concept in parenteral nutrition. Clinical Nutrition Supplements (2005) 1, 25-30.

Reference Type BACKGROUND

Grimm H, Mertes N, Goeters C, Schlotzer E, Mayer K, Grimminger F, Furst P. Improved fatty acid and leukotriene pattern with a novel lipid emulsion in surgical patients. Eur J Nutr. 2006 Feb;45(1):55-60. doi: 10.1007/s00394-005-0573-8. Epub 2005 Jul 22.

Reference Type BACKGROUND
PMID: 16041475 (View on PubMed)

Puder M, Valim C, Meisel JA, Le HD, de Meijer VE, Robinson EM, Zhou J, Duggan C, Gura KM. Parenteral fish oil improves outcomes in patients with parenteral nutrition-associated liver injury. Ann Surg. 2009 Sep;250(3):395-402. doi: 10.1097/SLA.0b013e3181b36657.

Reference Type BACKGROUND
PMID: 19661785 (View on PubMed)

Gura KM, Duggan CP, Collier SB, Jennings RW, Folkman J, Bistrian BR, Puder M. Reversal of parenteral nutrition-associated liver disease in two infants with short bowel syndrome using parenteral fish oil: implications for future management. Pediatrics. 2006 Jul;118(1):e197-201. doi: 10.1542/peds.2005-2662.

Reference Type BACKGROUND
PMID: 16818533 (View on PubMed)

Alwayn IP, Gura K, Nose V, Zausche B, Javid P, Garza J, Verbesey J, Voss S, Ollero M, Andersson C, Bistrian B, Folkman J, Puder M. Omega-3 fatty acid supplementation prevents hepatic steatosis in a murine model of nonalcoholic fatty liver disease. Pediatr Res. 2005 Mar;57(3):445-52. doi: 10.1203/01.PDR.0000153672.43030.75. Epub 2005 Jan 19.

Reference Type BACKGROUND
PMID: 15659701 (View on PubMed)

Bouletreau P, Chassard D, Allaouchiche B, Dumont JC, Auboyer C, Bertin-Maghit M, Bricard H, Ecochard R, Rangaraj J, Chambrier C, Schneid C, Cynober L. Glucose-lipid ratio is a determinant of nitrogen balance during total parenteral nutrition in critically ill patients: a prospective, randomized, multicenter blind trial with an intention-to-treat analysis. Intensive Care Med. 2005 Oct;31(10):1394-400. doi: 10.1007/s00134-005-2771-5. Epub 2005 Aug 24.

Reference Type BACKGROUND
PMID: 16132885 (View on PubMed)

Sergi G, Coin A, Enzi G, Volpato S, Inelmen EM, Buttarello M, Peloso M, Mulone S, Marin S, Bonometto P. Role of visceral proteins in detecting malnutrition in the elderly. Eur J Clin Nutr. 2006 Feb;60(2):203-9. doi: 10.1038/sj.ejcn.1602289.

Reference Type BACKGROUND
PMID: 16234837 (View on PubMed)

Shenkin A. Serum prealbumin: Is it a marker of nutritional status or of risk of malnutrition? Clin Chem. 2006 Dec;52(12):2177-9. doi: 10.1373/clinchem.2006.077412. No abstract available.

Reference Type BACKGROUND
PMID: 17138848 (View on PubMed)

Young GA, Hill GL. Assessment of protein-calorie malnutrition in surgical patients from plasma proteins and anthropometric measurements. Am J Clin Nutr. 1978 Mar;31(3):429-35. doi: 10.1093/ajcn/31.3.429.

Reference Type BACKGROUND
PMID: 415592 (View on PubMed)

Young GA, Collins JP, Hill GL. Plasma proteins in patients receiving intravenous amino acids or intravenous hyperalimentation after major surgery. Am J Clin Nutr. 1979 Jun;32(6):1192-9. doi: 10.1093/ajcn/32.6.1192.

Reference Type BACKGROUND
PMID: 87126 (View on PubMed)

Young GA, Hill GL. A controlled study of protein-sparing therapy after excision of the rectum: effects of intravenous amino acids and hyperalimentation on body composition and plasma amino acids. Ann Surg. 1980 Aug;192(2):183-91. doi: 10.1097/00000658-198008000-00009.

Reference Type BACKGROUND
PMID: 6773484 (View on PubMed)

Chinese medical clinical guidelines parenteral enteral nutrition 2008, edited by Chinese Medical Association, People's Medical Publishing House.

Reference Type BACKGROUND

Bernstein LH. The systemic inflammatory response syndrome C-reactive protein and transthyretin conundrum. Clin Chem Lab Med. 2007;45(11):1566-7; author reply 1568-9. doi: 10.1515/CCLM.2007.334. No abstract available.

Reference Type BACKGROUND
PMID: 17970714 (View on PubMed)

SSPC. Intralipid 20%, Summary of Product Characteristics, dated 14 February 2007

Reference Type BACKGROUND

SSPC. Novamin 11.4%, Summary of Product Characteristics, dated 01 December 2013

Reference Type BACKGROUND

McClave SA, Martindale RG, Vanek VW, McCarthy M, Roberts P, Taylor B, Ochoa JB, Napolitano L, Cresci G; A.S.P.E.N. Board of Directors; American College of Critical Care Medicine; Society of Critical Care Medicine. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). JPEN J Parenter Enteral Nutr. 2009 May-Jun;33(3):277-316. doi: 10.1177/0148607109335234. No abstract available.

Reference Type BACKGROUND
PMID: 19398613 (View on PubMed)

Braga M, Ljungqvist O, Soeters P, Fearon K, Weimann A, Bozzetti F; ESPEN. ESPEN Guidelines on Parenteral Nutrition: surgery. Clin Nutr. 2009 Aug;28(4):378-86. doi: 10.1016/j.clnu.2009.04.002. Epub 2009 May 21.

Reference Type BACKGROUND
PMID: 19464088 (View on PubMed)

Chowdary KV, Reddy PN. Parenteral nutrition: Revisited. Indian J Anaesth. 2010 Mar;54(2):95-103. doi: 10.4103/0019-5049.63637.

Reference Type BACKGROUND
PMID: 20661345 (View on PubMed)

Singer P, Berger MM, Van den Berghe G, Biolo G, Calder P, Forbes A, Griffiths R, Kreyman G, Leverve X, Pichard C, ESPEN. ESPEN Guidelines on Parenteral Nutrition: intensive care. Clin Nutr. 2009 Aug;28(4):387-400. doi: 10.1016/j.clnu.2009.04.024. Epub 2009 Jun 7.

Reference Type BACKGROUND
PMID: 19505748 (View on PubMed)

Fresenius Kabi. SomfKabiven Peripheral, emulsion for infusion. Summary of Product Characteristics, dated September.29. 2009

Reference Type BACKGROUND

Other Identifiers

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SMKV-011-CP3

Identifier Type: -

Identifier Source: org_study_id

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