Intranasal Breast Milk Therapy in HIE

NCT ID: NCT06746532

Last Updated: 2024-12-24

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

RECRUITING

Clinical Phase

EARLY_PHASE1

Total Enrollment

80 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-02-01

Study Completion Date

2030-12-31

Brief Summary

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This is an open-label prospective single-center randomized controlled trial to evaluate the effect of intranasal breast milk in hypoxic-ischemic encephalopathic neonates receiving therapeutic hypothermia on long term neurodevelopmental outcome compared to standard care.

Detailed Description

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Perinatal asphyxia and the resulting hypoxic-ischemic encephalopathy (HIE) are the leading cause of neonatal mortality and long-term neurodevelopmental disabilities. Based on our current knowledge, therapeutic hypothermia is the only therapy that has been proven to reduce central nervous system damage in HIE neonates. Improving neurodevelopmental outcomes of newborns with HIE has been an intense area of research over the past decade.

Breast milk is a complex biological substance that contains a variety of bioactive components including neurotrophic growth factors, cytokines, immunoglobulins, and multipotent stem cells. Studies have shown that exclusive breastfeeding in the early stages of development has a positive impact on cognitive outcomes. Animal studies support that mesenchymal stem cells and neurotrophic substances found in breast milk, when administered intranasally enter the central nervous system and reduce the extent of neurological damage. In preterm infants, it has been shown that intranasally administered breast milk is safe and well-tolerated.

In this open-label prospective randomized controlled single-center interventional study, the objective is to administer fresh, own-mother's breast milk intranasally to neonates with hypoxic-ischemic encephalopathy receiving therapeutic hypothermia, starting from the first day of life and continuing for 28 days.

The primary objective is to compare neurodevelopmental outcomes between the control group and the intervention group receiving intranasal breast milk treatment. The secondary objective is to compare the progression of enteral feeding and the duration of exclusive breastfeeding between the intervention and the control group.

Conditions

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Hypoxic-Ischaemic Encephalopathy Neonatal Encephalopathy Perinatal Asphyxia Neonatal Hypoxic Ischemic Encephalopathy

Keywords

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HIE intranasal breast milk perinatal asphyxia brain breast milk stem cells hypoxic-ischemic encephalopathy

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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Control

Standard care for moderate or severe hypoxic-ischemic encephalopathy with hypothermia.

Group Type NO_INTERVENTION

No interventions assigned to this group

Intranasal breast milk

Fresh own mother's breast milk expressed within 4 hours, will be administered 2 times daily, 0.4 ml in each nostril for 28 days.

Group Type EXPERIMENTAL

Intranasal breast milk

Intervention Type BIOLOGICAL

Own-mother's fresh breast milk (within 4 hours of having been expressed), is administered intranasally to neonates with hypoxic-ischemic encephalopathy receiving therapeutic hypothermia, starting from the first day of life and continuing for 28 days.

Dose: 2 times daily, 0.4 ml in each nostril.

Interventions

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Intranasal breast milk

Own-mother's fresh breast milk (within 4 hours of having been expressed), is administered intranasally to neonates with hypoxic-ischemic encephalopathy receiving therapeutic hypothermia, starting from the first day of life and continuing for 28 days.

Dose: 2 times daily, 0.4 ml in each nostril.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Moderate or severe hypoxic- ischemic encephalopathy, receiving therapeutic hypothermia

≥ 35. gestational week \< 48 hours of life
* Hypothermia treatment for 72 hours
* Parental consent form

Exclusion Criteria

* Congenital malformation
* Concurrent cerebral lesions
* ECMO therapy
* Contraindication of lactation
* Mother unable or unwilling to provide fresh breast milk
* Postpartum asphyxia
Maximum Eligible Age

48 Hours

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Semmelweis University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Unoke Meder, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Department of Neonatology, Pediatric Center, Semmelweis University, Budapest, Hungary

Locations

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Department of Neonatology, Pediatric Center, Semmelweis University, Budapest, Hungary

Budapest, , Hungary

Site Status RECRUITING

Countries

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Hungary

Central Contacts

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Unoke Meder, MD, PhD

Role: CONTACT

Phone: +36303987970

Email: [email protected]

Agnes Jermendy, MD, PhD

Role: CONTACT

Phone: +36204600798

Email: [email protected]

Facility Contacts

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Unoke Meder, MD, PhD

Role: primary

Miklos Szabo, MD, PhD

Role: backup

References

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Chen Y, Zhang C, Huang Y, Ma Y, Song Q, Chen H, Jiang G, Gao X. Intranasal drug delivery: The interaction between nanoparticles and the nose-to-brain pathway. Adv Drug Deliv Rev. 2024 Apr;207:115196. doi: 10.1016/j.addr.2024.115196. Epub 2024 Feb 7.

Reference Type BACKGROUND
PMID: 38336090 (View on PubMed)

Baak LM, Wagenaar N, van der Aa NE, Groenendaal F, Dudink J, Tataranno ML, Mahamuud U, Verhage CH, Eijsermans RMJC, Smit LS, Jellema RK, de Haan TR, Ter Horst HJ, de Boode WP, Steggerda SJ, Prins HJ, de Haar CG, de Vries LS, van Bel F, Heijnen CJ, Nijboer CH, Benders MJNL. Feasibility and safety of intranasally administered mesenchymal stromal cells after perinatal arterial ischaemic stroke in the Netherlands (PASSIoN): a first-in-human, open-label intervention study. Lancet Neurol. 2022 Jun;21(6):528-536. doi: 10.1016/S1474-4422(22)00117-X.

Reference Type BACKGROUND
PMID: 35568047 (View on PubMed)

Hoban R, Gallipoli A, Signorile M, Mander P, Gauthier-Fisher A, Librach C, Wilson D, Unger S. Feasibility of intranasal human milk as stem cell therapy in preterm infants with intraventricular hemorrhage. J Perinatol. 2024 Nov;44(11):1652-1657. doi: 10.1038/s41372-024-01982-8. Epub 2024 Apr 30.

Reference Type BACKGROUND
PMID: 38688998 (View on PubMed)

Keller T, Korber F, Oberthuer A, Schafmeyer L, Mehler K, Kuhr K, Kribs A. Intranasal breast milk for premature infants with severe intraventricular hemorrhage-an observation. Eur J Pediatr. 2019 Feb;178(2):199-206. doi: 10.1007/s00431-018-3279-7. Epub 2018 Nov 1.

Reference Type BACKGROUND
PMID: 30386923 (View on PubMed)

Other Identifiers

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NNGYK/40202-5/2024

Identifier Type: -

Identifier Source: org_study_id