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Safety and Efficacy Study of Nitric Oxide for Inhalation on Chronic Lung Disease in Premature Babies

Primary Purpose

Lung Disease

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
Nitric oxide
Placebo
Sponsored by
Mallinckrodt
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lung Disease focused on measuring Preemie, Inhaled Nitric Oxide

Eligibility Criteria

undefined - 26 Hours (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Inborn preterm infants 24+0 weeks-28+6 days weeks gestational age (defined by first trimester ultrasound or if not available based on the last menstrual period) who requires the use of surfactant within 24 hours of birth (either prophylactically, or for signs of developing respiratory distress), or who requires the use of continuous positive airway pressure (CPAP) (fraction of inspired oxygen concentration (FiO2) ≥ 0.30 on a mean airway pressure ≥ 4cm water (H2O)) within 24 hours of birth in order to maintain an oxygen saturation (SpO2) ≥ 85%.
  • Informed consent of the guardian.

Exclusion Criteria:

  • Outborn infants.
  • Infants ≥ 29 weeks gestational age.
  • Infants requiring FiO2 >0.5 to maintain SpO2 >85%, on a sufficient mean airway pressure (e.g., > 8 cm H2O on controlled mechanical ventilation (CMV)) in order to achieve adequate chest inflation (8-9 ribs on Chest X-ray) two hours after the proper administration of exogenous surfactant.
  • Any suspected congenital heart disease other than patent ductus arteriosus or atrial septal defect.
  • Any infant with severe bleeding or coagulation abnormalities at high-risk of diathesis, e.g., platelet <50,000 per millimeter cube (mm³), fibrinogen <0.5 gram per liter (g/L), other clotting factors <10%.
  • Any infant in whom a decision has been made not to provide full treatment, e.g., chromosomal abnormalities, severe multiple abnormalities, severe birth asphyxia, etc.
  • Use of another investigational drug or device before or during the active study period.

Sites / Locations

  • UCL St. LUC
  • Clinique Notre Dame
  • Universitair Ziekenhuis Antwerpen
  • Clinique St. Vincent CHC
  • Oulun yliopsistollinen sairaala
  • Centre Hospitalier Intercommunal de Creteil
  • Hospital Mere-Enfant
  • Hospital Robert Debre
  • Campus Charite Mitte
  • Universitaetsklinikum Heidelberg
  • Universitaetsklinikum Mannheim
  • Universitaetsklinikum Marburg
  • Universitaetsklinikum Muenchen
  • Universitaeklinikum Tuebingen
  • Univeritaetsklinik Ulm
  • Az. Osp. G. Salesi
  • Ospedali Riuniti
  • Policlinico S. Orsola
  • Azienda Ospedaliera Careggi
  • University Padova
  • Policlinico Gemelli
  • Beatrix Children's Hospital, University Medical Center Groningen
  • Sophia Kinderziekenhuis
  • Hospital de Cruces
  • Hospital Universitario Vall d'Hebron
  • Hospital Universitario Gregorio Mar
  • Hosspital Univeritario La Paz
  • Hospital Universitario Canarias
  • Hospital Universitario Virgen del Rocio
  • Hospital Universitario La Fe
  • Astrid Lindgrens barnsjukjus, Karolinska Unviersritets sjukhuset-Solna
  • Akademiska Sjukhuset
  • Meedway Mariton Hospital
  • Leicester Royal Infirmary
  • Kings College

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

Inhaled Nitric Oxide (INO)

Placebo

Arm Description

INO administered by nasal continuous positive airway pressure, nasal cannula or face mask at 5 parts per million (ppm) for between 7 and 21 days

Placebo gas administered by nasal continuous positive airway pressure, nasal cannula or face mask, for a maximum of 21 days.

Outcomes

Primary Outcome Measures

Survival Without Bronchopulmonary Dysplasia (BPD) in Preterm Infants With Respiratory Distress
Survival without BPD is defined as the number of preterm infants of 36 weeks gestational age who survived the treatment period without the need for supplemental oxygen

Secondary Outcome Measures

Full Information

First Posted
October 30, 2007
Last Updated
February 4, 2021
Sponsor
Mallinckrodt
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1. Study Identification

Unique Protocol Identification Number
NCT00551642
Brief Title
Safety and Efficacy Study of Nitric Oxide for Inhalation on Chronic Lung Disease in Premature Babies
Official Title
The Effects of Nitric Oxide for Inhalation on the Development of Chronic Lung Disease in Pre-term Infants
Study Type
Interventional

2. Study Status

Record Verification Date
February 2021
Overall Recruitment Status
Completed
Study Start Date
May 29, 2005 (Actual)
Primary Completion Date
March 16, 2008 (Actual)
Study Completion Date
July 17, 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mallinckrodt

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess the safety and efficacy of inhaled nitric oxide to reduce the risk of chronic lung disease in pre-term infants with respiratory distress, and to assess the long-term effects of the therapy on the development of these children over 7 years of clinical follow-up.
Detailed Description
Although the effects of inhaled Nitric Oxide on pulmonary vascular tone are well-described and relevant to term infants with persistent pulmonary hypertension, the pathophysiology of respiratory failure in preterm infants may be quite different. Chronic lung disease (CLD) represents the final pathway of a heterogeneous group of pulmonary disorders of infancy that usually start in the neonatal period. CLD most commonly occurs in preterm (<30 weeks of gestational age (GA) infants with birth weights less than 1,500 grams (g), and especially in those very preterm (<26 weeks GA) with birth weights less than 1,000 g, and who have been treated for respiratory distress syndrome (RDS).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lung Disease
Keywords
Preemie, Inhaled Nitric Oxide

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare Provider
Allocation
Randomized
Enrollment
800 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Inhaled Nitric Oxide (INO)
Arm Type
Active Comparator
Arm Description
INO administered by nasal continuous positive airway pressure, nasal cannula or face mask at 5 parts per million (ppm) for between 7 and 21 days
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo gas administered by nasal continuous positive airway pressure, nasal cannula or face mask, for a maximum of 21 days.
Intervention Type
Drug
Intervention Name(s)
Nitric oxide
Other Intervention Name(s)
INO max®
Intervention Description
Nitric Oxide vapour (gas) for inhalation (400 ppm)
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo gas for inhalation
Primary Outcome Measure Information:
Title
Survival Without Bronchopulmonary Dysplasia (BPD) in Preterm Infants With Respiratory Distress
Description
Survival without BPD is defined as the number of preterm infants of 36 weeks gestational age who survived the treatment period without the need for supplemental oxygen
Time Frame
21 days
Other Pre-specified Outcome Measures:
Title
Mortality at 7-year Follow-up
Description
Number of participants who died between 2 years and the 7-year Follow-up Period
Time Frame
at 7-year Follow-up
Title
Strengths and Difficulties Questionnaire Results for Participants at 7-year Follow-up
Description
The Strengths and Difficulties Questionnaire contained 25 questions that were used to create 5 scales (ranging from 10=most normal to 0=most abnormal) for emotional symptoms, conduct problems, hyperactivity, peer problems, and (10=most abnormal, 0=most normal) for prosocial.
Time Frame
At 7-year Follow-up

10. Eligibility

Sex
All
Maximum Age & Unit of Time
26 Hours
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Inborn preterm infants 24+0 weeks-28+6 days weeks gestational age (defined by first trimester ultrasound or if not available based on the last menstrual period) who requires the use of surfactant within 24 hours of birth (either prophylactically, or for signs of developing respiratory distress), or who requires the use of continuous positive airway pressure (CPAP) (fraction of inspired oxygen concentration (FiO2) ≥ 0.30 on a mean airway pressure ≥ 4cm water (H2O)) within 24 hours of birth in order to maintain an oxygen saturation (SpO2) ≥ 85%. Informed consent of the guardian. Exclusion Criteria: Outborn infants. Infants ≥ 29 weeks gestational age. Infants requiring FiO2 >0.5 to maintain SpO2 >85%, on a sufficient mean airway pressure (e.g., > 8 cm H2O on controlled mechanical ventilation (CMV)) in order to achieve adequate chest inflation (8-9 ribs on Chest X-ray) two hours after the proper administration of exogenous surfactant. Any suspected congenital heart disease other than patent ductus arteriosus or atrial septal defect. Any infant with severe bleeding or coagulation abnormalities at high-risk of diathesis, e.g., platelet <50,000 per millimeter cube (mm³), fibrinogen <0.5 gram per liter (g/L), other clotting factors <10%. Any infant in whom a decision has been made not to provide full treatment, e.g., chromosomal abnormalities, severe multiple abnormalities, severe birth asphyxia, etc. Use of another investigational drug or device before or during the active study period.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Clinical Team Leader
Organizational Affiliation
Mallinckrodt
Official's Role
Study Director
Facility Information:
Facility Name
UCL St. LUC
City
Bruxelles
Country
Belgium
Facility Name
Clinique Notre Dame
City
Charleroi
Country
Belgium
Facility Name
Universitair Ziekenhuis Antwerpen
City
Edegem
Country
Belgium
Facility Name
Clinique St. Vincent CHC
City
Rocourt
Country
Belgium
Facility Name
Oulun yliopsistollinen sairaala
City
Oulu
ZIP/Postal Code
FI-90220
Country
Finland
Facility Name
Centre Hospitalier Intercommunal de Creteil
City
Creteil
ZIP/Postal Code
94000
Country
France
Facility Name
Hospital Mere-Enfant
City
Nantes Cedex 1
ZIP/Postal Code
44093
Country
France
Facility Name
Hospital Robert Debre
City
Paris
ZIP/Postal Code
75019
Country
France
Facility Name
Campus Charite Mitte
City
Berlin
ZIP/Postal Code
10117
Country
Germany
Facility Name
Universitaetsklinikum Heidelberg
City
Heidelberg
ZIP/Postal Code
69115
Country
Germany
Facility Name
Universitaetsklinikum Mannheim
City
Mannheim
ZIP/Postal Code
68167
Country
Germany
Facility Name
Universitaetsklinikum Marburg
City
Marburg
ZIP/Postal Code
35033
Country
Germany
Facility Name
Universitaetsklinikum Muenchen
City
Muenchen
ZIP/Postal Code
81377
Country
Germany
Facility Name
Universitaeklinikum Tuebingen
City
Tuebingen
ZIP/Postal Code
72076
Country
Germany
Facility Name
Univeritaetsklinik Ulm
City
Ulm
ZIP/Postal Code
89075
Country
Germany
Facility Name
Az. Osp. G. Salesi
City
Ancona
ZIP/Postal Code
60123
Country
Italy
Facility Name
Ospedali Riuniti
City
Bergamo
ZIP/Postal Code
24128
Country
Italy
Facility Name
Policlinico S. Orsola
City
Bologna
ZIP/Postal Code
40138
Country
Italy
Facility Name
Azienda Ospedaliera Careggi
City
Firenze
ZIP/Postal Code
50134
Country
Italy
Facility Name
University Padova
City
Padova
ZIP/Postal Code
35128
Country
Italy
Facility Name
Policlinico Gemelli
City
Roma
ZIP/Postal Code
00168
Country
Italy
Facility Name
Beatrix Children's Hospital, University Medical Center Groningen
City
Groningen
ZIP/Postal Code
9713 GZ
Country
Netherlands
Facility Name
Sophia Kinderziekenhuis
City
Rotterdam
ZIP/Postal Code
3000 CB
Country
Netherlands
Facility Name
Hospital de Cruces
City
Barakaldo
ZIP/Postal Code
48903
Country
Spain
Facility Name
Hospital Universitario Vall d'Hebron
City
Barcelona
ZIP/Postal Code
08035
Country
Spain
Facility Name
Hospital Universitario Gregorio Mar
City
Madrid
ZIP/Postal Code
28007
Country
Spain
Facility Name
Hosspital Univeritario La Paz
City
Madrid
ZIP/Postal Code
28046
Country
Spain
Facility Name
Hospital Universitario Canarias
City
Santa Cruz de Tenerife
ZIP/Postal Code
38320
Country
Spain
Facility Name
Hospital Universitario Virgen del Rocio
City
Sevilla
ZIP/Postal Code
41013
Country
Spain
Facility Name
Hospital Universitario La Fe
City
Valencia
ZIP/Postal Code
46009
Country
Spain
Facility Name
Astrid Lindgrens barnsjukjus, Karolinska Unviersritets sjukhuset-Solna
City
Stockholm
ZIP/Postal Code
SE-171 76
Country
Sweden
Facility Name
Akademiska Sjukhuset
City
Uppsala
ZIP/Postal Code
SE-751 85
Country
Sweden
Facility Name
Meedway Mariton Hospital
City
Gillingham
ZIP/Postal Code
ME7 5NY
Country
United Kingdom
Facility Name
Leicester Royal Infirmary
City
Leicester
ZIP/Postal Code
LE1 5WW
Country
United Kingdom
Facility Name
Kings College
City
London
ZIP/Postal Code
SE5 9RS
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Discussion of statistical endpoints and analysis are included in manuscripts. Summary aggregate (basic) results (including adverse events information) and the study protocol are made available on clinicaltrials.gov (NCT00551642) when required by regulation. Individual de-identified patient data will not be disclosed. Requests for additional information should be directed to the company at medinfo@mnk.com.
Citations:
PubMed Identifier
28046032
Citation
Laube M, Amann E, Uhlig U, Yang Y, Fuchs HW, Zemlin M, Mercier JC, Maier RF, Hummler HD, Uhlig S, Thome UH. Inflammatory Mediators in Tracheal Aspirates of Preterm Infants Participating in a Randomized Trial of Inhaled Nitric Oxide. PLoS One. 2017 Jan 3;12(1):e0169352. doi: 10.1371/journal.pone.0169352. eCollection 2017.
Results Reference
derived
PubMed Identifier
23940237
Citation
Durrmeyer X, Hummler H, Sanchez-Luna M, Carnielli VP, Field D, Greenough A, Van Overmeire B, Jonsson B, Hallman M, Mercier JC, Marlow N, Johnson S, Baldassarre J; European Union Nitric Oxide Study Group. Two-year outcomes of a randomized controlled trial of inhaled nitric oxide in premature infants. Pediatrics. 2013 Sep;132(3):e695-703. doi: 10.1542/peds.2013-0007. Epub 2013 Aug 12.
Results Reference
derived
PubMed Identifier
20655106
Citation
Mercier JC, Hummler H, Durrmeyer X, Sanchez-Luna M, Carnielli V, Field D, Greenough A, Van Overmeire B, Jonsson B, Hallman M, Baldassarre J; EUNO Study Group. Inhaled nitric oxide for prevention of bronchopulmonary dysplasia in premature babies (EUNO): a randomised controlled trial. Lancet. 2010 Jul 31;376(9738):346-54. doi: 10.1016/S0140-6736(10)60664-2. Epub 2010 Jul 23.
Results Reference
derived

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Safety and Efficacy Study of Nitric Oxide for Inhalation on Chronic Lung Disease in Premature Babies

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