Acetaminophen in Combination With N-Acetylcysteine (NAC) Versus Placebo in Treating Fever
Primary Purpose
Liver Failure, Liver Failure, Acute, Drug Induced Liver Injury
Status
Withdrawn
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
APAP and NAC combination
APAP and Placebo
Sponsored by
About this trial
This is an interventional prevention trial for Liver Failure focused on measuring Acetaminophen, Acetylcysteine, Antidotes
Eligibility Criteria
Inclusion Criteria:
- adults aged 18 to 75 years old
- admitted to an inpatient unit at Columbia-Presbyterian Medical Center
- fever defined as an oral temperature of 38.5°C
Exclusion Criteria:
- if oral temperature cannot be obtained
- abnormal aminotransferase levels
- prior adverse reaction to acetaminophen or N-acetylcysteine
Sites / Locations
- Columbia University Medical Center
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
APAP and NAC combination
APAP and Placebo combination
Arm Description
N-acetyl-p-aminophenol and placebo (APAP-NAC) combination pill
N-acetyl-p-aminophenol and placebo (APAP-placebo) combination pill
Outcomes
Primary Outcome Measures
Difference in temperature reduction between participants who are administered combination N-acetyl-p-aminophenol and N-Acetylcysteine (APAP-NAC) versus combination APAP-placebo
Secondary Outcome Measures
Difference in liver function tests after study drug administration between participants who are administered combination N-acetyl-p-aminophenol and N-Acetylcysteine (APAP-NAC) versus combination APAP-placebo
Change in serum total protein (TP), albumin (Alb), total bilirubin (TB), direct bilirubin (DB), amino alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatate (AP) levels before and after the study drug administration.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01137591
Brief Title
Acetaminophen in Combination With N-Acetylcysteine (NAC) Versus Placebo in Treating Fever
Official Title
Acetaminophen in Combination With N-Acetylcysteine (NAC) vs. Placebo in the Treatment of Fever: A Double-Blind, Randomized Control Study
Study Type
Interventional
2. Study Status
Record Verification Date
March 2015
Overall Recruitment Status
Withdrawn
Why Stopped
Unable to recruit sufficient participants due to lack of funding; PI has left the institution.
Study Start Date
April 2009 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
undefined (undefined)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Columbia University
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of this study is to compare the efficacy of the an N-acetyl-p-aminophenol (APAP, also known as acetaminophen) and N-acetylcysteine (NAC) combination versus an APAP-placebo combination as an anti-pyretic agent.
Detailed Description
N-acetyl-p-aminophenol (APAP), or more commonly known as acetaminophen in the United States, accounts for more overdose and overdose deaths in the United States and United Kingdom than any other pharmaceutical agent. If N-acetylcysteine (NAC) is given within 8 to 10 hours of APAP ingestion, it has been shown to prevent serious liver failure and death in the setting of overdoses. Therefore, it may be beneficial to administer APAP in combination with NAC routinely to reduce rates of liver failure and death. Because NAC's main role is to reduce the accumulation of APAP's toxic metabolites, the concomitant administration of NAC should have no impact on the efficacy of APAP as an antipyretic and analgesic. Thus, we propose a single-center, non-inferiority randomized control study comparing the efficacy of the APAP-NAC combination as compared to APAP-placebo as an anti-pyretic agent.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Liver Failure, Liver Failure, Acute, Drug Induced Liver Injury, Prevention & Control, Fever
Keywords
Acetaminophen, Acetylcysteine, Antidotes
7. Study Design
Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
0 (Actual)
8. Arms, Groups, and Interventions
Arm Title
APAP and NAC combination
Arm Type
Experimental
Arm Description
N-acetyl-p-aminophenol and placebo (APAP-NAC) combination pill
Arm Title
APAP and Placebo combination
Arm Type
Placebo Comparator
Arm Description
N-acetyl-p-aminophenol and placebo (APAP-placebo) combination pill
Intervention Type
Drug
Intervention Name(s)
APAP and NAC combination
Other Intervention Name(s)
APAP: n-acetyl-p-aminophenol; acetaminophen; Tylenol, NAC: n-acetylcysteine; Mucomyst
Intervention Description
APAP 650mg and NAC 600mg combination oral tablet administered once
Intervention Type
Drug
Intervention Name(s)
APAP and Placebo
Other Intervention Name(s)
APAP: n-acetyl-p-aminophenol; acetaminophen; Tylenol
Intervention Description
APAP 650mg and Placebo combination oral tablet administered once
Primary Outcome Measure Information:
Title
Difference in temperature reduction between participants who are administered combination N-acetyl-p-aminophenol and N-Acetylcysteine (APAP-NAC) versus combination APAP-placebo
Time Frame
6 hours after study drug administration
Secondary Outcome Measure Information:
Title
Difference in liver function tests after study drug administration between participants who are administered combination N-acetyl-p-aminophenol and N-Acetylcysteine (APAP-NAC) versus combination APAP-placebo
Description
Change in serum total protein (TP), albumin (Alb), total bilirubin (TB), direct bilirubin (DB), amino alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatate (AP) levels before and after the study drug administration.
Time Frame
Within 24 hours of study drug administration
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
adults aged 18 to 75 years old
admitted to an inpatient unit at Columbia-Presbyterian Medical Center
fever defined as an oral temperature of 38.5°C
Exclusion Criteria:
if oral temperature cannot be obtained
abnormal aminotransferase levels
prior adverse reaction to acetaminophen or N-acetylcysteine
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Matthew Chang, MD
Organizational Affiliation
Columbia University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Columbia University Medical Center
City
New York
State/Province
New York
ZIP/Postal Code
10032
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
18163234
Citation
Bronstein AC, Spyker DA, Cantilena LR Jr, Green J, Rumack BH, Heard SE. 2006 Annual Report of the American Association of Poison Control Centers' National Poison Data System (NPDS). Clin Toxicol (Phila). 2007 Dec;45(8):815-917. doi: 10.1080/15563650701754763.
Results Reference
background
PubMed Identifier
3059186
Citation
Smilkstein MJ, Knapp GL, Kulig KW, Rumack BH. Efficacy of oral N-acetylcysteine in the treatment of acetaminophen overdose. Analysis of the national multicenter study (1976 to 1985). N Engl J Med. 1988 Dec 15;319(24):1557-62. doi: 10.1056/NEJM198812153192401.
Results Reference
background
PubMed Identifier
7658783
Citation
Vale JA, Proudfoot AT. Paracetamol (acetaminophen) poisoning. Lancet. 1995 Aug 26;346(8974):547-52. doi: 10.1016/s0140-6736(95)91385-8. No abstract available.
Results Reference
background
Links:
URL
http://www.nlm.nih.gov/medlineplus/ency/article/002598.htm
Description
Acetaminophen overdose information from the NIH
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Acetaminophen in Combination With N-Acetylcysteine (NAC) Versus Placebo in Treating Fever
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