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Stannsoporfin With Light Therapy for Newborn Babies With Jaundice (JASMINE_204)

Primary Purpose

Jaundice, Neonatal, Hyperbilirubinemia, Neonatal

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Phototherapy
Stannsoporfin
Placebo
Sponsored by
InfaCare Pharmaceuticals Corporation, a Mallinckrodt Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Jaundice, Neonatal focused on measuring G6PD deficiency, Antibody (ABO) incompatibility, Coombs positive ABO/ rhesus factor (RH) incompatibility, Intensive phototherapy in neonates

Eligibility Criteria

1 Hour - 72 Hours (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Term and near term infants ≥35 and ≤ 43 weeks gestational age (GA), age 0-48 hours with antibody (ABO) or rhesus factor (Rh) incompatibility (anti C, c, D, E or e) who are Coombs positive, or age 0-72 hours with G6PD deficiency
  2. Parental or guardian consent
  3. Birth weight ≥ 2500 grams
  4. At or above the age-specific threshold for initiating phototherapy (PT) per the American Academy of Pediatrics (AAP) guidelines based on measurement of total serum bilirubin (TSB)
  5. Parents agree to observe light precautions for 10 days post treatment

Exclusion Criteria:

  1. Elevated direct bilirubin ≥2 mg/dL, OR > 20% of the total serum bilirubin
  2. Alanine aminotransferase (ALT) > 2 times the upper limit of normal (ULN) and/or aspartate aminotransferase (AST) > 3 times ULN
  3. Abnormal renal function defined as creatinine and/or blood urea nitrogen >2 times the ULN
  4. Any other clinically significant abnormalities on screening laboratory evaluation [including electrocardiogram (ECG)] that in the opinion of the investigator makes the patient unsuitable for the clinical trial
  5. Apgar score ≤6 at age 5 minutes
  6. An unexplained existing rash or skin erythema
  7. Prior exposure to PT
  8. Clinical suggestion of neonatal thyroid disease or current uncontrolled thyroid disease in the mother (maternal Hashimoto's disease is not exclusionary)
  9. Cardio-respiratory distress, defined as a respiratory rate >60 breaths per minute at time of enrollment
  10. Any abnormal auditory or ophthalmologic findings on screening physical exam
  11. Treatment or need for treatment in the neonate with medications that are photoreactive or may prolong the QT interval (erythromycin ointment for eye prophylaxis is permitted), or family history of Long QT syndrome
  12. Known porphyrias or risk factors for porphyrias, including family history
  13. A maternal history of systemic lupus erythematosus
  14. Maternal use of phenobarbital 30 days before, or after delivery, if breast-feeding
  15. Maternal current drug or alcohol abuse, or maternal history of drug or alcohol abuse that, in the opinion of the Investigator, would not make the patient a suitable candidate for participation in the clinical trial
  16. Significant congenital anomalies or infections
  17. Risk of requiring surgery or exposure to operating room (OR) lights in the first 2 weeks of life
  18. Persistent hypoglycemia (blood glucose <40 mg/dL)
  19. Temperature instability defined as temperature consistently (3 consecutive times) <36 degrees centigrade (ºC) and/or >37.5 degrees centigrade (ºC) axillary
  20. Use of intravenous immunoglobulin (IVIg) or albumin prior to study drug administration
  21. Post-delivery treatment with medications that are known or suspected to displace bilirubin from albumin (e.g., ceftriaxone or sulfa-based antibiotics)
  22. Use of photosensitizing drugs or agents
  23. Unwillingness of parents/guardians to adhere to recommendations regarding light precautions
  24. Exposure to any investigational medications or devices after delivery, or participation in another clinical trial while participating in this trial
  25. Any other concurrent medical condition, which in the opinion of the Investigator, makes the patient unsuitable for the clinical trial

Sites / Locations

  • Arrowhead Regional Medical Center
  • University of California San Diego Medical Center
  • University of CA, San Francisco
  • Univ Florida Hospital
  • Kosair Children's Hospital
  • University of Louisville Hospital
  • Univ Med Ctr of Southern Nevada
  • Rutgers University Hospital
  • Winthrop University Hospital
  • Stoney Brook Univ Hospital
  • WakeMed Health and Hospitals
  • Toledo Children's Hospital
  • Hahnemann University Hospital/St. Christopher's Hospital for Children
  • Medical Univ of South Carolina
  • University of Tennessee Health Science Center
  • JPS Health Network
  • Univ Texas Medical Branch
  • Children's Hospital of Richmond at VCU

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Placebo Comparator

Experimental

Experimental

Arm Label

Placebo

Stannsoporfin 3.0 mg/kg

Stannsoporfin 4.5 mg/kg

Arm Description

Participants receive placebo and phototherapy

Participants receive stannsoporfin (3.0 mg/kg) and phototherapy

Participants receive stannsoporfin (4.5 mg/kg) and phototherapy

Outcomes

Primary Outcome Measures

Total Serum Bilirubin (mg/dL)
Total serum bilirubin (TSB) was measured at baseline (the measure that qualified the baby for inclusion) and at 48 hours after treatment. If a baby was discharged before 48 hours, the last measurement before discharge was used [last observation carried forward (LOCF)].

Secondary Outcome Measures

Time (Hour) at Which TSB First Crosses at or Below the Defined Age-specific Threshold for 54-hours Post-treatment (PT)
The hour that 50% of babies in the group (median) first crosses at or below the defined 54-hour threshold for the baby's age
Number of Participants With Phototherapy (PT) Failure
PT failure was defined by any of the following: re-start of PT within 6 hours after stopping re-hospitalization for hyperbilirubinaemia use of intravenous immunoglobulin (IVIg) need for an exchange transfusion
Number of Participants With Rebound Hyperbilirubinemia
Rebound hyperbilirubinaemia was defined as an increase in TSB above the age-specific threshold for initiating phototherapy, following the discontinuation of the initial phototherapy.

Full Information

First Posted
June 24, 2013
Last Updated
February 4, 2020
Sponsor
InfaCare Pharmaceuticals Corporation, a Mallinckrodt Company
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1. Study Identification

Unique Protocol Identification Number
NCT01887327
Brief Title
Stannsoporfin With Light Therapy for Newborn Babies With Jaundice
Acronym
JASMINE_204
Official Title
A Phase 2b Multicenter, Single Dose, Randomized, Double Blind, Placebo-Controlled, Parallel-Group Study Evaluating the Safety and Efficacy of Two Doses of Stannsoporfin in Combination With Phototherapy in Neonates
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
October 16, 2013 (Actual)
Primary Completion Date
March 22, 2016 (Actual)
Study Completion Date
March 22, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
InfaCare Pharmaceuticals Corporation, a Mallinckrodt Company

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
It is normal for red blood cells to die, even in newborn babies. The waste from that is called bilirubin. The liver clears bilirubin out of the body. Some babies are born with illness that makes red blood cells die too fast, so the liver is not strong enough to keep up with it. The yellowish color in eyes or skin means there is too much bilirubin in the body. It can be dangerous if a baby's bilirubin gets too high. Special lights are put on jaundiced babies (called phototherapy) to help the liver get rid of bilirubin. This study tests an experimental drug to see if it can help the liver even more, by safely cutting down the amount of bilirubin the body is making in the first place.
Detailed Description
Participants randomized (1:1:1) to treatment groups will be term or near-term infants with isoimmune hemolytic disease or glucose-6-phosphate dehydrogenase (G6PD) deficiency.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Jaundice, Neonatal, Hyperbilirubinemia, Neonatal
Keywords
G6PD deficiency, Antibody (ABO) incompatibility, Coombs positive ABO/ rhesus factor (RH) incompatibility, Intensive phototherapy in neonates

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Care ProviderInvestigator
Allocation
Randomized
Enrollment
91 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Participants receive placebo and phototherapy
Arm Title
Stannsoporfin 3.0 mg/kg
Arm Type
Experimental
Arm Description
Participants receive stannsoporfin (3.0 mg/kg) and phototherapy
Arm Title
Stannsoporfin 4.5 mg/kg
Arm Type
Experimental
Arm Description
Participants receive stannsoporfin (4.5 mg/kg) and phototherapy
Intervention Type
Procedure
Intervention Name(s)
Phototherapy
Other Intervention Name(s)
Light therapy
Intervention Description
Phototherapy starts within 30 minutes before or after injection
Intervention Type
Drug
Intervention Name(s)
Stannsoporfin
Other Intervention Name(s)
Experimental drug
Intervention Description
Stannsoporfin (3.0 or 4.5 mg/kg) administered by intramuscular (IM) injection (a shot in the muscle)
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Matching placebo, Saline
Intervention Description
Matching placebo administered by IM injection
Primary Outcome Measure Information:
Title
Total Serum Bilirubin (mg/dL)
Description
Total serum bilirubin (TSB) was measured at baseline (the measure that qualified the baby for inclusion) and at 48 hours after treatment. If a baby was discharged before 48 hours, the last measurement before discharge was used [last observation carried forward (LOCF)].
Time Frame
Baseline, 48 hours post-treatment
Secondary Outcome Measure Information:
Title
Time (Hour) at Which TSB First Crosses at or Below the Defined Age-specific Threshold for 54-hours Post-treatment (PT)
Description
The hour that 50% of babies in the group (median) first crosses at or below the defined 54-hour threshold for the baby's age
Time Frame
within 54 hours
Title
Number of Participants With Phototherapy (PT) Failure
Description
PT failure was defined by any of the following: re-start of PT within 6 hours after stopping re-hospitalization for hyperbilirubinaemia use of intravenous immunoglobulin (IVIg) need for an exchange transfusion
Time Frame
within 30 days after discharge
Title
Number of Participants With Rebound Hyperbilirubinemia
Description
Rebound hyperbilirubinaemia was defined as an increase in TSB above the age-specific threshold for initiating phototherapy, following the discontinuation of the initial phototherapy.
Time Frame
within 54 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Hour
Maximum Age & Unit of Time
72 Hours
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Term and near term infants ≥35 and ≤ 43 weeks gestational age (GA), age 0-48 hours with antibody (ABO) or rhesus factor (Rh) incompatibility (anti C, c, D, E or e) who are Coombs positive, or age 0-72 hours with G6PD deficiency Parental or guardian consent Birth weight ≥ 2500 grams At or above the age-specific threshold for initiating phototherapy (PT) per the American Academy of Pediatrics (AAP) guidelines based on measurement of total serum bilirubin (TSB) Parents agree to observe light precautions for 10 days post treatment Exclusion Criteria: Elevated direct bilirubin ≥2 mg/dL, OR > 20% of the total serum bilirubin Alanine aminotransferase (ALT) > 2 times the upper limit of normal (ULN) and/or aspartate aminotransferase (AST) > 3 times ULN Abnormal renal function defined as creatinine and/or blood urea nitrogen >2 times the ULN Any other clinically significant abnormalities on screening laboratory evaluation [including electrocardiogram (ECG)] that in the opinion of the investigator makes the patient unsuitable for the clinical trial Apgar score ≤6 at age 5 minutes An unexplained existing rash or skin erythema Prior exposure to PT Clinical suggestion of neonatal thyroid disease or current uncontrolled thyroid disease in the mother (maternal Hashimoto's disease is not exclusionary) Cardio-respiratory distress, defined as a respiratory rate >60 breaths per minute at time of enrollment Any abnormal auditory or ophthalmologic findings on screening physical exam Treatment or need for treatment in the neonate with medications that are photoreactive or may prolong the QT interval (erythromycin ointment for eye prophylaxis is permitted), or family history of Long QT syndrome Known porphyrias or risk factors for porphyrias, including family history A maternal history of systemic lupus erythematosus Maternal use of phenobarbital 30 days before, or after delivery, if breast-feeding Maternal current drug or alcohol abuse, or maternal history of drug or alcohol abuse that, in the opinion of the Investigator, would not make the patient a suitable candidate for participation in the clinical trial Significant congenital anomalies or infections Risk of requiring surgery or exposure to operating room (OR) lights in the first 2 weeks of life Persistent hypoglycemia (blood glucose <40 mg/dL) Temperature instability defined as temperature consistently (3 consecutive times) <36 degrees centigrade (ºC) and/or >37.5 degrees centigrade (ºC) axillary Use of intravenous immunoglobulin (IVIg) or albumin prior to study drug administration Post-delivery treatment with medications that are known or suspected to displace bilirubin from albumin (e.g., ceftriaxone or sulfa-based antibiotics) Use of photosensitizing drugs or agents Unwillingness of parents/guardians to adhere to recommendations regarding light precautions Exposure to any investigational medications or devices after delivery, or participation in another clinical trial while participating in this trial Any other concurrent medical condition, which in the opinion of the Investigator, makes the patient unsuitable for the clinical trial
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Global Clinical Leader
Organizational Affiliation
InfaCare Pharmaceuticals Corporation, a Mallinckrodt Company
Official's Role
Study Director
Facility Information:
Facility Name
Arrowhead Regional Medical Center
City
Colton
State/Province
California
ZIP/Postal Code
92324
Country
United States
Facility Name
University of California San Diego Medical Center
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
University of CA, San Francisco
City
San Francisco
State/Province
California
ZIP/Postal Code
94145
Country
United States
Facility Name
Univ Florida Hospital
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32209
Country
United States
Facility Name
Kosair Children's Hospital
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
University of Louisville Hospital
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40202
Country
United States
Facility Name
Univ Med Ctr of Southern Nevada
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89102
Country
United States
Facility Name
Rutgers University Hospital
City
Newark
State/Province
New Jersey
ZIP/Postal Code
07103
Country
United States
Facility Name
Winthrop University Hospital
City
Mineola
State/Province
New York
ZIP/Postal Code
11501
Country
United States
Facility Name
Stoney Brook Univ Hospital
City
Stony Brook
State/Province
New York
ZIP/Postal Code
22794
Country
United States
Facility Name
WakeMed Health and Hospitals
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27610
Country
United States
Facility Name
Toledo Children's Hospital
City
Toledo
State/Province
Ohio
ZIP/Postal Code
43606
Country
United States
Facility Name
Hahnemann University Hospital/St. Christopher's Hospital for Children
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19102
Country
United States
Facility Name
Medical Univ of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
University of Tennessee Health Science Center
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38163
Country
United States
Facility Name
JPS Health Network
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76104
Country
United States
Facility Name
Univ Texas Medical Branch
City
Galveston
State/Province
Texas
ZIP/Postal Code
77555
Country
United States
Facility Name
Children's Hospital of Richmond at VCU
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23298
Country
United States

12. IPD Sharing Statement

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Stannsoporfin With Light Therapy for Newborn Babies With Jaundice

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