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A Study to Evaluate the Effects of a New Formula on the Growth, Safety and Tolerance of Infants With Growth Failure

Primary Purpose

Growth Failure, Congenital Heart Disease

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
New Infant Formula
Sponsored by
Nutricia North America
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Growth Failure

Eligibility Criteria

1 Month - 8 Months (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Infants must have attained term gestation (≥37 weeks of gestational age) at the time of screening
  2. Infants, male or female, aged 1 through 8 months
  3. Infants with congenital heart disease or other organic/non-organic cause of growth failure with a weight-for-length z score ≤ -1.0 or weight gain ≤ -2.0 z score based on WHO growth standards. (for weight gain metrics please see Appendix I): Weight gain (g) for boys and girls by age ( -2 z scores for weight velocity). Infants with Down syndrome must have a weight for length z-score ≤-1.0 z score. Infants with Down syndrome who meet the weight gain criterion (≤ -2.0 z-score weight gain) and have a weight for length z-score >-1.0 z-score will not be eligible for enrolment.
  4. Infants expected to consume (or obtain via tube feeding), on average, 80% of their total energy intake from NF for 16 weeks
  5. Infants from families who are willing and able to have anthropometrics taken at the required frequency as well as to comply with all other protocol requirements
  6. Written informed consent from the parent/caregiver or legal guardian
  7. Parent/caregiver or legal guardian must be able to read, write, and understand English

Exclusion Criteria:

  1. Infants with known or suspected complex gastrointestinal anomalies or dysfunction, hepatic* or renal* dysfunction, or inherited metabolic disorders, congenital neurological insults, suspected or diagnosed conditions associated with malabsorption (e.g. cystic fibrosis)
  2. Infants with known or suspected systemic or congenital infections (e.g. human immunodeficiency virus, HBV, HCV)
  3. 3. Infants with known or suspected genetic conditions listed in Appendix VI and/or metabolic conditions known to interfere with growth or body dysmorphology that can interfere with obtaining standard anthropometric measurements (weight, length, head circumference, and mid upper arm circumference), with the exception of infants diagnosed with Down syndrome who may be enrolled in the study
  4. Infants with known or suspected cow milk allergy or children who have received cow milk formula for 7 days or less
  5. Infants expected to consume on average more than 20% of their energy intake from non-NF sources of nutrition: solids, expressed breast milk and /or parenteral nutrition.
  6. Child feeding directly at the breast more than twice per day
  7. Infants participating in any other studies involving investigational or marketed products concomitantly or within two weeks prior to the entry into the study. Infants participating in vaccination trials, who are only receiving follow-up blood monitoring, are not excluded.
  8. Principal Investigator's uncertainty about the willingness or ability of the parent/caregiver or legal guardian to comply with the protocol requirements
  9. Infants whose parent is younger than the legal age of consent
  10. Infants born large for gestational age (LGA). LGA: Birth weight > 90th percentile for gestational age (please see chart in Appendix I)
  11. Infants born small for gestational age (SGA). SGA: Birth weight < 10th percentile for gestational age (please see chart in Appendix I) * Note: For hepatic dysfunction, a conjugated bilirubin >2.0 mg/dL and for renal dysfunction child should not meet any of the pRIFLE criteria for renal disease (estimated creatinine clearance decreased by 25% by the Schwartz formula or urine output <0.5 mL/kg per hour over the previous 8 or more hours) or has chronic medical renal disease. In most children labs need not be obtained. These criteria only come into play when there is a consideration of liver or renal disease in the individual child.

Sites / Locations

  • Nemours Children's Specialty Care
  • GI Care for Kids
  • East Carolina University
  • Wake Forest University Baptist Medical Center
  • The Medical College of Wisconsin

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Evaluation of a new infant formula

Arm Description

To evaluate the effects of a new formula on the growth, safety and tolerance of infants with growth failure

Outcomes

Primary Outcome Measures

Change in weight-for-age z-score from baseline
weight for age z-score at 16 weeks (or at time of meeting criteria to switch to lower density formula if criteria is met prior to 16 weeks) and z-score at baseline

Secondary Outcome Measures

Weight-for-length
z-score
Length-for-age
z-score
Head circumference-for-age
z-score
Mid upper arm circumference (MUAC)-for-age
z-score
Weight velocity
z-score
Length velocity
z-score

Full Information

First Posted
March 28, 2018
Last Updated
December 7, 2020
Sponsor
Nutricia North America
Collaborators
Medical College of Wisconsin, GI Care for Kids, East Carolina University, Wake Forest University Health Sciences, Nemours Children's Clinic
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1. Study Identification

Unique Protocol Identification Number
NCT03563391
Brief Title
A Study to Evaluate the Effects of a New Formula on the Growth, Safety and Tolerance of Infants With Growth Failure
Official Title
A Prospective, Open Label, Multi-site Study in North America to Evaluate the Effects of a New Ready-to-feed, Nutrient Dense Formula on the Growth, Safety and Tolerance of Infants With Growth Failure
Study Type
Interventional

2. Study Status

Record Verification Date
December 2020
Overall Recruitment Status
Completed
Study Start Date
January 30, 2018 (Actual)
Primary Completion Date
April 7, 2020 (Actual)
Study Completion Date
May 30, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Nutricia North America
Collaborators
Medical College of Wisconsin, GI Care for Kids, East Carolina University, Wake Forest University Health Sciences, Nemours Children's Clinic

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
This study is a prospective, open-label, multi-site, growth, safety and tolerance study to evaluate a NF (New Formula). A minimum of 45 evaluable infants with confirmed growth failure will be enrolled. Growth failure for 30 infants will be due to congenital heart disease and 15 infants due to other organic or non-organic causes. Study infants (in-patient or living with parents/ caregivers at home) will be fed the NF for a period of up through 16 weeks or until the time the infant subject meets criteria for switching to a lower calorie density formula, relative to baseline in infants with growth failure. Weight, height, head circumference and mid upper arm circumference will be measured regularly throughout the study. NF and other food intake, tolerance and stool diaries will be completed regularly. Serious adverse and adverse events will be monitored throughout the study. Infants will be evaluated, at each study visit, for criteria to switch to a lower calorie density formula. The primary objective is to improve weight-for-age z score relative to baseline. The secondary objectives are to improve weight-for-length, length-for-age, head circumference-for-age, mid upper arm circumference-for-age, weight velocity and length velocity z scores relative to baseline.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Growth Failure, Congenital Heart Disease

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
A prospective, open-label, multi-site, growth, safety and tolerance study.
Masking
None (Open Label)
Allocation
N/A
Enrollment
30 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Evaluation of a new infant formula
Arm Type
Experimental
Arm Description
To evaluate the effects of a new formula on the growth, safety and tolerance of infants with growth failure
Intervention Type
Other
Intervention Name(s)
New Infant Formula
Intervention Description
New Infant Formula is a specialized, nutritionally complete, nutrient-dense infant formula specifically formulated for infants with growth failure.
Primary Outcome Measure Information:
Title
Change in weight-for-age z-score from baseline
Description
weight for age z-score at 16 weeks (or at time of meeting criteria to switch to lower density formula if criteria is met prior to 16 weeks) and z-score at baseline
Time Frame
16 weeks
Secondary Outcome Measure Information:
Title
Weight-for-length
Description
z-score
Time Frame
16 weeks
Title
Length-for-age
Description
z-score
Time Frame
16 weeks
Title
Head circumference-for-age
Description
z-score
Time Frame
16 weeks
Title
Mid upper arm circumference (MUAC)-for-age
Description
z-score
Time Frame
16 weeks
Title
Weight velocity
Description
z-score
Time Frame
16 weeks
Title
Length velocity
Description
z-score
Time Frame
16 weeks
Other Pre-specified Outcome Measures:
Title
Gastrointestinal tolerance
Description
3-day diaries
Time Frame
16 weeks
Title
Number of adverse events related to new infant formula (New Formula)
Description
Number of adverse events evaluated to be related to new infant formula (New Formula) using Adverse Events Decision Tree criteria
Time Frame
Up to 21 weeks starting from date of baseline visit

10. Eligibility

Sex
All
Minimum Age & Unit of Time
1 Month
Maximum Age & Unit of Time
8 Months
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Infants must have attained term gestation (≥37 weeks of gestational age) at the time of screening Infants, male or female, aged 1 through 8 months Infants with congenital heart disease or other organic/non-organic cause of growth failure with a weight-for-length z score ≤ -1.0 or weight gain ≤ -2.0 z score based on WHO growth standards. (for weight gain metrics please see Appendix I): Weight gain (g) for boys and girls by age ( -2 z scores for weight velocity). Infants with Down syndrome must have a weight for length z-score ≤-1.0 z score. Infants with Down syndrome who meet the weight gain criterion (≤ -2.0 z-score weight gain) and have a weight for length z-score >-1.0 z-score will not be eligible for enrolment. Infants expected to consume (or obtain via tube feeding), on average, 80% of their total energy intake from NF for 16 weeks Infants from families who are willing and able to have anthropometrics taken at the required frequency as well as to comply with all other protocol requirements Written informed consent from the parent/caregiver or legal guardian Parent/caregiver or legal guardian must be able to read, write, and understand English Exclusion Criteria: Infants with known or suspected complex gastrointestinal anomalies or dysfunction, hepatic* or renal* dysfunction, or inherited metabolic disorders, congenital neurological insults, suspected or diagnosed conditions associated with malabsorption (e.g. cystic fibrosis) Infants with known or suspected systemic or congenital infections (e.g. human immunodeficiency virus, HBV, HCV) 3. Infants with known or suspected genetic conditions listed in Appendix VI and/or metabolic conditions known to interfere with growth or body dysmorphology that can interfere with obtaining standard anthropometric measurements (weight, length, head circumference, and mid upper arm circumference), with the exception of infants diagnosed with Down syndrome who may be enrolled in the study Infants with known or suspected cow milk allergy or children who have received cow milk formula for 7 days or less Infants expected to consume on average more than 20% of their energy intake from non-NF sources of nutrition: solids, expressed breast milk and /or parenteral nutrition. Child feeding directly at the breast more than twice per day Infants participating in any other studies involving investigational or marketed products concomitantly or within two weeks prior to the entry into the study. Infants participating in vaccination trials, who are only receiving follow-up blood monitoring, are not excluded. Principal Investigator's uncertainty about the willingness or ability of the parent/caregiver or legal guardian to comply with the protocol requirements Infants whose parent is younger than the legal age of consent Infants born large for gestational age (LGA). LGA: Birth weight > 90th percentile for gestational age (please see chart in Appendix I) Infants born small for gestational age (SGA). SGA: Birth weight < 10th percentile for gestational age (please see chart in Appendix I) * Note: For hepatic dysfunction, a conjugated bilirubin >2.0 mg/dL and for renal dysfunction child should not meet any of the pRIFLE criteria for renal disease (estimated creatinine clearance decreased by 25% by the Schwartz formula or urine output <0.5 mL/kg per hour over the previous 8 or more hours) or has chronic medical renal disease. In most children labs need not be obtained. These criteria only come into play when there is a consideration of liver or renal disease in the individual child.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Praveen Goday, MD
Organizational Affiliation
The Medical College of Wisconsin
Official's Role
Principal Investigator
Facility Information:
Facility Name
Nemours Children's Specialty Care
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32207
Country
United States
Facility Name
GI Care for Kids
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
East Carolina University
City
Greenville
State/Province
North Carolina
ZIP/Postal Code
27834
Country
United States
Facility Name
Wake Forest University Baptist Medical Center
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
The Medical College of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States

12. IPD Sharing Statement

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A Study to Evaluate the Effects of a New Formula on the Growth, Safety and Tolerance of Infants With Growth Failure

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