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Effectiveness of N-acetyl Cysteine, Acetyl L- Carnitine and Medicated Paraffin Oil in Aluminium Phosphide Poisoning

Primary Purpose

the Study Focus to Improve the Standard of Care Used for Aluminuim Phosphide Poisoning and to Save Patients With the Minimal Organ Damage

Status
Unknown status
Phase
Phase 4
Locations
Egypt
Study Type
Interventional
Intervention
N-acetyl cysteine
acetyl L-carnitine
medicated paraffin oil
Sodium Bicarbonate Powder and ondansetron
Sponsored by
Cairo University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for the Study Focus to Improve the Standard of Care Used for Aluminuim Phosphide Poisoning and to Save Patients With the Minimal Organ Damage focused on measuring N-acetyl cysteine, Acety L- carnitine, paraffin oil, aluminium phosphide

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • All adult patients with history of acute intoxication with AlP presented to the Poison Control Center of Ain-Shams University hospitals during the period of the study

Exclusion Criteria:

  1. Patients less than 18
  2. Patients presented with delay time exceeding 12 hours after acute intoxication.
  3. Patients with history of cardiac, renal or hepatic diseases.
  4. Patients who show hypersensitivity to NAC, ALCAR or paraffin oil.

Sites / Locations

  • Poison Control Center of Ain-Shams University hospitals

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Placebo Comparator

Active Comparator

Active Comparator

Active Comparator

Arm Label

control group

N- acetyl cysteine grouo

Acetyl L-carnitine group

Medicated paraffin oil group

Arm Description

this group will have the standard and routine therapy of treatment of acute Aluminium Phosphide poisoning immediately after admission according to PCCA guidelines

N-acetyl cysteine will be given at dose of 300mg/kg/d IV in the first day then 150 mg/kg/d IV in addition to standard of care according to PCCA guidelines

Acetyl L-carnitine will be given at dose of 50 mg/kg IV once to be followed by additional doses of 15 mg/kg IV q4hr infused over 30 min. standard of care according to PCCA guidelines will also be provided

Gastric decontamination with sodium bicarbonate (NaHCO3; 44 mEq, orally) and medicated paraffin oil (200 mL) will be administered in addition to standard of care according to PCCA guidelines

Outcomes

Primary Outcome Measures

mortality rate reduction
the primary end point is to lower the mortality rate for patients poisoned with aluminium phosphide pellets
organ damage reduction
another primary end point is to reduce organ damage and injury for survivors

Secondary Outcome Measures

Full Information

First Posted
August 9, 2020
Last Updated
August 9, 2020
Sponsor
Cairo University
Collaborators
Ain Shams University hospitals
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1. Study Identification

Unique Protocol Identification Number
NCT04509258
Brief Title
Effectiveness of N-acetyl Cysteine, Acetyl L- Carnitine and Medicated Paraffin Oil in Aluminium Phosphide Poisoning
Official Title
Comparative Effectiveness of N-acetyl Cysteine, Acetyl L- Carnitine and Medicated Paraffin Oil in Acute Aluminium Phosphide Poisoning: A Clinical Trial
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Unknown status
Study Start Date
October 2020 (Anticipated)
Primary Completion Date
October 2021 (Anticipated)
Study Completion Date
December 2021 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Cairo University
Collaborators
Ain Shams University hospitals

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Aluminium Phosphide is a pesticide used in developing countries to prevent rodents and pests from spoiling the harvested grains. it is presented as tablets which can be administered accidently to humans or for committing suicide. this pesticide is fatal even in small concentration as mortality rate can reach 75- 100% of cases. in this study researchers tried to add some supplements to the routine treatment to improve and decrease the fatality rate.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
the Study Focus to Improve the Standard of Care Used for Aluminuim Phosphide Poisoning and to Save Patients With the Minimal Organ Damage
Keywords
N-acetyl cysteine, Acety L- carnitine, paraffin oil, aluminium phosphide

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
control group
Arm Type
Placebo Comparator
Arm Description
this group will have the standard and routine therapy of treatment of acute Aluminium Phosphide poisoning immediately after admission according to PCCA guidelines
Arm Title
N- acetyl cysteine grouo
Arm Type
Active Comparator
Arm Description
N-acetyl cysteine will be given at dose of 300mg/kg/d IV in the first day then 150 mg/kg/d IV in addition to standard of care according to PCCA guidelines
Arm Title
Acetyl L-carnitine group
Arm Type
Active Comparator
Arm Description
Acetyl L-carnitine will be given at dose of 50 mg/kg IV once to be followed by additional doses of 15 mg/kg IV q4hr infused over 30 min. standard of care according to PCCA guidelines will also be provided
Arm Title
Medicated paraffin oil group
Arm Type
Active Comparator
Arm Description
Gastric decontamination with sodium bicarbonate (NaHCO3; 44 mEq, orally) and medicated paraffin oil (200 mL) will be administered in addition to standard of care according to PCCA guidelines
Intervention Type
Drug
Intervention Name(s)
N-acetyl cysteine
Intervention Description
a drug which can have an off label use as an antidot for aluminium phosphide poisoning in addition to sodium bicarbonate and ondansetron as standard of care
Intervention Type
Dietary Supplement
Intervention Name(s)
acetyl L-carnitine
Intervention Description
Naturallu occuring amino acid derivative which can be taken as a dietary supplement involves in mitochondrial function and energy production and is suggested to have a role in lowering organ damage resulting from aluminium phosphide poisonong in addition to sodium bicarbonate and ondansetron as standard of care
Intervention Type
Drug
Intervention Name(s)
medicated paraffin oil
Intervention Description
refined mixture of liquid hydrocarbons which used as laxative and is suggested to reduce absorption of aluminium phosphide if taken within two hours of administration of the toxin in addition to sodium bicarbonate and ondansetron as standard of care
Intervention Type
Drug
Intervention Name(s)
Sodium Bicarbonate Powder and ondansetron
Intervention Description
standard of care for treatment of aluminuim phosphide is provided for patients poisoned with aluminuim phosphide
Primary Outcome Measure Information:
Title
mortality rate reduction
Description
the primary end point is to lower the mortality rate for patients poisoned with aluminium phosphide pellets
Time Frame
1 year
Title
organ damage reduction
Description
another primary end point is to reduce organ damage and injury for survivors
Time Frame
1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: All adult patients with history of acute intoxication with AlP presented to the Poison Control Center of Ain-Shams University hospitals during the period of the study Exclusion Criteria: Patients less than 18 Patients presented with delay time exceeding 12 hours after acute intoxication. Patients with history of cardiac, renal or hepatic diseases. Patients who show hypersensitivity to NAC, ALCAR or paraffin oil.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Mahmoud Sakr, PhD
Phone
+201117922833
Email
mahmoud.sakr@hotmail.com
First Name & Middle Initial & Last Name or Official Title & Degree
Hanan Abdel Wahab, Master's
Phone
+201062261010
Email
hanan.abdelwahab@yahoo.com
Facility Information:
Facility Name
Poison Control Center of Ain-Shams University hospitals
City
Cairo
State/Province
Abbasya
ZIP/Postal Code
11311
Country
Egypt
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Walaa Abdel Hamid, PhD
Phone
+201062261010
Email
walaa.abdelhamid@gmail.com
First Name & Middle Initial & Last Name & Degree
Dalia Zaafar, PhD
Phone
+201117922833
Email
dr.moda88@gmail.com

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
individual paticipant data is decided not to be shared for the privacy of the patients as patients in each group will be coded in numbers instead of their names

Learn more about this trial

Effectiveness of N-acetyl Cysteine, Acetyl L- Carnitine and Medicated Paraffin Oil in Aluminium Phosphide Poisoning

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