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Feeding During Ibuprofen or Indomethacin Treatment of Preterm Infants
This study is currently recruiting participants.
Verified by University of California, San Francisco, August 2009
First Received: July 31, 2008   Last Updated: August 17, 2009   History of Changes
Sponsor: University of California, San Francisco
Information provided by: University of California, San Francisco
ClinicalTrials.gov Identifier: NCT00728117
  Purpose

We hypothesize that feeding preterm infants while they receive indomethacin or ibuprofen therapy for treatment of a patent ductus arteriosus will decrease the incidence of feeding intolerance and shorten the time period that infants need to tolerate full enteral nutrition. We also hypothesize that this intervention will minimize the alterations in intestinal permeability that occur with these drugs and will improve the infants' hemodynamic response to enteral nutrition


Condition Intervention
Patent Ductus Arteriosus
Other: feeding
Other: fasting

Study Type: Interventional
Study Design: Treatment, Randomized, Open Label, Active Control, Parallel Assignment, Safety/Efficacy Study
Official Title: Should Very Low Birth Weight Infants Receive Enteral Nutrition During Indomethacin or Ibuprofen Treatment of a Patent Ductus Arteriosus? A Multi-Center Randomized Controlled Trial

Resource links provided by NLM:


Further study details as provided by University of California, San Francisco:

Primary Outcome Measures:
  • Assess the effect of feeding infants during indomethacin or ibuprofen therapy on the incidence of feeding intolerance and the number of days required to achieve full feedings (120 ml/kg/day). [ Time Frame: 4 years ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • incidence of necrotizing enterocolitis or spontaneous perforation [ Time Frame: 4 years ] [ Designated as safety issue: Yes ]
  • Assess the effect of feeding very low birth weight infants during indomethacin or ibuprofen therapy on intestinal permeability. [ Time Frame: 4 years ] [ Designated as safety issue: No ]
  • Assess the effect of feeding very low birth weight infants during indomethacin or ibuprofen therapy on the normal hyperemic response to feeding. [ Time Frame: 4 years ] [ Designated as safety issue: No ]

Estimated Enrollment: 400
Study Start Date: July 2008
Estimated Study Completion Date: July 2012
Estimated Primary Completion Date: July 2012 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
ibuprofen-feeding: Experimental
Study infants will receive trophic enteral nutrition (15 ml/kg/day) during the study drug period.The study drug period is defined as the interval between administration of the first dose of ibuprofen and 24 hours after the last dose of ibuprofen.
Other: feeding
Study infants will receive trophic enteral nutrition (15 ml/kg/day) during the study drug period.The study drug period is defined as the interval between administration of the first dose of ibuprofen or indomethacin and 24 hours after the last dose of ibuprofen or indomethacin.
ibuprofen-fasting: No Intervention
Study infants will be fasted during the study drug period.The study drug period is defined as the interval between administration of the first dose of ibuprofen and 24 hours after the last dose of ibuprofen.
Other: fasting
Study infants will be fasted during the study drug period.The study drug period is defined as the interval between administration of the first dose of ibuprofen or indomethacin and 24 hours after the last dose of ibuprofen or indomethacin.
indomethacin-feeding: Experimental
Study infants will receive trophic enteral nutrition (15 ml/kg/day) during the study drug period.The study drug period is defined as the interval between administration of the first dose of indomethacin and 24 hours after the last dose of indomethacin.
Other: feeding
Study infants will receive trophic enteral nutrition (15 ml/kg/day) during the study drug period.The study drug period is defined as the interval between administration of the first dose of ibuprofen or indomethacin and 24 hours after the last dose of ibuprofen or indomethacin.
indomethacin-fasting: No Intervention
Study infants will be fasted during the study drug period.The study drug period is defined as the interval between administration of the first dose of indomethacin and 24 hours after the last dose of indomethacin.
Other: fasting
Study infants will be fasted during the study drug period.The study drug period is defined as the interval between administration of the first dose of ibuprofen or indomethacin and 24 hours after the last dose of ibuprofen or indomethacin.

Detailed Description:

This study is a randomized controlled multi-center clinical trial to determine whether very low birth weight infants should receive feedings during indomethacin or ibuprofen treatment of a patent ductus arteriosus (PDA). Many neonatologists withhold feeds from premature infants receiving indomethacin or ibuprofen therapy for a PDA because of concerns that these drugs alter intestinal blood flow and permeability. However, there are no established studies which show that feeding during these medical treatments leads to bowel injury. At the same time, studies suggest that withholding feedings from premature infants may lead to intestinal atrophy and injury, leading to increased difficulty with feedings when they are initiated or re-started. Thus, this multi-center study evaluates whether feeding infants during indomethacin or ibuprofen therapy improves feeding tolerance by measuring the number of episodes of feeding intolerance and the number of days required to attain full feedings. In addition, this study will employ techniques to measure gastrointestinal permeability and mesenteric blood flow in patients who receive and don't receive feedings for their PDA treatment.

  Eligibility

Ages Eligible for Study:   23 Weeks to 33 Weeks
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Infants between 401-1,250 g birth weight who

    • Are receiving or are scheduled to begin enteral feedings and
    • Are about to receive pharmacologic treatment (either indomethacin or ibuprofen) to close their PDA.

Exclusion Criteria:

  • Serious congenital malformations
  • Chromosomal anomalies
  • Congenital or acquired gastrointestinal anomalies
  • Prior episode of necrotizing enterocolitis
  • Use of inotropic support for hypotension
  • Renal anomalies or disease
  • Are receiving > 80 ml/kg/d of enteral feeding
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00728117

Contacts
Contact: Ronald Clyman, M.D. 415-476-4462 clymanr@peds.ucsf.edu
Contact: Nami Jhaveri, M.D. JhaveriN@peds.ucsf.edu

Locations
United States, California
University of California san Francisco Recruiting
San Francisco, California, United States, 94143
Contact: Ronald Clyman, M.D.     415-476-4462     clymanr@peds.ucsf.edu    
Contact: Nami Jhaveri, M.D.         JhaveriN@peds.ucsf.edu    
Principal Investigator: Ronald Clyman, M.D.            
Santa Clara Valley Medical Center Recruiting
San Jose, California, United States, 95128
Contact: Priya Jegatheesan, M.D.     408-885-5423     Priya.Jegatheesan@hhs.co.santa-clara.ca.us    
Principal Investigator: Priya Jegatheesan, M.D.            
San Jose Pediatrix Medical Group Recruiting
San Jose, California, United States, 95124.
Contact: Meera Sankar, MD     408-377-8100     Meera_Sankar@pediatrix.com    
Principal Investigator: Meera Sankar, MD            
Alta Bates Summit Medical Center Recruiting
Oakland, California, United States
Contact: Golde Dudell, MD     510-567-0111     ggdmd@earthlink.net    
Principal Investigator: Golde Dudell, MD            
Loma Linda University Recruiting
Loma Linda, California, United States
Contact: Doug Deming, MD     909-558-7448     DDeming@llu.edu    
Principal Investigator: Douglas Deming, MD            
United States, Illinois
North Shore University Health System, Northwestern University Recruiting
Evanston, Illinois, United States, 60201
Contact: Mathew Derrick, MD     847-570-2920     mderrick@uchicago.edu    
Principal Investigator: Mathew Derrick, MD            
Children's Memorial Hospital-Northwestern University Recruiting
Chicago, Illinois, United States
Contact: Nic Porta, MD     773-880-3479     n-porta@northwestern.edu    
Principal Investigator: Nic Porta, MD            
United States, Massachusetts
Boston University-Boston Medical Center Recruiting
Boston, Massachusetts, United States, 02118
Contact: Alan Fujii, MD     617-414-3735     Alan.Fujii@bmc.org    
Principal Investigator: Alan Fujii, MD            
United States, Minnesota
Children's Hospital-Minneapolis Recruiting
Minneapolis, Minnesota, United States, 55404
Contact: Bob Couser, MD     651-247-4774     couse0011@comcast.net    
Principal Investigator: Bob Couser, MD            
Children's Hospital-Saint Paul Recruiting
Saint Paul, Minnesota, United States, 55102
Contact: Mark Mammel, MD     651-220-6261     mamme001@tc.umn.edu    
Principal Investigator: Mark Mammel, MD            
Mayo Clinic Recruiting
Rochester, Minnesota, United States
Contact: William Carey, MD     507-284-7434     Carey.William@mayo.edu    
Principal Investigator: William Carey, MD            
United States, New Jersey
Atlantic Health Organization Recruiting
Morristown, New Jersey, United States
Contact: Denise Hassinger, MD     973-971-5488     Denise.hassinger@atlantichealth.org    
Principal Investigator: Denise Hassinger, MD            
United States, New York
Columbia University Recruiting
New York, New York, United States
Contact: Richard Polin, MD     917-495-7900     rap32@columbia.edu    
Principal Investigator: Richard Polin, MD            
United States, Ohio
Case Western Reserve Recruiting
Cleveland, Ohio, United States
Contact: Jalal Abu-Shaweesh, MD     216-844-3387     Jalal.Abu-Shaweesh@UHhospitals.org    
Principal Investigator: Jalal Abu-Shaweesh, MD            
United States, Pennsylvania
University of Pittsburgh Recruiting
Pittsburgh, Pennsylvania, United States, 15122
Contact: Toby Yanowitz, M.D.     412-641-6260     tyanowitz@mail.magee.edu    
Principal Investigator: Toby Yanowitz, M.D.            
United States, Tennessee
Vanderbilt University Recruiting
Nashville, Tennessee, United States, 37232
Contact: Jeff Reese, MD     615-322-8643     jeff.reese@vanderbilt.edu    
Principal Investigator: Jeff Reese, MD            
United States, Virginia
University of Virginia, Charlottesville Recruiting
Charlottesville, Virginia, United States
Contact: Josh Attridge, MD     434-924-2490     JA5U@hscmail.mcc.virginia.edu    
Principal Investigator: Josh Attridge, MD            
Sponsors and Collaborators
University of California, San Francisco
Investigators
Principal Investigator: Ronald Clyman, M.D. University of California, San Francisco
  More Information

No publications provided

Responsible Party: University of California, San Francisco ( Ronald Clyman )
Study ID Numbers: RC3
Study First Received: July 31, 2008
Last Updated: August 17, 2009
ClinicalTrials.gov Identifier: NCT00728117     History of Changes
Health Authority: United States: Institutional Review Board

Keywords provided by University of California, San Francisco:
indomethacin
ibuprofen
preterm infant

Additional relevant MeSH terms:
Anti-Inflammatory Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Reproductive Control Agents
Gout Suppressants
Tocolytic Agents
Sensory System Agents
Therapeutic Uses
Indomethacin
Anti-Inflammatory Agents, Non-Steroidal
Cardiovascular Diseases
Analgesics
Congenital Abnormalities
Ductus Arteriosus, Patent
Ibuprofen
Heart Diseases
Cardiovascular Abnormalities
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Cardiovascular Agents
Pharmacologic Actions
Analgesics, Non-Narcotic
Peripheral Nervous System Agents
Antirheumatic Agents
Heart Defects, Congenital
Central Nervous System Agents

ClinicalTrials.gov processed this record on November 05, 2009