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Paracetamol and Patent Ductus Arteriosus (PDA)

The recruitment status of this study is unknown. The completion date has passed and the status has not been verified in more than two years.
Verified December 2012 by Cathy Hammerman, Shaare Zedek Medical Center.
Recruitment status was:  Recruiting
Information provided by (Responsible Party):
Cathy Hammerman, Shaare Zedek Medical Center Identifier:
First received: February 6, 2011
Last updated: December 18, 2012
Last verified: December 2012
The investigators propose that paracetamol will be similarly effective to ibuprofen in treating PDA in the premature neonate, with fewer side effects.

Condition Intervention Phase
Patent Ductus Arteriosus Drug: Paracetamol Drug: NSAID Drug: D5W Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Triple (Participant, Care Provider, Investigator)
Primary Purpose: Treatment
Official Title: Paracetamol in the Treatment of Patent Ductus Arteriosus in the Premature Neonate

Resource links provided by NLM:

Further study details as provided by Cathy Hammerman, Shaare Zedek Medical Center:

Primary Outcome Measures:
  • Closure of the Ductus [ Time Frame: 3 days ]

Secondary Outcome Measures:
  • Absence of peripheral vasoconstriction [ Time Frame: 48 hours ]
    Doppler flow velocity in anterior cerebral artery, superior mesenteric artery and renal artery will be measured before and after pharmacologic treatment.

  • Absence of hepatotoxicity [ Time Frame: 1 week ]
    Liver function will be compared between the two study groups at 1 week following completion of pharmacologic treatment

Estimated Enrollment: 80
Study Start Date: April 2012
Estimated Primary Completion Date: December 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: Paracetamol
Babies with hsPDA will be treated with paracetamol 15 mg/kg/dose x 4/day for three days
Drug: Paracetamol
po Paracetamol 15 mg/kg every 6 hours x 3 days
Experimental: NSAID
Babies with hsPDA will be randomized to treatment with IV indomethacin 17 mcg/kg/hr x 36 hr
IV indomethacin 2 mg/kg/dose for three doses at 12 hour intervals; or IV Ibuprofen 10 mg/kg infused over 15 minutes, followed by two doses of 5mg/kg each at 24 hour intervals (total of 3 doses).
Drug: D5W
Since the paracetamol is given q 6 hours, in order to maintain blinding of the clinical staff, a placebo (D5W) must be given intermittently between the doses of NSAID such that each infant will receive drug every 6 hours.

Detailed Description:
Preterm neonates with a hemodynamically significant PDA will potentially be candidates for study. After obtaining parental consent, the infants will be prospectively and randomly assigned to one of two groups: 1.po Paracetamol at a dose of 15 mg/kg every 6 hours at x 3 days or Group 2- IV indomethacin - 0.2 mg/kg/dose q 12h for three doses; or IV Ibuprofen 10 mg/kg infused over 15 minutes, followed by two doses of 5mg/kg each at 24 hour intervals (total of 3 doses).Clinical staff will be blinded as to the study group assignment of the babies and since the group 1 drug is to be given every six hours, all babies will receive a parenteral substance every 6 hours. For Group 2 infants, the intermittent doses will be IV D5W alternating with drug.All infants will fed trophic feeds (20 cc/kg/day) during the treatment for ductal closure.

Ages Eligible for Study:   up to 2 Weeks   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Echocardiographic diagnosis of hemodynamically significant patent ductus arteriosus

Exclusion Criteria:

  • Major congenital anomalies
  • Life-threatening infection
  • Active NEC and/or intestinal perforation
  • Recent (within the previous 24 hours) intraventricular hemorrhage Grade 3-4
  • Urine output <1 ml per kilogram per hour during the preceding 8 hours
  • Serum creatinine concentration of >1.6 mg %
  • Platelet count of <60,000 per cc.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its identifier: NCT01291654

Contact: Cathy Hammerman, MD +9722666-6238
Contact: Alona Bin-Nun, MD +9722666-6757

Shaare Zedek Medical Center Recruiting
Jerusalem, Israel, 91031
Contact: Cathy Hammerman, MD    +9722666-6238   
Principal Investigator: Cathy Hammerman, MD         
Sponsors and Collaborators
Shaare Zedek Medical Center
Principal Investigator: Cathy Hammerman, MD Hebrew University Faculty of Medicine
  More Information

Responsible Party: Cathy Hammerman, Prof. Pediatrics, Shaare Zedek Medical Center Identifier: NCT01291654     History of Changes
Other Study ID Numbers: SZMC-Hammerman-Acamol-2011
Study First Received: February 6, 2011
Last Updated: December 18, 2012

Keywords provided by Cathy Hammerman, Shaare Zedek Medical Center:

Additional relevant MeSH terms:
Ductus Arteriosus, Patent
Heart Defects, Congenital
Cardiovascular Abnormalities
Cardiovascular Diseases
Heart Diseases
Congenital Abnormalities
Analgesics, Non-Narcotic
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Anti-Inflammatory Agents, Non-Steroidal
Anti-Inflammatory Agents
Antirheumatic Agents
Gout Suppressants
Tocolytic Agents
Reproductive Control Agents
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action processed this record on August 22, 2017