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Trial record 1 of 1 for:    NCT03877965
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Pharmacokinetics and Safety Profile of Digoxin in Infants With Single Ventricle Congenital Heart Disease (DGX01)

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ClinicalTrials.gov Identifier: NCT03877965
Recruitment Status : Not yet recruiting
First Posted : March 18, 2019
Last Update Posted : July 17, 2019
Sponsor:
Collaborators:
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
The Emmes Company, LLC
Information provided by (Responsible Party):
Christoph P Hornik, MD MPH, Duke University

Study Description
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Brief Summary:
This is a prospective, multi-center, open-label, PK and safety profile study of enteral digoxin in children <6 months old at time of enrollment, post-surgical or hybrid stage 1 palliation, but prior to surgical stage 2 palliation.

Condition or disease Intervention/treatment
Congenital Heart Disease Drug: Digoxin

Study Design
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Study Type : Observational
Estimated Enrollment : 48 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Pharmacokinetics and Safety Profile of Digoxin in Infants With Single Ventricle Congenital Heart Disease
Estimated Study Start Date : August 20, 2019
Estimated Primary Completion Date : November 15, 2020
Estimated Study Completion Date : November 15, 2020

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Heart Diseases
Drug Information available for: Digoxin

Groups and Cohorts
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Group/Cohort Intervention/treatment
Children with single ventricle congenital heart disease
Receiving digoxin per standard of care during the interstage period
 Drug: Digoxin
Drug administered per standard of care, with a dosing regimen within the labeled dose range of 7.5-20 mcg/kg/day divided in 2 or 3 equal doses


Outcome Measures
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Primary Outcome Measures :
  1. Plasma concentrations of dixogin [ Time Frame: Approximately 7 months ]

Secondary Outcome Measures :
  1. Number of adverse events related to study procedures and serious, unexpected, suspected adverse reactions related to digoxin [ Time Frame: Approximately 7 months ]
  2. Number of participants with tachyarrythmias [ Time Frame: Approximately 7 months ]
  3. Number of participants with second and third degree atrioventricular conduction block [ Time Frame: Approximately 7 months ]
  4. Number of participants with sinus bradycardia [ Time Frame: Approximately 7 months ]
  5. Number of participants with need for temporary or permanent pacing [ Time Frame: Approximately 7 months ]
  6. Frequency of death [ Time Frame: Approximately 7 months ]
  7. PR interval [ Time Frame: Approximately 7 months ]
    Derived from electrocardiograms and their reports performed per standard of care

  8. QRS duration [ Time Frame: Approximately 7 months ]
    Derived from electrocardiograms and their reports performed per standard of care

  9. QT interval [ Time Frame: Approximately 7 months ]
    Derived from electrocardiograms and their reports performed per standard of care

  10. Corrected QT interval using Bazett's formula [ Time Frame: Approximately 7 months ]
    Derived from electrocardiograms and their reports performed per standard of care


Other Outcome Measures:
  1. Plasma concentration of NT-proBNP [ Time Frame: Approximately 7 months ]
  2. Plasma concentration of MR-proANP [ Time Frame: Approximately 7 months ]
  3. Right ventricular or left ventricular end diastolic volume [ Time Frame: Approximately 7 months ]
  4. Right ventricular or left ventricular end systolic volume [ Time Frame: Approximately 7 months ]
  5. Right ventricular or left ventricular ejection fraction [ Time Frame: Approximately 7 months ]
  6. Right ventricular or left ventricular shortening fraction [ Time Frame: Approximately 7 months ]
  7. Right ventricular or left ventricular end diastolic dimension [ Time Frame: Approximately 7 months ]
  8. Right ventricular or left ventricular end systolic dimension [ Time Frame: Approximately 7 months ]
  9. Right ventricular or left ventricular fractional area change [ Time Frame: Approximately 7 months ]
  10. Degree of atrioventricular valve regurgitation [ Time Frame: Approximately 7 months ]
  11. Qualitative right ventricular or left ventricular function assessment [ Time Frame: Approximately 7 months ]
  12. Cardiac output [ Time Frame: Approximately 7 months ]
    As measured by cardiac catheterization

  13. Pulmonary to systemic blood flow ratio [ Time Frame: Approximately 7 months ]
    As measured by cardiac catheterization

  14. Pulmonary vascular resistance [ Time Frame: Approximately 7 months ]
    As measured by cardiac catheterization

  15. Mean pulmonary artery pressure [ Time Frame: Approximately 7 months ]
    As measured by cardiac catheterization

  16. Right ventricular or left ventricular end diastolic pressure [ Time Frame: Approximately 7 months ]
    As measured by cardiac catheterization

  17. Right ventricular or left ventricular end systolic pressure [ Time Frame: Approximately 7 months ]
    As measured by cardiac catheterization

  18. Right and left pulmonary artery size [ Time Frame: Approximately 7 months ]
    As measured by cardiac catheterization

  19. Pressure gradients across the aortic arch [ Time Frame: Approximately 7 months ]
    As measured by cardiac catheterization

  20. Incidence of unplanned surgical intervention [ Time Frame: Approximately 7 months ]
    Including cannulation for mechanical circulatory support

  21. Incidence of listing for heart transplant [ Time Frame: Approximately 7 months ]
  22. Incidence of receiving heart transplant [ Time Frame: Approximately 7 months ]
  23. Hospital length of stay after S1P [ Time Frame: Approximately 7 months ]
  24. Number of days on mechanical ventilation after S1P [ Time Frame: Approximately 7 months ]
  25. Number of hospital readmissions from S1P discharge to S2p [ Time Frame: Approximately 7 months ]

Biospecimen Retention:   Samples Without DNA
Blood samples will be collected to assess pharmacokinetic and biomarker levels

Eligibility Criteria
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Ages Eligible for Study:   up to 6 Months   (Child)
Sexes Eligible for Study:   All
Sampling Method:   Probability Sample
Study Population
Up to 48 infants diagnosed with single ventricle congenital heart disease, receiving digoxin per standard of care during the interstage period
Criteria

Inclusion Criteria:

  • Diagnosis of single ventricle congenital heart disease
  • Status post-surgical or hybrid stage 1 palliation but prior to surgical stage 2 palliation
  • Age ≤ 30 days of life at time of stage 1 palliation
  • Age < 6 months at time of enrollment
  • Require treatment with enteral digoxin per their treating medical provider if their planned maintenance treatment dosing regimen is within the labeled dose range of 7.5 - 20 mcg/kg/day divided in 2 or 3 equal doses
  • Informed consent from parent(s) or legal guardian(s)

Exclusion Criteria:

  • Serum creatinine > 2 mg/dL at enrollment
  • Diagnosis of second degree or higher atrioventricular conduction block at enrollment
  • Diagnosis of clinically significant sinus bradycardia requiring intervention at enrollment
  • Known hypersensitivity to digoxin or other forms of digitalis
  • Extracorporeal life support (i.e., ECMO, dialysis, ventricular assist device) at enrollment
  • Received digoxin prior to enrollment
  • Received or anticipated to receive a loading dose of digoxin.
  • Any condition that would make the participant, in the opinion of the investigator, unsuitable for the study
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT03877965


Contacts
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Contact: Christoph Hornik, MD (919) 668 8935 christoph.hornik@duke.edu
Contact: Barrie Harper (919) 668-8291 barrie.harper@duke.edu

Locations
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United States, California
Mattel Children's Hospital at UCLA Not yet recruiting
Los Angeles, California, United States, 90095
Contact: Vanessa DePaz    310-267-7618    vdepaz@mednet.ucla.edu   
Principal Investigator: Nancy Halnon         
Rady Childrens Hospital and Health Center Not yet recruiting
San Diego, California, United States, 92123
Contact: Ellen Knodel    619-540-9781    eknodel@rchsd.org   
Principal Investigator: Denise Suttner         
United States, Colorado
The Children's Hospital Colorado Not yet recruiting
Aurora, Colorado, United States, 80045
Contact: Michael DiMaria, MD    720-777-4420    michael.dimaria@childrenscolorado.org   
Principal Investigator: Michael DeMaria         
United States, Florida
Nicklaus Children's Hospital Not yet recruiting
Miami, Florida, United States, 33155
Contact: Anabel Rodriguez    786-624-2590    anabel.rodriguez@nicklaushealth.org   
Principal Investigator: Danyal Khan, MD         
United States, Louisiana
Childrens Hospital New Orleans Not yet recruiting
New Orleans, Louisiana, United States, 70112
Contact: Marla Johnston    504-896-9718    marla.johnston@lcmchealth.org   
Principal Investigator: Danielle Gottlieb-Sen         
United States, Missouri
St. Louis Children's Hospital Not yet recruiting
Saint Louis, Missouri, United States, 63110
Contact: Taylor Merritt    314-362-1729    t.merritt@wustl.edu   
Principal Investigator: Pirooz Eghtesady         
United States, New York
Morgan Stanley Children's Hospital of New York Presbyterian Not yet recruiting
New York, New York, United States, 10032
Contact: Clase Kydanis    212-305-8509    kc3020@cumc.columbia.edu   
Principal Investigator: Brett Anderson, MD         
United States, North Carolina
Duke University Medical Center Not yet recruiting
Durham, North Carolina, United States, 27710
Contact: Melissa Harward    919-668-3910    melissa.harward@dm.duke.edu   
Principal Investigator: Chi Dang Hornik, Pharm. D.         
United States, Ohio
Cincinnati Childrens Hospital Medical Center Not yet recruiting
Cincinnati, Ohio, United States, 45229-3039
Contact: Sara Manning    513-803-1352    sara.manning@cchmc.org   
Principal Investigator: Alexis Benscoter         
United States, Pennsylvania
Children's Hospital of Pittsburgh of UPMC Not yet recruiting
Pittsburgh, Pennsylvania, United States, 15224
Contact: Sarah MacCallum       andersonsj3@upmc.edu   
Principal Investigator: Thomas Seery         
United States, South Carolina
Medical University of South Carolina Not yet recruiting
Charleston, South Carolina, United States, 29425
Contact: Layla Al Sarraf    843-876-5203    alsarral@musc.edu   
Principal Investigator: John Costello         
United States, Texas
Children's Memorial Hermann Hospital Not yet recruiting
Houston, Texas, United States, 77030
Contact: Maria Serna    713-500-5785    maria.e.serna@uth.tmc.edu   
Principal Investigator: Alvaro Coronado Munoz         
Sponsors and Collaborators
Christoph P Hornik, MD MPH
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
The Emmes Company, LLC
Investigators
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Principal Investigator: Christoph Hornik, MD Duke University
More Information
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Responsible Party: Christoph P Hornik, MD MPH, Associate Professor of Pediatrics, Duke University
ClinicalTrials.gov Identifier: NCT03877965     History of Changes
Other Study ID Numbers: Pro00102130
NICHD-2018-DGX01 ( Other Identifier: Duke )
HHSN27500002 ( Other Grant/Funding Number: NICHD )
First Posted: March 18, 2019    Key Record Dates
Last Update Posted: July 17, 2019
Last Verified: July 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No

Additional relevant MeSH terms:
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Heart Diseases
Heart Defects, Congenital
Cardiovascular Diseases
Cardiovascular Abnormalities
Congenital Abnormalities
Digoxin
 Anti-Arrhythmia Agents
Cardiotonic Agents
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Protective Agents
Physiological Effects of Drugs