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Erythropoietin Protects Very Preterm Infants Against Necrotizing Enterocolitis

Phase 2
Completed
Conditions
Premature Infant
Interventions
Drug: EPO
Drug: Normal saline
Registration Number
NCT03919500
Lead Sponsor
Zhengzhou University
Brief Summary

This study evaluates the effect of repeated low-dose erythropoietin (EPO) treatment on necrotizing enterocolitis (NEC) in very preterm infants. Half of participants will receive EPO, while the other half will receive a placebo.

Detailed Description

NEC is one of the most severe complications in preterm neonates and is associated with high morbility and mortality. Studies have reported that EPO treatment decreases the incidence and severity of experimental NEC in animal models. Evidence from previous clinical studies about the effect of EPO treatment against NEC have all been hampered by small numbers of patients. The study is to investigate whether repeated low-dose EPO protects against NEC. Preterm infants with gestational age ≤32 weeks who are admitted to neonatal intensive care units within 72 hours after birth are randomized to EPO (500IU/kg, intravenously every other day for 2 weeks) or control group (the same volume of saline). Primary outcome is the incidence of NEC at 36 weeks of corrected age. Secondary outcome is growth and neurodevelopment at 18 months of corrected age in infants with NEC.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
1285
Inclusion Criteria
  • Preterm infants with gestation age ≤ 32weeks
  • Within 72 hours after birth
  • Written informed consent obtained from parents
Exclusion Criteria
  • Genetic or metabolic diseases
  • Congenital abnormalities
  • Polycythemia
  • Intracranial hemorrhage grade III/IV
  • Unstable vital signs (such as respiration and circulation failure)

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
ErythropoietinEPOInfants in the EPO group are given EPO 500IU/kg dissolved in 2 ml saline intravenously every other day for 2 weeks starting within 72 hours after birth.
Normal salineNormal salineInfants in the control group are given normal saline intravenously with the same volume as EPO every other day for 2 weeks.
Primary Outcome Measures
NameTimeMethod
Incidence of NECAt 36 weeks of corrected age

To compare the incidence of NEC between EPO group and control group at 36 weeks of corrected age

Secondary Outcome Measures
NameTimeMethod
Incidence of low height in patients with NECAt corrected age of 18 months

To compare the incidence of low height in patients with NEC between EPO and control groups via the Standardized Growth Curve for Chinese Children at 18 months of corrected age.

Incidence of low weight in patients with NECAt corrected age of 18 months

To compare the incidence of low weight in patients with NEC between EPO and control group via the Standardized Growth Curve for Chinese Children at 18 months of corrected age.

Incidence of low head circumference in patients with NECAt corrected age of 18 months

To compare the incidence of low head circumference in patients with NEC between EPO and control group via the Standardized Growth Curve for Chinese Children at 18 months of corrected age.

Incidence of MDI<70 in patients with NECAt corrected age of 18 months

To compare the incidence of MDI\<70 in patients with NEC between EPO and control group via Bayley Scales of Infant Development (second edition) at 18 months of corrected age.

Incidence of cerebral palsy in patients with NECAt corrected age of 18 months

To compare the incidence of cerebral palsy in patients with NEC between EPO and control group at 18 months of corrected age.

Incidence of blindness in patients with NECAt corrected age of 18 months

To compare the incidence of blindness in patients with NEC between EPO and control group via visual acuity at 18 months of corrected age.

Incidence of deafness in patients with NECAt corrected age of 18 months

To compare the incidence of deafness in patients with NEC between EPO and control group via auditory brainstem response measurement at 18 months of corrected age.

The effect of EPO treatment on blood messenger RNA (mRNA) expressionAt 3 weeks after birth

To investigate different mRNA expression between EPO and control group, peripheral venous blood of preterm infants after EPO treatment will be collected in both EPO group and control group, and the transcriptome of the premature infant blood will be assayed by RNA sequencing.

Trial Locations

Locations (1)

Third Affiliated Hospital of Zhengzhou University

🇨🇳

Zhengzhou, Henan, China

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