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Comparison of rhBSSL With Placebo When Added to Infant Formula or Pasteurized Breast Milk During 4 Weeks of Treatment in Preterm Infants

Phase 3
Terminated
Conditions
Prevention of Growth Restriction
Interventions
Registration Number
NCT01413581
Lead Sponsor
Swedish Orphan Biovitrum
Brief Summary

The purpose of this study is to demonstrate that rhBSSL improves growth in preterm infants as compared with placebo.

Detailed Description

The purpose of this study is to demonstrate that rhBSSL improves growth in preterm infants as compared with placebo. The infants should be born before week 32 of gestational age.

The study drug, rhBSSL or placebo, will be administered during a 4 week treatment period by adding it to either infant formula or pasteurized breast milk.

The study will also evaluate the safety and tolerability of rhBSSL.

Eligible patients will be randomized in a ratio of 1:1 (rhBSSL:placebo). The study consists of maximum 1 week screening period, a 4-week treatment period and a 2 year follow-up period.

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
415
Inclusion Criteria
  • Preterm infants born before week 32 of gestation.
  • Preterm infant who is less than 33 weeks postmenstrual age at the time of randomization.
  • Preterm infant who is appropriate for gestational age (AGA) or small for gestational age (SGA) at birth.
  • Preterm infant who is receiving food enterally (bottle or gavage tube) at a level of at least 100 ml/kg/day at randomization.
  • Preterm infant whose enteral feeding consists of only infant formula or only pasteurized breast milk at the time of inclusion, and who are expected to remain on only infant formula for 4 weeks, or only pasteurized breast milk for at least 2 weeks following treatment initiation.
  • Preterm infant who is expected not to receive any fresh breast milk for 4 weeks following treatment initiation.
  • Informed consent is obtained.
Exclusion Criteria
  • Expected stay in the hospital is less than 4 weeks from the first dose of study drug.
  • Criteria to ensure no disease or treatment affecting growth or development, e.g. brain disease, necrotizing enterocolitis.
  • Enrolled in another concurrent clinical intervention study.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
rhBSSLrhBSSL (recombinant human bile-salt-stimulated lipase)rhBSSL (recombinant human bile-salt-stimulated lipase)
PlaceboPlaceboPlacebo
Primary Outcome Measures
NameTimeMethod
Growth velocity in grams per kilogram per day during 4 weeks of treatment.Baseline and Day 29
Secondary Outcome Measures
NameTimeMethod
Bayley Scale of Infant and Toddler Development, third edition: Social-emotional domain composite score at 24 months' corrected age24 months' corrected age
Bayley Scale of Infant and Toddler Development, third edition: Adaptive behavior domain composite score at 24 months' corrected age24 months' corrected age
Change from baseline in body weight (g) at 3 monthsBaseline and Month 3
Total body length (mm) at 12 months' corrected age12 months' corrected age
Total body height (cm) at 24 months' corrected age24 months' corrected age
Growth restrictionDay 29

Defined as growth velocity \<15 gram per kilogram bodyweight per day during 4 weeks of treatment

Head circumference (mm) at 12 months' corrected age.12 months´ corrected age
Head circumference (mm) at 24 months' corrected age.24 months´ corrected age
Time from baseline to 150 mL/kg/day of enteral feedingDate of first dose and date 150 mL/kg/day of enteral feeding achieved (or exceeded)
Re-admission to hospital within 1 month of dischargeDate of discharge and date of re-admission
Bayley Scale of Infant and Toddler Development, third edition: Cognitive domain composite score 12 months' corrected age12 months' corrected age
Body weight (g) at 24 months' corrected age24 months´ corrected age
Change from baseline in total body length (mm) at 4 weeksBaseline and Day 29
Change from baseline in total body length (mm) at 3 monthsBaseline and Month 3
Body weight (g) at 12 months' corrected age12 months´ corrected age
Change from baseline in head circumference (mm) at 3 months.Baseline and Month 3
Time to readiness for dischargeBaseline and date of readiness for discharge

Time until each of the following are fulfilled

* sustained weight gain (weight of 1800 g sustained for three days)

* ability to maintain normal body temperature

* ability to suckle feed

* ability to maintain stable cardiorespiratory function

Time to dischargeBaseline and date of discharge
Change from baseline in head circumference (mm) at 4 weeks.Baseline and Day 29
Bayley Scale of Infant and Toddler Development, third edition: Cognitive domain composite score at 24 months' corrected age24 months' corrected age
Bayley Scale of Infant and Toddler Development, third edition: Language domain composite score at 12 months' corrected age12 months' corrected age
Bayley Scale of Infant and Toddler Development, third edition: Language domain composite score at 24 months' corrected age24 months' corrected age
Bayley Scale of Infant and Toddler Development, third edition: Motor domain composite score at 12 months' corrected age12 months' corrected age
Bayley Scale of Infant and Toddler Development, third edition: Motor domain composite score at 24 months' corrected age24 months' corrected age
Neurodevelopment Disability Composite24 months' corrected age

Presence of :

* Composite score of less than 70 on any of the cognitive, language or motor domains of Bayley scale of infant and toddler development, third edition

* Bilateral deafness

* Bilateral blindness

* Cerebral palsy

Child Behavior Checklist total problem score at 24 months' corrected age24 months' corrected age visit
Number of patients with at least one treatment emergent Adverse EventDay 29 and Month 3

Total and by system organ class and preferred term (coded by MedDRA)

Number of patients with at least one treatment emergent Serious Adverse EventDay 29 and Month 3

Total and by system organ class and preferred term (coded by MedDRA)

Number of patients with at least one Serious Adverse Drug Reaction12 months' corrected age and 24 months' corrected age

Total and by system organ class and preferred term (coded by MedDRA)

Level of Vitamin A (nmol/L) at 4 weeksDay 29
Level of Vitamin D (nmol/L) at 4 weeksDay 29
Number of outpatient visits from the time of initial hospital discharge to home up to 24 months' corrected ageDate of initial hospital discharge to home to date of 24 months' corrected age
Number of inpatient visits from the time of initial hospital discharge to home up to 24 months' corrected ageDate of initial hospital discharge to home to date of 24 months' corrected age
Number of days of hospitalization from the time of initial hospital discharge to home up to 24 months' corrected ageDate of initial hospital discharge to home to date of 24 months' corrected age
Number of days in intensive care unit from the time of initial hospital discharge to home up to 24 months' corrected ageDate of initial hospital discharge to home to date of 24 months' corrected age
Number of days lost from work related to the child's condition from the time of initial hospital discharge to home up to 24 months' corrected ageDate of initial hospital discharge to home to date of 24 months' corrected age
Presence of chronic medical conditions/diagnoses at 24 months' corrected age24 months' corrected age
Docosahexaenoic acid (% of total fatty acids) in the serum triglyceride fraction at 4 weeksDay 29
Docosahexaenoic acid (% of total fatty acids) in the serum phosphatidylcholine fraction at 4 weeksDay 29
Arachidonic acid (% of total fatty acids) in the serum triglyceride fraction at 4 weeksDay 29
Arachidonic acid (% of total fatty acids) in the serum phosphatidylcholine fraction at 4 weeksDay 29
Number of patients with antibodies to rhBSSL at 4 weeksDay 29
Number of patients with antibodies to rhBSSL at Month 3Month 3
Number of patients with antibodies to rhBSSL at 12 months' corrected age12 months' corrected age

Trial Locations

Locations (1)

Swedish Orphan Biovitrum Investigational Site

🇸🇪

Umeå, Sweden

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