Finding Solutions to Thrive After Birth Asphyxia in Africa

Phase 1

Active, not recruiting

• Conditions: Birth Asphyxia
• Interventions: Drug: Sildenafil

• Registration Number: NCT05275725
• Lead Sponsor: Pia Wintermark

Brief Summary

Neonatal encephalopathy (NE) is the third leading cause of under 5-year mortality and contributes substantially to long-term neurological morbidity worldwide. In low-income countries (LICs), families often lack the resources to care for affected children. For those with disabilities, stigma is high, and social and emotional impacts are substantial. Improving our understanding of NE in LICs is crucial if intervention strategies are developed. Providing access to an affordable and easy-to-administer treatment after birth may improve survival, early brain development and later outcome, maximizing developmental potential.

The primary objective of this study is to investigate the feasibility, safety and tolerability of administering sildenafil as a neuroprotective/neurorestorative strategy to improve early brain development in a cohort of children with NE in Uganda.

Detailed Description

Not available

Study Timeline

• Study First Submitted: 2022-02-08
• Study First Submitted QC: 2022-03-02
• Study First Posted: 2022-03-11
• Study Start: 2022-07-01
• Status Verified: 2024-12
• Last Update Submitted: 2024-12-27
• Last Update Posted: 2024-12-31
• Primary Completion: 2025-01-31
• Study Completion: 2025-01-31

Recruitment & Eligibility

• Status: ACTIVE_NOT_RECRUITING
• Sex: All
• Target Recruitment: 18

Inclusion Criteria

• Male and female neonates meeting the criteria for birth asphyxia
• Gestational age ≥ 36 weeks and birth weight ≥ 1800 g;
• Admitted to Kawempe Hospital or Nsambya Hospital within 48 hours of life;
• Need for continued resuscitation after birth and/or 5-minute Apgar score ≤5;
• Evidence of neonatal encephalopathy by an abnormal neurological exam (modified Sarnat score of 2-3 or abnormal aEEG).

Exclusion Criteria

• Absent heart rate at 10 minutes/imminent death
• Neonates with major congenital malformations
• Neonates with grade 3 AKI (serum creatinine rise ≥3x lowest previous creatinine or creatinine > 2.5 mg/dL = 221 mcmol/L or receipt of dialysis)
• Neonates with intraventricular and/or intraparenchymal hemorrhage on cranial ultrasound (cUS) performed on day 1-2 of life
• Mother living permanently outside 20km radius of Kawempe Hospital or Nsambya Hospital
• Neonates whose parents are unwilling or unable to give informed written consent to enter the study

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Sildenafil	Sildenafil	-

Primary Outcome Measures

Name	Time	Method
Maximum tolerable dose of sildenafil	within 30 days of drug administration

Secondary Outcome Measures

Name	Time	Method
Sildenafil concentrations	within 30 days of drug administration
Incidence of adverse events (Safety and Tolerability)	within 30 days of drug administration	safety, assessed through the reporting of adverse events, such as death, hypotension, persistent pulmonary hypertension, altered hepatic function, seizures, intraventricular and/or intraparenchymal hemorrhage

Trial Locations

Locations (1)

Kawempe National Referral Hospital; 🇺🇬 Kawempe, Uganda