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ViDES Trial (Vitamin D Extra Supplementation)

Not Applicable
Recruiting
Conditions
Vitamin D Deficiency
Registration Number
NCT05459298
Lead Sponsor
The University of Texas Health Science Center, Houston
Brief Summary

The objective of the study is to compare supplementation with vitamin D at 800 IU/day to usual care for the first 28 days after birth with respect to 25 (OH) vitamin D levels and indicators of likely or plausible effects of vitamin D supplementation on the function or structure of the lung, bones, immune system, and brain in extremely premature (EP) infants who are \<28 weeks gestational age (GA) or \<1000 grams of birth weight (BW). The study results will be analyzed as intention to treat Bayesian analyses (Frequentist analyses will also be performed).

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
180
Inclusion Criteria
  • Infants born at < 28 weeks gestational age (GA) or <1000 grams birth weight (BW)
  • Inborn
  • Informed written consent in an Institutional Review Board (IRB)-approved manner
Exclusion Criteria
  • GA >32 weeks regardless of birth weight (BW)
  • Any major congenital anomaly
  • A known congenital nonbacterial infection
  • Prenatal diagnosis of disorders that affect vitamin D absorption (e.g, cystic fibrosis)
  • Such severe illness or immaturity that the attending neonatologist judges intensive care to be unjustified.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
25-hydroxyvitamin D (25[OH]D) levelabout 28 days after birth
Secondary Outcome Measures
NameTimeMethod
Number of days of supplemental oxygenfrom time of birth to time of discharge (about 0 to 60 weeks after birth)
Number of days of mechanical ventilationfrom time of birth to time of discharge (about 0 to 60 weeks after birth)
Number of days of positive pressure supportfrom time of birth to time of discharge (about 0 to 60 weeks after birth)
Number of participants who receive steroid treatment to decrease respiratory supportfrom baseline to 36 weeks postmenstrual age
Number of participants with recurrent wheezing2 years

Assessed using the validated International Study of Asthma and Allergies modified asthma scale, which is defined as having more than two episodes (with or without a documented respiratory tract infection) in the 6 months before the 2-year-old visit

Weight as assessed by sex-specific Z-score on the Fenton 2013 Growth Calculator2 years

Z-scores range from -4 standard deviations to +4 standard deviations. A higher Z-score indicates a better outcome.

Length as assessed by sex-specific Z-score on the Fenton 2013 Growth Calculator2 years

Z-scores range from -4 standard deviations to +4 standard deviations. A higher Z-score indicates a better outcome.

Head circumference as assessed by sex-specific Z-score on the Fenton 2013 Growth Calculator2 years

Z-scores range from -4 standard deviations to +4 standard deviations. A higher Z-score indicates a better outcome.

Number of participants with any fracturesfrom baseline to 36 weeks postmenstrual age
Number of participants with hospital-acquired sepsisfrom day 3 after birth to the time of discharge (which is 0 to 60 weeks after birth)
Calcium level0 to 36 weeks postmenstrual age
Phosphorus level0 to 36 weeks postmenstrual age
Alkaline phosphatase level0 to 36 weeks postmenstrual age
Neurodevelopment as assessed by the Bayley-IV Scales of Infant and Toddler Development2 years

Score ranges from 40 to 160, with a higher score indicating a better outcome.

Number of participants with neurodevelopmental impairment (NDI)2 years
Number of participants who die or have a morbidity36 weeks postmenstrual age

Morbidities include retinopathy of prematurity (ROP), intraventricular hemorrhage (IVH), bronchopulmonary dysplasia (BPD), neurodevelopmental impairment (NDI), necrotizing enterocolitis (NEC), and patent ductus arteriosus (PDA).

Vitamin D status as indicated by serum concentration of 24,25(OH)2D3 as assessed by Liquid Chromatography with tandem mass spectrometry (LC-MS/MS)about 28 days after birth
Vitamin D status as indicated by serum concentration of 24,25(OH)2D3 as assessed by LC-MS/MS36 weeks postmenstrual age
Vitamin D status as indicated by serum concentration of 3-epi-25(OH)D3 as assessed by LC-MS/MS36 weeks postmenstrual age
Vitamin D status as indicated by serum concentration of 25(OH)D3 as assessed by LC-MS/MS36 weeks postmenstrual age
25-hydroxyvitamin D (25[OH]D) level36 weeks after birth
Type of respiratory support required at 36 weeks postmenstrual age36 weeks postmenstrual age (or at the time of discharge home if earlier)

Data will be reported categorically as:

* Number of participants who survive without respiratory support

* Number of participants who survive with nasal cannula at ≤ 2 liters (L)/minute

* Number of participants who survive with nasal cannula \>2 L/minute or noninvasive positive airway pressure

* Number of participants who survive with invasive mechanical ventilation

* Number of participants who die

Length of Hospital stayfrom time of birth to time of discharge (about 0 to 60 weeks after birth)
Number of participants who are still on respiratory support22 to 26 months corrected age

Respiratory support includes supplemental oxygen and positive pressure ventilation.

Number of participants with pulmonary hypertension36 weeks postmenstrual age
Pre-discharge health system costsFrom time of birth to time of discharge (about 0 to 60 weeks after birth)

Facility costs will be extracted from the hospital's cost-accounting systems. Costs associated with physician services during the birth admission will be estimated using CPT-based claims data and Relative Value Units (RVUs) from the Medicare Fee Schedule. The cost of oral vitamin D will be determined using the average wholesale price listed in the Micromedex RedBook

Cost-effectiveness in preventing days of respiratory supportFrom time of birth to time of discharge (about 0 to 60 weeks after birth)

Incremental health system costs per prevented day of respiratory support

Cost-effectiveness in increasing survival without BPDFrom time of birth to time of discharge (about 0 to 60 weeks after birth)

Incremental health system costs per prevented day of respiratory support

Trial Locations

Locations (1)

The University of Texas Health Science Center at Houston

🇺🇸

Houston, Texas, United States

The University of Texas Health Science Center at Houston
🇺🇸Houston, Texas, United States
Maria del Mar Romero López, MD
Contact
713-500-7283
Maria.del.Mar.RomeroLopez@uth.tmc.edu
Emily Stephens, BSN, RNC-NIC
Contact
(713) 500-5734
Emily.K.Stephens@uth.tmc.edu
Matthew Rysavy, MD, PhD
Sub Investigator
Amir Khan, MD
Sub Investigator
Jon Tyson, MD, MPH
Sub Investigator
Claudia Pedroza, PhD
Sub Investigator
Mamta Naik, RD, PharmD, BCPPS
Sub Investigator

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