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AsthmaPhase 4NCT02584738

Nebulized Magnesium Sulfate as an Adjunct to Standard Therapy in Asthma Exacerbation

A Phase 4 study testing Nebulized Magnesium Sulfate, Nebulized isotonic saline and Nebulized Salbutamol in people with Asthma, run by Hospital General Naval de Alta Especialidad - Escuela Medico Naval at 1 site in Mexico.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

The purpose of this study is to investigate the effectiveness of nebulized magnesium sulfate in patient with moderate to severe asthma exacerbation in pediatric emergency Read more about this study

Who is it for?
Ages 2 to 15 years
Conditions the study is for
Asthma
What is being tested?
Nebulized Magnesium Sulfate, Nebulized isotonic saline and Nebulized Salbutamol
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
152 participants
Where
1 siteMexico
Study dates
Sep 2015to Jan 2018
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 2 to 15 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Clinical diagnosis of moderate or severe asthma exacerbations
  • 2 to 15 years old.
  • Served in the pediatric emergency department of naval high specialty General Hospital from September to December 2015.
  • Signing the consent by the parents.

Who cannot join

  • Coexistence of lung disease.
  • Severe kidney disease.
  • Severe liver disease.
  • Pregnancy.
  • Known previous reaction to magnesium.
  • Parents who have not signed the agreement.
Show all 12Show fewer
  • Patients without a clinical history of asthma.
  • Clinical diagnosis of mild asthma attack.
  • Previously included in the study.
  • Presence of comorbidities that endanger the patient's life.
  • The patient has clinical or gasometric criteria for advanced airway management.
  • Life-threatening symptoms.

Trial locations and contacts

1 site in 1 country.

Jesús Abisai Uicab Saucedo, Pediatrician contact

(52)5550371200 ext. 5423

abisaipec@msn.com

Mexico1 site, 1 recruiting
  • Hospital General Naval de Alta Especialidad

    Mexico City, Mexico City, 04480

    Jesús Abisai Uicab Saucedo, Pediatrician, (52)5550371200 ext. 5423, abisaipec@msn.com

    Recruiting

Other trials in Mexico

About this study

Official title: Efficacy of Nebulized Magnesium Sulfate as an Adjunct to Standard Therapy in Asthma Exacerbation. A Randomized Controlled Trial

The purpose of this study is to investigate the effectiveness of nebulized magnesium sulfate in patient with moderate to severe asthma exacerbation in pediatric emergency

Read the detailed description

The inclusion period of the patients in this research will be on September 2015 to November 2015. Patients are going to be selected by the medical staff on duty in the emergency paediatric service, according to the criteria previously established inclusion and exclusion. Immediately a baseline degree of respiratory distress using PRAM scale and heart rate, respiratory rate, blood pressure and oxygen saturation. While informed consent in which the objective and characteristics of the study will be obtained will be explained.

Patients will be randomly assigned one of the two treatments in the Research: standard treatment for moderate to severe asthma attack, according to GINA or standard treatment plus nebulised magnesium sulphate, according to the table of random allocation of treatment.

Evaluations were performed after administration of each spray, that is, at 20, 40, 60, 120, 180 and 240 minutes after beginning treatment. The parameters' to evaluate are going to be heart rate, respiratory rate, oxygen saturation, blood pressure and assessment of severity of acute asthma with PRAM scale.

The application of nebulized drugs are made in the emergency department of pediatrics by inhalation therapy staff who are also responsible for the preparation of medicines. It is clear that this staff not participate in the evaluation of patients, which will be performed by the research staff or by medical staff on duty in the pediatric emergency department.

Patients and evaluating physician will not pick out between the two solutions for nebulization not only colour but also smell or other special feature, because the solutions were arranged in two identical syringes. Administered alone at the end of the study treatment is known.

Later the entry or exit of the patient decide, who can be egress to show clinical improvement with decreased severity index PRAM, patients will be graduates of an outpatient treatment according to international guidelines on the management of acute asthma. All initial and outcome data will be recorded in a format of data collection All decisions will be made by patients pediatricians emergency department which will follow patients throughout the study and will have the power to release the study patients to use other interventions that they consider clinically necessary

Conditions
Asthma
Being tested
Nebulized Magnesium Sulfate, Nebulized isotonic saline, Nebulized Salbutamol, Ipratropium bromide, Methylprednisolone or Prednisolone
Keywords
Asthma, Exacerbation, Nebulization, Magnesium, Pediatric
Medical subject headings
Asthma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Nebulized Magnesium SulfateDrug

    Also called MgSO4

    Nebulized salbutamol and ipratropium bromide mixed with 2.5 ml of isotonic MgSO4 (150 mg) per dose every 20 minutes during the first hour.

    will be continued with nebulized standard treatment every hour for 4 hours.

  • Nebulized isotonic salineDrug

    Also called Standard treatment

    Nebulized salbutamol and ipratropium bromide mixed with 2.5 ml of isotonic saline per dose every 20 minutes during the first hour.

    will be continued with nebulized standard treatment every hour for 4 hours.

  • Nebulized SalbutamolDrug

    Nebulized salbutamol 2.5mg (2-5 years) or 5 mg (≥6 years)

  • Ipratropium bromideDrug

    Nebulized ipratropium bromide 250 mcg

  • Methylprednisolone or PrednisoloneDrug

    Also called Corticosteroid therapy

    Begin with intravenous methylprednisolone or oral prednisolone 2 mg/kg/day for each treatment

Study groups in NCT02584738
Study groupRoleWhat they receive
Nebulized Magnesium SulfateExperimentalNebulized salbutamol and ipratropium bromide mixed with 2.5 ml of isotonic MgSO4. Intravenous methylprednisolone or oral prednisolone
Receives: Drug: Nebulized Magnesium Sulfate; Drug: Nebulized Salbutamol; Drug: Ipratropium bromide; Drug: Methylprednisolone or Prednisolone
Nebulized isotonic salinePlacebo comparatorNebulized salbutamol and ipratropium bromide with 2.5 ml of isotonic saline. Intravenous methylprednisolone or oral prednisolone
Receives: Drug: Nebulized isotonic saline; Drug: Nebulized Salbutamol; Drug: Ipratropium bromide; Drug: Methylprednisolone or Prednisolone

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from Baseline Preschool Respiratory Assessment Measure (PRAM)

    Scalene muscle contraction, Suprasternal retractions, Wheezing, Air entry and O2 saturation.

    The score will be considering from the addition per each primary measure.

    Measured: 20, 40, 60, 120, 180 and 240 minutes after beginning treatment

  2. Change from Baseline Scalene muscle contraction

    Absent (0) or Present (2)

    Measured: 20, 40, 60, 120, 180 and 240 minutes after beginning treatment

  3. Change from Baseline Suprasternal retractions

    Absent (0) or Present (2)

    Measured: 20, 40, 60, 120, 180 and 240 minutes after beginning treatment

  4. Change from Baseline Wheezing

    Normal (0), Decreased at bases (1), Widespread decrease (2), or Absent/minimal (3)

    Measured: 20, 40, 60, 120, 180 and 240 minutes after beginning treatment

  5. Change from Baseline Air entry

    Absent (0), Expiratory only (1), Inspiratory and expiratory (2) or Audible without (3) stethoscope/silent chest with minimal air entry

    Measured: 20, 40, 60, 120, 180 and 240 minutes after beginning treatment

  6. Change from Baseline O2 saturation

    ≥95% (0), 92%-94% (1) or <92% (2)

    Measured: 20, 40, 60, 120, 180 and 240 minutes after beginning treatment

Secondary outcomes (4)
  1. Rate of hospitalization

    Reduction the rate of hospitalization

    Measured: 4 hour

  2. Change from Baseline Heart rate

    Beats per minute

    Measured: 20, 40, 60, 120, 180 and 240 minutes after beginning treatment

  3. Change from Baseline Respiratory rate

    Breaths per minute

    Measured: 20, 40, 60, 120, 180 and 240 minutes after beginning treatment

  4. Change from Baseline Blood pressure

    mmHg

    Measured: 60 minutes after beginning treatment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Oct 2015 (estimated)
  2. Study startSep 2015
  3. Primary completionJan 2016 (estimated)
  4. Study completionJan 2018 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
152 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02584738
Sponsor's protocol ID
HGNAE-03
Status last verified
Oct 2015
First submitted
14 Oct 2015
Last updated
2 Dec 2015
Results posted
No
Data monitoring committee
No

Publications

  • Birken CS, Parkin PC, Macarthur C. Asthma severity scores for preschoolers displayed weaknesses in reliability, validity, and responsiveness. J Clin Epidemiol. 2004 Nov;57(11):1177-81. doi: 10.1016/j.jclinepi.2004.02.016.

    PubMed 15567635
  • Gorelick MH, Stevens MW, Schultz TR, Scribano PV. Performance of a novel clinical score, the Pediatric Asthma Severity Score (PASS), in the evaluation of acute asthma. Acad Emerg Med. 2004 Jan;11(1):10-8. doi: 10.1197/j.aem.2003.07.015.

    PubMed 14709423
  • Rodrigo GJ, Plaza Moral V, Forns SB, Castro-Rodriguez JA, de Diego Damia A, Cortes SL, Moreno CM, Nannini LJ, Neffen H, Salas J; SEPAR; ALAT. [ALERTA 2 guidelines. Latin America and Spain: recommendations for the prevention and treatment of asmatic exacerbations. Spanish Pulmonology and Thoracic Surgery Society (SEPAR). Asthma Department of the Latinamerican Thoracic Association (ALAT)]. Arch Bronconeumol. 2010 Oct;46 Suppl 7:2-20. doi: 10.1016/S0300-2896(10)70041-7. No abstract available. Spanish.

    PubMed 21320808
  • Gourgoulianis KI, Chatziparasidis G, Chatziefthimiou A, Molyvdas PA. Magnesium as a relaxing factor of airway smooth muscles. J Aerosol Med. 2001 Fall;14(3):301-7. doi: 10.1089/089426801316970259.

    PubMed 11693841
  • Dominguez LJ, Barbagallo M, Di Lorenzo G, Drago A, Scola S, Morici G, Caruso C. Bronchial reactivity and intracellular magnesium: a possible mechanism for the bronchodilating effects of magnesium in asthma. Clin Sci (Lond). 1998 Aug;95(2):137-42.

    PubMed 9680494
  • Cairns CB, Kraft M. Magnesium attenuates the neutrophil respiratory burst in adult asthmatic patients. Acad Emerg Med. 1996 Dec;3(12):1093-7. doi: 10.1111/j.1553-2712.1996.tb03366.x.

    PubMed 8959161
  • Mohammed S, Goodacre S. Intravenous and nebulised magnesium sulphate for acute asthma: systematic review and meta-analysis. Emerg Med J. 2007 Dec;24(12):823-30. doi: 10.1136/emj.2007.052050.

    PubMed 18029512
  • Shan Z, Rong Y, Yang W, Wang D, Yao P, Xie J, Liu L. Intravenous and nebulized magnesium sulfate for treating acute asthma in adults and children: a systematic review and meta-analysis. Respir Med. 2013 Mar;107(3):321-30. doi: 10.1016/j.rmed.2012.12.001. Epub 2013 Jan 3.

    PubMed 23290189
  • Powell C, Dwan K, Milan SJ, Beasley R, Hughes R, Knopp-Sihota JA, Rowe BH. Inhaled magnesium sulfate in the treatment of acute asthma. Cochrane Database Syst Rev. 2012 Dec 12;12:CD003898. doi: 10.1002/14651858.CD003898.pub5.

    PubMed 23235599
  • Goodacre S, Cohen J, Bradburn M, Gray A, Benger J, Coats T; 3Mg Research Team. Intravenous or nebulised magnesium sulphate versus standard therapy for severe acute asthma (3Mg trial): a double-blind, randomised controlled trial. Lancet Respir Med. 2013 Jun;1(4):293-300. doi: 10.1016/S2213-2600(13)70070-5. Epub 2013 May 17.

    PubMed 24429154
  • Powell CV, Kolamunnage-Dona R, Lowe J, Boland A, Petrou S, Doull I, Hood K, Williamson PR; MAGNETIC study group. MAGNEsium Trial In Children (MAGNETIC): a randomised, placebo-controlled trial and economic evaluation of nebulised magnesium sulphate in acute severe asthma in children. Health Technol Assess. 2013 Oct;17(45):v-vi, 1-216. doi: 10.3310/hta17450.

    PubMed 24144222
  • Alansari K, Ahmed W, Davidson BL, Alamri M, Zakaria I, Alrifaai M. Nebulized magnesium for moderate and severe pediatric asthma: A randomized trial. Pediatr Pulmonol. 2015 Dec;50(12):1191-9. doi: 10.1002/ppul.23158. Epub 2015 Feb 4.

    PubMed 25652104
  • Rowe BH. Intravenous and inhaled MgSO4 for acute asthma. Lancet Respir Med. 2013 Jun;1(4):276-7. doi: 10.1016/S2213-2600(13)70097-3. Epub 2013 May 17. No abstract available.

    PubMed 24429139
  • Petrou S, Boland A, Khan K, Powell C, Kolamunnage-Dona R, Lowe J, Doull I, Hood K, Williamson P. Economic evaluation of nebulized magnesium sulphate in acute severe asthma in children. Int J Technol Assess Health Care. 2014 Oct;30(4):354-60. doi: 10.1017/S0266462314000440. Epub 2014 Nov 14.

    PubMed 25394502
  • Wang H, Xiong Y, Gong C, Yin L, Yan L, Yuan X, Liu S, Shi T, Dai J. Effect of inhaled magnesium sulfate on bronchial hyperresponsiveness. Indian J Pediatr. 2015 Apr;82(4):321-7. doi: 10.1007/s12098-014-1476-6. Epub 2014 Jun 12.

    PubMed 24916134

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Nebulized Magnesium Sulfate, Nebulized isotonic saline and Nebulized Salbutamol in people with Asthma, run by Hospital General Naval de Alta Especialidad - Escuela Medico Naval at 1 site in Mexico.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: status not confirmed, as of the sponsor's last update on 2 Dec 2015. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Mexico. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Jesús Abisai Uicab Saucedo, Pediatrician ((52)5550371200 ext. 5423, abisaipec@msn.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from Baseline Preschool Respiratory Assessment Measure (PRAM) (time frame: 20, 40, 60, 120, 180 and 240 minutes after beginning treatment). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02584738, which also lists 17 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Dec 2015.

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