AzTrials
AzTrials

Parenteral NutritionPhase 4NCT03149653

Crossover Study on the Effect of Omegaven in Combination With Different Lipid Emulsions in Home Parenteral Nutrition

A Phase 4 study testing ClinOleic (baseline), ClinOleic + Omegaven and Lipoplus (baseline) in people with Parenteral Nutrition, run by General University Hospital, Prague at 1 site in Czechia.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

The aim of this study was to evaluate the safety and tolerance of ClinOleic or Lipoplus or SMOFlipid lipid emulsions. After 6 weeks of each lipid emulsion, Omegaven (fish oil) was added for a further 4 weeks. Read more about this study

Who is it for?
Ages 18 to 85 years
Conditions the study is for
Parenteral Nutrition
What is being tested?
ClinOleic (baseline), ClinOleic + Omegaven and Lipoplus (baseline)
Could I receive a placebo?
No, everyone receives an active treatment
How many people
24 participants
Where
1 siteCzechia
Study dates
15 Jan 2012to 30 Jun 2016
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 18 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Home parenteral nutrition patients in need of parenteral nutrition administration > 4 days/week
  • Parenteral duration expectancy > 8 months
  • Stable clinical condition without any complications in the past 2 months
  • Written consent from the subject

Who cannot join

  • Known hypersensitivity to any of the active substances or excipients
  • Unstable conditions
  • Active cancer or its treatment
  • Established immunodeficiency
  • Advanced organ dysfunction from chronic disease

Trial locations and contacts

1 site in 1 country.

Czechia1 site
  • General University Hospital

    Prague, 12808

Other trials in Czechia

About this study

Official title: A Prospective, Randomized, Controlled, Double-blind, Crossover-Design, Mono-center, Phase IV Study Comparing the Effect of Omegaven in Combination With Clinoleic or Lipoplus or SMOFlipid in Home Parenteral Nutrition Patients

The aim of this study was to evaluate the safety and tolerance of ClinOleic or Lipoplus or SMOFlipid lipid emulsions. After 6 weeks of each lipid emulsion, Omegaven (fish oil) was added for a further 4 weeks. The safety and tolerance was evaluated after each lipid emulsion cycle by biochemistry, hematology and coagulation variables, vital signs and adverse events. We also analysed fatty acid profiles in plasma or erythrocyte phospholipids, antioxidant enzyme activities, lipid peroxidation products, plasma lipids and pro-inflammatory cytokine production after in vitro stimulation of whole blood by lipopolysacharide in HPN patients. The non-interventional group of healthy controls was included for comparison.

Read the detailed description

Intravenous lipid emulsions (LEs) are an indispensable part of home parenteral nutrition (HPN). All commercially obtainable LEs are applicable for HPN in providing a source of energy and essential fatty acids. The originally used soyabean oil-based LE (Intralipid) have been suspected of being associated with a higher risk of pro-inflammatory lipid-mediator production due to their high content of n-6 polyunsaturated fatty acids. The more modern mixes of soyabean oil, and/or olive oil, and/or fish oil LEs with beneficial responses compared with Intralipid are available. Given that there are no clear clinical recommendations for LE application in HPN, we performed this cross-over design, phase 4 study comparing ClinOleic, Lipoplus or SMOFlipid in chronic intestinal failure patients with additional escalation of fish oil using Omegaven.

Being tested
ClinOleic (baseline), ClinOleic + Omegaven, Lipoplus (baseline), Lipoplus + Omegaven, SMOFlipid (baseline)
Keywords
lipid emulsion, olive oil, fish oil, intestinal failure, home parenteral nutrition
Medical subject headings
Hyperphagia, Intestinal Failure

What participants receive

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

  • ClinOleic (baseline)Drug

    Also called ClinOleic 20% Baxter

    Lipid emulsion in pharmacy compounded all-in-one admixture

  • ClinOleic + OmegavenDrug

    Also called ClinOleic 20% Baxter + Omegaven 10% Fresenius Kabi

    Lipid emulsion in pharmacy compounded all-in-one admixture

  • Lipoplus (baseline)Drug

    Also called Lipoplus 20% BBraun Melsungen

    Lipid emulsion in pharmacy compounded all-in-one admixture

  • Lipoplus + OmegavenDrug

    Also called Lipoplus 20% BBraun Melsungen + Omegaven 10% Fresenius Kabi

    Lipid emulsion in pharmacy compounded all-in-one admixture

  • SMOFlipid (baseline)Drug

    Also called SMOFlipid 20% Fresenius Kabi

    Lipid emulsion in pharmacy compounded all-in-one admixture

  • SMOFlipid + OmegavenDrug

    Also called SMOFlipid 20% Fresenius Kabi + Omegaven 10% Fresenius Kabi

    Lipid emulsion in pharmacy compounded all-in-one admixture

Study groups in NCT03149653
Study groupRoleWhat they receive
1 Home Parenteral Nutrition, Cross-overExperimentalRandom Cycle Sequence - Cycle 1: Clinoleic (baseline), 50g/per day, 42 days Clinoleic + Omegaven, 40g + 10g/per day, 28 days. Cycle 2: Lipoplus (baseline), 50g/per day, 42 days Lipoplus + Omegaven, 40g + 10g/per day, 28 days. Cycle 3: SMOFlipid (baseline), 50g/per day, 42 days SMOFlipid + Omegaven, 40g + 10g/per day, 28 days.
Receives: Drug: ClinOleic (baseline); Drug: ClinOleic + Omegaven; Drug: Lipoplus (baseline); Drug: Lipoplus + Omegaven; Drug: SMOFlipid (baseline); Drug: SMOFlipid + Omegaven
2 Home Parenteral Nutrition, Cross-overActive comparatorRandom Cycle Sequence - Cycle 1: Clinoleic (baseline), 50g/per day, 42 days Clinoleic + Omegaven, 40g + 10g/per day, 28 days. Cycle 2: Lipoplus (baseline), 50g/per day, 42 days Lipoplus + Omegaven, 40g + 10g/per day, 28 days. Cycle 3: SMOFlipid (baseline), 50g/per day, 42 days SMOFlipid + Omegaven, 40g + 10g/per day, 28 days.
Receives: Drug: ClinOleic (baseline); Drug: ClinOleic + Omegaven; Drug: Lipoplus (baseline); Drug: Lipoplus + Omegaven; Drug: SMOFlipid (baseline); Drug: SMOFlipid + Omegaven
Comparator3No interventionHealthy Control

What is being measured

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

  1. Change from baseline lipid emulsion production of TNF-alpha after in vitro stimulation of whole blood by lipopolysacharide at 4 weeks of Omegaven lipid emulsion addition

    The whole blood culture supernatant concentration of TNF-alpha (ng/L)

    Measured: day 42, day 70

  2. Change from baseline lipid emulsion production of IL-1-beta after in vitro stimulation of whole blood by lipopolysacharide at 4 weeks of Omegaven lipid emulsion addition

    The whole blood culture supernatant concentration of IL-1-beta (ng/L)

    Measured: day 42, day 70

  3. Change from baseline lipid emulsion production of IL-6 after in vitro stimulation of whole blood by lipopolysacharide at 4 weeks of Omegaven lipid emulsion addition

    The whole blood culture supernatant concentration of IL-6 (ng/L)

    Measured: day 42, day 70

  4. Change from baseline lipid emulsion production of IL-8 after in vitro stimulation of whole blood by lipopolysacharide at 4 weeks of Omegaven lipid emulsion addition

    The whole blood culture supernatant concentration of IL-8 (ng/L)

    Measured: day 42, day 70

Secondary outcomes (19)
  1. Change from baseline lipid emulsion plasma concentration of TNF-alpha at 4 weeks of Omegaven lipid emulsion addition

    The plasma concentration of TNF-alpha (ng/L)

    Measured: day 42, day 70

  2. Change from baseline lipid emulsion plasma concentration of IL-1-beta at 4 weeks of Omegaven lipid emulsion addition

    The plasma concentration of IL-1-beta (ng/L)

    Measured: day 42, day 70

  3. Change from baseline lipid emulsion plasma concentration of IL-6 at 4 weeks of Omegaven lipid emulsion addition

    The plasma concentration of IL-6 (ng/L)

    Measured: day 42, day 70

  4. Change from baseline lipid emulsion plasma concentration of IL-8 at 4 weeks of Omegaven lipid emulsion addition

    The plasma concentration of IL-8 (ng/L)

    Measured: day 42, day 70

  5. Change from baseline lipid emulsion plasma concentration ratio of oxidized LDL/LDL cholesterol at 4 weeks of Omegaven lipid emulsion addition

    The plasma concentration ratio of oxidized LDL/LDL cholesterol (ox-LDL/LDL-C)

    Measured: day 42, day 70

  6. Change from baseline lipid emulsion plasma concentration of triglycerides at 4 weeks of Omegaven lipid emulsion addition

    The plasma concentration of triglycerides (mmol/L)

    Measured: day 42, day 70

  7. Change from baseline lipid emulsion plasma concentration of total cholesterol at 4 weeks of Omegaven lipid emulsion addition

    The plasma concentration of total cholesterol (mmol/L)

    Measured: day 42, day 70

  8. Change from baseline lipid emulsion plasma concentration of HDL cholesterol at 4 weeks of Omegaven lipid emulsion addition

    The plasma concentration of HDL cholesterol (mmol/L)

    Measured: day 42, day 70

  9. Change from baseline lipid emulsion plasma concentration of LDL cholesterol at 4 weeks of Omegaven lipid emulsion addition

    The plasma concentration of LDL cholesterol (mmol/L)

    Measured: day 42, day 70

  10. Change from baseline lipid emulsion plasma phospholipid fatty acid profile at 4 weeks of Omegaven lipid emulsion addition

    The plasma phospholipid fatty acid profile (mol%)

    Measured: day 42, day 70

  11. Change from baseline lipid emulsion erythrocyte phospholipid fatty acid profile at 4 weeks of Omegaven lipid emulsion addition

    The erythrocyte phospholipid fatty acid profile (mol%)

    Measured: day 42, day 70

  12. Change from baseline lipid emulsion plasma concentration of fibrothelial growth factor 19 at 4 weeks of Omegaven lipid emulsion addition

    The plasma concentration of fibrothelial growth factor 19 (ng/L)

    Measured: day 42, day 70

  13. Change from baseline lipid emulsion erythrocyte superoxide dismutase activity at 4 weeks of Omegaven lipid emulsion addition

    The erythrocyte activity of SOD (U/g Hb)

    Measured: day 42, day 70

  14. Change from baseline lipid emulsion erythrocyte catalase activity at 4 weeks of Omegaven lipid emulsion addition

    The erythrocyte activity of CAT (U/g Hb)

    Measured: day 42, day 70

  15. Change from baseline lipid emulsion erythrocyte glutathione peroxidase activity at 4 weeks of Omegaven lipid emulsion addition

    The erythrocyte activity of GPX (U/g Hb)

    Measured: day 42, day 70

  16. Change from baseline lipid emulsion erythrocyte glutathione reductase activity at 4 weeks of Omegaven lipid emulsion addition

    The erythrocyte activity of GR (U/g Hb)

    Measured: day 42, day 70

  17. Change from baseline lipid emulsion plasma paraoxonase 1 activity at 4 weeks of Omegaven lipid emulsion addition

    The plasma activity of PON1 (U/L)

    Measured: day 42, day 70

  18. Alteration of liver function

    Liver function tests

    Measured: week 6, week 10, week 16, week 20, week 26, week 30

  19. Septic complications

    Catheter-related bloodstream infections

    Measured: week 6, week 10, week 16, week 20, week 26, week 30

Timeline

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

  1. First posted11 May 2017
  2. Study start15 Jan 2012
  3. Primary completion7 Jan 2016
  4. Study completion30 Jun 2016

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
Crossover
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
24 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03149653
Sponsor's protocol ID
NT13236-4/2012
Status last verified
May 2017
First submitted
11 Apr 2017
Last updated
11 May 2017
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing ClinOleic (baseline), ClinOleic + Omegaven and Lipoplus (baseline) in people with Parenteral Nutrition, run by General University Hospital, Prague at 1 site in Czechia.

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 5 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: finished, as of the sponsor's last update on 11 May 2017. 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 Czechia. 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. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from baseline lipid emulsion production of TNF-alpha after in vitro stimulation of whole blood by lipopolysacharide at 4 weeks of Omegaven lipid emulsion addition (time frame: day 42, day 70). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 11 May 2017.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in