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NeurocognitivePhase 3DarbeNCT03169881

Darbepoetin Trial to Improve Red Cell Mass and Neuroprotection in Preterm Infants

A Phase 3 study testing Darbepoetin in people with Neurocognitive and Neuroprotective, run by NICHD Neonatal Research Network at 16 sites in United States.

Completed

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

Official record
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Trial summary

Study Hypothesis: Preterm infants administered weekly Darbe during the neonatal period will have improved neurocognitive outcome at 22-26 months compared to placebo Read more about this study

Who is it for?
Ages 1 hour to 24 hours
Conditions the study is for
Neurocognitive, Neuroprotective, Neonatal
What is being tested?
Darbepoetin
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
650 participants
Where
16 sitesUnited States
Study dates
20 Sep 2017to 12 May 2025
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

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 1 hour to 24 hours
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Inborn and outborn preterm infants
  • 23 0/7-28 6/7 weeks gestational age
  • ≤24 hours postnatal age

Who cannot join

  • Hematocrit > 60%
  • Infants with known congenital or chromosomal anomalies, including congenital heart disease and known brain anomalies
  • Hemorrhagic or hemolytic disease
  • EEG- confirmed seizures
  • Congenital thrombotic disease
  • Systolic blood pressures >100 mm Hg while not on pressor support
Show all 9Show fewer
  • Receiving Epo or Darbe clinically, or planning to receive Epo or Darbe during hospitalization
  • Infants in whom no aggressive therapy is planned
  • Family will NOT be available for follow-up at 22-26 months

Trial locations and contacts

16 sites in 1 country.

16 sites in 1 country

United States16 sites
  • University of New Mexico

    Albuquerque, New Mexico, 87131

  • Emory University

    Atlanta, Georgia, 30303

  • University of Alabama at Birmingham

    Birmingham, Alabama, 35233

  • Cincinnati Children's Medical Center

    Cincinnati, Ohio, 45267

  • Case Western Reserve University, Rainbow Babies and Children's Hospital

    Cleveland, Ohio, 44106

  • Research Institute at Nationwide Children's Hospital

    Columbus, Ohio, 43205

  • University of Texas Southwestern Medical Center at Dallas

    Dallas, Texas, 75235

  • RTI International

    Durham, North Carolina, 27705

  • Duke University

    Durham, North Carolina, 27710

  • University of Texas Health Science Center at Houston

    Houston, Texas, 77030

  • University of Iowa

    Iowa City, Iowa, 52242

  • Stanford University

    Palo Alto, California, 94304

  • Univeristy of Pennsylvania

    Philadelphia, Pennsylvania, 19104

  • Brown University - Women and Infants Hospital of Rhode Island

    Providence, Rhode Island, 02905

  • University of Rochester

    Rochester, New York, 14642

  • University of Utah

    Salt Lake City, Utah, 84108

Other trials in United States

About this study

Study Hypothesis: Preterm infants administered weekly Darbe during the neonatal period will have improved neurocognitive outcome at 22-26 months compared to placebo

Read the detailed description

Advances in neonatal care have led to significant improvements in the survival of the nearly 60,000 very low birth weight (VLBW) infants born each year in the U.S. Improving neurodevelopmental outcomes for these preterm infants continues to be a major goal for neonatal care providers. A subset of these infants sustain a grade 3 or 4 intraventricular hemorrhage (IVH) resulting in an increase in the incidence of developmental delay. Moreover, almost one third of preterm infants with normal head ultrasounds also develop cognitive delay. Although a variety of neuroprotective treatment strategies have been evaluated, no specific treatment has been identified to reduce or prevent brain injury in these most vulnerable preterm infants.

A potential neuroprotective therapy involves administering erythropoiesis stimulating agents (ESAs) such as erythropoietin (Epo) and Darbepoetin (Darbe, a longer acting ESA). In addition to stimulating erythropoiesis, ESAs have been shown to be protective in the developing brain in animal models, making it possibly beneficial for very premature infants who are at risk for intraventricular hemorrhage, hypoxic-ischemic injury, and developmental delay. The neuroprotective mechanisms of ESAs include increased neurogenesis, decreased neuronal susceptibility to glutamate toxicity, decreased neuronal apoptosis, decreased inflammation, decreased nitric oxide-mediated injury, increased antioxidant response, decreased axonal degeneration, and increased protective effects on glia. This is a randomized, masked, placebo controlled clinical study in which enrolled infants will receive weekly Darbe or placebo (sham) dosing.

Extended follow-up: Subjects will be seen for follow-up at 4-5 years (i.e., 4 years - 4 years 11 months) corrected age and 6-7 years (i.e., 6 years - 6 years 11 months) corrected age to characterize the functional, behavioral and neurological outcomes of the extremely low birth weight (ELBW) population at school age based on treatment with darbepoetin versus placebo in the neonatal period.

Being tested
Darbepoetin, Placebo

What participants receive

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

  • DarbepoetinDrug

    Also called Darbe

    Darbepoetin 10 micrograms/kg/once every week (IV or SC). Infants will be treated until 35 completed weeks gestation, discharge, or transfer to another hospital.

  • PlaceboDrug

    Also called normal saline for IV administration, or sham dosing

    normal saline for IV administration, or sham dosing. Infants will be treated until 35 completed weeks gestation, discharge, or transfer to another hospital.

Study groups in NCT03169881
Study groupRoleWhat they receive
DarbepoetinExperimentalDarbepoetin 10 micrograms/kg/once every week (IV or SC)
Receives: Drug: Darbepoetin
PlaceboPlacebo comparatorEqual volume normal saline for IV administration, or sham dosing
Receives: Drug: Placebo

What is being measured

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

  1. Bayley III Composite Cognitive Score

    Bayley Scale of Infant and Toddler Development (BSID)-III composite cognitive score, where subjects who died prior to the follow-up assessment are assigned the lowest possible score of 54. This is a standardized scale where a score that is more than 1 normative standard deviation from the normative mean of 100 signifies mild developmental delay (score < 85); 2 standard deviations below the mean, moderate delay (score < 70); and 3 standard deviations below the mean, severe delay (score < 55). This self-standing scale comprises the primary outcome for the Darbe study.

    Measured: 22-26 months corrected age (a median of 25 months corrected age, which corresponds to a median of 29 months calendar age in the analysis population), unless the subject died earlier

Secondary outcomes (13)
  1. Number of Transfusions Per Infant

    The number of transfusions recorded during the study, up to 35 completed weeks gestational age

    Measured: Birth, up to the earliest of: death, hospital discharge, or 35 completed weeks gestational age (a median of 9 weeks)

  2. Total Volume of Transfusions Per Infant

    The total volume of transfusions for the infant if ever transfused

    Measured: Birth, up to the earliest of: death, hospital discharge, or 35 completed weeks gestational age (a median of 9 weeks)

  3. Number of Donor Exposures Per Infant

    The number of donor exposures recorded during the study, up to 35 completed weeks gestational age

    Measured: Birth, up to the earliest of: death, hospital discharge, or 35 completed weeks gestational age (a median of 9 weeks)

  4. Hematocrit

    Hematocrit adjusted for center, gestational age group, and familial clustering

    Measured: at 2 and at 7 weeks in the study

  5. Red Cell Mass

    Red Cell Mass (Circulating Erythrocyte Volume), adjusted for center, gestational age group, and familial clustering

    Measured: at 2 and at 7 weeks in the study

  6. Necrotizing Enterocolitis, Bells Stage >=2 With Surgery

    This is measured as Yes if experienced necrotizing enterocolitis, Bells stage >=2 with surgery; Otherwise, No.

    Measured: Birth to initial hospital discharge or to death if it occurs earlier (a median of 94 days)

  7. Bronchopulmonary Dysplasia Grades 2 or 3

    This is measured as Yes if infant is on invasive mechanical ventilation, nasal cannula >2 L/min or noninvasive positive airway pressure at 36 weeks of postmenstrual age; Otherwise, No.

    Measured: At 36 weeks postmenstrual age

  8. Retinopathy of Prematurity Stage >=3 or Treatment for That Condition Received

    This is measured as Yes if experienced Retinopathy of prematurity stage >=3 or treatment for that condition received; Otherwise, No. Higher stages of ROP indicate a worse outcome; the stages range from 1 for "mild" disease, to 5 for "severe" disease.

    Measured: Birth to initial hospital discharge or to death if it occurs earlier (a median of 94 days)

  9. Intraventricular Hemorrhage Grade I+

    This is measured as Yes if experienced Grade I+ Intraventricular Hemorrhage; Otherwise, No.

    Measured: Birth to initial hospital discharge or to death if it occurs earlier (a median of 94 days)

  10. Length of Hospital Stay

    This is measured as the length of stay up to hospital discharge or death, whichever occurred first.

    Measured: At initial hospital discharge or at death if it occurs earlier (a median of 94 days), assessed up to one year of life.

  11. Death

    This is measured as Yes if an infant died between birth and 22-26 months corrected age; Otherwise, No.

    Measured: Birth, through the 22-26 months corrected age follow-up window, which corresponds to a median of 29 months calendar age in the analysis population

  12. Neurodevelopmental Impairment

    This is a 4-level outcome, where Severe NDI denotes a BSID III cognitive score less than 70, a Gross Motor Functional (GMF) level of 3-5 (where higher scores indicate worse outcomes), blindness (less than 20/200 vision), and/or profound hearing loss, Moderate NDI denotes a BSID III cognitive score from 70-84 and either a GMF level of 2 or limited blindness / moderate hearing loss, Mild NDI denotes a BSID III cognitive score from 70-84, or a cognitive score >=85 with a GMF level of 1 and/or mild hearing loss, and No NDI denotes a cognitive score >= 85 and an absence of neurosensory deficits.

    Measured: At 22-26 months corrected age (a median of 25 months corrected age)

  13. Any Cerebral Palsy

    This is measured as Yes if the child has been deemed by the medical examiner as having Cerebral Palsy; Otherwise, No.

    Measured: At 22-26 months corrected age (a median of 25 months corrected age)

Timeline

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

  1. First posted30 May 2017
  2. Study start20 Sep 2017
  3. Primary completion23 Dec 2022
  4. Study completion12 May 2025

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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Randomized, masked, placebo-controlled trial
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
650 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03169881
Sponsor's protocol ID
NICHD-NRN-0058
Acronym
Darbe
Status last verified
Jun 2026
First submitted
24 May 2017
Last updated
1 Jul 2026
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: NIH has had a long-standing policy to share and make available to the public the results and accomplishments of the activities that it funds. The NRN plans to share de-identified data after final publication in an NIH supported data repository such as the NICHD Data and Specimen Hub (https://dash.nichd.nih.gov) or NHLBI BIOLINCC (https://biolincc.nhlbi.nih.gov/home/).

Publications

  • Maxwell JR, Ohls RK, An G, Winter D, Beauman S, Buhrman J, Jantzie LL. Development of an electrochemiluminescence assay to measure serum darbepoetin concentration in extremely preterm infants. Bioanalysis. 2025 Dec;17(23):1553-1559. doi: 10.1080/17576180.2025.2600914. Epub 2025 Dec 14.

    PubMed 41392547
  • Ohls RK, Das A, Tan S, Lowe JR, Schibler K, Beauman SS, Bell EF, Laptook AR, Baserga M, Patel RM, Carlton DP, Flibotte J, Grisby C, Higgins RD, Shankaran S, Watterberg K, Hibbs AM, Carlo WA, Colaizy TT, Van Meurs KP, Kicklighter SD, Moore R, Sollinger C, Chalak LF, Ghavam S, Poindexter BB, Tyson JE, Cotten CM, Baack ML, Fathi O, DeMauro SB, Laughon MM, Reynolds AM, Duncan AF, Winter S, Wilson-Costello DE, Peralta-Carcelen M, Vohr BR, Harmon HM, Hintz SR, Cavanaugh B, Heyne RJ, Merhar S, Mosquera R, Sewell E, Malcolm WF, Richards LA, Benninger KL, Trembath A; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Darbepoetin, Red Cell Mass, and Neuroprotection in Preterm Infants: A Randomized Clinical Trial. JAMA Pediatr. 2025 Aug 1;179(8):836-845. doi: 10.1001/jamapediatrics.2025.0807.

    PubMed 40354084
  • Bahr TM, Tan S, Smith E, Beauman SS, Schibler KR, Grisby CA, Lowe JR, Bell EF, Laptook AR, Shankaran S, Carlton DP, Rau C, Baserga MC, Flibotte J, Zaterka-Baxter K, Walsh MC, Das A, Christensen RD, Ohls RK; Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network. Serum ferritin values in neonates <29 weeks' gestation are highly variable and do not correlate with reticulocyte hemoglobin content. J Perinatol. 2023 Nov;43(11):1368-1373. doi: 10.1038/s41372-023-01751-z. Epub 2023 Aug 18.

    PubMed 37596391
  • Vu PT, Ohls RK, Mayock DE, German KR, Comstock BA, Heagerty PJ, Juul SE; PENUT Consortium. Transfusions and neurodevelopmental outcomes in extremely low gestation neonates enrolled in the PENUT Trial: a randomized clinical trial. Pediatr Res. 2021 Jul;90(1):109-116. doi: 10.1038/s41390-020-01273-w. Epub 2021 Jan 11.

    PubMed 33432157

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Darbepoetin in people with Neurocognitive and Neuroprotective, run by NICHD Neonatal Research Network at 16 sites in United States.

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 3 inclusion and 9 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 1 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 16 sites in United States. 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 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

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

Are results available for this study?

Yes. Results are posted in the registry (first posted 30 Oct 2024). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

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?

Bayley III Composite Cognitive Score (time frame: 22-26 months corrected age (a median of 25 months corrected age, which corresponds to a median of 29 months calendar age in the analysis population), unless the subject died earlier). 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 NCT03169881, which also lists 4 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 1 Jul 2026.

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