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Malnutrition, ChildPhase 4NCT03563222

Safety and Efficacy Study to Compare Smoflipid and Intralipid 20% in Pediatric Patients of 3 Months to 16 Years of Age

A Phase 4 study testing Smoflipid and Intralipid, 20% in people with Malnutrition, Child, run by Fresenius Kabi at 1 site in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

Evaluate the safety and efficacy of Smoflipid compared to standard of care lipid emulsion Intralipid 20% administered via a central vein in pediatric patients 3 months to 16 years of age who require parenteral nutrition for at least 90 days and up to 1 year. Read more about this study

Who is it for?
Ages 3 months to 16 years
Conditions the study is for
Malnutrition, Child
What is being tested?
Smoflipid and Intralipid, 20%
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1 participants
Where
1 siteUnited States
Study dates
18 Dec 2019to 8 Jul 2022
Phase
Phase 4
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 3 months to 16 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Male and female patients 3 months to 16 years of age.
  • Patients who require PN for at least 5 days/week.
  • Patients who receive 60% or more of their total energy requirements as PN at enrollment and who are expected to receive 60% or more of their total energy requirements as PN for at least 90 days.
  • Written informed consent from parent(s) or legal representative(s). If possible, patient assent must also be obtained (according to local law).

Who cannot join

  • Known hypersensitivity to fish, egg, soybean, or peanut proteins, or to any of the active ingredients or excipients of Smoflipid or Intralipid 20%.
  • Hyperlipidemia or disorders of lipid metabolism characterized by hypertriglyceridemia (serum triglyceride concentration > 250 mg/dL).
  • Inborn errors of amino acid metabolism.
  • Cardiopulmonary instability (including pulmonary edema, cardiac insufficiency, myocardial infarction, acidosis and hemodynamic instability requiring significant vasopressor support).
  • Hemophagocytic syndrome.
  • Liver enzymes (either AST, or ALT, or GGT) exceeding 5 x upper limit of normal range
Show all 16Show fewer
  • Direct bilirubin ≥ 2.0 mg/dl
  • INR > 2.
  • Any known hepatic condition outside of Intestinal Failure-Associated Liver Disease (IFALD) that will increase direct bilirubin ≥ 2.0 mg/dl.
  • Clinically significant abnormal levels of any serum electrolyte (sodium, potassium, magnesium, calcium, chloride, phosphate).
  • Active bloodstream infection demonstrated by positive blood culture at screening.
  • Severe renal failure including patients on renal replacement therapy.
  • Abnormal blood pH, oxygen saturation, or carbon dioxide.
  • Pregnancy or lactation.
  • Participation in another clinical study.
  • Unlikely to survive longer than 90 days.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Children's Hospital of Pittsburgh of UPMC

    Pittsburgh, Pennsylvania, 15224

Other trials in United States

About this study

Official title: Prospective, Randomized (1:1), Double-Blind, Parallel-Group, Active-Controlled, Multicenter Study to Compare Safety and Efficacy of Smoflipid to Intralipid 20% in Pediatric Patients of 3 Months to 16 Years of Age Requiring Parenteral Nutrition for at Least 90 Days and up to 1 Year

Evaluate the safety and efficacy of Smoflipid compared to standard of care lipid emulsion Intralipid 20% administered via a central vein in pediatric patients 3 months to 16 years of age who require parenteral nutrition for at least 90 days and up to 1 year.

Being tested
Smoflipid, Intralipid, 20%
Keywords
Parenteral nutrition, Pediatrics, Malnutrition, Nutritional needs
Medical subject headings
Child Nutrition Disorders, Hyperphagia, Malnutrition

What participants receive

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

  • SmoflipidDrug

    Also called Smoflipid® Lipid Injectible Emulsion, USP 20%

    The study drugs will be infused via a dedicated line for parenteral nutrition (PN) into a central vein using a central venous catheter or a peripherally inserted central catheter.

    The initial rate of infusion should be no more than 0.05 mL/minute for the first 10 to 15 minutes. If no untoward reactions occur, the rate can be changed to permit infusion of 0.5 mL/kg/hour.

    The individual dosage of study drug should be infused at a constant rate for 10 to 24 h/d. The administration flow rate is determined by dividing the volume of study drug by the duration of the infusion. Maximum infusion rate for lipid should not exceed 0.125 g/kg/h lipid.

    Study drug infusions should be given 5 to 7 days per week. Study treatment will last for a minimum of 90 consecutive days and as long as PN is indicated, up to 365 consecutive days. If the indication for PN continues after Study Day 365, PN will continue per normal institution policy.

  • Intralipid, 20%Drug

    Also called Intralipid® 20% (20% i.v. fat emulsion)

    The study drugs will be infused via a dedicated line for parenteral nutrition (PN) into a central vein using a central venous catheter or a peripherally inserted central catheter.

    The initial rate of infusion should be no more than 0.05 mL/minute for the first 10 to 15 minutes. If no untoward reactions occur, the rate can be changed to permit infusion of 0.5 mL/kg/hour.

    The individual dosage of study drug should be infused at a constant rate for 10 to 24 h/d. The administration flow rate is determined by dividing the volume of study drug by the duration of the infusion. Maximum infusion rate for lipid should not exceed 0.125 g/kg/h lipid.

    Study drug infusions should be given 5 to 7 days per week. Study treatment will last for a minimum of 90 consecutive days and as long as PN is indicated, up to 365 consecutive days. If the indication for PN continues after Study Day 365, PN will continue per normal institution policy.

Study groups in NCT03563222
Study groupRoleWhat they receive
SmoflipidExperimentalSmoflipid is a sterile, nonpyrogenic, white, homogenous lipid emulsion for intravenous infusion. The lipid content of Smoflipid is 0.20 g/mL, and comprises a mixture of soybean oil, medium chain triglycerides, olive oil, and fish oil. Smoflipid is indicated as a source of calories and essential fatty acids for parenteral nutrition when oral or enteral nutrition is not possible, insufficient, or contraindicated. The mean essential fatty acid content of Smoflipid is 35 mg/mL linoleic acid (omega-6) and 4.5 mg/mL α-linolenic acid (omega-3).
Receives: Drug: Smoflipid
Intralipid, 20%Active comparatorIntralipid 20% is a sterile, non-pyrogenic fat emulsion intended as a source of calories and essential fatty acids. Intralipid 20% is indicated as a source of calories and essential fatty acids for patients requiring parenteral nutrition for extended periods of time and as a source of essential fatty acids for prevention of essential fatty acid deficiency. The major component fatty acids are linoleic acid, oleic acid, palmitic acid, α-linolenic acid and stearic acid.
Receives: Drug: Intralipid, 20%

What is being measured

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

  1. Body Weight

    Body weight of patients (patients < 36 months of age)

    Measured: from day 1 monthly to day 365

  2. Body Height

    Height oder length of body (patients <36 months of age)

    Measured: from day 1 monthly to day 365

  3. Head Circumference

    Circumference of head in patients > 36 months old

    Measured: from day 1 monthly to day 365

  4. Fatty Acid Profile in Total Plasma

    Fatty acid profile including linoleic acid, α-linolenic acid, arachidonic acid, docosahexaenoic acid, eicosapentaenoic acid and Mead acid, analyzed in total plasma

    Measured: from day 1 monthly to day 365

  5. Fatty Acid Profile in Red Blood Cell Membranes

    Fatty acid profile including linoleic acid, α-linolenic acid, arachidonic acid, docosahexaenoic acid, eicosapentaenoic acid and Mead acid, analyzed in red blood cell membranes

    Measured: from day 1 monthly to day 365

  6. Triene/Tetraene Ratio

    Triene/tetraene ratio (Holman Index) in total plasma to assess essential fatty acid deficiency (EFAD)

    Measured: from day 1 weekly to day 365

  7. Number of Patients in Each Treatment Group With Direct Bilirubin Levels > 2 mg/dL

    Measured: from day 1 monthly to day 365

  8. Time Until Reaching Direct Bilirubin Levels > 2 mg/dL

    Measured: from day 1 monthly to day 365

  9. Sterols in Plasma Including Phytosterols

    Measured: from day 1 monthly to day 365

  10. Change From Baseline Triglycerides

    Measured: from day 1 weekly to day 365

  11. Change From Baseline Urea Nitrogen

    Measured: from day 1 weekly to day 365

  12. Change From Baseline Alanine Aminotransferase (ALT)

    Measured: from day 1 weekly to day 365

  13. Change From Baseline Aspartate Aminotransferase (AST)

    Measured: from day 1 weekly to day 365

  14. Change From Baseline Direct Bilirubin

    Measured: from day 1 weekly to day 365

  15. Change From Baseline Total Bilirubin

    Measured: from day 1 weekly to day 365

  16. Change From Baseline Gamma-glutamyl Transferase (GGT)

    Measured: from day 1 weekly to day 365

  17. Change Form Baseline Alkaline Phosphatase (ALP)

    Measured: from day 1 weekly to day 365

  18. Change From Baseline Creatinine

    Measured: from day 1 weekly to day 365

  19. Change From Baseline Electrolytes (Na, K, Mg, Cl,Ca, Phosphate)

    Measured: from day 1 weekly to day 365

  20. Change From Baseline Trace Elements (Ferritin, Zn, Se, Cu, Mn, Cr)

    Measured: from day 1 weekly to day 365

  21. Change From Baseline Glucose

    Measured: from day 1 weekly to day 365

  22. Change From Baseline Total Protein

    Measured: from day 1 weekly to day 365

  23. Change From Baseline C-reactive Protein (CRP)

    Measured: from day 1 weekly to day 365

  24. Change From Baseline White Blood Cell (WBC) Count

    Measured: from day 1 weekly to day 365

  25. Change From Baseline Red Blood Cell (RBC) Count

    Measured: from day 1 weekly to day 365

  26. Change From Baseline Platelet Count

    Measured: from day 1 weekly to day 365

  27. Change From Baseline Hemoglobin

    Measured: from day 1 weekly to day 365

  28. Change From Baseline Hematocrit

    Measured: from day 1 weekly to day 365

  29. Change From Baseline International Normalized Ratio (INR)

    Measured: from day 1 weekly to day 365

  30. Change From Baseline Sterols (Beta-sitosterol, Campesterol, Stigmasterol, Brassicasterol, Ergosterol, Cholesterol, Desmosterol, Lanosterol, Beta-sitostanol, Lathosterol, Squalene)

    Measured: from day 1 monthly to day 365

  31. Vital Signs: Blood Pressure

    Systolic and diastolic blood pressure

    Measured: from day 1 monthly to day 365

  32. Vital Signs: Heart Rate

    Measured: from day 1 monthly to day 365

  33. Vital Signs: Body Temperature

    Measured: from day 1 monthly to day 365

  34. Adverse Events

    Measured: from day 1 weekly to day 365

  35. Genetic Polymorphisms of Fatty Acid Desaturase Genes FADS1 and FADS2

    The relation between genetic polymorphisms in the fatty acid desaturase genes Fatty acid desaturase 1 (FADS1) and Fatty acid desaturase 2 (FADS2) and plasma concentrations of linoleic acid, α-linolenic acid, arachidonic acid, docosahexaenoic acid, eicosapentaenoic acid, and Mead acid, as well as relation to and EFAD (triene/tetraene ratio)

    Measured: once during treatment phase (day 1 to day 365)

Timeline

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

  1. First posted20 Jun 2018
  2. Study start18 Dec 2019
  3. Primary completion12 Nov 2020
  4. Study completion8 Jul 2022

Why it stopped: Prematurely stopped in agreement with authorities (FDA)

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
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
1 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03563222
Sponsor's protocol ID
SMOF-028-CP4
Status last verified
Nov 2022
First submitted
5 Jun 2018
Last updated
12 Dec 2022
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Smoflipid and Intralipid, 20% in people with Malnutrition, Child, run by Fresenius Kabi at 1 site 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 4 inclusion and 16 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: stopped early, as of the sponsor's last update on 12 Dec 2022. 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 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. 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?

Yes. Results are posted in the registry (first posted 12 Dec 2022). 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?

Body Weight (time frame: from day 1 monthly to day 365). The study lists 35 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 12 Dec 2022.

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