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Moyamoya DiseaseNCT03882060

Effect of Recombinant Human EPO on the Postoperative Neurologic Outcome in Pediatric Moyamoya Patients

A study testing erythropoietin and Normal saline in people with Moyamoya Disease and Pediatrics, run by Seoul National University Hospital at 1 site in South Korea.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

This study evaluates the effect of recombinant human erythropoietin (rHuEPO) on the neovascularization of pediatric moyamoya disease patients. rHuEPO will be administrated during perioperative period of the first revascularization surgery. Read more about this study

Who is it for?
Ages Up to 18 years
What is being tested?
erythropoietin and Normal saline
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
60 participants
Where
1 siteSouth Korea
Study dates
8 Apr 2019to 31 Dec 2023
Phase
Interventional
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 Up to 18 years
  • All sexes
  • No healthy volunteers
  • Child, Adult

Who may be able to join

  • Pediatric Moyamoya patients scheduled for the first revascularization surgery

Who cannot join

  • Hypersensitivity or contraindication to rHuEPO
  • History of Unstable hypertension, Hypertensive encephalopathy, Thrombosis
  • Primary intracerebral hemorrhage (ICH), Subarachnoid hemorrhage (SAH), Arterio-venous malformation (AVM), Cerebral aneurysm, or cerebral neoplasm
  • History of seizure
  • Hemoglobin >16 mg/dl
  • Prolonged PT (PT > 15.5 seconds, PT INR > 1.2) or Prolonged aPTT (> 40 seconds)
Show all 9Show fewer
  • Thrombocytopenia (platelet count < 100,000/microL), Thrombocytosis (platelet count > 400,000/microL), Neutropenia (absolute neutrophil count (ANC) < 1500/microL)
  • Abnormal kidney function (Creatinine> 2.0 mg/dl, History of dialysis)
  • Abnormal hepatic function (aspartate transaminase> 80 unit/L, alanine aminotransferase> 80 unit/L)

Trial locations and contacts

1 site in 1 country.

South Korea1 site
  • Seoul National University Hospital

    Seoul, 110-744

Other trials in South Korea

About this study

Official title: The Effect of Recombinant Human Erythropoietin on the Postoperative Neurologic Outcome in Pediatric Moyamoya Disease Patients - A Double Blind Randomized Controlled Trial

This study evaluates the effect of recombinant human erythropoietin (rHuEPO) on the neovascularization of pediatric moyamoya disease patients. rHuEPO will be administrated during perioperative period of the first revascularization surgery. Primary outcome (Incidence of Good postoperative MCA territory revascularization by cerebral angiography) will be evaluated after 3-6 month of revascularization surgery.

Being tested
erythropoietin, Normal saline
Medical subject headings
Moyamoya Disease, Cerebrovascular Disorders

What participants receive

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

  • erythropoietinDrug

    Also called rHuEPO

    Recombinant human erythropoietin (500 U/kg IVS x 3 times) is administrated to increase the neovascularization after revascularization surgery.

  • Normal salineDrug

    Also called Control

    Control group, no intervention.

Study groups in NCT03882060
Study groupRoleWhat they receive
rHuEPOExperimentalrecombinant human erythropoietin 500 U/kg IVS x 3 times Preoperative day (12-24 hour before surgery) During surgery Postoperative day (12-24 hour after surgery)
Receives: Drug: erythropoietin
ControlPlacebo comparatorNormal saline 50mL x 3 times Preoperative day (12-24 hour before surgery) During surgery Postoperative day (12-24 hour after surgery)
Receives: Drug: Normal saline

What is being measured

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

  1. postoperative <12 month Angiogenesis

    Incidence of Good postoperative MCA territory revascularization by cerebral angiography or MRI (3 grade: good, fair, poor)

    Measured: <12 month after revascularization operation

Secondary outcomes (17)
  1. Short-term postoperative outcome: Incidence and number of the postoperative transient ischemic attack (TIA) within 1 week

    Incidence and number of the postoperative transient ischemic attack (TIA) within 1 week (yes or no)

    Measured: up to 1 week

  2. Short-term postoperative outcome: Adverse neurologic event

    seizure, increased intracranial pressure, cerebral infarct, hematoma, reoperation (yes or no)

    Measured: within the 1st postoperative hospital stay, up to 1 year

  3. Short-term postoperative outcome: Other postoperative complications

    e.g. Circulatory failure/arrest, Respiratory failure/arrest, Infection (yes or no)

    Measured: within the 1st postoperative hospital stay, up to 1 year

  4. Short-term postoperative outcome: ICU stay (days)

    ICU stay (discharge criteria: Stable V/S + Consciousness)

    Measured: within the 1st postoperative hospital stay, up to 1 year

  5. Short-term postoperative outcome: Total hospital stay (days)

    Total hospital stay (discharge criteria: Stable V/S + no progressive Sx)

    Measured: within the 1st postoperative hospital stay, up to 1 year

  6. Effect of rHuEPO on perioperative erythropoiesis: Total intraoperative and perioperative transfusion requirements (mL/kg)

    Total intraoperative and perioperative transfusion requirements (mL/kg)

    Measured: within the 1st postoperative hospital stay, up to 1 year

  7. Effect of rHuEPO on perioperative erythropoiesis: Perioperative Hemoglobin, Hematocrit, serum EPO level

    Perioperative Hemoglobin, Hematocrit, serum EPO level

    Measured: within the 1st postoperative hospital stay, up to 1 year

  8. Effect of rHuEPO on perioperative erythropoiesis: GFR, BUN, Creatinine

    GFR, BUN, Creatinine level

    Measured: within the 1st postoperative hospital stay, up to 1 year

  9. Postoperative <12 month neurologic outcome: Clinical outcomes (4 grade): Excellent, Good, Fair, Poor

    Clinical outcomes (4 grade): Excellent, Good, Fair, Poor

    Measured: Outpatient clinical visit, Usually Postoperative 3~6 month, up to 1 year

  10. Postoperative <12 month neurologic outcome: Brain Perfusion MRI (2 grade): Favorable, Unfavorable

    Brain Perfusion MRI (2 grade): Favorable, Unfavorable

    Measured: Outpatient clinical visit, Usually Postoperative 3~6 month, up to 1 year

  11. Long-term neurologic outcome: Clinical outcomes (4 grade): Excellent, Good, Fair, Poor

    Clinical outcomes (4 grade): Excellent, Good, Fair, Poor

    Measured: Outpatient clinical visit, Usually Postoperative 12~18 month, up to 2 years

  12. Long-term neurologic outcome: Brain MRI/A or Brain perfusion MRI

    Brain MRI/A or Brain perfusion MRI (2 grade): Favorable, Unfavorable

    Measured: Outpatient clinical visit, Usually Postoperative 12~18 month, up to 2 years

  13. Long-term neurologic outcome: Cognitive function assessed by Korean Wechsler Intelligence Scale for Children-Ⅳ (K-WISC-Ⅳ)

    Cognitive function assessed by Korean Wechsler Intelligence Scale for Children-Ⅳ (K-WISC-Ⅳ, has 4 domaines: Verbal Comprehension Index, Perceptual Reasoning Index, Working Memory Index, Processing Speed Index > final score is calculated from T-score)

    Measured: Outpatient clinical visit, Usually Postoperative 12~18 month, up to 2 years

  14. Preoperative Cerebral angiography: Suzuki grade, Bilateral involvement

    Cerebral angiography: Suzuki grade(1-6), Bilateral involvement (yes/no)

    Measured: Before up to 1 year

  15. Preoperative Brain MRI/A or Brain Perfusion MRI

    Brain MRI/A or Brain Perfusion MRI (2 grade): Favorable, Unfavorable

    Measured: If the preoperative w/u is not completed before recruitment, up to 1 week

  16. Preoperative Hemoglobin, Hematocrit, serum EPO level

    Preoperative Hemoglobin, Hematocrit, serum EPO level

    Measured: If the preoperative w/u is not completed before recruitment, up to 1 week

  17. Preoperative information: Homozygous RNF213

    Homozygous RNF213

    Measured: If the preoperative w/u is not completed before recruitment, up to 1 week

Timeline

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

  1. First posted20 Mar 2019
  2. Study start8 Apr 2019
  3. Primary completion31 Dec 2023 (estimated)
  4. Study completion31 Dec 2023 (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 N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Outcomes assessor
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03882060
Sponsor's protocol ID
H-1812-165-999
Status last verified
Nov 2023
First submitted
12 Mar 2019
Last updated
22 Nov 2023
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Hong JM, Lee SJ, Lee JS, Choi MH, Lee SE, Choi JW, Lim YC. Feasibility of Multiple Burr Hole With Erythropoietin in Acute Moyamoya Patients. Stroke. 2018 May;49(5):1290-1295. doi: 10.1161/STROKEAHA.117.020566. Epub 2018 Apr 6.

    PubMed 29626135
  • Malla RR, Asimi R, Teli MA, Shaheen F, Bhat MA. Erythropoietin monotherapy in perinatal asphyxia with moderate to severe encephalopathy: a randomized placebo-controlled trial. J Perinatol. 2017 May;37(5):596-601. doi: 10.1038/jp.2017.17. Epub 2017 Mar 9.

    PubMed 28277490
  • Kimakova P, Solar P, Solarova Z, Komel R, Debeljak N. Erythropoietin and Its Angiogenic Activity. Int J Mol Sci. 2017 Jul 13;18(7):1519. doi: 10.3390/ijms18071519.

    PubMed 28703764
  • Aljaaly HA, Aldekhayel SA, Diaz-Abele J, Karunanayka M, Gilardino MS. Effect of Erythropoietin on Transfusion Requirements for Craniosynostosis Surgery in Children. J Craniofac Surg. 2017 Jul;28(5):1315-1319. doi: 10.1097/SCS.0000000000003717.

    PubMed 28582302
  • Wu YW, Mathur AM, Chang T, McKinstry RC, Mulkey SB, Mayock DE, Van Meurs KP, Rogers EE, Gonzalez FF, Comstock BA, Juul SE, Msall ME, Bonifacio SL, Glass HC, Massaro AN, Dong L, Tan KW, Heagerty PJ, Ballard RA. High-Dose Erythropoietin and Hypothermia for Hypoxic-Ischemic Encephalopathy: A Phase II Trial. Pediatrics. 2016 Jun;137(6):e20160191. doi: 10.1542/peds.2016-0191. Epub 2016 May 2.

    PubMed 27244862
  • Bang OY, Fujimura M, Kim SK. The Pathophysiology of Moyamoya Disease: An Update. J Stroke. 2016 Jan;18(1):12-20. doi: 10.5853/jos.2015.01760. Epub 2016 Jan 29.

    PubMed 26846756
  • Kim T, Oh CW, Bang JS, Kim JE, Cho WS. Moyamoya Disease: Treatment and Outcomes. J Stroke. 2016 Jan;18(1):21-30. doi: 10.5853/jos.2015.01739. Epub 2016 Jan 29.

    PubMed 26846757
  • Yoo YC, Shim JK, Kim JC, Jo YY, Lee JH, Kwak YL. Effect of single recombinant human erythropoietin injection on transfusion requirements in preoperatively anemic patients undergoing valvular heart surgery. Anesthesiology. 2011 Nov;115(5):929-37. doi: 10.1097/ALN.0b013e318232004b.

    PubMed 22027622
  • Kim SK, Cho BK, Phi JH, Lee JY, Chae JH, Kim KJ, Hwang YS, Kim IO, Lee DS, Lee J, Wang KC. Pediatric moyamoya disease: An analysis of 410 consecutive cases. Ann Neurol. 2010 Jul;68(1):92-101. doi: 10.1002/ana.21981.

    PubMed 20582955
  • Kim JH, Jung JH, Phi JH, Kang HS, Kim JE, Chae JH, Kim SJ, Kim YH, Kim YY, Cho BK, Wang KC, Kim SK. Decreased level and defective function of circulating endothelial progenitor cells in children with moyamoya disease. J Neurosci Res. 2010 Feb 15;88(3):510-8. doi: 10.1002/jnr.22228.

    PubMed 19774676
  • Heeschen C, Aicher A, Lehmann R, Fichtlscherer S, Vasa M, Urbich C, Mildner-Rihm C, Martin H, Zeiher AM, Dimmeler S. Erythropoietin is a potent physiologic stimulus for endothelial progenitor cell mobilization. Blood. 2003 Aug 15;102(4):1340-6. doi: 10.1182/blood-2003-01-0223. Epub 2003 Apr 17.

    PubMed 12702503

Questions about this trial

What is this clinical trial studying?

A study testing erythropoietin and Normal saline in people with Moyamoya Disease and Pediatrics, run by Seoul National University Hospital at 1 site in South Korea.

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 1 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: status not confirmed, as of the sponsor's last update on 22 Nov 2023. 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 South Korea. 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.

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?

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?

postoperative <12 month Angiogenesis (time frame: <12 month after revascularization operation). 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 NCT03882060, which also lists 11 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 22 Nov 2023.

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