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Clinical Trial Details — Status: Withdrawn

Administrative data

NCT number NCT03275792
Other study ID # CHREB-12345
Secondary ID
Status Withdrawn
Phase Phase 1
First received
Last updated
Start date May 2020
Est. completion date April 2021

Study information

Verified date September 2019
Source University of Calgary
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

This study will provide feasibility data regarding the conduct of a clinical trail evaluating the use of early aggressive inpatient intravenous rehydration in children with Shiga Toxin producing E. coli infection.


Description:

Background: Shiga toxin-producing Escherichia coli (STEC) cause a spectrum of disease, ranging from asymptomatic carriage to bloody diarrhea and the hemolytic uremic syndrome (HUS). HUS is caused by a toxin that destroys red blood cells, consumes platelets and impairs kidney function. HUS results in morbidity and even death in otherwise healthy children. Over the last 30 years however, there has been extremely limited progress in preventing acute and long-term complications in children with STEC infection. However, it is believed that Shiga toxins generate clots or blockages in the kidneys that damage it much the way strokes cause brain damage. There is emerging evidence that if children with STEC infection are recognized early, then the interval between diarrhea onset and the presence of HUS could be exploited to preserve kidney function through the use of intravenous rehydration. Study Design: The investigators propose to conduct the first randomized clinical trial of volume expansion therapy in children with STEC infection. Employing Alberta's unique province-wide microbiology network and its only two pediatric tertiary care centres, the investigators will conduct a proof of principal feasibility study that evaluates novel technologies to identify STEC infected children and those at risk for HUS. Objectives: The primary outcome will be process: number of children recruited. Secondary outcomes will include: 1) resources: retention; refusal; compliance; eligibility criteria; questionnaires; data collection tools; and time requirements; 2) management: capacity and impact on clinical services; 3) scientific: utility of point-of-care STEC diagnostics; use of urine biomarkers to identify high risk children, monitoring of kidney injury and response to therapy; and safety. Significance: This pilot will provide the necessary data to integrate novel technologies into the design and conduct of a multicentre, multinational, clinical trial that will reduce morbidity and mortality from STEC infection.


Recruitment information / eligibility

Status Withdrawn
Enrollment 0
Est. completion date April 2021
Est. primary completion date April 2021
Accepts healthy volunteers No
Gender All
Age group 6 Months to 18 Years
Eligibility Inclusion Criteria: 1. Age <18.0 years; 2. STEC infection [positive culture OR antigen OR polymerase chain reaction test for Stx/gene]; 3. Day of illness 1-10: Children who develop HUS will do so by day #14 of illness;8 restricting enrolment to the first 10 days will ensure all participants are at risk of HUS. Exclusion Criteria: 1. Evidence of evolving HUS: A) Hematocrit <30% OR B) Platelet count <150 x 109/L; 2. Responsible physician desires patient admission (therefore unable to randomize); 3. Unable to contact family within 48 hours of positive stool test; 4. Patient with history of atypical HUS; 5. Chronic disease limiting fluid volumes administered (e.g. impaired cardiac function)

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
D5-0.9%NS
Admission for intravascular volume expansion
Routine home oral rehydration
Routine oral fluids as is given at home to all children with acute diarrheal disease

Locations

Country Name City State
Canada Alberta Children's Hospital Calgary Alberta

Sponsors (1)

Lead Sponsor Collaborator
University of Calgary

Country where clinical trial is conducted

Canada, 

Outcome

Type Measure Description Time frame Safety issue
Other Point-of-Care STEC diagnosis diagnostic accuracy compared with standard culture at the end of the 24 month study recruiting period
Other Urine biomarkers ability to predict progression to AKI and HUS at the end of the 24 month study recruiting period
Other Point-of-Care STEC diagnosis turnaround time at the end of the 24 month study recruiting period
Other Point-of-Care STEC diagnosis proportion O157 vs other STEC at the end of the 24 month study recruiting period
Primary Number of children enrolled in the study protocol The number of children recruited per month per site will be calculated and will be related to the number screened, number eligible, and number consented. at the end of the 24 month study recruiting period
Secondary The proportion of children enrolled in each study arm who develop adverse events For participants enrolled in each study arm we will quantify the proportion that are admitted to Intensive Care Units, the proportion requiring respiratory support (CPAP, BiPAP, endotracheal intubation), hypoxia defined by the administration of supplemental oxygen, and evidence of congestive heart failure defined by blinded independent reviewers. at the end of the 24 month study recruiting period
Secondary Retention The proportion of children who complete the study protocol at the end of the 24 month study recruiting period
Secondary Time requirements We will quantify the number of hours children remain admitted and to which clinical units at the end of the 24 month study recruiting period
Secondary Child/family perspectives 7-item likert scales will be employed to evaluate perspectives of parents and participants as appropriate related to study protocols, procedures and participation at the end of the 24 month study recruiting period
Secondary compliance/adherence The proportion of children enrolled in each study arm who comply with the key interventions of the respective study arms at the end of the 24 month study recruiting period
Secondary data collection tool performance Individual data fields will be audited with respect to data quality, reliability, completeness, timeliness of completion at the end of the 24 month study recruiting period
Secondary Impact on clinical services We will qualitatively explore with the department leads at the respective institutions if the study protocol had any impact on clinical care provided either to the admitted patients or to other patients on their services at the end of the 24 month study recruiting period
Secondary Cost We will quantify the costs per child in each study arm at the end of the 24 month study recruiting period
See also
  Status Clinical Trial Phase
Recruiting NCT05219110 - Hyperhydration in Children With Shiga Toxin-Producing E. Coli Infection Phase 3
Completed NCT05569746 - A Study to Assess Safety, Efficacy, and Pharmacokinetics of INM004 in Pediatric Patients With STEC-HUS Phase 2
Recruiting NCT05985122 - New Analytic Tools for aHUS and C3G Diagnosis N/A
Not yet recruiting NCT06389474 - Efficacy of INM004 in Children With STEC-HUS Phase 3
Completed NCT01406288 - Outbreak of Hemolytic Uremic Syndrome Linked to Escherichia Coli of Serotype O104:H4 N/A
Terminated NCT04132375 - Phase 2/3 Study to Evaluate PK, Safety & Efficacy of INM004 in STEC Positive Pediatric Patients for Prevention of HUS Phase 2/Phase 3
Completed NCT03776851 - Erythropoietin in Hemolytic Uremic Syndrome Phase 4
Completed NCT01666548 - Haemolytic Uraemic Syndrome in Childhood: Clinical, Cognitive and Psychological Aspects N/A
Recruiting NCT04745195 - Complement Prospective Evaluation of Thrombotic Microangiopathy on Endothelium
Active, not recruiting NCT03580941 - Usefulness of a Diagnostic Algorithm to Diagnose Thrombotic Microangiopathies in Pregnancy