Otitis Media With Effusion Clinical Trial
Official title:
Role of Empiric Anti-reflux Therapy in Pediatric Otitis Media With Effusion - a Pilot Study
Verified date | April 2015 |
Source | McMaster University |
Contact | n/a |
Is FDA regulated | No |
Health authority | Canada: Health Canada |
Study type | Interventional |
The accumulation of fluid behind the ear drum without any acute inflammation is known as
otitis media with effusion (OME). It is the most common cause of acquired hearing loss
during childhood. Long-term complications of OME include linguistic, developmental, and
social development delays due to hearing loss.
The cause of OME is not known; however, low grade infection of the middle ear, poor function
of the eustachian tube between the ear and the throat, and adenoid hypertrophy have all been
suggested as possible etiologies. Recent detection of the stomach enzyme pepsin in middle
ear fluid has led some to propose that OME is related to the reflux of stomach contents into
the ear, via the eustachian tube.
The purpose of the investigators study is to determine whether anti-reflux medication may
have a positive impact by clearing the accumulation of fluid in the middle ear with the aim
of preventing or reducing hearing loss in children diagnosed with OME. Empiric anti-reflux
therapy with proton pump inhibitor (PPI) medication is safe, proven and cost-effective. It
is used widely as a diagnostic and treatment strategy in the presence of the signs and
symptoms of gastroesophageal reflux disease (GERD). The signs and symptoms of GERD include
heartburn, recurrent vomiting or regurgitation, acid taste in mouth, throat irritation,
voice problems, heartburn, difficult or painful swallowing, asthma and recurrent pneumonia.
This pilot study will be a double-blinded, randomized, placebo-controlled trial that will
compare resolution rates for OME in children treated with lansoprazole or placebo for three
months. At the end of the study, those patients who have persistent middle ear effusions
will be brought to the operating room and have the fluid aspirated and sent for analysis for
pepsin.
Status | Completed |
Enrollment | 65 |
Est. completion date | June 2014 |
Est. primary completion date | June 2014 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 1 Year to 17 Years |
Eligibility |
Inclusion Criteria: - Children between the ages of 1 and 17 years referred to the McMaster Otolaryngology Clinic. - Presence of bilateral OME for at least 3 months based on: - Clinical history: patient may present with decrease in hearing, aural fullness and/or ear pressure, balance problems, ear tugging/rubbing, they typically do not have otalgia or fever. - Pneumatic otoscopy: observations suggestive of OME include presence of a dull tympanic membrane with presence of non purulent effusion (serous or mucoid), presence of a level of effusion, decrease or non motility of the tympanic membrane, retraction of the tympanic membrane. - Tympanometry: type B or type C tympanogram with normal air volume of the external auditory canal. - Pure tone audiometry: conductive hearing loss that typically varies from slight to moderate. Exclusion Criteria: - Presence of acute otitis media as determined by history and physical examination: - History of rapid acute onset of significant otalgia, decrease in hearing, fever, irritability. - Pneumatic otoscopy revealing purulent effusion, yellowness and/or redness with hypervascularity of the tympanic membrane, bulging of tympanic membrane with decrease of normal landmarks. - Presence of craniofacial abnormalities - Previous middle ear surgery (excluding myringotomy and tube) - Allergic reactions to lansoprazole, and any other adverse drug interactions to lansoprazole. |
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
Country | Name | City | State |
---|---|---|---|
Canada | Mcmaster University Medical Centre 3V1 Clinic | Hamilton | Ontario |
Lead Sponsor | Collaborator |
---|---|
Hamilton Health Sciences Corporation | McMaster University |
Canada,
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* Note: There are 27 references in all — Click here to view all references
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Collect the required data for sample size calculation | The purpose of this pilot study is to collect required data for a sample size calculation for a larger clinical trial and to determine recruitment rates. | Following the recruitment of 100 patients (~1 year) | No |
Secondary | Resolution of Otitis Media with Effusion | The secondary objectives are to compare the duration of OME between the placebo and treatment groups, and to compare the duration and degree of hearing loss at initial presentation and at three months. Other outcomes include degree of hearing improvement, complications of OME (i.e. recurrent OME, acute otitis media, surgery), frequency and severity of GERD symptoms, side effects of Lansoprazole use, and presence of pepsin in middle ear effusions collected from patients who received surgical treatment. | At presentation and at 1 month, 2months and 3 months post initiation of treatment | Yes |
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