Sensorineural Hearing Loss Clinical Trial
Official title:
Congenital Cytomegalovirus: Efficacy of Antiviral Treatment in a Randomized Controlled Trial
The objective of the trial is to investigate whether early treatment with oral valganciclovir of infants with both congenital cytomegalovirus infection and sensorineural hearing loss can prevent progression of hearing loss.
In the Netherlands all neonates are routinely screened for hearing during the first weeks
after birth with the Otoacoustic Emissions (OAE) procedure. After the second refer an
Automated Auditory Brainstem Response (AABR) is performed. The parents of all newborns, born
at ≥ 37 weeks gestational age, that fail this AABR in the Netherlands (about 550 yearly)
will be asked for consent for CMV-testing on the dried blood spots. Newborns diagnosed with
congenital CMV and with confirmed SNHL (≥ 20 dB) are eligible for inclusion. After informed
consent infants will be randomized before the age of 13 weeks to a treatment group (6 weeks
valganciclovir 32 mg/kg daily dose; oral solution) or control group (no antiviral
treatment). Infants will be monitored for leucopenia and liver- and kidney function.
Inclusion will continue for at least 1.5 years, or until 25 infants in each treatment arm
have been randomized.
At 1 year follow-up hearing and child development are assessed. Hearing will be assessed
with Brainstem Evoked Response Audiometry at an audiological center. Child development will
be assessed during a home visit with the Bayley Scales of Infant Development III and parents
will fill in the Dutch Child Development Inventory (NCDI) which will give more detailed
information on communicative development of their child. Viral loads in blood and urine will
be monitored during antiviral treatment as well as twice in the control group.
This study will provide information on the percentage of infants with a congenital CMV
infection who fail the neonatal hearing screening . The RCT will show whether early
treatment of congenital CMV infected children with hearing impairment prevents deterioration
of hearing loss and to what extent. The outcome may lead to implementation of congenital CMV
testing in the neonatal hearing screening program or possibly into the newborn blood
screening.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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