KiteLock 4% EDTA Lock Solution for the Prevention of Occlusions in Children With Intestinal Failure

Pediatric Intestinal Failure Clinical Trial

Official title:

Safety and Effectiveness of 4% Tetrasodium Ethylenediaminetetraacetic Acid Catheter Lock Solution in Preventing Central Venous Catheter Occlusions in Children With Intestinal Failure: A Randomized Controlled Trial

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05879835
• Other study ID #: CT23-001-SC001
• Status: Not yet recruiting
• Phase: N/A
• Start date: March 2024
• Est. completion date: June 2026

Study information

• Verified date: February 2024
• Source: SterileCare Inc.
• Contact: Joanne Greco
• Phone: 6472006232
• Email: jgreco[@]sterilecareinc.com
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

A multi-site, randomized, 2-arm open-label trial to determine if 4% Tetrasodium (EDTA) catheter lock solution is more effective than heparin lock (standard of care) in preventing central venous catheter occlusions in children with intestinal failure (IF) on total parenteral nutrition (TPN).

Description:

A total of 124 (62 per arm) will be enrolled into the study. Screening and informed consent (and assent if applicable) will be obtained prior to study procedures. The baseline assessment will be completed at recruitment to the study. Once the baseline assessment is complete and eligible subjects are randomized, the study drug will be dispensed per protocol. The study follow-up period will be 52 weeks. Four follow-up clinical in-person visits will occur at 2,12, 28, 40 and 52 weeks. Visits will be conducted by physicians or nurse practitioners. The study visits will assess general status, study bloodwork, adverse events, catheter patency, alteplase use, infection assessment, catheter integrity, and provide investigational product. Telephone follow up will occur on day-3 of intervention, and once per 4 weeks, as well as in the event of outpatient care/hospital admission, or safety event. Subject daily diaries will be utilized for detailed monitoring. Diary recordings will include adverse events, including occlusive events, and any subject specific details (e.g. dwell times, heparin flushing vs. aspiration) or issues in the delivery of the study locking solutions.

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 124
• Est. completion date: June 2026
• Est. primary completion date: December 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 4 Weeks to 18 Years

Eligibility

Inclusion Criteria:

1. Patients managed by the intestinal rehabilitation program at one of the participating centers.

2. Diagnosis of intestinal failure defined as need for PN support for >60 days in previous 74 days for primary intestinal disease (short bowel syndrome, primary motility disorder, mucosal enteropathy).

3. Expectation of the treating physician that the patient will require PN for at least 6 months following enrollment.

4. Age less than 18 years at diagnosis but greater than 4 weeks chronological age or 40 weeks estimated gestational age, whichever is greater.

5. Stable TPN cycling (4 hours off TPN minimum per day) enabling home TPN management

6. Presence of a tunneled central venous catheter (CVC), port-a-catheter, or peripherally inserted central catheter (PICC).

7. Clinical stability for at least 4 weeks and no acute medical comorbidities.

8. A minimum dwell time of 4 consecutive hours daily.

9. Care provider willing to provide informed consent to participate in the trial and willing to comply with randomization and study protocol.

Exclusion Criteria:

1. A temporary CVC (jugular or femoral) or peripheral catheter.

2. Patients receiving long-term PN, but not due to a primary intestinal disorder (i.e., oncology patients or premature neonates on PN due to intestinal immaturity).

3. Known hypersensitivity, allergy, or reaction to EDTA.

4. Pregnancy or nursing mother.

5. Participation in another investigational device or drug trial within 30 days prior to enrollment (unless approved by the principal investigators of the trial).

6. Severe coagulopathy (platelets <50,000, or INR > 1.5).

7. Diagnosis of immunodeficiency disorder.

8. Unstable medical condition requiring hospital admission

9. Received antibiotic therapy for CLABSI within last 14 days.

Related Conditions & MeSH terms

• Intestinal Failure
• Pediatric Intestinal Failure

Intervention

Device:
• KiteLock 4% Sterile Catheter Lock Solution
KiteLock™ is a clear, colorless, and sterile 4% (40 mg/ml) tetrasodium EDTA solution that contains no preservatives, latex, antibiotics, or ethanol and is nonpyrogenic. Tetrasodium salt of EDTA has been shown to disrupt in vivo and ex vivo-generated biofilms by destabilizing the structural integrity of micro-organisms at the cellular level.
• Heparin Lock Solution
Nonpyrogenic, hypertonic preparation of heparin sodium injection, USP with sodium chloride in water for injection.

Locations

Country	Name	City	State
n/a

Sponsors (1)

Lead Sponsor	Collaborator
SterileCare Inc.

Outcome

Type	Measure	Description	Time frame	Safety issue
Other	Proportion of subjects requiring hospital admission related to catheter complications	Proportion shall be reported for each study arm.	52 weeks
Other	Length of stay for hospitalization related to catheter complications	Length of hospital stay shall be reported in days. Mean shall be reported for each study arm	52 weeks
Primary	Incidence of catheter occlusions	Occlusion is defined as requiring chemical or surgical intervention to restore patency. Occlusion rates will be pooled for each study arm and reported per 1000 catheter days.	52 weeks
Secondary	Incidence of Central Line-Associated Blood Stream Infections (CLABSI)	CLABSI is defined per the Centers for Disease Control-National Healthcare Safety Network (CDC-NSHN) definition. CLABSI rates will be pooled for each study arm and reported per 1000 catheter days.	52 weeks
Secondary	Incidence of breakage, removal, or reinsertion of catheter	Breakage of the catheter line, surgical removal of the line or reinsertion of the line into the vein will be recorded. Event rates will be pooled for each study arm and reported per 1000 catheter days.	52 weeks
Secondary	Incidence of central venous thrombosis	Central venous thrombosis shall be clinically diagnosed by investigators, including the collection of brain imaging. Central Venous Thrombosis rates will be pooled for each study arm and reported per 1000 catheter days.	52 weeks
Secondary	Proportion of subjects with development of Intestinal failure-associated liver disease (IFALD)	IFALD is defined as (cholestasis defined as conjugated bilirubin >2mg/dL, advanced IFALD defined as conjugated bilirubin >6mg/dL) sustained for >2 weeks in absence of sepsis. Proportion shall be reported for each study arm	52 weeks
Secondary	Incidence of lock-related Serious Adverse Events (SAEs)	SAEs are defined per Good Clinical Practice. SAE rates will be pooled for each study arm and reported per 1000 catheter days.	52 weeks