Preterm Erythropoietin Neuroprotection Trial (PENUT Trial)
Completed · Phase 3 · Has a placebo group
Conditions studied: Extreme Prematurity
In brief
Recombinant human erythropoietin (Epo) is a promising novel neuroprotective agent. Epo decreases neuronal programmed cell death resulting from brain injury; it has anti-inflammatory effects, increases neurogenesis, and protects oligodendrocytes from injury. We hypothesize that neonatal Epo treatment of ELGANs will decrease the combined outcome of death or severe NDI from 40% to 30% (primary outcome), or the combined outcome of death plus moderate or severe NDI from 60% to 40% (secondary outcome) measured at 24-26 months corrected age. 1. To determine whether Epo decreases the combined outcome of death or NDI at 24-26 months corrected age. NDI is defined as the presence of any one of the following: CP, Bayley Scales of Infant and Toddler Development, 3rd Edition (Bayley-III) Cognitive Scale \< 70 (severe, 2 SD below mean) or 85 (moderate, 1 SD below mean). CP will be diagnosed and classified by standardized neurologic exam, with severity classified by Gross Motor Function Classification System (GMFCS). 2. To determine whether there are risks to Epo administration in ELGANs by examining, in a blinded manner, Epo-related safety measures comparing infants receiving Epo with those given placebo. 3. To test whether Epo treatment decreases serial measures of circulating inflammatory mediators, and biomarkers of brain injury. 4. To compare brain structure (as measured by MRI) in Epo treatment and control groups at 36 weeks PMA. MRI assessments will include documentation of intraventricular hemorrhage (IVH), white matter injury (WMI) and hydrocephalus (HC), volume of total and deep gray matter, white matter and cerebellum, brain gyrification, and tract-based spatial statistics (TBSS based on diffusion tensor imaging). As an exploratory aim, we will determine which of the above MRI measurements best predict neurodevelopment (CP, cognitive and motor scales) at 24-26 months corrected age. Anticipated outcomes: Early Epo treatment of ELGANs will decrease biochemical and MRI markers of brain injury, will be safe, and will confer improved neurodevelopmental outcome at 24-26 months corrected age compared to placebo, and will provide a much-needed therapy for this group of vulnerable infants.
Key facts
- Study ID
- NCT01378273
- Run by
- University of Washington
- People needed
- 941
- Starts
- 2013-12-01
- Expected to finish
- 2020-02-28
- Last updated by the study team
- 2026-05-19
Who can join
Age: 0 and older, up to 1. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- NICU inpatients between 24-0/7 and 27-6/7 weeks of gestation
- Less than twenty four hours of age
- Parental informed consent
You may not qualify if…
- Major life-threatening anomalies (brain, cardiac, chromosomal anomalies)
- Hematologic crises such as DIC, or hemolysis due to blood group incompatibilities
- Polycythemia (hematocrit > 65)
- Congenital infection
Where it is running
- University of Arkansas — Little Rock, Arkansas, United States
- University of Florida — Gainesville, Florida, United States
- South Miami Hospital — Miami, Florida, United States
- Florida Hospital — Orlando, Florida, United States
- All Childrens Hospital — St. Petersburg, Florida, United States
- Prentice Women's Hospital — Chicago, Illinois, United States
- Children's Hospital of the University of Illinois — Chicago, Illinois, United States
- University of Louisville — Louisville, Kentucky, United States
- Johns Hopkins — Baltimore, Maryland, United States
- Beth Israel Deaconess Hospital — Boston, Massachusetts, United States
- Children's Hospital of Minnesota, MN — Minneapolis, Minnesota, United States
- University of Minnesota Amplatz Children's Hospital — Minneapolis, Minnesota, United States
- Children's Hospital of Minnesota, St. Paul — Saint Paul, Minnesota, United States
- University of New Mexico Children's Hospital — Albuquerque, New Mexico, United States
- Maia Fareri Children's Hospital — Valhalla, New York, United States
- Wake Forest School of Medicine — Winston-Salem, North Carolina, United States
- Methodist Children's Hospital — San Antonio, Texas, United States
- University of Utah — Salt Lake City, Utah, United States
- University of Washington — Seattle, Washington, United States
Full record on ClinicalTrials.gov
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