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Trial registered on ANZCTR
Registration number
ACTRN12613000481774
Ethics application status
Approved
Date submitted
3/04/2013
Date registered
30/04/2013
Date last updated
30/04/2013
Type of registration
Prospectively registered
Titles & IDs
Public title
Improvement of feeding tolerance by using a new formula in preterm neonates
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Scientific title
Effects of a new hydrolyzed powdered formula on feeding tolerance in preterm neonates: a randomized placebo-controlled study
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Secondary ID [1]
282146
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Nil
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Universal Trial Number (UTN)
Nil
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Trial acronym
HPFN (Hydrolyzed Powdered Formula in Neonates)
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Feeding tollerance in very low birth weight neonates
288648
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Condition category
Condition code
Diet and Nutrition
288989
288989
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0
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Other diet and nutrition disorders
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Reproductive Health and Childbirth
289107
289107
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0
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Childbirth and postnatal care
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Neonates in group 1 receive a new powdered hydrolyzed formula. Formula will be oral liquid administered, divided in 8 feed/day, by enteral route, for the first 4 weeks of life. Daily volume will be adjusted on body weight (150 ml/Kg/day).
Macronutrients formula composition is reported below per 100 ml of product:
whey protein 3.1 (g), lactose 4.6 (g), maltodextrins 4.2 (g), medium chain triglicerides 0.6 (g), linoleic acid 710 (mg), linolenic acid 80 (mg), arachidonic acid 18 (mg), docosahexaenoic acid 18 (mg).
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Intervention code [1]
286753
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Treatment: Other
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Comparator / control treatment
Neonates in group 2 receive a standard formula. Formula will be oral liquid administered, divided in 8 feed/day, by enteral route, for the first 4 weeks of life. Daily volume will be adjusted on body weight (150 ml/Kg/day).
Composition of this formula is reported below per 100 ml of product:
whey protein 3.1 (g), lactose 5 (g), maltodextrins 2.8 (g), medium chain triglicerides 0.6 (g), linoleic acid 603 (mg), linolenic acid 85 (mg), arachidonic acid 17.5 (mg), docosahexaenoic acid 17.5 (mg).
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Control group
Active
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Outcomes
Primary outcome [1]
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Time to reach full enteral feeding (120 Kcal/Kg/day)
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Assessment method [1]
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Timepoint [1]
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1 week of life (rate of neonates reaching full enteral feeding within 7 day of life)
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Secondary outcome [1]
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Duration of hospital stay
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Assessment method [1]
301820
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Timepoint [1]
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40 weeks of postconceptional age (rate of neonates discharged within 40 weeks of postconceptional age)
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Eligibility
Key inclusion criteria
Newborns with birth weight <1500 g consecutively observed in Neonatal Intensive Care Unit
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Minimum age
0
Days
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Maximum age
20
Days
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Congenital or maternal infections, immunodeficiency, malformations, syndrome, genetic defects, evidence of infections and NEC before enrolment, critically ill condition (blood pH < 6.8, or hypoxia with persistent bradycardia for at least 1 hour), and hospitalization less than 2 weeks
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
All neonates observed in NICU with a body birth weight < 1500 g will be considered eligible for the study. Enrolled subject will be randomly allocated to group 1 (hydrolyzed powdered formula) or group 2 (standard formula for preterm). The two powdered formula will be provided in identical boxes without indication of group identity or content. Each box will be labeled with a unique serial number according to the randomization list, which was not available to the investigators until the data had been obtained,entered in the database and analyzed by a blinded statistician. After randomization, nurses, blinded to the study aims, gave the assigned preparation as liquid formula after specific dilution
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computer generated randomization list
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
The Kolmogorov-Smirnov test will be used to determine if variables are normally distributed. For continuous variables, groups will be compared using the test of equality of means, the Mann-Whitney test and Kruskal-Wallis test. The chi-square test and Fisher’s exact test will be used for categorical variables. For two related dichotomous variables, the McNemar test will be used to detect differences between study groups. We will perform a multivariate analysis (binary logistic regression) to evaluate whether PDA closure would be influenced by GA, modality of delivery, multiple birth, BW, sex, Apgar score at 5 minutes, or by study group assignment. The level of significance for all statistical tests is 2-sided, p<0.05. Statistical analysis will be performed, per intention-to-treat, by a statistician blinded to patient group assignment with SPSS Version 18.0 for Windows (SPSS Inc., Chicago, IL).
To demonstrate a reduction in the time to reach full enteral feeding of 5 d (15 +/- 5 d vs. 10 +/- d) in subjects receiving hydrolyzed formula with 97% power and type 1 error = 0.05 (2-tailed test), a minimum sample size of 30 patients for each group was required.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
3/06/2013
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
4944
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Italy
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State/province [1]
4944
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Rome
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Funding & Sponsors
Funding source category [1]
286913
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University
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Name [1]
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University of rome "La Sapienza"
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Address [1]
286913
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Piazzale Aldo Moro, 5 00185 Roma
06 49911
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Country [1]
286913
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Italy
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Primary sponsor type
University
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Name
University of Rome "La Sapienza"
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Address
Piazzale Aldo Moro, 5 00185 Roma
06 49911
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Country
Italy
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Secondary sponsor category [1]
285700
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University
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Name [1]
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Department of Translational Medicine, University Federico II of Naples
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Address [1]
285700
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via Pansini 5, 80131, Naples, Italy
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Country [1]
285700
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Italy
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Ethics approval
Ethics application status
Approved
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Summary
Brief summary
The use of total parenteral nutrition is necessary to ensure the survival of very low birth weight (VLBW) infant in the first weeks of life, given (due) to the intestinal immaturity and to the lack of formulas able to adequately meet nutritional needs using the enteral route. The formulas for preterm infants, although characterized by a high intake of calories and protein, help meet the nutritional needs when administered at high volumes. However, delayed gastric emptying, typical of the first weeks of life of the preterm infant, limits the use of enteral nutrition as the sole source of energy and protein. On the other hand, prolonged use of parenteral nutrition is associated with an increased risk of infectious complications, metabolic and liver. Several studies show that the hydrolyzed formulas promote gastric emptying and provide better tolerance of enteral nutrition in adults and children. In the preterm infant, however, the use of this type of formulas is limited by poor nutritional value of the products currently available on the market. Therefore, the use of a hydrolyzate formula high in energy and protein, may improve tolerance while respecting nutritional needs.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Gianluca Terrin
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Address
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Dipartimento Scienze Ginecologiche-Ostetriche e Scienze Urologiche Universita di Roma La Sapienza viale Regina Elena 285 00198, Rome, Italy
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Country
38578
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Italy
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Phone
38578
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+39 3339191207
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Gianluca Terrin
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Address
38579
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Dipartimento Scienze Ginecologiche-Ostetriche e Scienze Urologiche Universita di Roma La Sapienza viale Regina Elena 285 00198, Rome, Italy
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Country
38579
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Italy
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Phone
38579
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+39 3339191207
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Fax
38579
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Email
38579
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[email protected]
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Contact person for scientific queries
Name
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Gianluca Terrin
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Address
38580
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Dipartimento Scienze Ginecologiche-Ostetriche e Scienze Urologiche Universita di Roma La Sapienza viale Regina Elena 285 00198, Rome, Italy
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Country
38580
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Italy
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Phone
38580
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+39 3339191207
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Fax
38580
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Email
38580
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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