Phase 2
N=12
Safety of Clonidine in Infants With Hypoxic Ischemic Encephalopathy During Therapeutic Hypothermia
Encephalopathy, Hypoxic-Ischemic
Bottom Line
View on ClinicalTrials.gov: NCT01862250 ↗Enrolled (actual)
12
Serious AEs
0.0%
Results posted
Jan 2018
Primary outcome: Primary: Steady State Clonidine Blood Levels During Hypothermia — 0.6 ng/ml
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 2
- Interventions
- Clonidine (Duraclon®) (Drug)
- Age
- Pediatric · 0+ yrs
- Sex
- All
- Sponsor
- Johns Hopkins University
- Primary completion
- Apr 2015
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Steady State Clonidine Blood Levels During Hypothermia |
0.6 | — |
| PRIMARY Amount of Morphine Given |
0.02 | — |
| SECONDARY Presence of Shivering After Clonidine |
— | — |
| SECONDARY Time to Passive Rewarming |
8.7 | — |
Summary
This research is being done to find out the safety of the investigational study drug, Clonidine Hydrochloride ( CLON). , in infants who are undergoing whole body cooling for the treatment of hypoxic ischemic encephalopathy (HIE). The only known and effective treatment for HIE is therapeutic hypothermia or whole body cooling for72 hours. During the cooling process, babies get agitated, shiver and are uncomfortable. To treat these side effects morphine is frequently used. CLON is very effective in decreasing shivering in adults and children. Furthermore, in some preclinical studies, clonidine has been shown to be neuroprotective (safe for the brain in models of brain injury)..This is a Phase I-II to determine if low dose CLON will reduce the incidence of shivering and whether it has short term cardiovascular safety. In this Phase I-II study, the investigators will determine the (i) the maximum tolerated dose of CLON during cooling for HIE, (ii) the effects of CLON on heart rate, blood pressure, core body temperature and cerebral autoregulation (ability to maintain constant blood flow to the brain) and (iii) association between blood levels and changes in the above parameters. In this study the investigators hope to find ways to improve sedation, shivering and agitation in newborn infants with HIE on the cooling protocol. Our ultimate goal is determine the potential neuro-protective properties of clonidine in newborn babies with HIE.
Eligibility Criteria
Inclusion Criteria
- Infants ≥35 0/7 weeks gestation with the diagnosis of HIE who are being treated with therapeutic hypothermia, who have indwelling arterial lines
- Informed parental consent
Exclusion Criteria
- Infants who are considered moribund and the clinical team is considering withdrawal of support
- Infants who need > 20 µg/kg/min of dopamine or the addition of epinephrine or dobutamine to maintain a mean arterial pressure (MAP) ≥ 45 mmHg, or milrinone for cardiovascular support
- Baseline heart rate (HR) <80 bpm during hypothermia
- Infants suspected of major chromosomal anomalies, except trisomy 21
- Infants with major cardiovascular anomalies
- Infants with severe persistent pulmonary hypertension of the newborn who are enrolled and who then need Extracorporal Membrane Oxygenation (ECMO) will be withdrawn from the study
Data sourced from ClinicalTrials.gov (NCT01862250). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.