Phase 3
N=134
Steroids for Pediatric Apnea Research in Kids
Obstructive Sleep Apnea Syndrome
Bottom Line
View on ClinicalTrials.gov: NCT02180672 ↗Enrolled (actual)
134
Serious AEs
0.8%
Results posted
Mar 2021
Primary outcome: Primary: Obstructive Apnea Hypopnea Index — 7.69; 6.33 events per hour
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- Nasal Fluticasone (Drug); Placebo (Drug)
- Age
- Pediatric · 5+ yrs
- Sex
- All
- Sponsor
- Children's Hospital of Philadelphia
- Primary completion
- Dec 2019
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Obstructive Apnea Hypopnea Index |
7.69; 6.33 | — |
| SECONDARY OAHI |
6.11; 6.27 | — |
| SECONDARY Nasal Obstruction Symptom Evaluation (NOSE) |
3.66; 5.31 | — |
| SECONDARY The Epworth Sleepiness Scale |
7.68; 8.56 | — |
| SECONDARY Pediatric Quality of Life Inventory (PedsQL) |
78.69; 73.67 | — |
| SECONDARY Behavior Rating Inventory of Executive Function (BRIEF) |
47.42; 49.5 | — |
| SECONDARY Conners Abbreviated Symptom Questionnaire |
5.62; 6.50 | — |
| SECONDARY Purdue Peg Board |
-1.12; -1.31 | — |
| SECONDARY Conners Continuous Performance Test (CPT) |
52.67; 52.92 | — |
| SECONDARY Child Behavior Checklist |
49.92; 51.94; 51.89; 52; 51.45; 51.19 | — |
Summary
This double-blind, randomized controlled trial will evaluate the use of nasal corticosteroids for the treatment of the childhood obstructive sleep apnea syndrome (OSAS). Efficacy, duration of action and side-effects will be determined.
Eligibility Criteria
Inclusion Criteria
- 5-10 years of age.
- Mild to moderate OSAS, defined as an obstructive apnea index of 1-20/hr of total sleep time or obstructive apnea hypopnea index of 2-30/hr of total sleep time.
- Parent-related symptoms of habitual snoring (>3 nights per week)
- No history of adenotonsillectomy.
- Parental/guardian permission (informed consent) and if appropriate, child assent
Exclusion Criteria
- Severe OSAS or significant hypoxemia or hypercapnia on polysomnography, such that definitive treatment should not be delayed (AHI > 30/hr, more than 2% total sleep time with arterial oxygen saturation (SpO2) 60 mm Hg for > 5 minutes, pathologic arrhythmias).
- History of recurrent throat infections (as defined by the American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guidelines For Tonsillectomy (7)) in the past few years as follows: > 7 episodes in the past year or > 5 episodes/year over the past 2 years or > 3 episodes/year over the past 3 years.
- Abnormalities on baseline safety screening tests, i.e., Dual Energy X-ray Absorptiometry (DXA) scan showing spine or whole body bone mineral density 3) as OSAS is likely to persist in these subjects.
- Previous adenoidectomy unless adenoidal tissue has been documented to have regrown.
- Previous tonsillectomy.
- Continuous positive airway pressure (CPAP) therapy.
- Any NCS use in the past 3 months or NCS use for > 2 weeks in the past year.
- Current immunotherapy or daily antihistamine use.
- Recent (past month) nasal septum ulcers, surgery or trauma.
- Other major illness other than asthma, such as craniofacial anomalies, endocrine or neuromuscular disease, or past history of cancer. This includes children with conditions that may be worsened by OSAS, such as hypertension or diabetes.
- Current use of ketoconazole or other potent CYP3A4 inhibitors.
- Families planning to move out of the area within the year.
- Subjects who do not speak either English or Spanish well enough to complete the validated neurobehavioral instruments.
- Parents/guardians or subjects who, in the opinion of the Investigator, may be non-compliant with study schedules or procedures.
Data sourced from ClinicalTrials.gov (NCT02180672). 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.