E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Acute cardiorespiratory deterioration in preterm neonates 6-12 hours after open arterial duct ligation that is called post ligation cardiac syndrome (PLCS). |
Kardio-respiratoorse seisundi halvenemine enneaegsetel vastsündinutel 6-12 tundi peale avatud arterioosjuha ligeerimist mida nimetatakse post ligation cardiac syndrome (PLCS). |
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E.1.1.1 | Medical condition in easily understood language |
Deterioration of heart and lung function in preterm neonates 6-12 hours after open arterial duct operation. |
Südame-vereringesüsteemi ja hingamissüsteemi seisundi halvenemine enneaegsetel vastsündinutel 6-12 tundi peale avatud arterioosjuha operatsiooni. |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cardiovascular Diseases [C14] |
MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To describe the pharmacokinetics and pharmacodynamics of milrinone in premature neonates after patent arterial duct surgical ligation. |
Kirjeldada milrinooni farmakokineetikat ja farmakodünaamikat enneaegsetel vastsündinutel peale avatud arterioosjuha kirurgilist sulgemist. |
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E.2.2 | Secondary objectives of the trial |
To assess the safety profile of milrinone in preterm neonates, treated for post ligation cardiac syndrome. |
Hinnata milrinooni ohutust enneaegsetel vastsündinutel, keda ravitakse peale arterioosjuha ligeerimist tekkiva südamepuudulikkuse tõttu. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1) Neonates and infants up to 90 days of age 2) Haemodynamically significant PDA requiring surgical ligation 3) Arterial catheter and/or central venous catheter in place on clinical indication 4) Informed consent given by the parents or guardians |
1) Vastsündinud ja imikud kuni 90 päeva vanuseni 2) Hemodünaamiliselt oluline avatud arterioosjuha, mille kirurgiline sulgemine on näidustatud 3) Arteri- ja/või tsentraalvenoosse kanüül on paigaldatud kliinilistel näidustustel 4) Vanemate või seadusliku esindaja kirjalik teavitatud nõusolek uuringus osalemiseks
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E.4 | Principal exclusion criteria |
1) Renal failure requiring renal replacement therapy (peritoneal dialysis) or serum creatinine >100 μmol/l or oliguria <0.5 ml/kg/min within 6 hours 2) Hypersensitivity to milrinone or any other component of the study drug 3) Situation where the treating physician considers milrinone to be contraindicated 4) Major congenital malformation 5) Known metabolic disease 6) Informed consent from parents or guardians not obtained 7) Critically unstable state of the patient, likely fatal within 72 hours 8) The patient is already recruited in another clinical trial investigating a medical product |
1) Neerupuudulikkus: neeruasendusravi (peritoneaaldialüüsi) vajadus või seerumi kreatiniin >100 μmol/l või oliguuria <0.5 ml/kg/min kuue tunni jooksul 2) Ülitundlikkus milrinooni või mõne muu uuringuravimis sisalduva komponendi suhtes 3) Olukord, kui raviarsti arvates on milrinooni manustamine vastunäidustatud 4) Kaasasündinud väärareng, mis oluliselt mõjutab oodatava eluea pikkust 5) Teadaolev ainevahetushaigus 6) Puudub vanemate või seadusliku esindaja teavitatud nõusolek uuringus osalemiseks 7) Üliraske seisund, mis suure tõenäosusega viib surmlõppele 72 tunni jooksul 8) Osalemine teises ravimuuringus
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E.5 End points |
E.5.1 | Primary end point(s) |
The pharmacokinetics of milrinone in neonates and infants up to 90 days of age, treated for post ligation cardiac syndrome..
Adverse events experienced by neonates receiving milrinone.
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Milrinooni farmakokineetika vastsündinutel ja imikutel kuni 90 päeva vanuseni, keda ravitakse peale arterioosjuha ligeerimist tekkiva südamepuudulikkuse tõttu.
Milrinooni ebasoodsad toimed vastsündinutel. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Pharmacokinetic parameters are evaluated during the 24 hour treatment period and 12 hours after the end of treatment with IMP.
Adverse events are recorded until 7 days after the end of treatment with IMP. |
Milrinooni farmakokineetikat hinnatakse 24 tunnise raviperioodi jooksul ja 12 tundi peale ravi lõpetamist milrinooniga.
Ebasoodsaid toimeid registreeritakse kuni 7 päeva peale ravi lõpetamist. |
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E.5.2 | Secondary end point(s) |
Pharmacodynamics of milrinone, including effects on blood pressure, heart rate and percutaneous oxygen saturation; central haemodynamics (LVO, RVO, ejection fraction, myocardial shortening fraction and tissue Doppler velocities) assessed by heart ultrasonography, regional cerebral perfusion (rScO2, cFTOE), assessed by NIRS and microcirculation, assessed by SDF imaging in neonates undergoing PDA ligation with and without milrinone treatment.
Clinical and biochemical measures of systemic hypoperfusion, including blood gases, lactate; diuresis.
Clinical outcome at FU visit – survival, duration of respiratory and vasoactive support.
Neurological evaluation as assessed by cerebral ultrasound (and if persistently abnormal, by MRI or CT) at any time up until the FU visit;
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Milrinooni faramakodünaamika: toime vererõhule, südamesagedusele, hapnikusaturatsioonile, tsentraalse hemodünaamika parameetritele (hinnatakse südame ultraheliuuringul), aju regionaalsele verevoolule(hinnatakse NIRS monitooringuga) ja naha mikrotsirkulatsioonile (hinnatakse videokapillaroskoopial).
Süsteemse hüpoperfusiooni kliinilised ja biokeemilised tunnused - veregaasid, laktaat, diurees.
Kliiniline tulem FU visiidil - elulemus, hingamis- ja vereringetoetuse kestus.
Neuroloogiline hindamine aju ultraheliuuringul, vajadusel CT või MRT uuringul FU visiidil.
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
The pharmacodynamic effect of milrinone is evaluated during 24 hour treatment period, haemodynamic parameters are recorded continuously or 3 and 24 hours after the start of treatment (heart ultrasonography and videocapillaroscopy).
Clinical and biochemical measures of hypoperfusion are taken every 6 hours during the treatment period.
FU visit is 7 days after the end of treatment with IMP. |
Milrinooni farmakodünaamilist toimet hinnatakse 24 tunnise raviperioodi jooksul, hemodünaamika parameetrid salvestatakse pidevalt või 3 ja 24 tundi peale ravi alustamist (südame ultraheliuuring ja videokapillaroskoopia).
Hüpoperfusiooni kliinilisi ja biokeemilisi tunnuseid hinnatakse ravi ajal iga 6 tunni järel.
FU visiit on 7 päeva peale ravi lõpetamist milrinooniga. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 2 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | No |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 8 |
E.8.9.1 | In the Member State concerned days | |