Safe Excipient Exposure in Neonates and Small ChildreN
SEEN
1 other identifier
observational
630
0 countries
N/A
Brief Summary
The purpose of this study is to explore the quantity of excipient exposure in neonatal and young pediatric patients in a Danish Hospital. The focus will be on the preservatives ethanol, propyl glycol, benzyl alcohol, methyl-p-hydroxybenzoate and propanyl-p-hydroxybenzoate and the artificial sweeteners acesulfam potassium, aspartame, glycerol and sorbitol.
Trial Health
Trial Health Score
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participants targeted
Target at P75+ for all trials
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Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
September 3, 2015
CompletedFirst Posted
Study publicly available on registry
September 10, 2015
CompletedStudy Start
First participant enrolled
January 1, 2016
CompletedPrimary Completion
Last participant's last visit for primary outcome
April 1, 2017
CompletedFebruary 7, 2017
February 1, 2017
1.2 years
September 3, 2015
February 4, 2017
Conditions
Keywords
Outcome Measures
Primary Outcomes (9)
Blood alcohol content measured in per mille (grams of ethanol and propylene glycol pr. kilograms of blood) in the patient
Both concentrations of ethanol and propylene glycol are included in the calculations. with propylene glycol 1/3 as intoxicating as ethanol.
Single day
Concentration (mg/kg/day) of benzyl alcohol in the patient
Single day
Concentration (mg/kg/day) of acesulfam potassium in the patient
Single day
Concentration (mg/kg/day) of aspartame in the patient
Single day
Concentration (mg/kg/day) of glycerin in the patient
Single day
Concentration (mg/kg/day) of sorbitol in the patient
Single day
Concentration (mg/l) of methyl-p-hydroxybenzoate in the patient
Single day
Concentration (mg/kg/day) of propyl-p-hydroxybenzoate in the patient
Single day
Concentration (mg/kg/day) of polysorbate-80 in the patient
Single day
Secondary Outcomes (16)
Identification of patient group (according to age-interval) most vulnerable to excipient exposure (measured in number of excipients)
During the participants hospitalization, an expected average of 2 months
Identification of patient group (according to age-interval) most vulnerable to excipient exposure (amounts of each excipient measured in (mg/l))
During the participants hospitalization, an expected average of 2 months
Identification of patient group (according to affected organ system) most vulnerable to excipient exposure (measured in number of excipients)
During the participants hospitalization, an expected average of 2 months
Identification of patient group (according to affected organ system) most vulnerable to excipient exposure (amounts of each excipient measured in (mg/l))
During the participants hospitalization, an expected average of 2 months
Identification of number of patient exposed to ethanol levels above tolerance levels proposed by international medicines agencies like EMA and FDA
Single day
- +11 more secondary outcomes
Study Arms (2)
Neonatal patients
Receiving 2 or more drugs at one day during their hospitalisation. For each drug, it is listed whether it is an extemporaneous, registered, the preparation, dosis, amount, interval, formulation and route of administration. It is noted if the drug contains ethanol, propylene glycol, benzyl alcohol, methyl-p-hydroxybenzoate, propanyl-p-hydroxybenzoate, acesulfam potassium, aspartame, glycerin and/or sorbitol.
Pediatric patients (28 days ≤ 5 years)
Receiving 3 or more drugs at one day during their hospitalisation. For each drug, it is listed whether it is an extemporaneous, registered, the preparation, dosis, amount, interval, formulation and route of administration. It is noted if the drug contains ethanol, propylene glycol, benzyl alcohol, methyl-p-hydroxybenzoate, propanyl-p-hydroxybenzoate, acesulfam potassium, aspartame, glycerin and/or sorbitol.
Interventions
The drug source(s) and amount administered daily are noted.
The drug source(s) and amount administered daily are noted.
The drug source(s) and amount administered daily are noted.
The drug source(s) and amount administered daily are noted.
The drug source(s) and amount administered daily are noted.
The drug source(s) and amount administered daily are noted.
The drug source(s) and amount administered daily are noted.
The drug source(s) and amount administered daily are noted.
The drug source(s) and amount administered daily are noted.
The drug source(s) and amount administered daily are noted.
Eligibility Criteria
Neonatal patients and pediatric patients (≤ 5 years) who, at one point, have been/are being treated at the "Neonatalklinikken" (units 5021, 5023, 5024) or "BørneUngeklinikken" (units 5061, 5062, 5054, 4144) of Rigshospitalet, Denmark. To be included in the study, the patients must receive * 2 or more different drugs if \< 28 days old * 3 or more different drugs if 28 day ≤ 5 years old
You may qualify if:
- if \< 28 days: must receive 2 or more prescriptions a day
- if 28 days ≤ 5 years: must receive 3 or more prescriptions a day
- must have been/be submitted and treated at the neonatal department (units 5021, 5023, 5024) or pediatric department (units 5061, 5062, 5054, 4144) of Rigshospitalet
You may not qualify if:
- no up-dated weight is listed
- \> 5 years old
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Bispebjerg Hospitallead
- Rigshospitalet, Denmarkcollaborator
Related Publications (15)
Nellis G, Metsvaht T, Varendi H, Toompere K, Lass J, Mesek I, Nunn AJ, Turner MA, Lutsar I; ESNEE consortium. Potentially harmful excipients in neonatal medicines: a pan-European observational study. Arch Dis Child. 2015 Jul;100(7):694-9. doi: 10.1136/archdischild-2014-307793. Epub 2015 Apr 8.
PMID: 25854872BACKGROUNDSouza A Jr, Santos D, Fonseca S, Medeiros M, Batista L, Turner M, Coelho H. Toxic excipients in medications for neonates in Brazil. Eur J Pediatr. 2014 Jul;173(7):935-45. doi: 10.1007/s00431-014-2272-z. Epub 2014 Feb 6.
PMID: 24500397BACKGROUNDMarek E, Kraft WK. Ethanol pharmacokinetics in neonates and infants. Curr Ther Res Clin Exp. 2014 Oct 22;76:90-7. doi: 10.1016/j.curtheres.2014.09.002. eCollection 2014 Dec.
PMID: 25379066BACKGROUNDNguyen KA, Claris O, Kassai B. Unlicensed and off-label drug use in a neonatal unit in France. Acta Paediatr. 2011 Apr;100(4):615-7. doi: 10.1111/j.1651-2227.2010.02103.x. Epub 2010 Dec 17. No abstract available.
PMID: 21410525BACKGROUNDJacqz-Aigrain E. Drug policy in Europe Research and funding in neonates: current challenges, future perspectives, new opportunities. Early Hum Dev. 2011 Mar;87 Suppl 1:S27-30. doi: 10.1016/j.earlhumdev.2011.01.007. Epub 2011 Jan 26.
PMID: 21269785BACKGROUNDAllegaert K. Neonates need tailored drug formulations. World J Clin Pediatr. 2013 Feb 8;2(1):1-5. doi: 10.5409/wjcp.v2.i1.1. eCollection 2013 Feb 8.
PMID: 25254168BACKGROUNDBellis JR, Kirkham JJ, Thiesen S, Conroy EJ, Bracken LE, Mannix HL, Bird KA, Duncan JC, Peak M, Turner MA, Smyth RL, Nunn AJ, Pirmohamed M. Adverse drug reactions and off-label and unlicensed medicines in children: a nested case-control study of inpatients in a pediatric hospital. BMC Med. 2013 Nov 7;11:238. doi: 10.1186/1741-7015-11-238.
PMID: 24229060BACKGROUNDNahata MC. Safety of "inert" additives or excipients in paediatric medicines. Arch Dis Child Fetal Neonatal Ed. 2009 Nov;94(6):F392-3. doi: 10.1136/adc.2009.160192. No abstract available.
PMID: 19846397BACKGROUNDWhittaker A, Currie AE, Turner MA, Field DJ, Mulla H, Pandya HC. Toxic additives in medication for preterm infants. Arch Dis Child Fetal Neonatal Ed. 2009 Jul;94(4):F236-40. doi: 10.1136/adc.2008.146035. Epub 2009 Jan 21.
PMID: 19158148BACKGROUNDSaiyed MM, Lalwani T, Rana D. Is off-label use a risk factor for adverse drug reactions in pediatric patients? A prospective study in an Indian tertiary care hospital. Int J Risk Saf Med. 2015;27(1):45-53. doi: 10.3233/JRS-150642.
PMID: 25766066BACKGROUNDCollison KS, Makhoul NJ, Zaidi MZ, Al-Rabiah R, Inglis A, Andres BL, Ubungen R, Shoukri M, Al-Mohanna FA. Interactive effects of neonatal exposure to monosodium glutamate and aspartame on glucose homeostasis. Nutr Metab (Lond). 2012 Jun 14;9(1):58. doi: 10.1186/1743-7075-9-58.
PMID: 22697049BACKGROUNDOrnoy A, Ergaz Z. Alcohol abuse in pregnant women: effects on the fetus and newborn, mode of action and maternal treatment. Int J Environ Res Public Health. 2010 Feb;7(2):364-79. doi: 10.3390/ijerph7020364. Epub 2010 Jan 27.
PMID: 20616979BACKGROUNDLass J, Kaar R, Jogi K, Varendi H, Metsvaht T, Lutsar I. Drug utilisation pattern and off-label use of medicines in Estonian neonatal units. Eur J Clin Pharmacol. 2011 Dec;67(12):1263-71. doi: 10.1007/s00228-011-1072-x. Epub 2011 Jun 11.
PMID: 21667125BACKGROUNDFister P, Urh S, Karner A, Krzan M, Paro-Panjan D. The prevalence and pattern of pharmaceutical and excipient exposure in a neonatal unit in Slovenia. J Matern Fetal Neonatal Med. 2015;28(17):2053-61. doi: 10.3109/14767058.2014.976549. Epub 2015 Sep 4.
PMID: 25316561BACKGROUNDValeur KS, Hertel SA, Lundstrom KE, Holst H. Safe excipient exposure in neonates and small children - protocol for the SEEN project. Dan Med J. 2017 Feb;64(2):A5324.
PMID: 28157063DERIVED
Related Links
MeSH Terms
Interventions
Intervention Hierarchy (Ancestors)
Study Officials
- PRINCIPAL INVESTIGATOR
Kristine Svinning Valeur, MS
University Hospital Bispebjerg and Frederiksberg
Study Design
- Study Type
- observational
- Observational Model
- CASE CONTROL
- Time Perspective
- RETROSPECTIVE
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- MS
Study Record Dates
First Submitted
September 3, 2015
First Posted
September 10, 2015
Study Start
January 1, 2016
Primary Completion
April 1, 2017
Last Updated
February 7, 2017
Record last verified: 2017-02