NCT02545712

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

50
Monitor

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
630

participants targeted

Target at P75+ for all trials

Status
unknown

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

September 3, 2015

Completed
7 days until next milestone

First Posted

Study publicly available on registry

September 10, 2015

Completed
4 months until next milestone

Study Start

First participant enrolled

January 1, 2016

Completed
1.2 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 1, 2017

Completed
Last Updated

February 7, 2017

Status Verified

February 1, 2017

Enrollment Period

1.2 years

First QC Date

September 3, 2015

Last Update Submit

February 4, 2017

Conditions

Keywords

EthanolPropylene glycolBenzyl alcoholAcesulfam potassiumAspartameGlycerinSorbitolMethyl-p-hydroxybenzoatePropanyl-p-hydroxybenzoatePatients

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.

Other: Exposure to ethanolOther: Exposure to propylene glycolOther: Exposure to benzyl alcoholOther: Exposure to acesulfam potassiumOther: Exposure to aspartameOther: Exposure to glycerolOther: Exposure to sorbitolOther: Exposure to methyl-p-hydroxybenzoateOther: Exposure to propanyl-p-hydroxybenzoateOther: Exposure to polysorbate-80

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.

Other: Exposure to ethanolOther: Exposure to propylene glycolOther: Exposure to benzyl alcoholOther: Exposure to acesulfam potassiumOther: Exposure to aspartameOther: Exposure to glycerolOther: Exposure to sorbitolOther: Exposure to methyl-p-hydroxybenzoateOther: Exposure to propanyl-p-hydroxybenzoateOther: Exposure to polysorbate-80

Interventions

The drug source(s) and amount administered daily are noted.

Also known as: Ethyl achohol
Neonatal patientsPediatric patients (28 days ≤ 5 years)

The drug source(s) and amount administered daily are noted.

Neonatal patientsPediatric patients (28 days ≤ 5 years)

The drug source(s) and amount administered daily are noted.

Neonatal patientsPediatric patients (28 days ≤ 5 years)

The drug source(s) and amount administered daily are noted.

Also known as: Acesulfame-K
Neonatal patientsPediatric patients (28 days ≤ 5 years)

The drug source(s) and amount administered daily are noted.

Neonatal patientsPediatric patients (28 days ≤ 5 years)

The drug source(s) and amount administered daily are noted.

Also known as: Glycerol
Neonatal patientsPediatric patients (28 days ≤ 5 years)

The drug source(s) and amount administered daily are noted.

Neonatal patientsPediatric patients (28 days ≤ 5 years)

The drug source(s) and amount administered daily are noted.

Also known as: including sodium-methyl-p-hydroxybenzoate
Neonatal patientsPediatric patients (28 days ≤ 5 years)

The drug source(s) and amount administered daily are noted.

Also known as: including sodium-propanyl-p-hydroxybenzoate
Neonatal patientsPediatric patients (28 days ≤ 5 years)

The drug source(s) and amount administered daily are noted.

Neonatal patientsPediatric patients (28 days ≤ 5 years)

Eligibility Criteria

AgeUp to 5 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)
Sampling MethodNon-Probability Sample
Study Population

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

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: 25854872BACKGROUND
  • Souza 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: 24500397BACKGROUND
  • Marek 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: 25379066BACKGROUND
  • Nguyen 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: 21410525BACKGROUND
  • Jacqz-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: 21269785BACKGROUND
  • Allegaert 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: 25254168BACKGROUND
  • Bellis 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: 24229060BACKGROUND
  • Nahata 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: 19846397BACKGROUND
  • Whittaker 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: 19158148BACKGROUND
  • Saiyed 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: 25766066BACKGROUND
  • Collison 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: 22697049BACKGROUND
  • Ornoy 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: 20616979BACKGROUND
  • Lass 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: 21667125BACKGROUND
  • Fister 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: 25316561BACKGROUND
  • Valeur 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.

Related Links

MeSH Terms

Interventions

EthanolacetosulfameGlycerol

Intervention Hierarchy (Ancestors)

AlcoholsOrganic ChemicalsTriose Sugar AlcoholsSugar AlcoholsCarbohydrates

Study Officials

  • Kristine Svinning Valeur, MS

    University Hospital Bispebjerg and Frederiksberg

    PRINCIPAL INVESTIGATOR

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