NCT06114836

Brief Summary

The goal of this investigator-initiated, single-center, randomized controlled trial (RCT) is to compare the effects of four weeks of three therapies on clinical and mechanistic outcomes based on pH-Imp testing using a three-arm parallel design in NICU infants with objective GERD diagnosis. The three therapies being compared are natural maturation, proton pump inhibitor (PPI) use, and added rice (AR) formula use. The main goals are:

  • to evaluate and compare the efficacy of the three commonly used treatment interventions used in the NICU for GERD in a randomized controlled manner with the primary endpoint of oral feeding success and absence of troublesome symptoms (as defined below).
  • to characterize the mechanisms of primary end point (success or failure) using pH-Impedance metrics.

Trial Health

77
On Track

Trial Health Score

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

Enrollment
369

participants targeted

Target at P75+ for not_applicable

Timeline
30mo left

Started Mar 2024

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
recruiting

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

Trial Relationships

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Study Timeline

Key milestones and dates

Study Progress46%
Mar 2024Nov 2028

First Submitted

Initial submission to the registry

October 26, 2023

Completed
7 days until next milestone

First Posted

Study publicly available on registry

November 2, 2023

Completed
4 months until next milestone

Study Start

First participant enrolled

March 14, 2024

Completed
4.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 1, 2028

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

November 1, 2028

Last Updated

May 5, 2026

Status Verified

April 1, 2026

Enrollment Period

4.6 years

First QC Date

October 26, 2023

Last Update Submit

April 29, 2026

Conditions

Keywords

Proton Pump InhibitorpH Impedanceadded rice formula

Outcome Measures

Primary Outcomes (5)

  • Achievement of primary outcome: Improvement or maintenance of oral feeding and/or absence of GERD symptoms (based on feeding method at inception)

    Achievement of the primary outcome will be measured by treatment group to determine efficacy. For subjects on full oral feeds at inception, the primary outcome will be met if there is maintenance of oral feeds AND absence of associated GERD symptoms. For subjects receiving any tube feeding at inception, the primary outcome will be met if there is improvement in oral feeding (ratio of oral to tube feeds) OR absence of troublesome symptoms. The metric for measuring the absence of troublesome symptoms will be vomiting \<2 times/day or coughing \<18 times/day.

    At 4 weeks of therapy or discharge, whichever occurs first

  • Decrease in ARI on treatment

    Change in acid reflux index from time one pH impedance study (prior to treatment) to time 2 pH impedance study (during treatment) will be compared among treatment groups.

    At time 2 study (4 weeks or prior to discharge, whichever is earliest)

  • Decreased frequency of GER events on treatment

    Change in number of reflux events from time one pH impedance study (prior to treatment) to time 2 pH impedance study (during treatment) will be compared among treatment groups.

    At time 2 study (4 weeks or prior to discharge, whichever is earliest)

  • Improvement (Increase) in distal baseline impedance on treatment

    Change in distal baseline impedance from time one pH impedance study (prior to treatment) to time 2 pH impedance study (during treatment) will be compared among treatment groups.

    At time 2 study (4 weeks or prior to discharge, whichever is earliest)

  • Decrease in symptom associated probability on treatment

    Change in symptom associated probability from time one pH impedance study (prior to treatment) to time 2 pH impedance study (during treatment) will be compared among treatment groups.

    At time 2 study (4 weeks or prior to discharge, whichever is earliest)

Study Arms (3)

Natural maturation

NO INTERVENTION

Allows for time for infant maturation without treatment.

Proton Pump Inhibitor (PPI)

ACTIVE COMPARATOR

Omeprazole will be prescribed for 4 weeks using the dose of 1.5mg/kg/dose daily.

Drug: Omeprazole

Added Rice (AR) Formula

ACTIVE COMPARATOR

Added rice formula will be ordered as the infant diet for the 4-week treatment period.

Other: AR formula

Interventions

Omeprazole will be the PPI prescribed for 4 weeks.

Also known as: PPI
Proton Pump Inhibitor (PPI)

Added rice formula will be ordered for 4 weeks.

Added Rice (AR) Formula

Eligibility Criteria

Age1 Day - 8 Months
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17)

You may qualify if:

  • NICU infants of any gestational age who are between 37 - 47 weeks postmenstrual age at inception of the study meeting the following requirements:
  • GERD diagnosis using pH-impedance criteria (Acid Reflux Index ≥ 3% plus at least one of the following: # GER events \>70 / day, Symptom Associated Probability ≥ 95%, Discal Baseline Impedance \< 900 Ω)
  • Full enteral feeds
  • No current GERD therapies

You may not qualify if:

  • Known lethal chromosomal abnormalities or complex congenital syndromes
  • Severe neurologic pathologies requiring neuroactive medications or neurosurgery
  • Positive airway pressure or oxygen flow \> 4 LPM
  • Upper gastrointestinal malformations requiring surgery

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Nationwide Children's Hospita

Columbus, Ohio, 43215, United States

RECRUITING

MeSH Terms

Interventions

Omeprazole

Intervention Hierarchy (Ancestors)

2-PyridinylmethylsulfinylbenzimidazolesSulfoxidesSulfur CompoundsOrganic ChemicalsPyridinesHeterocyclic Compounds, 1-RingHeterocyclic CompoundsBenzimidazolesHeterocyclic Compounds, 2-RingHeterocyclic Compounds, Fused-Ring

Study Officials

  • Sudarshan R sudarshan.jadcherla@nationwidechildrens.org

    Nationwide Children's Hospital

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Infants will be randomized to one of three arms: Natural maturation, Proton Pump Inhibitor (PPI) treatment, or Added rice (AR) formula. Subjects will be stratified and allocated 1:1:1 based on tube feeds (yes or no) and ARI (3-7% or \>7%).
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Principal Investigator, Innovative Feeding Disorders Research Program

Study Record Dates

First Submitted

October 26, 2023

First Posted

November 2, 2023

Study Start

March 14, 2024

Primary Completion (Estimated)

November 1, 2028

Study Completion (Estimated)

November 1, 2028

Last Updated

May 5, 2026

Record last verified: 2026-04

Data Sharing

IPD Sharing
Will not share

Will revisit at a later date

Locations