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Sponsored by: |
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) |
Information provided by: | National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) |
ClinicalTrials.gov Identifier: | NCT00294684 |
The Biliary Atresia Research Consortium (BARC) is conducting a clinical trial to evaluate whether long-term treatment with corticosteroids improves the outcome of the Kasai or gall-bladder Kasai in infants with biliary atresia. BARC is a clinical network of 10 clinical sites supported by the National Institutes of Health whose goal is to improve the treatment of biliary atresia and other cholestatic diseases in children. In this clinical trial BARC is testing whether corticosteroid therapy following the Kasai will improve bile drainage and long term outcome in infants with biliary atresia. Subjects in this trial must start treatment within 72 hours of the Kasai procedure and be part of a prospective study of the natural history of biliary atresia also being conducted by BARC (http://www.clinicaltrials.gov/ct/show/NCT00061828?order=3).
Condition | Intervention |
Biliary Atresia |
Drug: Corticosteroids Drug: Placebo |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator), Placebo Control, Parallel Assignment, Safety/Efficacy Study |
Official Title: | A Randomized, Double-Blinded, Placebo-Controlled Trial of Corticosteroid Therapy Following Portoenterostomy in Infants With Biliary Atresia |
Estimated Enrollment: | 140 |
Study Start Date: | November 2005 |
Estimated Study Completion Date: | June 2012 |
Estimated Primary Completion Date: | June 2012 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
1: Active Comparator |
Drug: Corticosteroids
Schedule and dosing of corticosteroids following portoenterostomy in infants with biliary atresia are listed below. Days 1-3: Methylprednisolone, IV-4mg/kg/day, divided BID Days 4-7: Prednisolone, PO-4mg/kg/day, divided BID Week 2: 4 mg/kg/day, divided BID Week 3: 2 mg/kg/day, divided BID Week 4: 2 mg/kg/day, divided BID Week 5: 1 mg/kg/day, once a day Week 6: 1 mg/kg/day, once a day Week 7: 0.8 mg/kg/day, once a day Week 8: 0.6 mg/kg/day, once a day Week 9: 0.4 mg/kg/day, once a day Week 10: 0.2 mg/kg/day, once a day Week 11: 0.1 mg/kg/day, once a day Week 12-13: 0.1 mg/kg/day, every other day Week 14: Stop |
2: Placebo Comparator |
Drug: Placebo
Schedule and dosing of placebo following portoenterostomy in infants with biliary atresia: Days 1-3: IV - normal saline 4 mg/kg/day, divided BID Days 4-7: PO placebo 4 mg/kg/day, divided BID Week 2: PO placebo 4 mg/kg/day, divided BID Week 3: PO placebo 2 mg/kg/day, divided BID Week 4: PO placebo 2 mg/kg/day, divided BID Week 5: PO placebo 1 mg/kg/day, once a day Week 6: PO placebo 1 mg/kg/day, once a day Week 7: PO placebo 0.8 mg/kg/day, once a day Week 8: PO placebo 0.6 mg/kg/day, once a day Week 9: PO placebo 0.4 mg/kg/day, once a day Week 10: PO placebo 0.2 mg/kg/day, once a day Week 11: PO placebo 0.1 mg/kg/day, once a day Week 12-13: PO placebo 0.1 mg/kg/day, once a day every other day Week 14: Stop |
This is a multi-center randomized, double-blinded, placebo-controlled trial to prospectively determine the efficacy of corticosteroids on the outcome of infants with biliary atresia. The trial will be conducted by the NIDDK-funded network of ten clinical centers comprising the Biliary Atresia Clinical Research Consortium (BARC), whose goal is to study the etiology, pathogenesis, diagnosis, and treatment of infants with biliary atresia. For the trial, our overall hypothesis is that therapy with corticosteroids following portoenterostomy (including gall bladder Kasai procedure) will improve bile drainage and long-term outcome in infants with biliary atresia. This hypothesis will be tested through the following specific aims and hypotheses:
Aim 1: To determine whether corticosteroid therapy decreases serum bilirubin concentration after portoenterostomy.
Aim 2: To determine whether corticosteroid treatment after portoenterostomy will improve outcome as defined by survival without transplantation at 24 months of age.
Aim 3: To determine whether corticosteroid treatment after portoenterostomy will improve growth of infants with biliary atresia.
Aim 4: To determine whether corticosteroid treatment improves biochemical indicators of each of the fat-soluble vitamins after supplementation with standard doses.
Aim 5: To determine whether corticosteroid treatment after portoenterostomy will decrease the incidence of persistent ascites or ascites that requires medical treatment.
The significance of the proposed trial is that it will determine whether corticosteroids are an effective medical treatment to improve bile drainage and long-term outcome, and whether its use reduces the need for liver transplantation in infants with biliary atresia.
Subjects will be recruited from patients enrolled in the BARC prospective observational database study who undergo portoenterostomy or portochelecystostomy (gall bladder Kasai) for biliary atresia.
The Primary outcome measure is the percentage of patients with serum total bilirubin <1.5 mg/dL and with native liver at 6 months after portoenterostomy.
Secondary outcome measures are:
Growth
Serum biomarkers of sufficiency of fat-soluble vitamins
All measurements will be made at 12 and 24 months of age (unless noted otherwise):
Ages Eligible for Study: | up to 6 Months |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
United States, California | |||||
University of California at San Francisco | Recruiting | ||||
San Francisco, California, United States, 94143 | |||||
Contact: Philip Rosenthal, MD 415-476-5892 prosenth@peds.ucsf.edu | |||||
Principal Investigator: Philip Rosenthal, MD | |||||
United States, Colorado | |||||
The Children's Hospital | Recruiting | ||||
Denver, Colorado, United States, 80218 | |||||
Contact: Ronald Sokol, MD 303-861-6669 sokol.ronald@tchden.edu | |||||
Sub-Investigator: Cara Mack, MD | |||||
Sub-Investigator: Michael Narkewicz, MD | |||||
Principal Investigator: Ronald Sokol, MD | |||||
United States, Illinois | |||||
Children's Memorial Hospital | Recruiting | ||||
Chicago, Illinois, United States, 60614 | |||||
Contact: Peter Whitington, MD 773-880-4643 p-whitington@northwestern.edu | |||||
Sub-Investigator: Riccardo Superina, MD | |||||
Principal Investigator: Peter Whitington, MD | |||||
United States, Indiana | |||||
Riley Children's Hospital | Recruiting | ||||
Indianapolis, Indiana, United States, 46202 | |||||
Contact: Jean Molleston, MD 317-274-3774 jpmolles@iupui.edu | |||||
Contact: Ann Klipsch, RN (317) 274-3774 aeye@iupui.edu | |||||
Principal Investigator: Jean Molleston, MD | |||||
United States, Maryland | |||||
Johns Hopkins School of Medicine | Recruiting | ||||
Baltimore, Maryland, United States, 21287 | |||||
Contact: Kathleen Schwarz, MD 410-955-8769 kschwarz@jhmi.edu | |||||
Principal Investigator: Kathleen Schwarz, MD | |||||
United States, Missouri | |||||
Washington University School of Medicine | Recruiting | ||||
St Louis, Missouri, United States, 63110 | |||||
Contact: Ross Shepherd, MD 314-454-2337 shepherd_r@kids.wustl.edu | |||||
Principal Investigator: Ross Shepherd, MD | |||||
United States, New York | |||||
Mount Sinai Medical Center | Recruiting | ||||
New York, New York, United States, 10029 | |||||
Contact: Frederick J Suchy, MD 212-241-6933 frederick.suchy@mssm.edu | |||||
Principal Investigator: Frederick J Suchy, MD | |||||
Sub-Investigator: Nanda Kerkar, MD | |||||
United States, Ohio | |||||
Children's Hospital Medical Center | Recruiting | ||||
Cincinnati, Ohio, United States, 45229 | |||||
Contact: Jorge Bezerra, MD 513-636-4928 jorge.bezerra@chmcc.org | |||||
Principal Investigator: Jorge Bezerra, MD | |||||
Sub-Investigator: John Bucuvalas, MD | |||||
United States, Pennsylvania | |||||
Children's Hospital of Philadelphia | Recruiting | ||||
Philadelphia, Pennsylvania, United States, 19104 | |||||
Contact: Barbara Haber, MD 215-590-2985 haber@email.chop.edu | |||||
Principal Investigator: Barbara Haber, MD | |||||
Sub-Investigator: Elizabeth Rand, MD | |||||
Children's Hospital at Pittsburgh | Recruiting | ||||
Pittsburgh, Pennsylvania, United States, 15213 | |||||
Contact: Benjamin Shneider, MD 412-692-5412 benjamin.shneider@chp.edu | |||||
Sub-Investigator: David Perlmutter, MD | |||||
Sub-Investigator: Robert Squires, MD | |||||
Principal Investigator: Benjamin Shneider, MD | |||||
United States, Texas | |||||
Texas Children's Hospital/Baylor College of Medicine | Recruiting | ||||
Houston, Texas, United States, 77030 | |||||
Contact: Saul Karpen, MD 832-824-3754 skarpen@bcm.tmc.edu | |||||
Principal Investigator: Saul Karpen, MD | |||||
United States, Washington | |||||
Children's Hospital and Regional Medical Center | Recruiting | ||||
Seattle, Washington, United States, 98105 | |||||
Contact: Karen Murray, MD 206-987-2587 karen.murray@seattlechildrens.org | |||||
Contact: Melissa Young (206) 987-1037 melissa.young@seattlechildrens.org | |||||
Principal Investigator: Karen Murray, MD |
Study Chair: | Ronald Sokol, MD | The Children's Hospital, Denver |
Study Director: | Patricia Robuck, PhD | National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) |
Principal Investigator: | John Magee, MD | University of Michigan Medical Center, Ann Arbor |
Biliary Atresia Research Consortium (BARC) 
  |
Responsible Party: | University of Michigan Medical Center ( John Magee, MD, Principal Investigator ) |
Study ID Numbers: | START |
First Received: | February 21, 2006 |
Last Updated: | September 23, 2008 |
ClinicalTrials.gov Identifier: | NCT00294684 |
Health Authority: | United States: Food and Drug Administration |
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