Title

Phase III Randomized Study of Lucinactant in Full Term Newborn Infants With Meconium Aspiration Syndrome
A Multicenter, Randomized, Controlled Trial Comparing the Safety and Effectiveness of Bronchoalveolar Lavage With Lucinactant to Standard Care for the Treatment of the Meconium Aspriation Syndrome (MAS) in Newborn Infants
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Study Participants

    69
OBJECTIVES:

Evaluate the safety and efficacy of lucinactant administered by bronchoalveolar lavage (BAL) in the treatment of meconium aspiration syndrome (MAS) in newborn infants.
PROTOCOL OUTLINE:

This is a randomized, multicenter study. Patients are randomized to one of two treatment arms.

Arm I: Patients receive lucinactant by bronchoalveolar lavage, into the right and left lung, followed by lung drainage. Treatment repeats when patient stabilizes or every 15 minutes for 2 courses.

Arm II: Patients receive standard treatment including oxygen, conventional mechanical ventilation, sedation, paralysis, vasopressors, and alkalinization.

Patients are followed for 12 months.
Study Started
Mar 31
2000
Primary Completion
Nov 30
2002
Study Completion
Nov 30
2004
Results Posted
May 01
2012
Estimate
Last Update
May 03
2012
Estimate

Drug Lucinactant

Lucinactant suspension was administered as 10 mg total phospholipid (TPL)/mL, by bronchoalveolar lavage within 90 minutes of randomization. The dose was determined based on the infant's body weight such that the total dose was 16 mL/kg for each of the 2 lavage procedures and 32 mL/kg overall. Infants received 2 doses of lucinactant. Each dose consisted of separate lavage procedures for each lung within 15 minutes (up to 60 minutes) of each other.

  • Other names: Surfactant, KL₄Surfactant

Other Standard Care

The Standard Care (SC) group received therapies including, but not limited to, the use of oxygen, controlled mechanical ventilation (CMV), sedation, paralysis, vasopressors, and/or alkalinization. The use of adjunctive therapies (namely: high frequency oscillatory ventilation, high frequency jet ventilation, bolus surfactant, inhaled nitric oxide, extra-corporeal membrane oxygenation, or systemic corticosteroids) were not included in SC

  • Other names: Negative Control

Lucinactant Experimental

Lucinactant via bronchoaveolar lavage

Standard Care Other

Standard Care included the use of oxygen, CMV, sedation, paralysis, vasopressors, and/or alkalinization

Criteria

Inclusion Criteria:

Diagnosis of meconium aspiration syndrome (MAS)
Continuous mechanical ventilation (CMV) at time of entry
Enrollment within 48 hours of birth
Gestational age of ≥ 37 weeks
Oxygenation index of ≥ 5 and ≤ 30
Written informed consent signed and dated by the infant's parent(s) or legal guardian(s)

Exclusion Criteria:

Congenital anomalies likely to affect any primary or secondary endpoints
Uncontrollable air leaks
Hydrops fetalis
Rupture ≥ 3 weeks of the fetal membranes
Evidence of overwhelming bacterial infection at time of randomization
Markedly labile persistent pulmonary hypertension at time of randomization
Profound neurologic manifestations
Sustained postductal SpO₂of < 87% for ≥ 15 minutes at an FiO₂of 1.00

Summary

Lucinactant

Standard Care

All Events

Event Type Organ System Event Term Lucinactant Standard Care

Number of Days Receiving Mechanical Ventilation (MV)

A patient is not receiving MV if he/she is removed from the mechanical ventilator for ≥ 24 hours. If a patient subsequently requires intubation and MV, the additional time will count as days receiving MV.

Lucinactant

10.2
days (Mean)
Standard Deviation: 9.96

Standard Care

8.1
days (Mean)
Standard Deviation: 8.52

Incidence of Death

Lucinactant

Standard Care

Number of Participants With Air Leaks

Includes pulmonary interstitial emphysema (PIE), Pneumothorax, Pneumomediastinium, and Pneumopericardium

Lucinactant

2.0
participants

Standard Care

Total

69
Participants

Gestational Age

39.9
weeks (Mean)
Standard Deviation: 1.21

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

Lucinactant

Standard Care