Filtered Sunlight Phototherapy to Treat Significant Jaundice: Safety and Efficacy in Neonates (FSPT)

University of Minnesota (UMN) logo

University of Minnesota (UMN)

Status

Completed

Conditions

Jaundice, Neonatal

Treatments

Device: Filtered-sunlight phototherapy
Device: Intensive phototherapy

Study type

Interventional

Funder types

Other

Identifiers

NCT02612727
1108M03601_Phase 2

Details and patient eligibility

About

At present, much of sub-Saharan Africa, including Nigeria and other resource-limited countries, are without ready access to CPT, due to factors including the lack of PT devices, which are expensive and require consistent electric power to operate. NHB is a significant cause of neonatal morbidity and mortality, but preventable when appropriate treatment is initiated. We have shown that FS-PT is safe and efficacious for the treatment of mild-moderate NHB. The major goal of this study is to demonstrate that FS-PT is efficacious for the treatment of significant/severe NHB, generally defined as TB of ≥12-14mg/dL (but more specially as defined as needing phototherapy per American Academy of Pediatric 2004 guidelines). This arm was done at 1 site in Nigeria (in Ogbomoso). The rationale for conducting the study is that in Nigeria, and other countries that cannot afford effective commercial light devices and/or have no reliable electric power to operate them, filtered sunlight phototherapy might offer a safe and effective treatment for neonatal jaundice.

Full description

Severe neonatal hyperbilirubinemia (NHB) and its progression to kernicterus is a leading cause of deaths and disabilities among newborns in the developing world, particularly in sub-Saharan Africa including Nigeria. Many infants live in villages/towns far from clinical facilities capable of providing conventional artificial blue light phototherapy (CPT) which is the standard treatment for NHB in the industrialized world. Hence, more babies succumb to this preventable tragedy principally on account of lack of electricity and/or available/affordable CPT. To make treatment of NHB more readily available, we designed and tested a novel, yet simple, practical alternative device to deliver blue light PT in underserved areas from filtered sunlight. The investigators pilot study demonstrated that appropriately filtered sunlight phototherapy (FS-PT) not only offers safe and affordable treatment for infants with mild-moderate NHB, but is also no less efficacious than CPT. Other studies have shown faster decline at higher bilirubin (TB) levels and with higher irradiances. The next logical step to move this urgently needed and exciting therapy forward is to test FS-PT in infants with significant/severe NHB as defined by the American Academy of Pediatrics (AAP) criteria for high-risk infants. In doing so, the investigators will potentially be preventing acute bilirubin encephalopathy (ABE) and kernicterus in many of these infants.

Enrollment

174 patients

Sex

All

Ages

Under 14 days old

Volunteers

Accepts Healthy Volunteers

Inclusion criteria

Subjects will be eligible to participate in the study if all of the following conditions exist:

  • At time of birth, infant is > 35 weeks gestation (or ≥ 2.2 kg if gestational age is not available.
  • Infant is < 14 days old at the time of enrollment.
  • Infant has an elevated TB defined as at the level recommended for high-risk infants per AAP guidelines or higher.
  • Parent or guardian has given consent for the infant to participate.

Exclusion criteria

Subjects will be excluded from enrollment in the study if any of the following conditions exist:

  • Infants with a condition requiring referral for treatment not available at the hospital study site.
  • Infants with a life-expectancy of < 24 hours at screening enrollment.
  • Infants requiring oxygen therapy unless that can be provided while under PT.
  • Infants clinically dehydrated or sunburned at the time of screening enrollment.
  • Infants with a temperature < 36.0 or > 37.5 degrees Centigrade that does not return to normothermia within 1 hour.

Trial design

Primary purpose

Treatment

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

None (Open label)

174 participants in 2 patient groups

Filtered-sunlight phototherapy
Experimental group
Description:
Infants will receive >= four hours per day of filtered-sunlight phototherapy for 1 to 10 days. The filtering will be done using Air Blue 80 window tinting film.
Treatment:
Device: Filtered-sunlight phototherapy
Intensive phototherapy
Active Comparator group
Description:
Infants will receive >= four hours per day of intensive phototherapy for 1 to 10 days.
Treatment:
Device: Intensive phototherapy

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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