PrematurityPhase 3PREMYCNCT00718705
Reduction of Spontaneous Prematurity by Antibiotic Treatment (Josamycin)
A Phase 3 study testing Josamycin in people with Prematurity, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.
Trial summary
The purpose of this study is to test the effectiveness of an antibiotic treatment (Josamycin) in the case of positive PCR for Ureaplasma spp. and/or Mycoplasma hominis in the second quarter on the risk of premature birth. Read more about this study
- Who is it for?
- Ages 18 years and older, women only
- Conditions the study is for
- Prematurity
- What is being tested?
- Josamycin
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 3,200 participants
- Where
- 1 siteFrance
- Study dates
- Jul 2008to Sep 2011
- Phase
- Phase 3
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- Women only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Patient older ≥ 18 years
- French speaking
- Women who have an amniocentesis between 15 and 20 weeks of amenorrhoea for an antenatal diagnosis
- Affiliated to social security or an equivalent system
- Karyotype analysis and ultrasound morphological normal (apart from minor signs of trisomy 21)
- Clear amniotic fluid (not contaminated by the mother's blood)
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- Gestational age is between 15 WA(day+0) and 20 WA(day+6)
- Patient have not allergy to macrolides
- Do not have cure underway by macrolide
- Patient followed during her pregnancy in an investigator site
- Informed consent and signed
Who cannot join
- No speaking french
- Having an allergy to macrolides
- Having a multiple pregnancy
- Morphological Anomaly
- Patient no consented
- Lactose Intolerance
- Not agreed to participate
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Reduction of Spontaneous Prematurity: Impact of Antibiotic Treatment (Josamycin) in Case of Positive PCR for Ureaplasma Spp and/or Mycoplasma Hominis in Amniotic Fluid
The purpose of this study is to test the effectiveness of an antibiotic treatment (Josamycin) in the case of positive PCR for Ureaplasma spp. and/or Mycoplasma hominis in the second quarter on the risk of premature birth.
Read the detailed description
Infection would be the cause of 40 % of spontaneous premature deliveries. The physiopathological hypothesis accepted is a premature ascent of present bacteria in the low genital ways towards the decidual, the foetal membranes then the amniotic liquid. These bacteria are responsible for an inflammatory reaction to the interface feto-maternal characterized by the production of proinflammatory cytokines and pro-contractants agents (prostaglandins, oxytocin) by the decidual and the membranes.
These mediators cause uterine contractions, a maturation of the uterine collar, a rupture of the membranes then a premature birth.
Several recent publications show on the one hand that Mycoplasma hominis and Ureaplasma spp. are the bacteria most frequently found in the amniotic liquid in the second quarter of the pregnancy and that a positive PCR for these bacteria is associated with a premature birth.
A probable assumption would be that Mycoplasma hominis or Ureaplasma spp. cause a premature birth by infecting the fetal membranes and the decidual, then activating the immune system and the pro-inflammatory production of cytokines. These bacteria are sensitive to antibiotic treatment.
Nevertheless, no randomized controlled trials have been carried out to determine wether an antibiotic treatment would decrease spontaneous prematurity in the case of positive PCR in the amniotic liquid.
- Conditions
- Prematurity
- Being tested
- Josamycin, Placebo
- Keywords
- Prematurity, Ureaplasma spp, Mycoplasma Hominis, Amniotic fluid, Josamycine
- Medical subject headings
- Premature Birth
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
JosamycinDrug
josamycin with posology of 2 grams per day by oral way during 10 days
PlaceboDrug
Placebo with posology of 2 grams per day by oral way during 10 days
| Study group | Role | What they receive |
|---|---|---|
| 1 | Experimental | josamycin Receives: Drug: Josamycin |
| 2 | Placebo comparator | Placebo Receives: Drug: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Premature birth
Measured: between 22 and 37 completed weeks of pregnancy.
Secondary outcomes (16)
Antenatal :occurence of a miscarriage late
Measured: between 16 and 22 weeks of amenorrhoea
Antenatal : premature delivery
Measured: at week of amenorrhea <= 34, 32, 28
Antenatal : hospitalisation for risk of premature delivery
Measured: antenatal period
antenatal : Number of day of hospitalisation for risk of premature delivery
Measured: antenatal period
Antenatal : premature rupture of membranes
Measured: before 37 week of amenorrhea
Antenatal : occurence of chorioamnionitis defined by 2 of the following criteria :maternal temperature > 38°C, uterine contractions, Fetid leucorrhoeas, foetal tachycardia > 160bpm, C reactive protein >10mg/l
Measured: antenatal period
During childbirth : Hyperthermia > 38°C
Measured: Childbirth period
During childbirth : fetal tachycardia > 160 bpm
Measured: childbirth period
Post-partum : Hyperthermia > 38°C for more than 24hours
Measured: post partum period
Post partum :need an antibiotic treatment for more than 48 hours
Measured: post partum period
Neonatal : neonatal mortality late
Measured: from day 7 to day 28
Neonatal : early neonatal mortality
Measured: from day 0 to day 6
Neonatal morbidity : immediate neonatal state
Measured: neonatal period
Neonatal morbidity : infection
Measured: neonatal period
Neonatal morbidity : respiratory disease
Measured: neonatal period
Neonatal morbidity : digestive disease
Measured: neonatal period
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Jul 2008 (estimated)
- Study startJul 2008
- Primary completionSep 2011
- Study completionSep 2011
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for PrematurityStudies of the same condition, open and under way.
- More trials run by Assistance Publique - Hôpitaux de ParisThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 3,200 participants (actual)
Sponsor and investigators
- Lead sponsor
- Assistance Publique - Hôpitaux de Paris
- Sponsor type
- University, hospital or other
- Collaborators
- Bayer
- Responsible party
- Sponsor
- Investigators
- Gilles KAYEM, Principal investigator, Assistance Publique - Hôpitaux de Paris
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00718705
- Sponsor's protocol ID
- P060216
- Acronym
- PREMYC
- Status last verified
- May 2011
- First submitted
- 17 Jul 2008
- Last updated
- 29 Dec 2011
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Marcellin L, Batteux F, Chouzenoux S, Schmitz T, Lorthe E, Mehats C, Goffinet F, Kayem G. Second-trimester amniotic fluid proteins changes in subsequent spontaneous preterm birth. Acta Obstet Gynecol Scand. 2023 May;102(5):597-604. doi: 10.1111/aogs.14544. Epub 2023 Mar 14.
PubMed 36918342Kayem G, Doloy A, Schmitz T, Chitrit Y, Bouhanna P, Carbonne B, Jouannic JM, Mandelbrot L, Benachi A, Azria E, Maillard F, Fenollar F, Poyart C, Bebear C, Goffinet F. Antibiotics for amniotic-fluid colonization by Ureaplasma and/or Mycoplasma spp. to prevent preterm birth: A randomized trial. PLoS One. 2018 Nov 7;13(11):e0206290. doi: 10.1371/journal.pone.0206290. eCollection 2018.
PubMed 30403730
Study at a glance
From the registry record, last updated by the sponsor on 29 Dec 2011. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Reduction of Spontaneous Prematurity: Impact of Antibiotic Treatment (Josamycin) in Case of Positive PCR for Ureaplasma Spp and/or Mycoplasma Hominis in Amniotic Fluid
- ClinicalTrials.gov ID
- NCT00718705
- Acronym / sponsor ID
- PREMYC / P060216
- Conditions
- Prematurity
- Keywords
- Prematurity, Ureaplasma spp, Mycoplasma Hominis, Amniotic fluid, Josamycine
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 3,200 participants (actual)
- Lead sponsor
- Assistance Publique - Hôpitaux de ParisUniversity, hospital or other
- Collaborators
- Bayer
- Study start
- Jul 2008
- Primary completion
- Sep 2011 (actual)
- Study completion
- Sep 2011 (actual)
- First posted
- 21 Jul 2008 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to test the effectiveness of an antibiotic treatment (Josamycin) in the case of positive PCR for Ureaplasma spp. and/or Mycoplasma hominis in the second quarter on the risk of premature birth.
Detailed description
Infection would be the cause of 40 % of spontaneous premature deliveries. The physiopathological hypothesis accepted is a premature ascent of present bacteria in the low genital ways towards the decidual, the foetal membranes then the amniotic liquid. These bacteria are responsible for an inflammatory reaction to the interface feto-maternal characterized by the production of proinflammatory cytokines and pro-contractants agents (prostaglandins, oxytocin) by the decidual and the membranes.
These mediators cause uterine contractions, a maturation of the uterine collar, a rupture of the membranes then a premature birth.
Several recent publications show on the one hand that Mycoplasma hominis and Ureaplasma spp. are the bacteria most frequently found in the amniotic liquid in the second quarter of the pregnancy and that a positive PCR for these bacteria is associated with a premature birth.
A probable assumption would be that Mycoplasma hominis or Ureaplasma spp. cause a premature birth by infecting the fetal membranes and the decidual, then activating the immune system and the pro-inflammatory production of cytokines. These bacteria are sensitive to antibiotic treatment.
Nevertheless, no randomized controlled trials have been carried out to determine wether an antibiotic treatment would decrease spontaneous prematurity in the case of positive PCR in the amniotic liquid.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| 1 | Experimental | Drug: Josamycinjosamycin |
| 2 | Placebo comparator | Drug: PlaceboPlacebo |
Who may qualify
- Ages
- 18 years and older
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (11 listed)
- Patient older ≥ 18 years
- French speaking
- Women who have an amniocentesis between 15 and 20 weeks of amenorrhoea for an antenatal diagnosis
- Affiliated to social security or an equivalent system
- Karyotype analysis and ultrasound morphological normal (apart from minor signs of trisomy 21)
Key exclusion criteria (7 listed)
- No speaking french
- Having an allergy to macrolides
- Having a multiple pregnancy
- Morphological Anomaly
- Patient no consented
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Josamycinjosamycin with posology of 2 grams per day by oral way during 10 days | Drug | 1 |
| PlaceboPlacebo with posology of 2 grams per day by oral way during 10 days | Drug | 2 |
Primary outcome
Premature birth
Time frame: between 22 and 37 completed weeks of pregnancy.
16 secondary outcomes
Antenatal :occurence of a miscarriage late
Time frame: between 16 and 22 weeks of amenorrhoea
Antenatal : premature delivery
Time frame: at week of amenorrhea <= 34, 32, 28
Antenatal : hospitalisation for risk of premature delivery
Time frame: antenatal period
antenatal : Number of day of hospitalisation for risk of premature delivery
Time frame: antenatal period
Antenatal : premature rupture of membranes
Time frame: before 37 week of amenorrhea
Antenatal : occurence of chorioamnionitis defined by 2 of the following criteria :maternal temperature > 38°C, uterine contractions, Fetid leucorrhoeas, foetal tachycardia > 160bpm, C reactive protein >10mg/l
Time frame: antenatal period
During childbirth : Hyperthermia > 38°C
Time frame: Childbirth period
During childbirth : fetal tachycardia > 160 bpm
Time frame: childbirth period
Post-partum : Hyperthermia > 38°C for more than 24hours
Time frame: post partum period
Post partum :need an antibiotic treatment for more than 48 hours
Time frame: post partum period
Neonatal : neonatal mortality late
Time frame: from day 7 to day 28
Neonatal : early neonatal mortality
Time frame: from day 0 to day 6
Neonatal morbidity : immediate neonatal state
Time frame: neonatal period
Neonatal morbidity : infection
Time frame: neonatal period
Neonatal morbidity : respiratory disease
Time frame: neonatal period
Neonatal morbidity : digestive disease
Time frame: neonatal period
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Dec 2011.
- Derived from this study: PubMed 36918342Marcellin L, Batteux F, Chouzenoux S, Schmitz T, Lorthe E, Mehats C, Goffinet F, Kayem G. Second-trimester amniotic fluid proteins changes in subsequent spontaneous preterm birth. Acta Obstet Gynecol Scand. 2023 May;102(5):597-604. doi: 10.1111/aogs.14544. Epub 2023 Mar 14.
- Derived from this study: PubMed 30403730Kayem G, Doloy A, Schmitz T, Chitrit Y, Bouhanna P, Carbonne B, Jouannic JM, Mandelbrot L, Benachi A, Azria E, Maillard F, Fenollar F, Poyart C, Bebear C, Goffinet F. Antibiotics for amniotic-fluid colonization by Ureaplasma and/or Mycoplasma spp. to prevent preterm birth: A randomized trial. PLoS One. 2018 Nov 7;13(11):e0206290. doi: 10.1371/journal.pone.0206290. eCollection 2018.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Gilles KAYEM principal investigator
Assistance Publique - Hôpitaux de Paris
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Josamycin in people with Prematurity, run by Assistance Publique - Hôpitaux de Paris at 1 site in France.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 11 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 29 Dec 2011. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in France. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Premature birth (time frame: between 22 and 37 completed weeks of pregnancy.). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00718705, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Dec 2011.