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Bronchopulmonary DysplasiaPhase 3BuSNCT04862377

Intratracheal Budesonide With Surfactant to Prevent Bronchopulmmonary Dysplasia.

A Phase 3 study testing Poractant Alfa Intratracheal Suspension [Curosurf] and Budesonide 0.5 MG/ML in people with Bronchopulmonary Dysplasia and Respiratory Distress Syndrome in Premature Infant, run by Hospital Clinic of Barcelona.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This study is designed to determine whether intratracheal administration of budesonide combined with surfactant, as compared to surfactant alone, will modify ecographic (lung ultrasound score) and biological markers (IL-6 concentration in respiratory secretions) at 7 days of life in preterm infants ≤32 weeks of… Read more about this study

Who is it for?
Ages Up to 48 hours
What is being tested?
Poractant Alfa Intratracheal Suspension [Curosurf] and Budesonide 0.5 MG/ML
Could I receive a placebo?
No, everyone receives an active treatment
How many people
50 participants
Where
No sites listed yet
Study dates
1 Oct 2021to 1 Apr 2026
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 Up to 48 hours
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Infants born equal or earlier than 32 weeks of gestational age admitted in the Neonatal Intensive Care Unit.
  • Parental consent signed.
  • Less than or equal to 48 hours postnatal age.

Who cannot join

  • Infants with known major congenital anomalies (eg. congenital upper airwayobstruction, congenital lung anomaly, severe pulmonary hypoplasia, hydrops,neuromuscular diseases, chromosomopaties)
  • Infants with poor prognosis and risk of imminent death
  • Infants who have received the first dose of surfactant before of the enrolment to the study.

Trial locations and contacts

No sites are listed yet.

Marta Teresa-Palacio, MD contact

0034 93 227 56 00 ext. 7503

teresa@clinic.cat

About this study

Official title: Efficacy and Safety of the Intratracheal Administration of Budesonide With Porcine Pulmonary Surfactant in Very Preterm Infants to Prevent Bronchopulmonary Dysplasia: Randomized Clinical Trial (BuS Trial)

This study is designed to determine whether intratracheal administration of budesonide combined with surfactant, as compared to surfactant alone, will modify ecographic (lung ultrasound score) and biological markers (IL-6 concentration in respiratory secretions) at 7 days of life in preterm infants ≤32 weeks of gestational age (GA).

Read the detailed description

Bronchopulmonary dysplasia (BPD) is one of the main morbidities associated with extreme prematurity and, despite the improvement of respiratory care in the latest years, overall incidence is not decreasing. Etiology of BPD is multifactorial and local inflammation plays an important role in it, therfore, local anti-inflammatory drugs could be effective in preventing BPD.

Recent randomised trials have shown a lower incidence of BPD/death with the use of a combination of budesonide with surfactat compared to surfactant alone, and further clinical trials are currently ongoing.

This is a controlled phase IV, randomised, unicenter clinical trial designed to evaluate the effect of intratracheal administration of budesonide combined with surfactant, as compared to surfactant alone, in BPD in preterm infants ≤32 weeks of GA. Investigators will compare ecographic and biological markers, as well as respiratory outcomes.

Being tested
Poractant Alfa Intratracheal Suspension [Curosurf], Budesonide 0.5 MG/ML
Keywords
Bronchopulmonary dysplasia, Respiratory Distress Syndrome in premature infant, Prematurity, Lung injury, Poractant alfa, Pulmonary surfactant, Budesonide, Anti-inflammatory agents, Glucocorticoids, Lung ultrasound, IL-6
Medical subject headings
Bronchopulmonary Dysplasia, Premature Birth, Lung Injury

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Poractant Alfa Intratracheal Suspension [Curosurf]Drug

    Also called Curosurf®

    Poractant alfa (Curosurf®):

    First dose of treatment: 200mg/Kg. Further doses (up to a total maximum of 3 within first 48 hours of life): 100mg/Kg.

  • Budesonide 0.5 MG/MLDrug

    Also called Budesonida Aldo-Unión 0.5mg/mL suspensión para inhalación por nebulizador®

    Poractant alfa (Curosurf®) + Budesonide nebulizer solution (Budesonida Aldo-Unión 0.5mg/mL suspensión para inhalación por nebulizador®):

    First dose: 200mg/Kg of surfactant + 0.25mg/Kg of budesonide. Further doses (up to a total maximum of 3 within first 48 hours of life): 100mg/Kg of surfactant + 0.25mg/Kg of budesonide.

Study groups in NCT04862377
Study groupRoleWhat they receive
Standard treatment groupActive comparatorInfants randomised to the "standard treatment" arm will receive intratracheal surfactant as per usual clinical indications of respiratory distress syndrome in these preterm infants. In that sense, and based in those clinical indications, we have developed a risk calculator for surfactant administration in preterm infants ≤32 weeks GA. We will use it to decide what patients will receive surfactant (calculator available on: https://1drv.ms/x/s!Arjkl83HIXSngP8TWh8O6oi6Ztdw3w?e=gNCMxP).
Receives: Drug: Poractant Alfa Intratracheal Suspension [Curosurf]
Interventional treatment groupExperimentalInfants randomised to the "interventional treatment" arm will receive intratracheal surfactant mixed with budesonide. Indication of surfactant, as equal as for the "standard treatment" arm, will be decided using the calculator.
Receives: Drug: Poractant Alfa Intratracheal Suspension [Curosurf]; Drug: Budesonide 0.5 MG/ML
Control groupNo interventionInfants ≤32 weeks with no indications for surfactant administration. Their clinical management will be the usual in our neonatal unit.

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Lung ultrasound score at 7 days of life.

    LUS will be performed with the patients in supine position and slightly lying on the side of the taken view. Each lung will be divided in five areas through longitudinal orientation and images will be taken using the linear probe (VF 13-5MHz).

    Measured: 7 days of life

  2. IL-6 concentration in respiratory secretions at 7 days of life.

    Nasopharyngeal aspirate (NPA) will be collected by standard procedure. IL-6 concentration will be determined by Human IL-6 Quantikine ELISA (R\&D Systems Inc., Minneapolis, MN, USA).

    Measured: 7 days of life

Secondary outcomes (7)
  1. Lung ultrasound score at 28 days of life.

    LUS will be performed with the patients in supine position and slightly lying on the side of the taken view. Each lung will be divided in five areas through longitudinal orientation and images will be taken using the linear probe (VF 13-5MHz).

    Measured: 28 days of life

  2. IL-6 concentration in respiratory secretions at 28 days of life.

    Nasopharyngeal aspirate (NPA) will be collected by standard procedure. IL-6 concentration will be determined by Human IL-6 Quantikine ELISA (R\&D Systems Inc., Minneapolis, MN, USA).

    Measured: 28 days of life

  3. Number of days of oxygen

    Number of days on FiO2 >21% supplied by any respiratory support

    Measured: 7 and 28 days of age, 36 weeks of post-menstrual age.

  4. Number of days of respiratory support

    Number of days on each level of respiratory support:

    • No respiratory support
    • Nasal cannula at flow rates ≤ 2L/min
    • Nasal cannula at flow rates > 2L/min
    • CPAP/BIPAP
    • Invasive mechanical ventilation

    Measured: 7 and 28 days of age, 36 weeks of post-menstrual age.

  5. Mean airway pressure (MAP)

    Maximum MAP mesured in cmH2O at 7 and 28 days of age, 36 weeks of postmenstrual age.

    Measured: 7 and 28 days of age, 36 weeks of post-menstrual age.

  6. Incidence of bronchopulmonary dysplasia

    BPD will be defined according to the 2001 workshop definition (Jobe AH, Bancalari E. Bronchopulmonary dysplasia. American Journal of Respiratory and Critical Care Medicine. American Lung Association; 2001; pp 1723-9).

    Measured: 36 weeks of post-menstrual age.

  7. Respiratory status and neurodevelopment

    Neurodevelopment will be assessed using Bayley-III test.

    Measured: 24 months of age.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Apr 2021
  2. Study start1 Oct 2021 (estimated)
  3. Primary completion1 Apr 2024 (estimated)
  4. Study completion1 Apr 2026 (estimated)

Resources

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
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a randomised trial. Infants who fit criteria for surfactante administration will be randomly assigned into 2 groups: "Standard treatment group" receiving only intratracheal surfactant, and "Interventional treatment group" receiving intratracheal surfactant combined with budesoinde. It will be a third group of patients ≤32 weeks ("Control group") who won´t fit criteria for surfactant administration.
Masking
Single blind
Who is masked
Participant
Enrolment
50 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04862377
Sponsor's protocol ID
BuS2020
Acronym
BuS
Status last verified
Apr 2021
First submitted
5 Mar 2021
Last updated
13 Sep 2021
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Heo M, Jeon GW. Intratracheal administration of budesonide with surfactant in very low birth weight infants to prevent bronchopulmonary dysplasia. Turk J Pediatr. 2020;62(4):551-559. doi: 10.24953/turkjped.2020.04.004.

    PubMed 32779407
  • Oulego-Erroz I, Alonso-Quintela P, Terroba-Seara S, Jimenez-Gonzalez A, Rodriguez-Blanco S. Early assessment of lung aeration using an ultrasound score as a biomarker of developing bronchopulmonary dysplasia: a prospective observational study. J Perinatol. 2021 Jan;41(1):62-68. doi: 10.1038/s41372-020-0724-z. Epub 2020 Jul 14.

    PubMed 32665687
  • Alonso-Ojembarrena A, Lubian-Lopez SP. Lung ultrasound score as early predictor of bronchopulmonary dysplasia in very low birth weight infants. Pediatr Pulmonol. 2019 Sep;54(9):1404-1409. doi: 10.1002/ppul.24410. Epub 2019 Jun 10.

    PubMed 31216121
  • Forster K, Sass S, Ehrhardt H, Mous DS, Rottier RJ, Oak P, Schulze A, Flemmer AW, Gronbach J, Hubener C, Desai T, Eickelberg O, Theis FJ, Hilgendorff A. Early Identification of Bronchopulmonary Dysplasia Using Novel Biomarkers by Proteomic Screening. Am J Respir Crit Care Med. 2018 Apr 15;197(8):1076-1080. doi: 10.1164/rccm.201706-1218LE. No abstract available.

    PubMed 29053024
  • Venkataraman R, Kamaluddeen M, Hasan SU, Robertson HL, Lodha A. Intratracheal Administration of Budesonide-Surfactant in Prevention of Bronchopulmonary Dysplasia in Very Low Birth Weight Infants: A Systematic Review and Meta-Analysis. Pediatr Pulmonol. 2017 Jul;52(7):968-975. doi: 10.1002/ppul.23680. Epub 2017 Feb 6.

    PubMed 28165675
  • Yeh TF, Chen CM, Wu SY, Husan Z, Li TC, Hsieh WS, Tsai CH, Lin HC. Intratracheal Administration of Budesonide/Surfactant to Prevent Bronchopulmonary Dysplasia. Am J Respir Crit Care Med. 2016 Jan 1;193(1):86-95. doi: 10.1164/rccm.201505-0861OC.

    PubMed 26351971
  • Kuo HT, Lin HC, Tsai CH, Chouc IC, Yeh TF. A follow-up study of preterm infants given budesonide using surfactant as a vehicle to prevent chronic lung disease in preterm infants. J Pediatr. 2010 Apr;156(4):537-41. doi: 10.1016/j.jpeds.2009.10.049. Epub 2010 Feb 6.

    PubMed 20138301
  • Yeh TF, Lin HC, Chang CH, Wu TS, Su BH, Li TC, Pyati S, Tsai CH. Early intratracheal instillation of budesonide using surfactant as a vehicle to prevent chronic lung disease in preterm infants: a pilot study. Pediatrics. 2008 May;121(5):e1310-8. doi: 10.1542/peds.2007-1973. Epub 2008 Apr 21.

    PubMed 18426851
  • Aldecoa-Bilbao V, Balcells-Esponera C, Herranz Barbero A, Borras-Novell C, Izquierdo Renau M, Iriondo Sanz M, Salvia Roiges M. Lung ultrasound for early surfactant treatment: Development and validation of a predictive model. Pediatr Pulmonol. 2021 Feb;56(2):433-441. doi: 10.1002/ppul.25216. Epub 2020 Dec 23.

    PubMed 33369257
  • Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med. 2001 Jun;163(7):1723-9. doi: 10.1164/ajrccm.163.7.2011060. No abstract available.

    PubMed 11401896

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Poractant Alfa Intratracheal Suspension [Curosurf] and Budesonide 0.5 MG/ML in people with Bronchopulmonary Dysplasia and Respiratory Distress Syndrome in Premature Infant, run by Hospital Clinic of Barcelona.

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 3 inclusion and 3 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: status not confirmed, as of the sponsor's last update on 13 Sep 2021. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. 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?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Marta Teresa-Palacio, MD (0034 93 227 56 00 ext. 7503, teresa@clinic.cat), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Lung ultrasound score at 7 days of life. (time frame: 7 days of life). The study lists 2 primary outcomes in all. 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 NCT04862377, which also lists 10 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 13 Sep 2021; AzTrials last refreshed its copy on 8 Nov 2026.

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