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| Name | Class |
|---|---|
| Nutricia Liverpool | INDUSTRY |
| Danone Institute International | OTHER |
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This study involves the use of 2 different Neocate formulas: a control formula called Neocate Infant and a test Neocate formula. These kinds of formulas are for use in children from birth to 8 months of age with Cow Milk Allergy (CMA), other food allergies, and other gastrointestinal disorders. The purpose of this study is to compare the control and test Neocate formulas for safety, tolerability, and effectiveness (in promoting growth) when used in subjects with CMA.
This study will also look at the test Neocate formula to see if it is hypoallergenic when used in subjects with CMA.
Infants who qualify will begin a 7-day milk protein elimination diet that excludes all milk or products which contain milk. Parents will be asked to keep a food diary of everything the child eats during the week following the Screening Visit. During this week, the child can continue to drink their current hypoallergenic formula.
Subjects will be assessed at seven study visits at baseline, two weeks, four weeks and then monthly until the end of the study period, where the following will be assessed:
Study Visit 1 (Day -7): Baseline
This will be carried out at entry to the trial to collect baseline data; at this visit subjects will under go the following assessments:
Assess Patient suitability Obtain Informed Consent Obtain Subject number Perform physical exam and clinical assessment Medical history and assessment including SCORing Atopic Dermatitis assessment (SCORAD) Obtain weight, length and head circumference Collect a 9ml venous blood sample The following is to analysed by the central lab; Plasma total protein/albumin and prealbumin Blood urea nitrogen, electrolytes and creatinine Complete blood count with differential Alkaline phosphatase. Serum Iron, Total Iron Binding Capacity and Ferritin Plasma fatty acid analysis Provide stool lab kits and explain to parent/caregiver how to collect stool sample during the pre-evaluation week Provide one-week subject diary (Subject Diary 1) and instruct parent/caregiver on how to complete record, clinical symptoms and stool characteristics (frequency, consistency and color) in subject diary.
Provide the one-week Food Frequency Diary A and instruct the parent/caregiver on how to complete this assessment Provide information on following a milk protein exclusion diet, with or without the exclusion of other allergenic food proteins as advised by the subject's physician Record all concomitant medications taken within two weeks prior to the Baseline Visit
Study Visit 2 (Day 0): Once subjects have completed the pre-evaluation period subjects will undergo the following assessment:
Review Subject Diary 1 and Food Frequency Diary A, for study compliance Randomisation assignment to one of the two study formulas Perform physical exam and clinical assessment Obtain weight, length/height and head circumference Provide two-week subject diary (Subject Diary 2a) and instruct parent/caregiver on how to record clinical symptoms and stool characteristics in subject diary.
Provide the one-week Food Frequency Diary B and instruct the parent/caregiver on how to complete this assessment Collect stool sample that was obtained in previous week at home
Phone review (Day 7)
Subjects will be reviewed at this time point by telephone to review if any clinical symptoms have occurred while ingesting study formula. If it is determined by the Principal Investigator that the subject has had any clinically significant reaction(s) to the study formula, the subject must return to the clinic for evaluation. Subjects will progress to Phase II and continue feeding with the formula they have consumed as part of the seven-day, post-challenge feeding period.
Study Visit 3 (Day 14): Two weeks on formula
Once subjects have been consuming their assigned formula for a two week period the following assessment will be carried out:
Obtain weight, length and head circumference Collect Subject Diary 2a and Food Frequency Diary B Review of open feeding period and presence of any clinical symptoms Provide one-week subject diary (Subject Diary 3) to be completed the week before returning for Visit 4 and instruct parent/caregiver on how to record, clinical symptoms and stool characteristics in subject diary.
Provide three-day Food Diary 1 to be completed the week before returning for visit 4 and instruct parent/caregiver on how to complete the food records Instruct parent to collect stool sample during the week before study Visit 4. Review study product requirement and dispense as necessary
Study Visit 4 (Day 28): One month on formula
Once subject have been consuming test formula for one month they will undergo the following assessment:
Perform clinical assessment and SCORAD Obtain weight, length and head circumference Obtain stool sample collected by parent Collect and review Subject Diary 3 and Food Diary 1 Review study product requirement and dispense as necessary
Study Visit 5 (Day 56): Two months on formula Obtain weight, length and head circumference Provide 3 day subject diary (Subject Diary 4) to be completed in the following week and instruct parent/caregiver on how to record clinical symptoms and stool characteristics in subject diary Provide three-day Food Diary 2 to be completed in the following week and instruct parent/caregiver on how to complete the food records Review study product requirement and dispense as necessary
Study Visit 6 (Day 84): Three months on formula Obtain weight, length and head circumference Collect Subject Diary 4 and Food Diary 2 Provide one week subject diary (Subject Diary 5) to be completed in the week prior to the final study visit and instruct parent/caregiver on how to complete the food records, clinical symptoms and stool characteristics in subject diary Provide three-day Food Diary 3 to be completed in the week prior to the final study visit and instruct parent/caregiver on how to complete the food records Instruct parent to take stool sample during the week before the final study visit Review study product requirement and dispense as necessary
Study Visit 7 (Day 112): Final visit - four months on formula or Early Termination Perform clinical assessment and SCORAD Obtain weight, length and head circumference Obtain stool sample collected by parent Collect and review Subject Diary 5 and Food Diary 3 Collect blood sample Ensure Parents/caregivers have returned all diaries to the appropriate clinician at each center Study personnel will review the forms with the parents/caregivers Parents/caregivers will return all partial and unopened cans of the test formula
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| New Neocate | Experimental | new Neocate |
|
| Neocate Infant | Active Comparator | Neocate Infant formula |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Neocate Infant | Dietary Supplement | minimum of 8 fl. oz daily |
| |
| Measure | Description | Time Frame |
|---|---|---|
| The primary endpoint is attained growth (i.e. incremental gains in weight) over the study period. | The primary endpoint is attained growth (i.e. incremental gains in weight) over the study period. Length and head circumference measures will also be collected and analysed. Both the growth velocities of the group as a whole (cross-sectional group data) and individuals (longitudinal individual data) will be reviewed and analysed. In assessing group data, comparisons of increments per unit of time will be made. Due to the varying ages of the subjects recruited to the study, growth measures will be concerted to z-scores using an appropriate reference population to allow a meaningful comparison of the ability of the formulas to promote growth. In assessing the growth of individual infants, data will be plotted on National Centre for Health Statistics (NCHS) growth charts and assessed qualitatively. | 4 months |
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Inclusion Criteria:
Subjects aged from birth to 8 months old with documented allergy to cow milk protein are eligible to enter the study. Subjects with other IgE or non IgE mediated allergies to food in addition to milk protein (e.g. multiple food allergy or an eosinophilic disorder) are also eligible to enter the study. However all subjects must have a confirmed allergy to milk confirmed by one of the following criteria, within two months prior to the baseline visit:
Written informed consent / ability to give informed consent.
These subjects are expected to consume a minimum intake of test formula to ensure an average daily intake, which provides at least 50% of their daily energy requirements,
Exclusion Criteria:
All subjects
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| Name | Affiliation | Role |
|---|---|---|
| Barbara Mourmans | Study Mgr Nutricia Research - Centre for Specialised Nutrition | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Pendleton Pediatrics | Chandler | Arizona | 85224 | United States | ||
| Visions Clinical Research - Tucson |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33006765 | Derived | Amari S, Shahrook S, Namba F, Ota E, Mori R. Branched-chain amino acid supplementation for improving growth and development in term and preterm neonates. Cochrane Database Syst Rev. 2020 Oct 2;10(10):CD012273. doi: 10.1002/14651858.CD012273.pub2. | |
| 31425366 | Derived | Harvey BM, Eussen SRBM, van Helvoort A, Harthoorn LF. Cow's Milk Allergic Infants on Elemental Formula Maintain Adequate Mineral Status Despite Using Acid-suppressive Drugs. J Pediatr Gastroenterol Nutr. 2019 Nov;69(5):e147-e148. doi: 10.1097/MPG.0000000000002469. No abstract available. |
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| new Neocate |
| Dietary Supplement |
minimum of 8 fl oz daily |
|
| Tucson |
| Arizona |
| 85712 |
| United States |
| Children's Investigational Research Program, LLC (CHIRP) | Bentonville | Arkansas | 72712 | United States |
| Children's Hospital, LA | Los Angeles | California | 90027 | United States |
| David Geffen School of Medicine at UCLA | Los Angeles | California | 90095 | United States |
| Rosario B. Retino, MD, Inc | Ontario | California | 91762 | United States |
| Choc Psf, Amc | Orange | California | 92868 | United States |
| Nemours Children's Clinic | Jacksonville | Florida | 32207 | United States |
| Alzein Pediatrics | Evergreen Park | Illinois | 60805 | United States |
| Regional Research Specialists, LLC | Shreveport | Louisiana | 71106 | United States |
| Craig A. Spiegel, M.D. | Bridgeton | Missouri | 63044 | United States |
| Meridian Clinical Research, LLC | Omaha | Nebraska | 68134 | United States |
| Weill Cornell Medical College | New York | New York | 10021 | United States |
| Asheboro Research Associates | Asheboro | North Carolina | 27203 | United States |
| Duke University | Durham | North Carolina | 27710 | United States |
| Pediatrics, PLLC | Holly Springs | North Carolina | 27540 | United States |
| John Panuto, M.D. | Middleburg Heights | Ohio | 44130 | United States |
| The Children's Hospital of Philadelphia | Philadelphia | Pennsylvania | 19104 | United States |
| Childrens Hospital of Pittsburgh | Pittsburgh | Pennsylvania | 15213 | United States |
| PI-Coor Clinical Research, LLC | Burke | Virginia | 22015 | United States |
| Virginia Commonwealth University | Richmond | Virginia | 23219 | United States |
| Advanced Pediatrics | Vienna | Virginia | 22180 | United States |
| 25845680 | Derived | Burks AW, Harthoorn LF, Van Ampting MT, Oude Nijhuis MM, Langford JE, Wopereis H, Goldberg SB, Ong PY, Essink BJ, Scott RB, Harvey BM. Synbiotics-supplemented amino acid-based formula supports adequate growth in cow's milk allergic infants. Pediatr Allergy Immunol. 2015 Jun;26(4):316-22. doi: 10.1111/pai.12390. |
| ID | Term |
|---|---|
| D016269 | Milk Hypersensitivity |
| ID | Term |
|---|---|
| D005512 | Food Hypersensitivity |
| D006969 | Hypersensitivity, Immediate |
| D006967 | Hypersensitivity |
| D007154 | Immune System Diseases |
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