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出境医 / 临床实验 / Natural Berry Extract Treatment of Hemangiomas (Pediaberry)

Natural Berry Extract Treatment of Hemangiomas (Pediaberry)

Study Description
Brief Summary:
This is a prospective, randomized, double-blind, placebo-controlled parallel group study evaluating the use of PediaBerry for the treatment of hemangiomas in infants ≤ 4 months of corrected gestation age over a 6-month treatment period. Subjects will be followed to age 18 months. A total of 44 subjects will be PediaBerry group and 22 subjects in the placebo control group.

Condition or disease Intervention/treatment Phase
Hemangioma Drug: PediaBerry Early Phase 1

Detailed Description:

PediaBerry™ is a proprietary blend of powdered berry extracts. Placebo: powdered sugar plus McCormick Color from Nature Food Colors Berry and Sky Blue powdered food color (https://www.mccormick.com/spices-and-flavors/extracts-and-food-colors/food-colors/color-from-nature-assorted-food-color ).

Cream vehicle is mixed with PediaBerry™ or placebo at the time of application.Children will receive once daily topical and oral gavage dosing of PediaBerry or placebo.

The first study visit will take place within 2 weeks of subject recruitment. The subject enrollment, consenting and randomization will occur as study visit #0 and will occur at Riley Children's Hospital or Nationwide Children's Hospital. Data collection will be the same at all study visits starting with study visit #1 until the completion of the study. The first dose of PediaBerry™ or placebo will be administered prior to completion of study visit #1, and will also be given at study visits #2-6. Study visits #2-6 will occur monthly study visits until the subject completes 6 months of treatment.Subjects will be weighed and treatment doses adjusted accordingly. Study visits #7-11 to watch for signs of rebound hemangioma proliferation will occur every other month until age 12 months and then at age 15 and 18 months. Urine samples, photos and caliper measurements will occur at each study visit. Some subjects may have less than 11 study visits depending on the age at the time of subject enrollment.

Study Design
Layout table for study information
Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 66 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description: pilot study to determine effect size for possible FDA phase I/II trial
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description: investigational pharmacy will have access to randomization schemes and will package study drug from bulk supplies. All other study team members and participants are blinded.
Primary Purpose: Treatment
Official Title: Natural Berry Extract Treatment of Hemangiomas
Actual Study Start Date : December 1, 2020
Estimated Primary Completion Date : June 30, 2022
Estimated Study Completion Date : December 31, 2022
Arms and Interventions
Arm Intervention/treatment
Experimental: Pediaberry group
PediaBerry™ is a proprietary blend powdered berry extracts
Drug: PediaBerry
PediaBerry or placebo will be mixed with a cream vehicle for topical administration or with water for oral administration
Other Name: placebo

Placebo Comparator: Placebo
Placebo: powdered sugar plus McCormick Color from Nature Food Colors Berry and Sky Blue powdered food color (https://www.mccormick.com/spices-and-flavors/extracts-and-food-colors/food-colors/color-from-nature-assorted-food-color ).
Drug: PediaBerry
PediaBerry or placebo will be mixed with a cream vehicle for topical administration or with water for oral administration
Other Name: placebo

Outcome Measures
Primary Outcome Measures :
  1. Decreased Hemangioma Size [ Time Frame: 6 month treatment period ]
    Decrease in the size of hemangioma > 50%


Secondary Outcome Measures :
  1. Decreased urinary micro RNA 126 levels [ Time Frame: 6 month treatment period ]
    Urinary micro RNA 126 levels are analyzed using quantitative polymerase chain reactions


Eligibility Criteria
Layout table for eligibility information
Ages Eligible for Study:   1 Month to 4 Months   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Children with hemangiomas ≤ 4 months of corrected gestational age
  • Hemangioma size ≥ 1.5 cm diameter

Exclusion Criteria:

  • Children with hemangiomas that threaten the life of the child or development of vital structures.
  • Children who are breast feeding and mother is taking beta blocker medication
  • Children with previously treated hemangiomas
  • Congenital hemangiomas - cannot distinguish between rapidly involuting and non-involuting congenital hemangiomas
  • Hemangiomas located in the perineal/diapering area - product will get contaminated or wiped off with diapering
  • Children with food allergies to blueberries or any other kind of berry
  • Legal guardian unable to provide informed consent
Contacts and Locations

Contacts
Layout table for location contacts
Contact: Amy O Miller, MA/CCRP (317)-278-2720 amym@iu.edu
Contact: Sashwati Roy, PhD 317-278-2706 roysa@iu.edu

Locations
Layout table for location information
United States, Indiana
Riley Hospital for Children Recruiting
Indianapolis, Indiana, United States, 46202
Contact: Amy O Miller, MA/CCRP    317-278-2720    amym@iu.edu   
Contact: Ashley Moore, RN    (317) 278-7858    amurdick@iu.edu   
Principal Investigator: Gayle Gordillo, MD         
Sponsors and Collaborators
Indiana University
National Institute of General Medical Sciences (NIGMS)
National Institutes of Health (NIH)
Investigators
Layout table for investigator information
Principal Investigator: Gayle Gordillo, MD Indiana University
Tracking Information
First Submitted Date  ICMJE June 24, 2019
First Posted Date  ICMJE July 16, 2019
Last Update Posted Date February 9, 2021
Actual Study Start Date  ICMJE December 1, 2020
Estimated Primary Completion Date June 30, 2022   (Final data collection date for primary outcome measure)
Current Primary Outcome Measures  ICMJE
 (submitted: August 19, 2019)
Decreased Hemangioma Size [ Time Frame: 6 month treatment period ]
Decrease in the size of hemangioma > 50%
Original Primary Outcome Measures  ICMJE
 (submitted: July 11, 2019)
Hemangioma Size [ Time Frame: 6 month treatment period ]
Decrease in the size of hemangioma > 50%
Change History
Current Secondary Outcome Measures  ICMJE
 (submitted: August 19, 2019)
Decreased urinary micro RNA 126 levels [ Time Frame: 6 month treatment period ]
Urinary micro RNA 126 levels are analyzed using quantitative polymerase chain reactions
Original Secondary Outcome Measures  ICMJE
 (submitted: July 11, 2019)
Decreased urinary miR126 levels [ Time Frame: 6 month treatment period ]
Urinary miR126 levels are analyzed using quantitative PCR
Current Other Pre-specified Outcome Measures Not Provided
Original Other Pre-specified Outcome Measures Not Provided
 
Descriptive Information
Brief Title  ICMJE Natural Berry Extract Treatment of Hemangiomas
Official Title  ICMJE Natural Berry Extract Treatment of Hemangiomas
Brief Summary This is a prospective, randomized, double-blind, placebo-controlled parallel group study evaluating the use of PediaBerry for the treatment of hemangiomas in infants ≤ 4 months of corrected gestation age over a 6-month treatment period. Subjects will be followed to age 18 months. A total of 44 subjects will be PediaBerry group and 22 subjects in the placebo control group.
Detailed Description

PediaBerry™ is a proprietary blend of powdered berry extracts. Placebo: powdered sugar plus McCormick Color from Nature Food Colors Berry and Sky Blue powdered food color (https://www.mccormick.com/spices-and-flavors/extracts-and-food-colors/food-colors/color-from-nature-assorted-food-color ).

Cream vehicle is mixed with PediaBerry™ or placebo at the time of application.Children will receive once daily topical and oral gavage dosing of PediaBerry or placebo.

The first study visit will take place within 2 weeks of subject recruitment. The subject enrollment, consenting and randomization will occur as study visit #0 and will occur at Riley Children's Hospital or Nationwide Children's Hospital. Data collection will be the same at all study visits starting with study visit #1 until the completion of the study. The first dose of PediaBerry™ or placebo will be administered prior to completion of study visit #1, and will also be given at study visits #2-6. Study visits #2-6 will occur monthly study visits until the subject completes 6 months of treatment.Subjects will be weighed and treatment doses adjusted accordingly. Study visits #7-11 to watch for signs of rebound hemangioma proliferation will occur every other month until age 12 months and then at age 15 and 18 months. Urine samples, photos and caliper measurements will occur at each study visit. Some subjects may have less than 11 study visits depending on the age at the time of subject enrollment.

Study Type  ICMJE Interventional
Study Phase  ICMJE Early Phase 1
Study Design  ICMJE Allocation: Randomized
Intervention Model: Parallel Assignment
Intervention Model Description:
pilot study to determine effect size for possible FDA phase I/II trial
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Masking Description:
investigational pharmacy will have access to randomization schemes and will package study drug from bulk supplies. All other study team members and participants are blinded.
Primary Purpose: Treatment
Condition  ICMJE Hemangioma
Intervention  ICMJE Drug: PediaBerry
PediaBerry or placebo will be mixed with a cream vehicle for topical administration or with water for oral administration
Other Name: placebo
Study Arms  ICMJE
  • Experimental: Pediaberry group
    PediaBerry™ is a proprietary blend powdered berry extracts
    Intervention: Drug: PediaBerry
  • Placebo Comparator: Placebo
    Placebo: powdered sugar plus McCormick Color from Nature Food Colors Berry and Sky Blue powdered food color (https://www.mccormick.com/spices-and-flavors/extracts-and-food-colors/food-colors/color-from-nature-assorted-food-color ).
    Intervention: Drug: PediaBerry
Publications *
  • Hoak JC, Warner ED, Cheng HF, Fry GL, Hankenson RR. Hemangioma with thrombocytopenia and microangiopathic anemia (Kasabach-Merritt syndrome): an animal model. J Lab Clin Med. 1971 Jun;77(6):941-50.
  • Gordillo G, Fang H, Khanna S, Harper J, Phillips G, Sen CK. Oral administration of blueberry inhibits angiogenic tumor growth and enhances survival of mice with endothelial cell neoplasm. Antioxid Redox Signal. 2009 Jan;11(1):47-58. doi: 10.1089/ars.2008.2150.
  • Gordillo G, Fang H, Park H, Roy S. Nox-4-dependent nuclear H2O2 drives DNA oxidation resulting in 8-OHdG as urinary biomarker and hemangioendothelioma formation. Antioxid Redox Signal. 2010 Apr 15;12(8):933-43. doi: 10.1089/ars.2009.2917.
  • Gordillo GM, Atalay M, Roy S, Sen CK. Hemangioma model for in vivo angiogenesis: inducible oxidative stress and MCP-1 expression in EOMA cells. Methods Enzymol. 2002;352:422-32.
  • Gordillo GM, Biswas A, Khanna S, Pan X, Sinha M, Roy S, Sen CK. Dicer knockdown inhibits endothelial cell tumor growth via microRNA 21a-3p targeting of Nox-4. J Biol Chem. 2014 Mar 28;289(13):9027-38. doi: 10.1074/jbc.M113.519264. Epub 2014 Feb 4.
  • Gordillo GM, Onat D, Stockinger M, Roy S, Atalay M, Beck FM, Sen CK. A key angiogenic role of monocyte chemoattractant protein-1 in hemangioendothelioma proliferation. Am J Physiol Cell Physiol. 2004 Oct;287(4):C866-73. Epub 2004 May 26.
  • Biswas A, Khanna S, Roy S, Pan X, Sen CK, Gordillo GM. Endothelial cell tumor growth is Ape/ref-1 dependent. Am J Physiol Cell Physiol. 2015 Sep 1;309(5):C296-307. doi: 10.1152/ajpcell.00022.2015. Epub 2015 Jun 24.
  • Biswas A, Pan X, Meyer M, Khanna S, Roy S, Pearson G, Kirschner R, Witman P, Faith EF, Sen CK, Gordillo GM. Urinary Excretion of MicroRNA-126 Is a Biomarker for Hemangioma Proliferation. Plast Reconstr Surg. 2017 Jun;139(6):1277e-1284e. doi: 10.1097/PRS.0000000000003349.
  • Atalay M, Gordillo G, Roy S, Rovin B, Bagchi D, Bagchi M, Sen CK. Anti-angiogenic property of edible berry in a model of hemangioma. FEBS Lett. 2003 Jun 5;544(1-3):252-7.
  • Biswas A, Clark EC, Sen CK, Gordillo GM. Phytochemical Inhibition of Multidrug Resistance Protein-1 as a Therapeutic Strategy for Hemangioendothelioma. Antioxid Redox Signal. 2017 Jun 10;26(17):1009-1019. doi: 10.1089/ars.2016.6881. Epub 2016 Nov 9.
  • Gordillo GM, Biswas A, Khanna S, Spieldenner JM, Pan X, Sen CK. Multidrug Resistance-associated Protein-1 (MRP-1)-dependent Glutathione Disulfide (GSSG) Efflux as a Critical Survival Factor for Oxidant-enriched Tumorigenic Endothelial Cells. J Biol Chem. 2016 May 6;291(19):10089-103. doi: 10.1074/jbc.M115.688879. Epub 2016 Mar 9. Erratum in: J Biol Chem. 2016 Jul 1;291(27):14394.
  • Bruckner AL, Frieden IJ. Hemangiomas of infancy. J Am Acad Dermatol. 2003 Apr;48(4):477-93; quiz 494-6. Review.
  • Dinehart SM, Kincannon J, Geronemus R. Hemangiomas: evaluation and treatment. Dermatol Surg. 2001 May;27(5):475-85. Review.
  • Drolet BA, Esterly NB, Frieden IJ. Hemangiomas in children. N Engl J Med. 1999 Jul 15;341(3):173-81. Review.
  • Metry DW, Hebert AA. Benign cutaneous vascular tumors of infancy: when to worry, what to do. Arch Dermatol. 2000 Jul;136(7):905-14.
  • Chiller KG, Passaro D, Frieden IJ. Hemangiomas of infancy: clinical characteristics, morphologic subtypes, and their relationship to race, ethnicity, and sex. Arch Dermatol. 2002 Dec;138(12):1567-76.
  • Bauman NM, McCarter RJ, Guzzetta PC, Shin JJ, Oh AK, Preciado DA, He J, Greene EA, Puttgen KB. Propranolol vs prednisolone for symptomatic proliferating infantile hemangiomas: a randomized clinical trial. JAMA Otolaryngol Head Neck Surg. 2014 Apr;140(4):323-30. doi: 10.1001/jamaoto.2013.6723.
  • Tozzi A. Oral Propranolol for Infantile Hemangioma. N Engl J Med. 2015 Jul 16;373(3):284. doi: 10.1056/NEJMc1503811.
  • Léauté-Labrèze C, Hoeger P, Mazereeuw-Hautier J, Guibaud L, Baselga E, Posiunas G, Phillips RJ, Caceres H, Lopez Gutierrez JC, Ballona R, Friedlander SF, Powell J, Perek D, Metz B, Barbarot S, Maruani A, Szalai ZZ, Krol A, Boccara O, Foelster-Holst R, Febrer Bosch MI, Su J, Buckova H, Torrelo A, Cambazard F, Grantzow R, Wargon O, Wyrzykowski D, Roessler J, Bernabeu-Wittel J, Valencia AM, Przewratil P, Glick S, Pope E, Birchall N, Benjamin L, Mancini AJ, Vabres P, Souteyrand P, Frieden IJ, Berul CI, Mehta CR, Prey S, Boralevi F, Morgan CC, Heritier S, Delarue A, Voisard JJ. A randomized, controlled trial of oral propranolol in infantile hemangioma. N Engl J Med. 2015 Feb 19;372(8):735-46. doi: 10.1056/NEJMoa1404710.
  • Langley A, Pope E. Propranolol and central nervous system function: potential implications for paediatric patients with infantile haemangiomas. Br J Dermatol. 2015 Jan;172(1):13-23. doi: 10.1111/bjd.13379. Epub 2014 Dec 10.
  • Barlow CF, Priebe CJ, Mulliken JB, Barnes PD, Mac Donald D, Folkman J, Ezekowitz RA. Spastic diplegia as a complication of interferon Alfa-2a treatment of hemangiomas of infancy. J Pediatr. 1998 Mar;132(3 Pt 1):527-30.
  • Marczylo TH, Cooke D, Brown K, Steward WP, Gescher AJ. Pharmacokinetics and metabolism of the putative cancer chemopreventive agent cyanidin-3-glucoside in mice. Cancer Chemother Pharmacol. 2009 Nov;64(6):1261-8. doi: 10.1007/s00280-009-0996-7. Epub 2009 Apr 11.
  • Fang J. Bioavailability of anthocyanins. Drug Metab Rev. 2014 Nov;46(4):508-20. doi: 10.3109/03602532.2014.978080. Epub 2014 Oct 27. Review.
  • Manach C, Williamson G, Morand C, Scalbert A, Rémésy C. Bioavailability and bioefficacy of polyphenols in humans. I. Review of 97 bioavailability studies. Am J Clin Nutr. 2005 Jan;81(1 Suppl):230S-242S. doi: 10.1093/ajcn/81.1.230S. Review.
  • Mahmood I. Application of allometric principles for the prediction of pharmacokinetics in human and veterinary drug development. Adv Drug Deliv Rev. 2007 Sep 30;59(11):1177-92. Epub 2007 Aug 16. Review.
  • Sharma V, McNeill JH. To scale or not to scale: the principles of dose extrapolation. Br J Pharmacol. 2009 Jul;157(6):907-21. doi: 10.1111/j.1476-5381.2009.00267.x. Epub 2009 Jun 5. Review.
  • Chang LC, Haggstrom AN, Drolet BA, Baselga E, Chamlin SL, Garzon MC, Horii KA, Lucky AW, Mancini AJ, Metry DW, Nopper AJ, Frieden IJ; Hemangioma Investigator Group. Growth characteristics of infantile hemangiomas: implications for management. Pediatrics. 2008 Aug;122(2):360-7. doi: 10.1542/peds.2007-2767.
  • Garzon MC, Drolet BA, Baselga E, Chamlin SL, Haggstrom AN, Horii K, Lucky AW, Mancini AJ, Metry DW, Newell B, Nopper AJ, Frieden IJ; Hemangioma Investigator Group. Comparison of infantile hemangiomas in preterm and term infants: a prospective study. Arch Dermatol. 2008 Sep;144(9):1231-2. doi: 10.1001/archderm.144.9.1231.

*   Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
 
Recruitment Information
Recruitment Status  ICMJE Recruiting
Estimated Enrollment  ICMJE
 (submitted: July 11, 2019)
66
Original Estimated Enrollment  ICMJE Same as current
Estimated Study Completion Date  ICMJE December 31, 2022
Estimated Primary Completion Date June 30, 2022   (Final data collection date for primary outcome measure)
Eligibility Criteria  ICMJE

Inclusion Criteria:

  • Children with hemangiomas ≤ 4 months of corrected gestational age
  • Hemangioma size ≥ 1.5 cm diameter

Exclusion Criteria:

  • Children with hemangiomas that threaten the life of the child or development of vital structures.
  • Children who are breast feeding and mother is taking beta blocker medication
  • Children with previously treated hemangiomas
  • Congenital hemangiomas - cannot distinguish between rapidly involuting and non-involuting congenital hemangiomas
  • Hemangiomas located in the perineal/diapering area - product will get contaminated or wiped off with diapering
  • Children with food allergies to blueberries or any other kind of berry
  • Legal guardian unable to provide informed consent
Sex/Gender  ICMJE
Sexes Eligible for Study: All
Ages  ICMJE 1 Month to 4 Months   (Child)
Accepts Healthy Volunteers  ICMJE No
Contacts  ICMJE
Contact: Amy O Miller, MA/CCRP (317)-278-2720 amym@iu.edu
Contact: Sashwati Roy, PhD 317-278-2706 roysa@iu.edu
Listed Location Countries  ICMJE United States
Removed Location Countries  
 
Administrative Information
NCT Number  ICMJE NCT04020419
Other Study ID Numbers  ICMJE 1810087420
2R01GM095657 ( U.S. NIH Grant/Contract )
Has Data Monitoring Committee Yes
U.S. FDA-regulated Product
Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
IPD Sharing Statement  ICMJE
Plan to Share IPD: No
Responsible Party Gayle Gordillo, Indiana University
Study Sponsor  ICMJE Indiana University
Collaborators  ICMJE
  • National Institute of General Medical Sciences (NIGMS)
  • National Institutes of Health (NIH)
Investigators  ICMJE
Principal Investigator: Gayle Gordillo, MD Indiana University
PRS Account Indiana University
Verification Date February 2021

ICMJE     Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP