ClinicalTrials.gg
CompletedNCT03387579Updated Jul 30, 2025Results posted

Comparison of Smoflipid to Soy-based Lipid Reduction for Cholestasis Prevention in Surgical Neonates

A Phase 3 interventional study of Smoflipid 20% Lipid Emulsion for Injection and Intralipid, 20% Intravenous Emulsion in Cholestasis of Parenteral Nutrition, sponsored by Indiana University. Completed at 1 site in United States. Per ClinicalTrials.gov, last updated 2025-07-30.

Sponsored by Indiana University · Phase 3, Interventional, and Prevention

Phase
Phase 3
Study type
Interventional
Enrollment
24
Allocation
Randomized
Sex
All
01

Study summary

Intestinal failure associated liver disease is a cholestatic liver disease associated with prolonged need for parenteral nutrition that can lead to such significant complications as liver failure. In the neonatal population, infants with history of intestinal resection and short bowel syndrome are at increased risk for this disease. The investigators plan to compare two possible lipid dosing preventative strategies including a composite, fish oil lipid and soy-based lipid reduction.

Read the detailed description

Intestinal failure associated liver disease (IFALD) is a cholestatic liver disease associated with prolonged need for parenteral nutrition. This disease can lead to such serious complications as liver failure and need for transplantation. In the neonatal population, short bowel syndrome, due to intestinal resection, is the most common cause of intestinal failure. While the exact cause is yet to be determined, it is felt the lipid component of parenteral nutrition is a large contributor to the development of this disease. Currently, there is no standard preventative strategy to attempt to decrease the risk of IFALD in the high risk, post-surgical neonatal population. The investigators aim to complete a randomized trial comparing two possible preventative strategies. One group will receive a composite lipid containing fish oil (Smoflipid) and the other group will receive soy-based lipid at reduced dosing.

02

Conditions studied

  • Cholestasis of Parenteral Nutrition

Browse trials for

03

In context

Cholestasis

150 studies on the registry are indexed under Cholestasis; 18 are open to participants now.

This study's enrollment of 24 is below the median of 53 across 90 interventional studies indexed under Cholestasis.

Browse Cholestasis studies →

Lead sponsor

Indiana University is the lead sponsor of 986 studies on the registry; 198 are open to participants now.

Of its 148 completed or terminated interventional studies of FDA-regulated products, 118 (80%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
Child (0–17), Adult (18–64), Older adult (65+)
Sexes eligible
All
Accepts healthy volunteers
No

Eligibility criteria

Inclusion Criteria: Neonates with anticipated need for parenteral nutrition (based on primary physicians opinion) for greater than or equal to four weeks and one of the following diagnoses:

  • Anatomic: Neonate with intestinal atresia, omphalocele, gastroschisis, or volvulus with or without intestinal resection.
  • Ischemic/perforation: Neonates with spontaneous intestinal perforation or necrotizing enterocolitis requiring surgical intervention.

Exclusion Criteria:

  • Current weight less than 750 grams
  • or ALT greater than 5 times the within 2 weeks of enrollment
  • Direct greater than 2 mg/dL on any consecutive measurements 5 - 7 days apart within 2 weeks of enrollment
  • Severe coagulopathy with greater than 95th percentile for age (>1.7 at less than 5 days of age, > 1.5 older than five days of age)
  • Culture confirmed sepsis with positive blood, urine, or CSF culture within 2 weeks of enrollment
  • Renal failure requiring dialysis
  • Cyanotic heart disease requiring prostaglandin therapy
  • Hypertriglyceridemia (greater than 250mg/dL) at time of enrollment
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

ALT and AST (liver enzymes)

Two enzymes measured in a routine blood test of the liver. Higher levels can mean the liver is under strain or damaged. SGPT and SGOT are older names for ALT and AST.

Criteria usually give a limit as a multiple of the upper limit of normal (ULN), often higher when cancer has spread to the liver.

ULN (upper limit of normal)

The top of the normal range for a blood test, as set by the laboratory that runs it. Each lab prints its own range next to your result.

“≤ 2.5 × ULN” means the result can be up to two and a half times that top value.

Bilirubin

A yellow substance made when red blood cells are broken down, which the liver clears. A high level can mean a problem with the liver or the bile ducts.

Criteria often allow more for people with Gilbert’s syndrome, a harmless inherited condition that raises bilirubin.

INR, PT and aPTT (clotting tests)

Blood tests of how long blood takes to clot. The INR is the prothrombin time (PT) put on a common scale; about 1 is usual for someone not taking a blood thinner.

Criteria often make an exception for people on a blood thinner such as warfarin, whose INR is raised on purpose.

05

Study design

Phase
Phase 3
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
24 participants (actual)

Study arms

  • Experimental
    Smoflipid 20%

    Patients randomized to this arm will receive the composite fish oil lipid, Smoflipid, at standard dosing up to 3 g/kg/day. Patients will be started on a dose of 1 g/kg/day and titrated up to maximum dose. As enteral nutrition is advanced the lipid dose will be weaned per study protocol and dietary recommendations.

    Drug: Smoflipid 20% Lipid Emulsion for Injection

  • Experimental
    Intralipid 20% Reduction

    Patients randomized to this arm will receive soy-based lipid (Intralipid) at a dose of 1 g/kg/day throughout their enrollment in the study.

    Drug: Intralipid, 20% Intravenous Emulsion

  • Other
    Intralipid 20% Historic

    Patients who retrospectively received soy-based lipid (Intralipid) at standard dosing of 2-3 g/kg/day were eligible for inclusion. Patients in this group were matched to prospective patients based on diagnosis, gestational age, and length of lipid therapy.

    Drug: Intralipid, 20% Intravenous Emulsion

Interventions

06

What researchers measure

Primary outcomes

  1. Number of Participants With Cholestasis

    Cholestasis was defined as a direct bilirubin \> 2 mg/dL on two measurements 5 to 7 days apart.

    Time frame: Patients were monitored during time enrolled in study for a maximum of up to 12 weeks or 84 days.

Secondary outcomes

  1. Weight Velocity

    Weight velocity was calculated as the difference in weight from end to start of study divided by number of days enrolled in study.

    Time frame: Patient weight was recorded at enrollment, weekly during time enrolled, and at end of study for up to a maximum of 12 weeks. End and enrollment weights were used to calculate velocity.

  2. Length Velocity

    Length velocity was defined as the difference in length from end of study compared to enrollment divided by the number of days enrolled in study.

    Time frame: Length was measured at enrollment, weekly during time enrolled in study, and end of study up to a maximum of 12 weeks. End and enrollment measurements were used for velocity.

  3. Head Circumference (OFC) Velocity

    OFC velocity was calculated as difference end and start of study divided by number of days enrolled in study.

    Time frame: OFC was measured at enrollment, weekly, and end of study. Enrollment and end of study measurements used for velocity.

  4. Average Total Calorie Intake

    Total calorie intake, including parenteral and enteral sources, were averaged on a weekly basis.

    Time frame: Daily calorie intake was recorded and averaged on a weekly basis for duration of study enrollment up to max of 12 weeks.

  5. Number of Patients With Enteral Autonomy at End of Study

    Percentage of patients with enteral autonomy at time of leaving or stopping study was calculated. Enteral autonomy was defined as relying on enteral nutrition only for nutrition intake with no need for parenteral nutrition supplementation.

    Time frame: Enteral autonomy was recorded at the study end point for each individual patient. This end point was at time of stopping study lipid, discharge from hospital, or maximum of 12 weeks.

  6. Number of Patients With Essential Fatty Acid Deficiency (EFAD)

    Essential fatty acid deficiency was defined as a triene to tetraene ratio greater than 0.05.

    Time frame: Essential fatty acid levels were measured every 4 weeks during enrollment for a maximum of up to 12 weeks.

  7. AST Change Over Time

    The change of AST over time was calculated and compared between groups. AST change was calculated as AST end - AST enrollment.

    Time frame: AST was recorded at enrollment and every 2 weeks while enrolled in the study up to a maximum of 12 weeks.

  8. ALT Change Over Time

    The rate of change of ALT over time was compared between groups using mixed model analysis. Change of ALT was calculated as ALT at end of study compared to ALT at enrollment.

    Time frame: ALT measured at enrollment and every 2 weeks for max 12 weeks.

  9. Alkaline Phosphatase Change Over Time

    Alkaline phosphatase was recorded at enrollment and every 2 weeks. The change in alkaline phosphatase was calculated as alkaline phosphatase at end minus enrollment.

    Time frame: Alkaline phosphatase was measured at enrollment and every 2 weeks for max of 12 weeks.

  10. Triglyceride Level Over Time

    All enrolled patients had serum triglyceride levels monitored at enrollment and weekly. The triglyceride level changes was calculated using values at the end of study compared to enrollment with mean and standard deviation calculated for each treatment group.

    Time frame: Serum triglyceride levels monitored at enrollment and weekly during time enrolled in study for a maximum of 12 weeks.

  11. Gamma Glutamyl Transferase (GGT) Over Time

    GGT was documented at baseline and regularly intervals with level compared over time between groups. GGT was compared by treatment group for levels at end of study and enrollment.

    Time frame: GGT was measured at enrollment and every 2 weeks while enrolled in the study for a maximum of up to 12 weeks.

  12. Number of Patients With Retinopathy of Prematurity

    The rate of retinopathy of prematurity (ROP) was compared between groups. ROP was diagnosed based on ophthalmologist examination with all stages included.

    Time frame: Diagnosis was based on diagnosis during time of initial hospitalization to level 4 NICU.

  13. Number of Patients With Bronchopulmonary Dysplasia (BPD) or Chronic Lung Disease

    The rate of BPD was documented and compared between groups. BPD was diagnosed based on need for respiratory support at 28 days of age. All levels of severity were included.

    Time frame: All patient had diagnosis of BPD documented from admission at level 4 NICU.

  14. NICU Length of Stay

    The length of stay at the level 4 NICU was compared between groups.

    Time frame: Length of stay will be calculated based on documenting each patient's admission date and date leaving the NICU.

  15. Three Year Development- Communication

    During the third year of chronological age an Ages and Stages questionnaire (ASQ) was completed by the parents. For each section the range of score possible is 0-60. Higher scores show improved outcomes. Scores are separated into on schedule, monitoring zone, and below cutoff. These thresholds vary by aged screened. Possible screens used for this age group include 36 months, 42 months, and 48 months dependent on exact chronologic age screen completed. At 36 months communication 45-60 is on schedule; 35-40 monitoring, and \<35 below cutoff. For 42 months on schedule 40-60; monitoring 30-35; below cutoff \<35. For 48 months on schedule 45-60; monitoring 35-40; below cutoff \<35.

    Time frame: ASQ was completed during the third year of life from 3 years 0 days to 3 years 364 days of chronologic age.

  16. Three Year Development: Gross Motor

    During the third year of chronological age an Ages and Stages questionnaire (ASQ) was completed by the parents. For each section the range of score possible is 0-60. Higher scores indicate improved outcome, there are three possible scoring categories on schedule (normal), monitoring zone, below cutoff. Score thresholds by possible screens include: 36 months on schedule 50-60; monitoring 40-45; below cutoff \<40. 42 months on schedule 50-60; monitoring 40-45; below cutoff \<40. 48 months on schedule 45-60; monitoring 35-40; below cutoff \<35.

    Time frame: three year chronological age 3 years and 0 days to 3 years and 364 days

  17. Three Year Development: Fine Motor

    During the third year of chronological age an Ages and Stages questionnaire (ASQ) was completed by the parents. For each section the range of score possible is 0-60. Higher scores show improved outcomes with three scoring categories: on schedule (normal), monitoring zone, and below cutoff. These thresholds vary by each category and screening age. Based on the possible screens for chronological age the score categories are: 36 months: 35-60 on schedule; 20-30 monitoring; \<20 below cutoff. 42 months: 35-60 on schedule; 20-30 monitoring; \<20 below cutoff. 48 months: 35-60 on schedule; 20-30 monitoring; \<20 below cutoff.

    Time frame: three year chronological age (3 years and 0 days to 3 years and 364 days)

  18. Three Year Development: Problem Solving

    During the third year of chronological age an Ages and Stages questionnaire (ASQ) was completed by the parents. For each section the range of score possible is 0-60. Higher scores indicate improved outcomes with three possible score categories: on schedule (normal), monitoring zone, and below cutoff. Category thresholds vary by outcome category and age of screen. There are three possible screens that were used for this population, chosen based on chronologic age. The score categories based on age are: 36 months: 45-60 on schedule; 35-40 monitoring; \<35 below cutoff. 42 months: 40-60 on schdule; 30-35 monitoring; \<30 below cutoff. 48 months: 45-60 on schedule; 35-40 monitoring; \<35 below cutoff

    Time frame: three year chronological age (3 years and 0 days to 3 years and 364 days)

  19. Three Year Development: Personal Social

    During the third year of chronological age an Ages and Stages questionnaire (ASQ) was completed by the parents. For each section the range of score possible is 0-60. Higher scores indicate improved outcomes with three score categories possible including on schedule (normal), monitoring zone, and below cutoff. These thresholds vary based on outcome measure and age of screen completed. Screen used depends on chronological age at screen. Score thresholds for each age include: 36 months: 45-60 on schedule; 35-40 monitoring; \<35 below cutoff. 42 months: 45-60 on schedule; 35-40 monitoring; \<35 below cutoff. 48 months: 40-60 on schedule; 30-40 monitoring; \<30 below cutoff.

    Time frame: three year chronological age (3 years and 0 days to 3 years and 364 days)

07

Results

Posted Aug 26, 2022

Participant flow

Patients were eligible for enrollment if they were admitted to the level IV NICU, required abdominal surgery, and needed TPN. Patients were excluded if they had signs of liver disease at baseline. Informed consent was obtained, and once screening lab work completed patients were randomized into one of two prospective treatment groups. Historic controls were included from previous two years prior to enrollment with selection based on same eligibility criteria.

Participant flow — Overall Study
MilestoneSmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
Started121224
Completed121224
Not completed000

Outcome measures

PrimaryNumber of Participants With Cholestasis

Cholestasis was defined as a direct bilirubin \> 2 mg/dL on two measurements 5 to 7 days apart.

Time frame:
Patients were monitored during time enrolled in study for a maximum of up to 12 weeks or 84 days.
Reported as:
Count of participants · Participants
Number of Participants With Cholestasis
ParticipantsSmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
Number of Participants With Cholestasis137
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Fisher Exact · p = 0.590
  • Smoflipid 20% vs Intralipid 20% Historic · Fisher Exact · p = 0.224
  • Intralipid 20% Reduction vs Intralipid 20% Historic · Fisher Exact · p = 1.00
SecondaryWeight Velocity

Weight velocity was calculated as the difference in weight from end to start of study divided by number of days enrolled in study.

Time frame:
Patient weight was recorded at enrollment, weekly during time enrolled, and at end of study for up to a maximum of 12 weeks. End and enrollment weights were used to calculate velocity.
Reported as:
Mean · grams per day
Weight Velocity
grams per daySmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
Weight Velocity28.6 ± 10.623.0 ± 11.924.6 ± 8.2
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction vs Intralipid 20% Historic · Kruskal-Wallis · p = 0.471
SecondaryLength Velocity

Length velocity was defined as the difference in length from end of study compared to enrollment divided by the number of days enrolled in study.

Time frame:
Length was measured at enrollment, weekly during time enrolled in study, and end of study up to a maximum of 12 weeks. End and enrollment measurements were used for velocity.
Reported as:
Mean · centimeters per day
Length Velocity
centimeters per daySmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
Length Velocity0.13 ± 0.080.09 ± 0.650.10 ± 0.08
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction vs Intralipid 20% Historic · Kruskal-Wallis · p = 0.525
SecondaryHead Circumference (OFC) Velocity

OFC velocity was calculated as difference end and start of study divided by number of days enrolled in study.

Time frame:
OFC was measured at enrollment, weekly, and end of study. Enrollment and end of study measurements used for velocity.
Reported as:
Mean · centimeters per day
Head Circumference (OFC) Velocity
centimeters per daySmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
Head Circumference (OFC) Velocity0.09 ± 0.030.07 ± 0.060.10 ± 0.05
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction vs Intralipid 20% Historic · Kruskal-Wallis · p = 0.753
SecondaryAverage Total Calorie Intake

Total calorie intake, including parenteral and enteral sources, were averaged on a weekly basis.

Time frame:
Daily calorie intake was recorded and averaged on a weekly basis for duration of study enrollment up to max of 12 weeks.
Reported as:
Mean · kcal per kilograms per day
Average Total Calorie Intake
kcal per kilograms per daySmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
Average Total Calorie Intake114.0 ± 9.1101.9 ± 10.5109.1 ± 8.3
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction vs Intralipid 20% Historic · Kruskal-Wallis · p = 0.008
SecondaryNumber of Patients With Enteral Autonomy at End of Study

Percentage of patients with enteral autonomy at time of leaving or stopping study was calculated. Enteral autonomy was defined as relying on enteral nutrition only for nutrition intake with no need for parenteral nutrition supplementation.

Time frame:
Enteral autonomy was recorded at the study end point for each individual patient. This end point was at time of stopping study lipid, discharge from hospital, or maximum of 12 weeks.
Reported as:
Count of participants · Participants
Number of Patients With Enteral Autonomy at End of Study
ParticipantsSmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
Number of Patients With Enteral Autonomy at End of Study91023
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction vs Intralipid 20% Historic · Fisher Exact · p = 0.127
SecondaryNumber of Patients With Essential Fatty Acid Deficiency (EFAD)

Essential fatty acid deficiency was defined as a triene to tetraene ratio greater than 0.05.

Time frame:
Essential fatty acid levels were measured every 4 weeks during enrollment for a maximum of up to 12 weeks.
Reported as:
Count of participants · Participants
Number of Patients With Essential Fatty Acid Deficiency (EFAD)
ParticipantsSmoflipid 20%Intralipid 20% Reduction
Number of Patients With Essential Fatty Acid Deficiency (EFAD)01
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Fisher Exact · p = 1.00
SecondaryAST Change Over Time

The change of AST over time was calculated and compared between groups. AST change was calculated as AST end - AST enrollment.

Time frame:
AST was recorded at enrollment and every 2 weeks while enrolled in the study up to a maximum of 12 weeks.
Reported as:
Mean · units per liter
AST Change Over Time
units per literSmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
AST Change Over Time-8.3 ± 25.52.9 ± 62.45.1 ± 49.8
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Mixed Models Analysis · p = 0.046 (Intralipid 20% reduction versus smoflipid 20%) · Estimate: 8.553standard error 4.249
  • Smoflipid 20% vs Intralipid 20% Historic · Mixed Models Analysis · p = 0.040 (Intralipid 20% historic versus smoflipid) · Estimate: 7.023standard error 3.376
  • Intralipid 20% Reduction vs Intralipid 20% Historic · Mixed Models Analysis · p = 0.718 (Intralipid 20% Historic versus Intralipid 20% reduction) · Estimate: -1.530standard error 4.231
SecondaryALT Change Over Time

The rate of change of ALT over time was compared between groups using mixed model analysis. Change of ALT was calculated as ALT at end of study compared to ALT at enrollment.

Time frame:
ALT measured at enrollment and every 2 weeks for max 12 weeks.
Reported as:
Mean · units per liter
ALT Change Over Time
units per literSmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
ALT Change Over Time8.7 ± 14.925.3 ± 53.317.2 ± 51.7
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Mixed Models Analysis · p = 0.003 (Intralipid 20% reduction versus Smoflipid 20%) · Estimate: 13.436standard error 4.440
  • Smoflipid 20% vs Intralipid 20% Historic · Mixed Models Analysis · p = 0.270 (Intralipid 20% historic versus Smoflipid 20%) · Estimate: 3.936standard error 3.553
  • Intralipid 20% Reduction vs Intralipid 20% Historic · Mixed Models Analysis · p = 0.034 (Intralipid 20% historic versus Intralipid 20% reduction) · Estimate: -9.500standard error 4.416
SecondaryAlkaline Phosphatase Change Over Time

Alkaline phosphatase was recorded at enrollment and every 2 weeks. The change in alkaline phosphatase was calculated as alkaline phosphatase at end minus enrollment.

Time frame:
Alkaline phosphatase was measured at enrollment and every 2 weeks for max of 12 weeks.
Reported as:
Mean · units per liter
Alkaline Phosphatase Change Over Time
units per literSmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
Alkaline Phosphatase Change Over Time107.0 ± 146.9166.1 ± 126.6150.2 ± 139.9
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Mixed Models Analysis · p = 0.006 (Intralipid 20% reduction versus Smoflipid 20%) · Estimate: 42.674standard error 15.216
  • Smoflipid 20% vs Intralipid 20% Historic · Mixed Models Analysis · p = 0.305 (Intralipid 20% historic versus smoflipid 20%) · Estimate: 11.117standard error 10.771
  • Intralipid 20% Reduction vs Intralipid 20% Historic · Mixed Models Analysis · p = <0.001 (Intralipid 20% historic versus Intralipid 20% reduction) · Estimate: -31.557standard error 67.673
SecondaryTriglyceride Level Over Time

All enrolled patients had serum triglyceride levels monitored at enrollment and weekly. The triglyceride level changes was calculated using values at the end of study compared to enrollment with mean and standard deviation calculated for each treatment group.

Time frame:
Serum triglyceride levels monitored at enrollment and weekly during time enrolled in study for a maximum of 12 weeks.
Reported as:
Mean · mg/dL
Triglyceride Level Over Time
mg/dLSmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
Triglyceride Level Over Time-18.5 ± 31.0013.3 ± 54.513.7 ± 48.0
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Mixed Models Analysis · p = 0.835 (Intralipid 20% reduction versus smoflipid 20%) · Estimate: -0.593standard error 2.848
  • Smoflipid 20% vs Intralipid 20% Historic · Mixed Models Analysis · p = 0.799 (Intralipid 20% historic versus smoflipid 20%) · Estimate: -0.522standard error 2.050
  • Intralipid 20% Reduction vs Intralipid 20% Historic · Mixed Models Analysis · p = 0.714 (Intralipid 20% historic versus Intralipid 20% reduction) · Estimate: 0.714standard error 2.758
SecondaryGamma Glutamyl Transferase (GGT) Over Time

GGT was documented at baseline and regularly intervals with level compared over time between groups. GGT was compared by treatment group for levels at end of study and enrollment.

Time frame:
GGT was measured at enrollment and every 2 weeks while enrolled in the study for a maximum of up to 12 weeks.
Reported as:
Mean · units per liter
Gamma Glutamyl Transferase (GGT) Over Time
units per literSmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
Gamma Glutamyl Transferase (GGT) Over Time-0.8 ± 99.755.7 ± 73.337.3 ± 121.7
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Mixed Models Analysis · p = 0.379 · Estimate: 11.162standard error 12.626
  • Smoflipid 20% vs Intralipid 20% Historic · Mixed Models Analysis · p = 0.717 (Intralipid 20% historic versus smoflipid 20%) · Estimate: 3.853standard error 10.615
  • Intralipid 20% Reduction vs Intralipid 20% Historic · Mixed Models Analysis · p = 0.576 · Estimate: -7.310standard error 13.025
SecondaryNumber of Patients With Retinopathy of Prematurity

The rate of retinopathy of prematurity (ROP) was compared between groups. ROP was diagnosed based on ophthalmologist examination with all stages included.

Time frame:
Diagnosis was based on diagnosis during time of initial hospitalization to level 4 NICU.
Reported as:
Count of participants · Participants
Number of Patients With Retinopathy of Prematurity
ParticipantsSmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
Number of Patients With Retinopathy of Prematurity213
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Fisher Exact · p = 1.00
  • Intralipid 20% Reduction vs Intralipid 20% Historic · Fisher Exact · p = 1.00
SecondaryNumber of Patients With Bronchopulmonary Dysplasia (BPD) or Chronic Lung Disease

The rate of BPD was documented and compared between groups. BPD was diagnosed based on need for respiratory support at 28 days of age. All levels of severity were included.

Time frame:
All patient had diagnosis of BPD documented from admission at level 4 NICU.
Reported as:
Count of participants · Participants
Number of Patients With Bronchopulmonary Dysplasia (BPD) or Chronic Lung Disease
ParticipantsSmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
Number of Patients With Bronchopulmonary Dysplasia (BPD) or Chronic Lung Disease225
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Fisher Exact · p = 1.00
  • Intralipid 20% Reduction vs Intralipid 20% Historic · Fisher Exact · p = 0.640
  • Smoflipid 20% vs Intralipid 20% Historic · Fisher Exact · p = 1.00
SecondaryNICU Length of Stay

The length of stay at the level 4 NICU was compared between groups.

Time frame:
Length of stay will be calculated based on documenting each patient's admission date and date leaving the NICU.
Reported as:
Mean · days
NICU Length of Stay
daysSmoflipid 20%Intralipid 20% ReductionIntralipid 20% Historic
NICU Length of Stay72.2 ± 57.633.3 ± 46.040.2 ± 42.2
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction vs Intralipid 20% Historic · Kruskal-Wallis · p = 0.211
SecondaryThree Year Development- Communication

During the third year of chronological age an Ages and Stages questionnaire (ASQ) was completed by the parents. For each section the range of score possible is 0-60. Higher scores show improved outcomes. Scores are separated into on schedule, monitoring zone, and below cutoff. These thresholds vary by aged screened. Possible screens used for this age group include 36 months, 42 months, and 48 months dependent on exact chronologic age screen completed. At 36 months communication 45-60 is on schedule; 35-40 monitoring, and \<35 below cutoff. For 42 months on schedule 40-60; monitoring 30-35; below cutoff \<35. For 48 months on schedule 45-60; monitoring 35-40; below cutoff \<35.

Time frame:
ASQ was completed during the third year of life from 3 years 0 days to 3 years 364 days of chronologic age.
Reported as:
Mean · score on a scale
Three Year Development- Communication
score on a scaleSmoflipid 20%Intralipid 20% Reduction
Three Year Development- Communication40.3 ± 22.441.2 ± 17.7
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Wilcoxon (Mann-Whitney) · p = 0.720
SecondaryThree Year Development: Gross Motor

During the third year of chronological age an Ages and Stages questionnaire (ASQ) was completed by the parents. For each section the range of score possible is 0-60. Higher scores indicate improved outcome, there are three possible scoring categories on schedule (normal), monitoring zone, below cutoff. Score thresholds by possible screens include: 36 months on schedule 50-60; monitoring 40-45; below cutoff \<40. 42 months on schedule 50-60; monitoring 40-45; below cutoff \<40. 48 months on schedule 45-60; monitoring 35-40; below cutoff \<35.

Time frame:
three year chronological age 3 years and 0 days to 3 years and 364 days
Reported as:
Mean · score on a scale
Three Year Development: Gross Motor
score on a scaleSmoflipid 20%Intralipid 20% Reduction
Three Year Development: Gross Motor43.0 ± 24.254.1 ± 8.19
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Wilcoxon (Mann-Whitney) · p = 0.500
SecondaryThree Year Development: Fine Motor

During the third year of chronological age an Ages and Stages questionnaire (ASQ) was completed by the parents. For each section the range of score possible is 0-60. Higher scores show improved outcomes with three scoring categories: on schedule (normal), monitoring zone, and below cutoff. These thresholds vary by each category and screening age. Based on the possible screens for chronological age the score categories are: 36 months: 35-60 on schedule; 20-30 monitoring; \<20 below cutoff. 42 months: 35-60 on schedule; 20-30 monitoring; \<20 below cutoff. 48 months: 35-60 on schedule; 20-30 monitoring; \<20 below cutoff.

Time frame:
three year chronological age (3 years and 0 days to 3 years and 364 days)
Reported as:
Mean · score on a scale
Three Year Development: Fine Motor
score on a scaleSmoflipid 20%Intralipid 20% Reduction
Three Year Development: Fine Motor32.2 ± 21.634.9 ± 19.1
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · t-test, 2 sided · p = 0.774
SecondaryThree Year Development: Problem Solving

During the third year of chronological age an Ages and Stages questionnaire (ASQ) was completed by the parents. For each section the range of score possible is 0-60. Higher scores indicate improved outcomes with three possible score categories: on schedule (normal), monitoring zone, and below cutoff. Category thresholds vary by outcome category and age of screen. There are three possible screens that were used for this population, chosen based on chronologic age. The score categories based on age are: 36 months: 45-60 on schedule; 35-40 monitoring; \<35 below cutoff. 42 months: 40-60 on schdule; 30-35 monitoring; \<30 below cutoff. 48 months: 45-60 on schedule; 35-40 monitoring; \<35 below cutoff

Time frame:
three year chronological age (3 years and 0 days to 3 years and 364 days)
Reported as:
Mean · score on a scale
Three Year Development: Problem Solving
score on a scaleSmoflipid 20%Intralipid 20% Reduction
Three Year Development: Problem Solving47.9 ± 19.547.3 ± 11.1
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Wilcoxon (Mann-Whitney) · p = 0.457
SecondaryThree Year Development: Personal Social

During the third year of chronological age an Ages and Stages questionnaire (ASQ) was completed by the parents. For each section the range of score possible is 0-60. Higher scores indicate improved outcomes with three score categories possible including on schedule (normal), monitoring zone, and below cutoff. These thresholds vary based on outcome measure and age of screen completed. Screen used depends on chronological age at screen. Score thresholds for each age include: 36 months: 45-60 on schedule; 35-40 monitoring; \<35 below cutoff. 42 months: 45-60 on schedule; 35-40 monitoring; \<35 below cutoff. 48 months: 40-60 on schedule; 30-40 monitoring; \<30 below cutoff.

Time frame:
three year chronological age (3 years and 0 days to 3 years and 364 days)
Reported as:
Mean · score on a scale
Three Year Development: Personal Social
score on a scaleSmoflipid 20%Intralipid 20% Reduction
Three Year Development: Personal Social46.5 ± 20.647.1 ± 10.5
Statistical analysis
  • Smoflipid 20% vs Intralipid 20% Reduction · Wilcoxon (Mann-Whitney) · p = 0.475

Adverse events

Collected over Adverse event data was collected while patient was receiving study lipid, up to a maximum of 12 weeks.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Smoflipid 20%0/12 (0%)2/12 (16.7%)8/12 (66.7%)
Intralipid 20% Reduction0/12 (0%)2/12 (16.7%)6/12 (50%)
Most frequent serious events
Most frequent serious events
EventSmoflipid 20%Intralipid 20% Reduction
Rapid infusionProduct Issues1/121/12
Intestinal perforationGastrointestinal disorders0/121/12
gastrointestinal bleedGastrointestinal disorders1/120/12
Most frequent other events
Showing 10 of 23
Most frequent other events
EventSmoflipid 20%Intralipid 20% Reduction
AnemiaBlood and lymphatic system disorders8/126/12
Elevated GGTGastrointestinal disorders1/122/12
Elevated LFTGastrointestinal disorders0/122/12
HypoalbuminemiaMetabolism and nutrition disorders2/122/12
HyperglycemiaMetabolism and nutrition disorders0/122/12
HypophosphatemiaMetabolism and nutrition disorders1/122/12
HypoglycemiaMetabolism and nutrition disorders1/122/12
HypertriglyceridemiaMetabolism and nutrition disorders1/122/12
HypochloremiaMetabolism and nutrition disorders2/120/12
Metabolic alkalosisMetabolism and nutrition disorders2/120/12

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Smoflipid 20%Intralipid 20% ReductionIntralipid 20% HistoricTotal
<=18 years12122448
Between 18 and 65 years0000
>=65 years0000
Age, Continuous
Age, Continuous(days)Smoflipid 20%Intralipid 20% ReductionIntralipid 20% HistoricTotal
Median4 (3.3 to 11.3)5 (4 to 5)2 (1 to 2.8)3.5 (2 to 5)
Sex: Female, Male
Sex: Female, Male(Participants)Smoflipid 20%Intralipid 20% ReductionIntralipid 20% HistoricTotal
Female75921
Male571527
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Smoflipid 20%Intralipid 20% ReductionIntralipid 20% HistoricTotal
Hispanic or Latino1023
Not Hispanic or Latino11122245
Unknown or Not Reported0000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Smoflipid 20%Intralipid 20% ReductionIntralipid 20% HistoricTotal
American Indian or Alaska Native0101
Asian0022
Native Hawaiian or Other Pacific Islander0000
Black or African American20810
White10111334
More than one race0000
Unknown or Not Reported0011
Region of Enrollment
Region of Enrollment(participants)Smoflipid 20%Intralipid 20% ReductionIntralipid 20% HistoricTotal
United States12122448
08

Study locations

1 site
  • Riley Hospital for Children at IU Health
    Indianapolis, Indiana 46202, United States
09

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: No

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Nov 2018 to primary completion in Mar 2021, 27 months.

Results were first posted in Aug 2022, 1 year 4 months after primary completion.

Of 12 phase 3 interventional studies under Cholestasis, half reached primary completion within 38 months of starting (the median), counting those still running; a quarter within 26 and three quarters within 64. This study's 27 months is below that.

How these figures are worked out, and which studies are left out of them.

Registered
Dec 3, 2017
First posted
Jan 2, 2018
StartActual
Nov 30, 2018
Primary completionActual
Mar 28, 2021
CompletionActual
Mar 19, 2024
Results first posted
Aug 26, 2022
Last update
Jul 30, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 30, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03387579
Lead sponsor
Indiana University
Responsible party
Charles P.B. Vanderpool (Assistant Professor of Clinical Pediatrics, Co-chair, Nutrition Support Team at Riley Hospital for Children, Medical Director, Pediatric Intestinal Rehabilitation Program, Indiana University) — Principal investigator
First posted
Jan 2, 2018
Start date
Nov 30, 2018
Primary completion
Mar 28, 2021
Completion
Mar 19, 2024
Results posted
Aug 26, 2022
Last update
Jul 30, 2025

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Jul 2025. You cannot join it, but the record below documents what was studied.

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Studies of the drugs tested here: SMOFlipid · Soybean oil, phospholipid emulsion

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