ClinicalTrials.gg
RecruitingNCT06049680Updated Oct 22, 2026

Safety Study of SMOFlipid to Evaluate the Risk of Developing EFAD and/or PNAC in Pediatric and Adult Patients

A Phase 4 interventional study of SMOFlipid® (lipid injectable emulsion) in Malnutrition, Child, Malnutrition and Essential Fatty Acid Deficiency (EFAD), sponsored by Fresenius Kabi. Recruiting at 6 sites in United States. Open to participants aged 1 Month to 17 Years. Per ClinicalTrials.gov, last updated 2026-10-22.

Sponsored by Fresenius Kabi · Phase 4, Interventional, and Other

From the registry’s dates

  • Started Oct 2024; still recruiting 2 years later.
Updated Oct 22, 2026Site recruiting status changedPrimary completion moved+2 moreGo to Updates ↓
Phase
Phase 4
Study type
Interventional
Enrollment
100
Allocation
Not applicable
Ages
1 Month to 17 Years
Sex
All
01

Study summary

Evaluate the risk of developing EFAD and/or PNAC in adult and pediatric patients 1 month of age and older, who are anticipated to need 8 weeks or longer of parenteral nutrition treatment with SMOFlipid.

02

Conditions studied

  • Malnutrition, Child
  • Malnutrition
  • Essential Fatty Acid Deficiency (EFAD)
  • Parenteral Nutrition Associated Cholestasis
03

In context

Child Nutrition Disorders

167 studies on the registry are indexed under Child Nutrition Disorders; 36 are open to participants now.

This study's planned enrollment of 100 is below the median of 402 across 132 interventional studies indexed under Child Nutrition Disorders.

Browse Child Nutrition Disorders studies →

Lead sponsor

Fresenius Kabi is the lead sponsor of 51 studies on the registry; 3 are open to participants now.

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

04

Who can participate

Ages eligible
1 Month to 17 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Age Limits: and Adults

Inclusion criteria

Inclusion Criteria:

  1. Male or female patients, at least 1 month of age.
  2. Patients who require PN for at least 5 days/week.
  3. Patients who receive 80% or more of their total energy requirements as PN at enrollment and who are expected to receive 80% or more of their total energy requirements as PN for at least 56 days.
  4. Written . In case of pediatric patients, informed consent must be obtained from parent(s) or legal representatives. If possible, the assent of the pediatric patient must also be obtained (according to local law).

Exclusion criteria

Exclusion Criteria:

  1. Use of any other lipid injectable emulsion than SMOFlipid within 6 months prior to study participation
  2. Known to fish, egg, soybean, or peanut proteins, or to any of the active ingredients or of SMOFlipid.
  3. Hyperlipidemia or disorders of lipid metabolism characterized by hypertriglyceridemia (serum triglyceride concentration >250 mg/dL in infants or >400 mg/dL in older pediatric and adult patients).
  4. Inborn errors of amino acid metabolism.
  5. Cardiopulmonary instability (including pulmonary edema, cardiac insufficiency, myocardial infarction, acidosis and hemodynamic instability requiring significant vasopressor support).
  6. Hemophagocytic syndrome.
  7. Liver enzymes (either , or ALT, or GGT) exceeding 2 x
  8. Direct exceeding 2 x upper limit of normal range
  9. exceeding 2 x upper limit of normal range and patient not receiving oral anticoagulants.
  10. Any known hepatic condition outside of IFALD that will increase direct bilirubin ≥2.0 mg/dL.
  11. abnormal levels of any serum electrolyte (sodium, potassium, magnesium, calcium, chloride, phosphate).
  12. Active bloodstream infection demonstrated by positive blood culture at screening.
  13. Severe renal failure ( \<15 ml/min per 1.73 m2) including patients on renal replacement therapy.
  14. Abnormal blood pH, oxygen saturation, or carbon dioxide.
  15. Pregnancy or lactation.
  16. Participation in another interventional clinical study.
  17. Unlikely to survive longer than 56 days.
Terms in these criteria, in plain language(9)

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.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

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.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

GFR and eGFR (kidney filtering)

GFR (glomerular filtration rate) is how much blood the kidneys filter each minute. It is usually estimated from a blood test — eGFR, by formulas such as CKD-EPI or MDRD — and some studies ask for it to be measured directly instead. Usually given in mL/min/1.73 m².

Check the method, the units and the minimum the study states. A value of 90 or above is in the normal-or-high range, but kidney damage can show in other tests too.

05

Study design

Phase
Phase 4
Primary purpose
Other
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
100 participants (estimated)

Study arms

  • Other
    Single arm SMOFlipid® (lipid injectable emulsion)

    Investigational drug: SMOFlipid® (lipid injectable emulsion).

    Drug: SMOFlipid® (lipid injectable emulsion)

Interventions

  • SMOFlipid is a sterile, nonpyrogenic, white, homogenous lipid emulsion for intravenous infusion. The lipid content of SMOFlipid is 0.20 g/mL, and comprises a mixture of soybean oil, MCT, olive oil, and fish oil. SMOFlipid belongs to the pharmacotherapeutic group: "Solutions for parenteral nutrition, fat emulsions" (ATC-code: B05BA02). SMOFlipid is indicated in adult and pediatric patients, including term and preterm neonates, as a source of calories and essential fatty acids for parenteral nutrition when oral or enteral nutrition is not possible, insufficient, or contraindicated.

06

What researchers measure

Primary outcomes

  1. Incidence of PNAC

    defined as direct bilirubin level \> 2 mg/dL, confirmed by a second sample collected 7 days after the first sample

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  2. Time to direct bilirubin > 2mg/dL

    (confirmed by a second sample collected 7 days after the first)

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  3. Incidence of EFAD

    Triene/tetraene ratio in total plasma to assess EFAD (Holman 1960), Severity of EFAD will be graded based on triene/tetraene ratio, as suspected ≥ 0.05, moderate ≥ 0.20 and severe ≥ 0.40 (Cober et al 2012)

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  4. Incidence of clinical EFAD

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  5. Fatty acids

    analyzed in total plasma, including linoleic acid, α-linolenic acid, arachidonic acid, docosahexaenoic acid, eicosapentaenoic acid and Mead acid

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

Secondary outcomes

  1. Laboratory values: triglycerides

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  2. Laboratory values: direct bilirubin

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  3. Laboratory values: total bilirubin

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  4. Laboratory values: alanine aminotransferase (ALT)

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  5. Laboratory values: aspartate aminotransferase (AST)

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  6. Laboratory values: gamma-glutamyl transferase (GGT)

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  7. Laboratory values: alkaline phosphatase (ALP)

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  8. Laboratory values: creatinine

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  9. Laboratory values: urea nitrogen

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  10. Laboratory values: electrolytes

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  11. Laboratory values: glucose

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  12. Laboratory values: total protein

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  13. Laboratory values hematology: white blood cell count (WBC), red blood cell count (RBC), and platelet count

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  14. Laboratory values hematology: Hemoglobin

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  15. Laboratory values hematology Hematocrit

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  16. Laboratory values hematology: International normalized ratio

    Time frame: At baseline before start of treatment to assess eligibility

  17. Vital signs: Blood pressure

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  18. Vital signs: Heart rate

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  19. Vital signs: Body temperature

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  20. Incidence of adverse events

    Time frame: Start of Treatment until After End of Last Study PN (+6 months for pediatric patients). Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

  21. BMI

    BMI is the weight in kilograms divided by height in meters squared. Alternatively, BMI can be calculated by dividing the weight in kilograms by the height in centimeters squared, and then multiplying the result by 10,000.

    Time frame: Start of Treatment until After End of Last Study PN Duration of Treatment: Study treatment will last for a minimum of 8 weeks (56 consecutive days) and as long as PN is indicated, up to 1 year (365 consecutive days).

07

Study locations

4 of 6 sites recruiting
08

Updates

1 registry update since Sep 25, 2026
Sites
1 site added. The University of Chicago is now Terminated
Show site
  • Duke University Medical Center · Durham, United States
Oct 22, 2026
Primary completion
Aug 2026→Nov 2026
Oct 22, 2026
Study completion
Sep 2026→Jan 2027
Oct 22, 2026
Site contacts
Changed at 1 site. See the sites
Show the site
  • The University of Chicago · Chicago, United StatesContact removed E•••@uchicagomedicine.org · •••3075
Oct 22, 2026
Show all 1 update
  1. Oct 22, 2026
    1 site added. The University of Chicago is now Terminated
    Show site
    • Duke University Medical Center · Durham, United States
    Primary completion Aug 2026→Nov 2026
    Study completion Sep 2026→Jan 2027
    Site contacts Changed at 1 site. See the sites
    Show the site
    • The University of Chicago · Chicago, United StatesContact removed E•••@uchicagomedicine.org · •••3075
    + 1 other change: verification date

From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗

09

Registry details

Key details

Study ID
NCT06049680
Lead sponsor
Fresenius Kabi
Responsible party
Sponsor
First posted
Sep 22, 2023
Start date
Oct 28, 2024
Primary completion
Nov 2026 (estimated)
Completion
Jan 2027 (estimated)
Last update
Oct 22, 2026

Study contacts

Martin Stumpf, PhD
Contact
martin.stumpf@fresenius-kabi.com
+49 6172 686 ext. 8655
Jean-Marc Lohse, PhD
Contact
Jean-Marc.Lohse@fresenius-kabi.com
+49 6172 686 ext. 4911
Jeffrey Rudolph, MD
principal investigator · University of Pittsburgh

Oversight

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

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