Tralement versus a fixed-dose trace element combination product of zinc, copper, and selenious acid to evaluate product safety in adult patients requiring long-term parenteral nutrition.
A Phase IV, multi-center, randomized single-blind trial to evaluate the safety profile of Tralement versus a fixed-dose trace element product of zinc, copper, and selenious acid in adult patients who are expected to require at least six-months of home parenteral nutrition. This study will enroll new prescribed home parenteral nutrition users, i.e. a patient enrolled in the study within six weeks of initiating first-time use of parenteral nutrition requiring trace element additives. Note: a portion of patients who meet inclusion criteria may have received parenteral nutrition in an inpatient setting before discharge home. Eligible participants who satisfy the inclusion requirements and no exclusion criteria will be consented to participate in this study and enter the screening study phase. The screening evaluation will be conducted within 5 days of the dose administration of study drug. Study participants meeting entry criteria of normal brain MRI and laboratory manganese concentrations (whole blood/plasma/serum/RBC) will begin study drug on Day 1. Participants will undergo 2 additional post-baseline brain MRI scans at Months 3 and 6 and have 5 separate neuropsychological tests at Day 1, Month 3, and Month 6. Additional clinical monitoring including safety and laboratory assessments will occur during the 6-month opt-in extension study. All patients in each assigned trace element parenteral nutrition group will have parenteral nutrition formulations evaluated for manganese content at Day 1, Month 1, Month 3, and Month 6.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Tralement with Manganese Sulfate
Tralement without Manganese Sulfate
To assess brain deposition of manganese in Tralement versus a fixed-dose trace element product of zinc, copper, and selenious acid.
Change from baseline in basal ganglia index (BG-index) as determined by T1-weighted brain MRI images.
Time frame: 6 Months
To assess the efficacy & safety of Tralement versus a fixed-dose trace element product of zinc, copper, and selenious acid.
Change from baseline in blood (plasma/serum/RBC) manganese levels assessed
Time frame: 6 Months
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