RecruitingPhase 1Phase 2NCT07101640

PK, Safety and Preliminary Efficacy Study of Montelukast in Critically Ill Infants With Developing Bronchopulmonary Dysplasia

Pharmacokinetics, Safety and Preliminary Efficacy Study of Montelukast in Critically Ill Infants With Developing Bronchopulmonary Dysplasia


Sponsor

Duke University

Enrollment

28 participants

Start Date

Feb 23, 2026

Study Type

INTERVENTIONAL

Conditions

Summary

The purpose of the study is to learn how safe montelukast may be in premature infants at significant risk for Bronchopulmonary Dysplasia (BPD) and to determine how much and how quickly montelukast moves from the stomach into the bloodstream, and how quickly it is removed from the bloodstream. Data supporting the prospect of montelukast benefit involved 6 previous studies involving 206 preterm infants. The dosing ranged from 0.5 to 2.5 mg/kg/day, which aligns with the proposed initial dose of 0.75 mg/kg/day. Though each previous study had a small population, collectively they reveal montelukast as a promising drug in populations of preterm infants developing BPD and for individual preterm infants who are "developing BPD." Thus, researchers expect clinical benefit for preterm infants in this study. Despite the benefit-to-risk ratio presented by these previous studies, the optimal dose remains to be determined; thus, this study design and PK analysis will start with the lowest dose that is likely to provide direct benefit to participants.


Eligibility

Max Age: 28 Weeks

Inclusion Criteria5

  • Documented informed consent from parent or guardian, prior to study activities
  • Receiving mechanical ventilation \[high frequency or conventional\] and requiring supplemental oxygen (FiO2 ≥ 30%) at time of randomization
  • \<28 weeks' gestational age and \<1000 g bodyweight at birth
  • to 28 (inclusive) days postnatal age at the time of first study drug dose
  • Able to tolerate 5 mL of enteral volume

Exclusion Criteria7

  • Previous enrollment and dosing in the current PRISM study (NICHD-2023-MON01)
  • Previous exposure to montelukast within 7 days prior to randomization
  • Known allergy to montelukast
  • PI deems infant - prior to enrollment - is not expected to survive
  • Has a disease complication that would preclude safe participation of the participant
  • Increased respiratory support due to intercurrent illness (e.g., sepsis, necrotizing enterocolitis, etc.). Infants should be excluded from the study until after resolution of the acute event
  • Congenital lung and diaphragmatic malformations

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Interventions

DRUGmontelukast 4 mg granule

Montelukast sodium (4 mg oral granules) dissolved into 5mL of breast milk/formula yielding a solution concentration of 0.8mg/mL. Dosed once daily by weight, montelukast (0.75 mg/kg/day) or placebo .

DRUGPlacebo

Plain breast milk or formula


Locations(4)

Arkansas Children's Hospital

Little Rock, Arkansas, United States

University Medical Center of Southern Nevada

Las Vegas, Nevada, United States

University of North Carolina (UNC)

Chapel Hill, North Carolina, United States

East Carolina University

Greenville, North Carolina, United States

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NCT07101640


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