Last reviewed · How we verify

NCT03913221

Caffeine for Hypoxic-Ischemic Encephalopathy

Completed Phase 1 Results posted Last updated 27 March 2025
What this trial tests

Phase 1 trial testing Caffeine Citrate 5 mg/kg in Hypoxic-Ischemic Encephalopathy in 17 participants. Completed in 31 December 2024.

Timeline
14 August 2019
Primary endpoint
1 January 2023
31 December 2024

Quick facts

Lead sponsorUniversity of North Carolina, Chapel Hill
PhasePhase 1
StatusCompleted
Study typeINTERVENTIONAL
Allocationnon randomized
Designsequential
Maskingnone
Primary purposetreatment
Enrollment17
Start date14 August 2019
Primary completion1 January 2023
Estimated completion31 December 2024
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

University of North Carolina, Chapel Hill

Who can join

Under 24 Hours, any sex, with Hypoxic-Ischemic Encephalopathy. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Area Under Plasma Concentration-time at Time t (AUC0-t) for Caffeine Primary · 7 samples will be collected with the following optimal sampling windows: 0-15 minutes, 30-60 minutes, 1-3 hours, 3-6 hours, 6-12 hours, 12-18 hours, 15 minutes prior to next dose.

AUC0-t defines area under the plasma concentration-time curve (AUC) from administration to the last quantifiable concentration at time t.

AUC (0-72)
GroupValue95% CI
Low Dose Caffeine (5 mg/kg)1137.36± 324.96
High Dose Caffeine (10 mg/kg)1177.94± 134.42
AUC (0-infinity)
GroupValue95% CI
Low Dose Caffeine (5 mg/kg)2213.26± 540.81
High Dose Caffeine (10 mg/kg)2768.25± 338.06
Number of Participants With Seizures Requiring >1 Anti-Epileptic Medication Secondary · From the first dose of caffeine to 7 days following the final dose.

As a potential complication of caffeine exposure, seizure activity requiring \>1 anti-epileptic medication is reported.

GroupValue95% CI
Low Dose Caffeine (5 mg/kg)1
High Dose Caffeine (10 mg/kg)0
Number of Participants With Necrotizing Enterocolitis Secondary · From the first dose of caffeine to 7 days following the final dose.

As a potential complication of caffeine exposure, the number of participants with necrotizing enterocolitis defined as Bell Stage II or III are reported.

GroupValue95% CI
Low Dose Caffeine (5 mg/kg)0
High Dose Caffeine (10 mg/kg)0
Number of Participants With Abnormal MRI Brain Findings Based on NICHD Neonatal Research Network Score Secondary · During initial hospitalization, approximately 7-14 postnatal days

The National Institute of Child Health and Human Development (NICHD) Neonatal Research Network developed and validated an MRI scoring system that categorizes severity of brain injury in the Trial of Hypothermia for Neonatal Hypoxic-Ischemic Encephalopathy. A higher score is considered a worse outcome. * Score 0: Normal T2 MRI * Score 1A: Minimal cerebral lesions only with involvement of basal ganglia, thalamus * Score 1B: Extensive cerebral lesions * Score 2A: Basal ganglia thalamic, anterior or posterior limb of internal capsule, or watershed infarction * Score 2B: 2A with cerebral lesions *

Score 0
GroupValue95% CI
Low Dose Caffeine (5 mg/kg)3
High Dose Caffeine (10 mg/kg)2
Score 1A
GroupValue95% CI
Low Dose Caffeine (5 mg/kg)2
High Dose Caffeine (10 mg/kg)2
Score 1B
GroupValue95% CI
Low Dose Caffeine (5 mg/kg)1
High Dose Caffeine (10 mg/kg)3
Score 2A
GroupValue95% CI
Low Dose Caffeine (5 mg/kg)0
High Dose Caffeine (10 mg/kg)0
Score 2B
GroupValue95% CI
Low Dose Caffeine (5 mg/kg)2
High Dose Caffeine (10 mg/kg)0
Score 3
GroupValue95% CI
Low Dose Caffeine (5 mg/kg)0
High Dose Caffeine (10 mg/kg)0

Adverse events — posted to ClinicalTrials.gov

Time frame: From the first dose of study intervention through 7 days after the last dose of study intervention, approximately 10 days.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Low Dose Caffeine (5 mg/kg)
Serious: 3/9 (33%)
Deaths: 1/9
High Dose Caffeine (10 mg/kg)
Serious: 2/8 (25%)
Deaths: 1/8

Serious adverse events (3 terms)

ReactionSystemLow Dose Caffeine (5 mg/kg)High Dose Caffeine (10 mg/…
Extracorporeal membrane oxygenation (ECMO)Surgical and medical procedures
SeizuresNervous system disorders
Bowel perforationGastrointestinal disorders
Other adverse events (13 terms — click to expand)

ReactionSystemLow Dose Caffeine (5 mg/kg)High Dose Caffeine (10 mg/…
ThrombocytopeniaBlood and lymphatic system disorders
Acute Kidney InjuryRenal and urinary disorders
Hepatic DysfunctionHepatobiliary disorders
HypoglycemiaMetabolism and nutrition disorders
Pulmonary HypertensionRespiratory, thoracic and mediastinal disorders
HypotensionVascular disorders
Supraventricular TachycardiaRespiratory, thoracic and mediastinal disorders
Subcutaneous Fat NecrosisSkin and subcutaneous tissue disorders
HypertensionVascular disorders
Disseminated Intrvascular CoagulopathyHepatobiliary disorders
HyperglycemiaMetabolism and nutrition disorders
Direct HyperbilirubinemiaHepatobiliary disorders
SeizuresNervous system disorders

Most-reported serious reactions: Extracorporeal membrane oxygenation (ECMO), Seizures, Bowel perforation.

Data from ClinicalTrials.gov NCT03913221 adverse events section.

Sponsor's own description

Hypoxic-ischemic encephalopathy (HIE) due to perinatal asphyxia is common and often fatal. Therapeutic hypothermia reduces mortality and morbidity in infants with HIE. Even with the widespread use of therapeutic hypothermia, \~60% of infants with HIE die or have neurodevelopmental impairment. As a result, there is an urgent, unmet public health need to develop adjuvant therapies to improve survival and neurodevelopmental outcomes in this population. Caffeine may offer neuroprotection for infants with HIE by blocking adenosine receptors in the brain and reducing neuronal cell death. In animal models of HIE, caffeine reduces white matter brain injury. Drugs in the same class as caffeine (i.e., methylxanthines) have been shown to be protective against acute kidney injury in the setting of HIE. However, their safety and efficacy have not been studied in the setting of therapeutic hypothermia and their effect on neurological outcomes is not known. Since these drugs reduce injury to the kidney in infants with HIE, they may also reduce injury to the brain. This phase I study will evaluate the pharmacokinetics, safety, and preliminary effectiveness of caffeine as an adjuvant therapy to improve neurodevelopmental outcomes in infants with HIE.

Publications & conference data

6 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Advances in Therapies to Treat Neonatal Hypoxic-Ischemic Encephalopathy.
    Ranjan AK, Gulati A. · · 2023 · cited 41× · PMID 37892791 · DOI 10.3390/jcm12206653
  2. Ferroptosis: A Promising Therapeutic Target for Neonatal Hypoxic-Ischemic Brain Injury.
    Peeples ES, Genaro-Mattos TC. · · 2022 · cited 41× · PMID 35806425 · DOI 10.3390/ijms23137420
  3. Comparing the efficacy in reducing brain injury of different neuroprotective agents following neonatal hypoxia-ischemia in newborn rats: a multi-drug randomized controlled screening trial.
    Sabir H, Maes E, Zweyer M, Schleehuber Y, et al · · 2023 · cited 25× · PMID 37301929 · DOI 10.1038/s41598-023-36653-9
  4. Neonatal encephalopathy due to suspected hypoxic ischemic encephalopathy: pathophysiology, current, and emerging treatments.
    Babbo CC, Mellet J, van Rensburg J, Pillay S, et al · · 2024 · cited 13× · PMID 39237728 · DOI 10.1007/s12519-024-00836-9
  5. A phase I trial of caffeine to evaluate safety in infants with hypoxic-ischemic encephalopathy.
    Jackson W, Gonzalez D, Greenberg RG, Lee YZ, et al · · 2024 · cited 7× · PMID 37587184 · DOI 10.1038/s41372-023-01752-y
  6. Pharmacological Therapies for Consequences of Perinatal Hypoxic-Ischemic Brain Injury: Where Are We Now?
    Gebala P, Janowska J, Sypecka J. · · 2025 · PMID 41155490 · DOI 10.3390/ijms262010200

Verify or expand the search:

Other trials of Caffeine Citrate 5 mg/kg

Trials testing the same drug.

Other recruiting trials for Hypoxic-Ischemic Encephalopathy

Currently open trials in the same condition.

Other University of North Carolina, Chapel Hill trials

Trials by the same sponsor.

Verify against primary sources

Data sources for this page

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT03913221.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing