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A randomised controlled trial comparing epinephrine and dexamethasone to placebo in the treatment of infants with
Anna Heath1,2,3, David Rios4, Kristina I Vogel5
1Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada. anna.heath@sickkids.ca.
Insights
The Bronchiolitis in Infants Placebo Versus Epinephrine and Dexamethasone (BIPED) study investigates if a combination treatment reduces infant hospitalizations for bronchiolitis. This trial aims to provide evidence on the efficacy of epinephrine and dexamethasone in managing this common childhood respiratory infection.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Clinical Trials
Background:
- Bronchiolitis is a leading cause of infant hospitalization in developed countries.
- Current treatment primarily involves supportive care, placing a significant burden on healthcare systems.
- The Bronchiolitis in Infants Placebo Versus Epinephrine and Dexamethasone (BIPED) study addresses this need.
Purpose of the Study:
- To evaluate the efficacy of a combination of epinephrine and dexamethasone in reducing hospitalisation for bronchiolitis in infants.
- To assess the impact of this treatment on hospital admissions, healthcare visits, and costs within 21 days.
- To determine if the combination therapy is superior to placebo in managing bronchiolitis.
Main Methods:
- Phase III, multi-centre, randomized, controlled, double-blinded, placebo-controlled trial.
- Participants are infants presenting to the emergency department with bronchiolitis.
- The study compares a combination of epinephrine and dexamethasone against a placebo.
Main Results:
- The study is designed to determine if epinephrine and dexamethasone reduce the need for hospitalisation up to 7 days post-presentation.
- Secondary outcomes include emergency department admissions, all-cause hospital admissions, healthcare visits, and associated costs.
- Safety outcomes such as gastrointestinal bleeding, serious bacterial infections, and death are monitored.
Conclusions:
- The BIPED study will provide crucial evidence on the effectiveness of combined epinephrine and dexamethasone for infant bronchiolitis.
- Analysis will be conducted using a pre-defined statistical analysis plan (SAP) to ensure unbiased results.
- Findings will inform clinical practice regarding the management of bronchiolitis in emergency departments.
Background:
Bronchiolitis is a common lung infection that affects infants and young children. While most children can be treated at home, some require hospitalisation where supportive care, such as fluids and oxygen, is the suggested treatment. Bronchiolitis is the leading cause of infant hospitalisation in developed countries and exerts a significant burden on the healthcare system. The aim of the Bronchiolitis in Infants Placebo Versus Epinephrine and Dexamethasone (BIPED) study is to evaluate the effects of a combination of epinephrine and dexamethasone, given during initial presentation at the emergency department, on hospitalisation for bronchiolitis. This article outlines the statistical analysis plan (SAP) for the BIPED study. The BIPED study is a Phase III, multi-centre, randomised, controlled, double-blinded superiority, placebo-controlled trial to determine whether the combination of epinephrine and dexamethasone is successful in reducing hospitalisation for bronchiolitis up to 7 days following presentation at an emergency department with bronchiolitis. The secondary outcomes include hospital admissions for bronchiolitis at the emergency department enrolment visit, and all-cause hospital admissions, health care provider visits and health care-related costs in the 21 days following enrolment. The safety outcomes are gastrointestinal bleeding, serious bacterial infection, severe varicella and death.
Discussion:
The BIPED study will provide evidence on whether a combination of epinephrine and dexamethasone reduces hospitalisation in infants following presentation to the emergency department with bronchiolitis. These data will be analyzed using this SAP, submitted before the data became available for analysis, to reduce the risk of bias in our reported outcomes.
Trial Registration:
ClinicalTrials.gov NCT03567473. Registered on June 25, 2018.
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