INIS
project manager–trial coordinator: Lucille Sebastian
INIS is a major international, double-blind, placebo-controlled randomised
trial that will evaluate the effect on mortality and disability of
adding polyclonal IVIG to standard antibiotic therapy in 5000 newborn
infants with sepsis. Of these, 1500 are being recruited in Australia
and New Zealand.
Newborn infants, particularly those born early, are deficient in immunoglobulin
(IgG) and so are at an increased risk of infection.
Each year over 2500 babies in Australia and New Zealand develop serious
infection. About 250 die and another 375 survive with lifelong disability.
In developed countries, neonatal infection causes over 720 000 deaths
or severe disabilities each year.
While effective antibiotic treatment is essential, resistance to antibiotics
is increasing. Polyclonal IVIG may help to reduce death and brain
inflammation resulting from infection.
The primary measure of outcome is survival free of major sensorineural
disability at two years, corrected for gestational age.
As well, some infants in Australia and New Zealand will also undergo
a Bayley II Scales assessment at 2 years of age, which is a gold standard
test for evaluating sensorineural disability and developmental status
(that is, how they talk, walk, think, see and hear).
The Commonwealth Government has guaranteed the supply of IVIG (Intragam
P) for the trial in Australia.
The CTC is the coordinating centre for the study in Australia and
New Zealand.
Eligibility
Babies are eligible for this trial if they have:
a proven or suspected serious infection,and
birth weight under 1500 grams, or are receiving artificial respiratory support by endotracheal tube,or have evidence of infection in blood culture, cerebrospinal fluid or a usually sterile body fluid, and
antibiotics are already being prescribed
Infants are not eligible if they have already received IVIG, or if IVIG is definitely indicated or contraindicated for any reason.
Recruitment started in the United Kingdom in October 2001 and in Australia in February 2002.