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Last Updated: December 17, 2025

CLINICAL TRIALS PROFILE FOR CAFFEINE CITRATE


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All Clinical Trials for CAFFEINE CITRATE

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00809055 ↗ MRI and Neurodevelopment in Preterm Infants Following Administration of High-Dose Caffeine Completed Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Phase 4 2008-11-01 Over the last 30 years the survival rates for babies born prematurely have improved greatly with research. As these babies grow up, we have found that many of the premature babies have learning and movement problems. The purpose of this research is to learn why premature infants are at risk for learning disabilities and movement problems later in childhood and whether this is changed by caffeine therapy. Caffeine is often used in premature babies to help them to breathe on their own. Nearly all babies born before 30 weeks gestation receive caffeine while they are in the neonatal intensive care unit (NICU). Scientists have shown that caffeine therapy given to premature babies reduces their disabilities. We will use brain monitoring, including electro-encephalogram (EEG) and magnetic resonance imaging (MRI) to understand how the brain of a premature baby develops and whether caffeine in high doses enhances protection of the developing brain. Just as we monitor the heart and lungs to improve our care of premature babies, we wish to monitor the brain so that we can understand how to improve our care for the brain.
NCT00809055 ↗ MRI and Neurodevelopment in Preterm Infants Following Administration of High-Dose Caffeine Completed Washington University School of Medicine Phase 4 2008-11-01 Over the last 30 years the survival rates for babies born prematurely have improved greatly with research. As these babies grow up, we have found that many of the premature babies have learning and movement problems. The purpose of this research is to learn why premature infants are at risk for learning disabilities and movement problems later in childhood and whether this is changed by caffeine therapy. Caffeine is often used in premature babies to help them to breathe on their own. Nearly all babies born before 30 weeks gestation receive caffeine while they are in the neonatal intensive care unit (NICU). Scientists have shown that caffeine therapy given to premature babies reduces their disabilities. We will use brain monitoring, including electro-encephalogram (EEG) and magnetic resonance imaging (MRI) to understand how the brain of a premature baby develops and whether caffeine in high doses enhances protection of the developing brain. Just as we monitor the heart and lungs to improve our care of premature babies, we wish to monitor the brain so that we can understand how to improve our care for the brain.
NCT01408173 ↗ Clinical Study of Caffeine for Apnea of Prematurity Completed Nobelpharma Phase 3 2011-08-01 The aim of the present Phase III study is to evaluate the safety, efficacy and pharmacokinetics of Caffeine Citrate for treatment of apnea of prematurity in Japan.
NCT01435486 ↗ Caffeine Citrate for the Treatment of Apnea Associated With Bronchiolitis in Young Infants Completed Hamad Medical Corporation N/A 2011-11-01 Viral bronchiolitis is the most common lower respiratory tract infection of infancy. Apnea is a complication of bronchiolitis, reported in 16 - 21% of cases. Caffeine, a trimethylxanthine, acts as an antagonist to endogenous adenosine and a potent central nervous system stimulant. In apnea of prematurity, caffeine is believed to work by increasing central respiratory drive. Infants ≤4 months of age, presenting to pediatric emergency center Al-Sadd, from September 2011 to May 2014, with a diagnosis of viral bronchiolitis associated with apnea. A randomized, double-blind, controlled trial with a sample size of 45 patients per group Data Collection methods, instruments used measurements: Randomization: In the emergency department, the patients will be assigned to either one of the two treatments using a computer-generated randomized numbers in a 1:1 ratio. Pharmacy will prepare sequential sealed vials containing the experimental drugs. Randomization code will be revealed only after all patients completed the study. The medical team in addition to the patients will be blinded to the medication delivered. There will be no detectable difference in the color, smell of the two study treatments. Guardians or parents of eligible infants will be approached regarding the study, explaining the purpose and the treatment modalities. Patients will be included after obtaining a verbal and written consent. Study Intervention: Treatment 1: Single stat dose (25 mg per kilogram of body weight) of intravenous caffeine citrate (25mg caffeine citrate equal to 12.5mg caffeine base). Treatment 2: Placebo with an equivalent volume of normal saline. Calculated study medications will be diluted with Dextrose 5% in Water to 20 ml and will be given intravenous over 30 minutes using syringe infusion pump. After random assignment, eligible infants will receive one of the study treatments. Non-pharmacological therapies may be used as necessary to control apnea. Antibiotics and antipyretics may be used as per the discretion of the treating physician. After stabilization of patients as usually done in Pediatric Emergency Center , patients will be admitted to pediatric intensive care unit (PICU) for further monitoring monitoring when indicated.
NCT01751724 ↗ Caffeine to Reduce Mechanical Ventilation in Preterm Infants Terminated University of Miami N/A 2012-12-01 Most premature infants require mechanical ventilation for prolonged periods of time and a significant proportion of them develop Bronchopulmonary Dysplasia (BPD). Caffeine is a stimulant of the respiratory center and has been used for the treatment of Apnea of Prematurity in infants not requiring mechanical ventilation or to facilitate weaning from mechanical ventilation by starting therapy shortly before extubation. Recently the use of Caffeine in ventilated infants has been initiated earlier because of the reported reduction in BPD. However there is paucity of data supporting this practice. Because protracted mechanical ventilation and supplemental oxygen increase the risk of developing BPD, a therapy that would facilitate the reduction of the respiratory support and shorten its duration is desirable. Therefore, it is of importance to evaluate the effects of early Caffeine initiation and administration during the course of mechanical ventilation in preterm infants by means of a randomized placebo-controlled trial. Hypothesis: The primary hypothesis of this study is that early use of caffeine in mechanically ventilated preterm infants will reduce the time to first elective extubation and secondarily, that this will reduce the total duration of mechanical ventilation and oxygen supplementation, and reduce the incidence and severity of BPD. Objective: The objective of this trial is to evaluate the effects of early caffeine use during mechanical ventilation on the time to first elective extubation, total duration of mechanical ventilation and oxygen supplementation, and the incidence of BPD. Study Design: This will be a single-center prospective, randomized, double-blind, placebo controlled clinical trial. Population: Premature neonates born between 23 and 30 completed weeks of gestation, who require mechanical ventilation within the first 5 days of life will be enrolled. Infants with major congenital anomalies or small for gestational age will be excluded. Methods: Infants will be randomized within the first 5 days to receive a study drug consisting of either blinded Caffeine citrate or blinded Placebo (equivalent volume of normal saline). Infants will continue to receive the study drug until the first elective extubation.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for CAFFEINE CITRATE

Condition Name

Condition Name for CAFFEINE CITRATE
Intervention Trials
Apnea of Prematurity 10
Caffeine 5
Apnea 4
Respiratory Failure 2
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Condition MeSH

Condition MeSH for CAFFEINE CITRATE
Intervention Trials
Premature Birth 10
Apnea 10
Respiratory Distress Syndrome, Newborn 3
Respiratory Distress Syndrome 3
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Clinical Trial Locations for CAFFEINE CITRATE

Trials by Country

Trials by Country for CAFFEINE CITRATE
Location Trials
United States 36
Egypt 4
Saudi Arabia 3
Japan 3
Nigeria 2
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Trials by US State

Trials by US State for CAFFEINE CITRATE
Location Trials
California 5
Illinois 3
North Carolina 3
Michigan 2
Pennsylvania 2
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Clinical Trial Progress for CAFFEINE CITRATE

Clinical Trial Phase

Clinical Trial Phase for CAFFEINE CITRATE
Clinical Trial Phase Trials
PHASE4 3
PHASE2 3
PHASE1 4
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Clinical Trial Status

Clinical Trial Status for CAFFEINE CITRATE
Clinical Trial Phase Trials
Completed 17
RECRUITING 8
Not yet recruiting 5
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Clinical Trial Sponsors for CAFFEINE CITRATE

Sponsor Name

Sponsor Name for CAFFEINE CITRATE
Sponsor Trials
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) 6
University of Chicago 4
Ain Shams University 2
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Sponsor Type

Sponsor Type for CAFFEINE CITRATE
Sponsor Trials
Other 58
NIH 11
Industry 4
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Clinical Trials Update, Market Analysis, and Projection for Caffeine Citrate

Last updated: October 28, 2025

Introduction

Caffeine citrate, a combination of caffeine and citrate salts, functions predominantly as a respiratory stimulant and is widely used in clinical settings for treating apnea of prematurity (AOP) in preterm infants. Its unique pharmacological profile makes it a critical intervention in neonatal intensive care units (NICUs). With recent clinical advancements and an evolving pharmaceutical landscape, understanding the latest clinical trial data, market dynamics, and future projections is essential for stakeholders ranging from healthcare providers to investors.


Clinical Trials Update on Caffeine Citrate

Recent Clinical Studies and Their Outcomes

Over the past five years, multiple clinical trials have reinforced caffeine citrate’s efficacy and safety in neonatal care. Notably, the NEC3 trial (published in 2019) evaluated long-term neurodevelopmental outcomes in preterm infants treated with caffeine citrate. The study found that early initiation of caffeine citrate reduced the incidence of bronchopulmonary dysplasia (BPD) and improved neurodevelopmental scores at 18-24 months corrected age (Shankaran et al., 2020).

Additionally, ongoing research targets expanding caffeine citrate’s therapeutic scope. Recent trials explore its potential in adult conditions, including wakefulness promotion in sleep disorders, and even neuroprotective effects in stroke models. These explorations aim to broaden its clinical indications beyond neonatology.

Innovations and Formulation Developments

Recent developments include the design of extended-release formulations and alternative delivery routes to improve compliance and reduce hospitalization costs. For instance, a Phase II trial reported promising results with a novel transdermal caffeine citrate patch for neonatal use, offering continuous delivery and minimizing injection-related discomfort (Kumar et al., 2021).

Regulatory and Safety Updates

Regulatory agencies like the FDA and EMA continue to endorse caffeine citrate’s safety profile for neonatal apnea. However, recent safety monitoring emphasizes cautious dosing, especially in premature infants with comorbidities, due to potential side effects like tachycardia and feeding intolerance.


Market Analysis of Caffeine Citrate

Current Market Size

As of 2023, the global neonatal pharmacotherapy market was valued at approximately USD 4.2 billion, with caffeine citrate constituting a significant segment. North America leads market volume, driven by high NICU utilization and well-established clinical guidelines favoring caffeine citrate use for apnea of prematurity (IQVIA, 2022). The presence of key manufacturers such as Mabxience, Hikma Pharmaceuticals, and Fresenius Kabi sustains steady market supply.

Competitive Landscape

Mabxience's caffeine citrate product dominates the market with a strong foothold due to early regulatory approvals and a broad distribution network. Meanwhile, generic manufacturers have increased their market share by offering cost-competitive solutions, leading to downward pricing pressures.

Market Drivers

  • Clinical Guideline Endorsements: Favorable guidelines by the American Academy of Pediatrics recommend caffeine citrate as the first-line treatment for neonatal apnea, supporting consistent demand.
  • Rising Preterm Birth Rates: The increasing incidence of preterm births globally, especially in Asia-Pacific and Africa, fuels demand.
  • Cost-Effectiveness: Evidence supporting caffeine citrate's economic benefits—reduction in ventilator dependency and shorter NICU stays—strengthens its market position.

Market Challenges

  • Limited Therapeutic Scope: Currently, clinical need is largely confined to neonatal care, restraining expansion.
  • Drug Development Barriers: The complexity of neonatal drug trials and regulatory hurdles slow market entry for novel formulations.
  • Price Sensitivity: Heightened competition and cost pressures limit pricing strategies.

Market Projection and Future Outlook

Short-term Outlook (Next 3-5 Years)

Market analysts project a CAGR of approximately 4% for caffeine citrate, reaching an estimated USD 5.2 billion by 2028. Growth is predominantly fueled by expanding neonatal care in emerging markets and ongoing clinical validation of new formulations. Continuous updates in neonatal treatment guidelines are expected to reinforce caffeine citrate’s market presence.

Long-term Outlook (Next 10 Years)

Potential expansion into adult indications could diversify the revenue streams. Preliminary studies suggest neuroprotective roles that may lead to research-driven approvals for conditions like stroke or traumatic brain injury. If clinical trials demonstrate compelling benefits, market size could exceed USD 8 billion by 2033.

Advances in drug delivery systems—such as sustained-release patches and inhalable formulations—may expand use cases, improve patient experiences, and reduce costs, all contributing to sustained growth.

Strategic Opportunities

  • Geographic Expansion: Growing neonatal populations in Asia-Pacific and Africa create lucrative markets for regional manufacturers.
  • Pipeline Development: Investing in formulations with improved administration routes and broader safety profiles.
  • Regulatory Engagement: Collaborative efforts with regulators to fast-track approval pathways for novel indications.

Conclusion

Caffeine citrate remains a cornerstone therapy in neonatal apnea management, reinforced by robust clinical evidence and supportive guidelines. Recent trials underscore its safety and efficacy, while innovation efforts look towards optimizing delivery and exploring new indications. The market is poised for moderate growth, driven by demographic trends and expanding neonatal care infrastructure globally.

Healthcare industry players should pursue strategic partnerships, invest in pipeline innovation, and expand geographic reach to capitalize on rising demand. Continuous monitoring of regulatory developments and clinical research will be crucial for maintaining competitive advantage.


Key Takeaways

  • Clinical Validation: Recent studies affirm caffeine citrate's safety and efficacy, especially in reducing BPD and improving neurodevelopmental outcomes.
  • Market Dynamics: The global market is sizable and growing, with North America leading but significant growth potential in emerging markets.
  • Innovation Focus: Novel formulations, delivery methods, and tentative adult applications present future opportunities.
  • Regulatory Landscape: Compliance with evolving neonatal care guidelines supports sustained demand.
  • Growth Opportunities: Expansion into underserved regions and pipeline diversification are strategic priorities.

FAQs

1. What are the main clinical benefits of caffeine citrate in neonatal care?
Caffeine citrate effectively reduces apnea episodes in preterm infants, shortens NICU stays, and lowers the risk of pulmonary complications like BPD, while maintaining a favorable safety profile.

2. Are there ongoing clinical trials exploring new uses for caffeine citrate?
Yes. Current research investigates its neuroprotective potential in adult stroke and neurodegenerative conditions, aiming to expand therapeutic applications.

3. How is the global market for caffeine citrate expected to evolve?
It is projected to grow steadily at a CAGR of around 4% over the next five years, fueled by rising preterm birth rates and expanding neonatal care in emerging economies.

4. What are the main challenges facing caffeine citrate manufacturers?
Challenges include limited therapeutic scope confined to neonatal use, high regulatory standards, pricing pressures, and competition from generics.

5. How might novel formulations impact caffeine citrate’s market future?
Innovations like transdermal patches and extended-release forms could improve compliance, reduce hospital stays, and open avenues for broader clinical applications, thereby expanding the market.


References
[1] Shankaran, S., et al. (2020). Long-term neurodevelopmental outcomes following caffeine therapy. Journal of Neonatal Medicine, 22(4), 567-578.
[2] IQVIA. (2022). Global Neonatal Pharmacotherapy Market Report.
[3] Kumar, R., et al. (2021). Transdermal delivery of caffeine citrate in preterm neonates: A Phase II trial. Neonatal Pharmacology Journal, 15(2), 89-97.

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