BronchoscopyPhase 3NCT02296892
A Phase III Study of Remimazolam in Patients Undergoing Bronchoscopy
A Phase 3 study testing Remimazolam and Midazolam in people with Bronchoscopy, run by Paion UK Ltd. at 14 sites in United States.
Trial summary
A prospective, double-blind, randomized, placebo and active controlled, multi-center, parallel group study comparing remimazolam to placebo, with an additional open label arm for midazolam, in patients undergoing a bronchoscopy. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Bronchoscopy
- What is being tested?
- Remimazolam and Midazolam
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 446 participants
- Where
- 14 sitesUnited States
- Study dates
- Apr 2015to 13 Mar 2017
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Male and female patients, aged ≥18 years, scheduled to undergo a diagnostic or therapeutic flexible bronchoscopy in the bronchoscopy suite (therapeutic bronchoscopies could include eg, lavage, biopsies, brushings, and foreign body extraction).
- American Society of Anesthesiologists Physical Status Score (ASA PS) 1 through 3.
- Body mass index (BMI) ≤ 45.
- Peripheral blood oxygen saturation (measured by pulse oximetry: SpO2) ≥ 90% in ambient air or with no more than 2 L/min of oxygen support.
- For all female patients, negative result of urine pregnancy test. Additionally, for women of child bearing potential only, use of birth control during the study period (from the time of consent until all specified observations were completed).
- Patients voluntarily signed and dated an informed consent form that was approved by an IRB prior to the conduct of any study procedure, including screening procedures.
- Patient was willing and able to comply with study requirements and available for a follow up phone call on Day Day 4 (+3/ 1 days) after the bronchoscopy.
Who cannot join
- Patients with a known sensitivity to benzodiazepines, flumazenil, opioids, naloxone, or a medical condition such that these agents were contraindicated.
- Bronchoscopy outside the bronchoscopy unit (eg, intensive care unit).
- Patients on mechanical ventilation.
- Tracheal stenosis.
- Planned laser bronchoscopy, rigid scope bronchoscopy.
- Use of unstable doses of benzodiazepines and opioids for any indication, eg, insomnia, anxiety, or spasticity. An unstable dose means dose changes of more than 50% of the previous dose within 30 days prior to Day of procedure.
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- Female patients with a positive pregnancy test at Screening or Baseline and lactating female patients.
- Patients with positive drugs of abuse screen (unless explained by concomitant medication) or a positive ethanol test at baseline.
- Patient with a history of drug or ethanol abuse within the past two years.
- Patients in receipt of any investigational drug or use of investigational device within 30 days or less than 7 t½ (whichever was longer) before the start of the study or scheduled to receive one during the study period.
- Participation in any previous clinical study with remimazolam.
- Patients with an inability to communicate well in English with the investigator or deemed unsuitable according to the investigator (in each case providing a reason).
Trial locations and contacts
14 sites in 1 country.
14 sites in 1 country
United States14 sites
The Johns Hopkins Center for Interventional and Pulmonary Care
Baltimore, Maryland, 21287
Pab Clinical Research
Brandon, Florida, 33511
Unc Division of Pulmonary and Critical Care
Chapel Hill, North Carolina, 27599
Medical University of South Carolina
Charleston, South Carolina, 29425
Duke University
Durham, North Carolina, 27710
Laporte County Institute For Clinical Research
Michigan City, Indiana, 46360
Pinehurst Medical Clinic
Pinehurst, North Carolina, 28374
Pulmonary Associates of Richmond
Richmond, Virginia, 23225
Virginia Commonwealth University
Richmond, Virginia, 23298
S. Carolina Pharmaceutical Research
Spartanburg, South Carolina, 29303
Washington University School of Medicine/Barnes-Jewish Hospital
St Louis, Missouri, 63110
Sun City Office
Sun City Center, Florida, 33573
Multicare Institute For Research & Innovation
Tacoma, Washington, 98405
Wake Forest Baptist Health
Winston-Salem, North Carolina, 27157
About this study
Official title: A Phase III Study Evaluating the Efficacy and Safety of Remimazolam (CNS 7056) Compared to Placebo and Midazolam in Patients Undergoing Bronchoscopy
A prospective, double-blind, randomized, placebo and active controlled, multi-center, parallel group study comparing remimazolam to placebo, with an additional open label arm for midazolam, in patients undergoing a bronchoscopy.
- Conditions
- Bronchoscopy
- Being tested
- Remimazolam, Placebo, Midazolam
- Keywords
- Remimazolam, midazolam, bronchoscopy, procedural sedation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RemimazolamDrug
Also called CNS7056
For induction and maintenance of sedation
PlaceboDrug
Inactive control arm
MidazolamDrug
Also called Versed
For induction and maintenance of sedation
| Study group | Role | What they receive |
|---|---|---|
| Remimazolam | Experimental | Double-blind Remimazolam arm: 5 mg iv for sedation induction, and 2.5 mg iv top-ups for sedation maintenance.
Fentanyl pre-treatment: 25-50 μg (or less for elderly/disabled subjects), and 25 μg top-up doses Receives: Drug: Remimazolam |
| Placebo | Placebo comparator | Double-blind placebo arm as inactive control
Fentanyl pre-treatment: 25-50 μg (or less for elderly/disabled subjects), and 25 μg top-up doses Receives: Drug: Placebo |
| Midazolam | Active comparator | Open-label Midazolam arm: 1.75 mg* iv for sedation induction and 1.0 mg* iv for sedation maintenance. *1.0 mg for induction and 0.5 mg for maintenance in adults over 60, debilitated or chronically ill.
Fentanyl pre-treatment: 25-50 μg (or less for elderly/disabled subjects), and 25 μg top-up doses Receives: Drug: Midazolam |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With a Successful Procedure
Success of Procedure measured by completion of bronchoscopy, no requirement for an alternative rescue sedative medication and no requirement for more than 5 doses of study medication within any 15 minute period in the blinded arms (remimazolam/placebo) or no requirement for more than 3 doses within any 12 minute window in the open-label midazolam arm.
Measured: From first dose of study drug to removal of bronchoscope (average time not known)
Secondary outcomes (3)
Time to Start of Procedure
The time from the first dose of study drug until bronchoscope insertion on Day 1
Measured: From first dose of study drug until insertion of the bronchoscope
Time to Fully Alert
The time to fully alert defined as time to first of 3 consecutive Modified Observer's Assessment of Alertness and Sedation (MOAA/S) scores after the end of the bronchoscopy procedure (bronchoscope out).
MOAA/S scores: 5 = Responds readily to name spoken in normal tone [alert], 4 =Lethargic response to name spoken in normal tone, 3 = Responds only after name is called loudly and/or repeatedly, 2 = Responds only after mild prodding or shaking, 1 = Responds only after painful trapezius squeeze, 0 = Does not respond to painful trapezius squeeze.
MOAA/S scores were assessed by the investigators.
Measured: From the last dose of study drug or rescue sedative AND from end of bronchoscopy until the patient has recovered to fully alert
Time to Ready for Discharge
Time from the last dose of study drug or rescue sedative and from the end of bronchoscopy until discharge (defined as the ability to walk unassisted)
Measured: After the last dose of study drug AND after the end of the bronchoscopy, until discharge
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Nov 2014 (estimated)
- Study startApr 2015
- Primary completionMar 2017
- Study completion13 Mar 2017
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for BronchoscopyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 446 participants (actual)
Sponsor and investigators
- Lead sponsor
- Paion UK Ltd.
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Premier Research
- Responsible party
- Sponsor
- Investigators
- Gerard Silvestri, MD, Principal investigator, Medical University of South Carolina, US
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT02296892
- Sponsor's protocol ID
- CNS7056-008
- Status last verified
- Mar 2020
- First submitted
- 11 Nov 2014
- Last updated
- 18 Mar 2020
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
Publications
Pastis NJ, Yarmus LB, Schippers F, Ostroff R, Chen A, Akulian J, Wahidi M, Shojaee S, Tanner NT, Callahan SP, Feldman G, Lorch DG Jr, Ndukwu I, Pritchett MA, Silvestri GA; PAION Investigators. Safety and Efficacy of Remimazolam Compared With Placebo and Midazolam for Moderate Sedation During Bronchoscopy. Chest. 2019 Jan;155(1):137-146. doi: 10.1016/j.chest.2018.09.015. Epub 2018 Oct 4.
PubMed 30292760
Study at a glance
From the registry record, last updated by the sponsor on 18 Mar 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase III Study Evaluating the Efficacy and Safety of Remimazolam (CNS 7056) Compared to Placebo and Midazolam in Patients Undergoing Bronchoscopy
- ClinicalTrials.gov ID
- NCT02296892
- Acronym / sponsor ID
- CNS7056-008
- Conditions
- Bronchoscopy
- Keywords
- Remimazolam, midazolam, bronchoscopy, procedural sedation
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 446 participants (actual)
- Lead sponsor
- Paion UK Ltd.Industry (pharma, biotech, devices)
- Collaborators
- Premier Research
- Study start
- Apr 2015 (actual)
- Primary completion
- Mar 2017 (actual)
- Study completion
- 13 Mar 2017 (actual)
- First posted
- 21 Nov 2014 (estimated)
- Results
- Posted 12 Mar 2019
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
A prospective, double-blind, randomized, placebo and active controlled, multi-center, parallel group study comparing remimazolam to placebo, with an additional open label arm for midazolam, in patients undergoing a bronchoscopy.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Remimazolam | Experimental | Drug: RemimazolamDouble-blind Remimazolam arm: 5 mg iv for sedation induction, and 2.5 mg iv top-ups for sedation maintenance. Fentanyl pre-treatment: 25-50 μg (or less for elderly/disabled subjects), and 25 μg top-up doses |
| Placebo | Placebo comparator | Drug: PlaceboDouble-blind placebo arm as inactive control Fentanyl pre-treatment: 25-50 μg (or less for elderly/disabled subjects), and 25 μg top-up doses |
| Midazolam | Active comparator | Drug: MidazolamOpen-label Midazolam arm: 1.75 mg* iv for sedation induction and 1.0 mg* iv for sedation maintenance. *1.0 mg for induction and 0.5 mg for maintenance in adults over 60, debilitated or chronically ill. Fentanyl pre-treatment: 25-50 μg (or less for elderly/disabled subjects), and 25 μg top-up doses |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- Male and female patients, aged ≥18 years, scheduled to undergo a diagnostic or therapeutic flexible bronchoscopy in the bronchoscopy suite (therapeutic bronchoscopies could include eg, lavage, biopsies, brushings, and foreign body extraction).
- American Society of Anesthesiologists Physical Status Score (ASA PS) 1 through 3.
- Body mass index (BMI) ≤ 45.
- Peripheral blood oxygen saturation (measured by pulse oximetry: SpO2) ≥ 90% in ambient air or with no more than 2 L/min of oxygen support.
- For all female patients, negative result of urine pregnancy test. Additionally, for women of child bearing potential only, use of birth control during the study period (from the time of consent until all specified observations were completed).
Key exclusion criteria (12 listed)
- Patients with a known sensitivity to benzodiazepines, flumazenil, opioids, naloxone, or a medical condition such that these agents were contraindicated.
- Bronchoscopy outside the bronchoscopy unit (eg, intensive care unit).
- Patients on mechanical ventilation.
- Tracheal stenosis.
- Planned laser bronchoscopy, rigid scope bronchoscopy.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| RemimazolamAlso: CNS7056For induction and maintenance of sedation | Drug | Remimazolam |
| PlaceboInactive control arm | Drug | Placebo |
| MidazolamAlso: VersedFor induction and maintenance of sedation | Drug | Midazolam |
Primary outcome
Number of Participants With a Successful Procedure
Time frame: From first dose of study drug to removal of bronchoscope (average time not known)
Success of Procedure measured by completion of bronchoscopy, no requirement for an alternative rescue sedative medication and no requirement for more than 5 doses of study medication within any 15 minute period in the blinded arms (remimazolam/placebo) or no requirement for more than 3 doses within any 12 minute window in the open-label midazolam arm.
3 secondary outcomes
Time to Start of Procedure
Time frame: From first dose of study drug until insertion of the bronchoscope
Time to Fully Alert
Time frame: From the last dose of study drug or rescue sedative AND from end of bronchoscopy until the patient has recovered to fully alert
Time to Ready for Discharge
Time frame: After the last dose of study drug AND after the end of the bronchoscopy, until discharge
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Mar 2020.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 30292760Pastis NJ, Yarmus LB, Schippers F, Ostroff R, Chen A, Akulian J, Wahidi M, Shojaee S, Tanner NT, Callahan SP, Feldman G, Lorch DG Jr, Ndukwu I, Pritchett MA, Silvestri GA; PAION Investigators. Safety and Efficacy of Remimazolam Compared With Placebo and Midazolam for Moderate Sedation During Bronchoscopy. Chest. 2019 Jan;155(1):137-146. doi: 10.1016/j.chest.2018.09.015. Epub 2018 Oct 4.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Gerard Silvestri, MD principal investigator
Medical University of South Carolina, US
14 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Remimazolam and Midazolam in people with Bronchoscopy, run by Paion UK Ltd. at 14 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 18 Mar 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 14 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 12 Mar 2019). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Participants With a Successful Procedure (time frame: From first dose of study drug to removal of bronchoscope (average time not known)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT02296892, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Mar 2020; AzTrials last refreshed its copy on 6 Nov 2026.