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Reversal of Neuromuscular BlockadePhase 4NCT03346057

Safety of Sugammadex for the Reversal of Neuromuscular Blockade in American Society of Anesthesiologists (ASA) Class 3 or 4 Participants (MK-8616-145)

A Phase 4 study testing Sugammadex 2 mg/kg, Sugammadex 4 mg/kg and Sugammadex 16 mg/kg in people with Reversal of Neuromuscular Blockade, run by Merck Sharp & Dohme LLC at 30 sites in 4 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this trial is to evaluate the safety of sugammadex for the reversal of neuromuscular blockade (NMB) induced by neuromuscular blockade agents (NMBA) rocuronium or vecuronium in adult American Society of Anesthesiologists (ASA) Physical Status Class 3 and 4 participants. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Reversal of Neuromuscular Blockade
What is being tested?
Sugammadex 2 mg/kg, Sugammadex 4 mg/kg and Sugammadex 16 mg/kg
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
344 participants
Where
30 sitesin 4 countries
Study dates
20 Dec 2017to 4 Sep 2019
Phase
Phase 4
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

  • Has a body mass index (BMI) < 40 kg/m2.
  • Is categorized as ASA Physical Status Class 3 or 4, as determined by the Investigator.
  • Has a planned surgical procedure that requires NMB with either rocuronium or vecuronium.
  • Has a planned surgical procedure (e.g., gastrointestinal, urologic, or laparoscopic) that in the opinion of the investigator does not preclude maintenance of moderate or deep depth of NMB throughout the case.
  • If female who is not of reproductive potential, is one of the following: (1) postmenopausal; (2) has had a hysterectomy and/or bilateral oophorectomy, bilateral salpingectomy, or bilateral tubal ligation/occlusion at least 6 weeks prior to screening; (3) has a congenital or acquired condition that prevents childbearing; or (4) is undergoing surgical sterilization (e.g., hysterectomy or tubal ligation) as the planned surgical procedure associated with participation in this study.
  • If female who is sexually active and of child-bearing potential, agrees to use a medically accepted method of contraception through seven days after receiving protocol-specified medication. Abstinence (relative to heterosexual activity) can be used as the sole method of contraception if it is consistently employed as the subject's preferred and usual lifestyle and if considered acceptable by local regulatory agencies and Ethics Review Committees/Institutional Review Boards.
  • Is able to provide (or the participant's legally authorized representative, in accordance with local requirements), written informed consent for the trial. The participant or legally authorized representative may also provide consent for Future Biomedical Research.

Who cannot join

  • Has a pacemaker or automatic implantable cardioverter-defibrillator that precludes the assessment of bradycardia or arrhythmias.
  • Has a medical condition or surgical procedure that precludes reversal of neuromuscular block at the end of surgery.
  • Has a neuromuscular disorder(s) that may affect neuromuscular block and/or trial assessments.
  • Is dialysis-dependent or has severe renal insufficiency, defined as estimated creatinine clearance of <30 mL/min.
  • Has or is suspected of having a personal history or family history (parents, grandparents, or siblings) of malignant hyperthermia.
  • Has or is suspected of having an allergy (e.g., hypersensitivity and/or anaphylactic reaction) to study treatments or its/their excipients, to opioids/opiates, muscle relaxants or their excipients, or other medication(s) used during general anesthesia.
Show all 10Show fewer
  • Has received or is planned to receive toremifene within 24 hours before or within 24 hours after study medication administration.
  • Has any condition that would contraindicate the administration of study medication.
  • Is pregnant, is attempting to become pregnant, or is lactating.
  • Is currently participating in or has participated in an interventional clinical trial (including any other current or ongoing trial with a sugammadex treatment arm) with an investigational compound or device within 30 days of signing the informed consent form of this current trial.

Trial locations and contacts

30 sites in 4 countries.

30 sites in 4 countries

United States20 sites
  • Mission Hospital - Memorial ( Site 1016)

    Asheville, North Carolina, 28801

  • University of Alabama - Birmingham ( Site 1046)

    Birmingham, Alabama, 35233

  • Brigham & Women's Hospital ( Site 1039)

    Boston, Massachusetts, 02115

  • Cleveland Clin Foundation ( Site 1032)

    Cleveland, Ohio, 44195

  • University Hospital- Columbia MO ( Site 1060)

    Columbia, Missouri, 65212

  • University of Missouri Health Care ( Site 1022)

    Columbia, Missouri, 65212

  • Hermann Drive Surgical Center ( Site 1021)

    Houston, Texas, 77004

  • University of Kansas Medical Center ( Site 1050)

    Kansas City, Kansas, 66160

  • Loma Linda University Medical Center ( Site 1029)

    Loma Linda, California, 92354

  • Jackson Memorial Hospital ( Site 1007)

    Miami, Florida, 33136

  • Zablocki VA Medical Center ( Site 1011)

    Milwaukee, Wisconsin, 53295

  • Vanderbilt University Medical Center ( Site 1033)

    Nashville, Tennessee, 37232

  • Jersey Shore University Medical Center ( Site 1058)

    Neptune City, New Jersey, 07753

  • Saint Peter's University Hospital [New Brunswick, NJ] ( Site 1017)

    New Brunswick, New Jersey, 08901

  • Tulane University ( Site 1057)

    New Orleans, Louisiana, 70112

  • Ochsner Clinic Foundation ( Site 1005)

    New Orleans, Louisiana, 70121

  • Temple University Hospital ( Site 1004)

    Philadelphia, Pennsylvania, 19140-5103

  • Beaumont Hospital, Royal Oak ( Site 1034)

    Royal Oak, Michigan, 48073

  • University of California Davis Medical Center ( Site 1001)

    Sacramento, California, 95817

  • University Banner Medical Center ( Site 1019)

    Tucson, Arizona, 85719

Other trials in United States

Denmark4 sites
  • Aarhus Universitets hospital ( Site 1252)

    Aarhus, 8200

  • Rigshospitalet ( Site 1253)

    Copenhagen, 2100

  • Bispebjerg og Frederiksberg Hospital ( Site 1250)

    Copenhagen NV, 2400

  • Regionshospitalet Viborg ( Site 1254)

    Viborg, 8800

Other trials in Denmark

Austria3 sites
  • A.O. Krankenhaus Dornbirn ( Site 1151)

    Dornbirn, Voralberg, 6850

  • Landeskrankenhaus Feldkirch ( Site 1152)

    Feldkirch, 6800

  • Sozialmedizinisches Zentrum Ost - Donauspital ( Site 1150)

    Vienna, 1220

Other trials in Austria

Germany3 sites
  • Klinikum Rechts der Isar Technische Universitaet Muenchen ( Site 1350)

    München, 81675

  • Klinikum am Steinenberg Reutlingen ( Site 1352)

    Reutlingen, 72764

  • Josephs-Hospitals Warendorf ( Site 1351)

    Warendorf, 48231

Other trials in Germany

About this study

Official title: A Phase 4 Randomized, Active-Comparator Controlled Clinical Trial to Study the Safety of Sugammadex (MK-8616) for the Reversal of Neuromuscular Blockade Induced by Either Rocuronium Bromide or Vecuronium Bromide in American Society of Anesthesiologists (ASA) Class 3 or 4 Subjects

The purpose of this trial is to evaluate the safety of sugammadex for the reversal of neuromuscular blockade (NMB) induced by neuromuscular blockade agents (NMBA) rocuronium or vecuronium in adult American Society of Anesthesiologists (ASA) Physical Status Class 3 and 4 participants. The primary objectives of the study are to characterize the incidence of treatment emergent sinus bradycardia, treatment emergent sinus tachycardia, or other treatment emergent cardiac arrhythmias after administration of sugammadex and to evaluate the general safety of sugammadex in a population of ASA Class 3 and 4 participants in a surgical setting.

Being tested
Sugammadex 2 mg/kg, Sugammadex 4 mg/kg, Sugammadex 16 mg/kg, Neostigmine + Glycopyrrolate, Rocuronium
Keywords
arrhythmia, bradycardia, neuromuscular blocking agents, surgery, tachycardia
Medical subject headings
Arrhythmias, Cardiac, Bradycardia, Tachycardia

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Sugammadex 2 mg/kgDrug

    Also called MK-8616, Bridion

    Following administration of NMBA (Rocuronium or Vecuronium) to achieve moderate NMB, participants received a single i.v. bolus of Sugammadex 2 mg/kg for reversal of moderate NMB. Moderate block is a level of NMB in which peripheral nerve stimulation elicits one to four muscle twitches.

  • Sugammadex 4 mg/kgDrug

    Also called MK-8616, Bridion

    Following administration of NMBA (Rocuronium or Vecuronium) to achieve deep NMB, participants received a single i.v. bolus of Sugammadex 4 mg/kg for reversal of deep NMB. Deep block is a level of NMB in which peripheral nerve stimulation elicits no muscle twitches and high-frequency muscle stimulation elicits minimal levels of muscle contraction.

  • Sugammadex 16 mg/kgDrug

    Also called MK-8616, Bridion

    Following administration of NMBA (Rocuronium) to achieve deep NMB, participants received a single i.v. bolus of Sugammadex 16 mg/kg for reversal of deep NMB. Deep block is a level of NMB in which peripheral nerve stimulation elicits no muscle twitches and high-frequency muscle stimulation elicits minimal levels of muscle contraction.

  • Neostigmine + GlycopyrrolateDrug

    Following administration of NMBA (Rocuronium or Vecuronium) to achieve moderate NMB, participants received a single i.v. bolus of Neostigmine (50 μg/kg; 5 mg maximum) and Glycopyrrolate (10 μg/kg; 1 mg maximum) for reversal of moderate NMB. Moderate block is a level of NMB in which peripheral nerve stimulation elicits one to four muscle twitches.

  • RocuroniumDrug

    To achieve NMB, participants received steroidal NMBA Rocuronium Bromide administered via IV infusion and dosed according to participant body weight. NMBAs were concomitant medications used per label and at Investigator's discretion as an adjunct to general anesthesia.

  • VecuroniumDrug

    To achieve NMB, participants received steroidal NMBA Vecuronium Bromide administered via IV infusion and dosed according to participant body weight. NMBAs were concomitant medications used per label and at Investigator's discretion as an adjunct to general anesthesia.

Study groups in NCT03346057
Study groupRoleWhat they receive
Sugammadex 2 mg/kgExperimentalSugammadex 2 mg/kg administered as a single intravenous (IV) dose
Receives: Drug: Sugammadex 2 mg/kg; Drug: Rocuronium; Drug: Vecuronium
Sugammadex 4 mg/kgExperimentalSugammadex 4 mg/kg administered as a single IV dose
Receives: Drug: Sugammadex 4 mg/kg; Drug: Rocuronium; Drug: Vecuronium
Sugammadex 16 mg/kgExperimentalSugammadex 16 mg/kg administered as a single IV dose
Receives: Drug: Sugammadex 16 mg/kg; Drug: Rocuronium
Neostigmine + GlycopyrrolateActive comparatorNeostigmine 50 μg/kg (up to 5 mg maximum dose) plus glycopyrrolate 10 μg/kg (up to 1 mg maximum dose) administered as a single IV dose
Receives: Drug: Neostigmine + Glycopyrrolate; Drug: Rocuronium; Drug: Vecuronium

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Percentage of Participants With Treatment-Emergent Sinus Bradycardia Events

    The percentage of participants experiencing treatment-emergent sinus bradycardia events was identified with continuous electrocardiogram (ECG) monitoring. Treatment-emergent sinus bradycardia were defined as a heart rate <60 bpm that has also decreased more than 20% compared to participant baseline heart rate value, sustained for at least 1 minute after administration of study intervention. Treatment-emergent sinus bradycardia events may or may not have been considered an adverse event (AE), as determined by investigator judgment.

    Measured: Up to approximately 35 minutes post-administration

  2. Percentage of Participants With Treatment-Emergent Sinus Tachycardia Events

    The percentage of participants experiencing treatment-emergent sinus tachycardia events was identified with continuous ECG monitoring. Treatment-emergent sinus tachycardia is defined as a heart rate ≥100 bpm that has also increased more than 20% compared to participant baseline heart rate value, sustained for at least 1 minute after administration of study intervention. Treatment-emergent sinus tachycardia events may or may not have been considered an AE, as determined by investigator judgment.

    Measured: Up to approximately 35 minutes post-administration

  3. Percentage of Participants With Other Treatment-Emergent Cardiac Arrhythmia Events

    The percentage of participants experiencing other treatment-emergent cardiac arrhythmia events was identified with continuous ECG monitoring. Other treatment-emergent cardiac arrhythmias were defined as new or worsening arrhythmias (e.g., atrial fibrillation, atrial tachycardia, ventricular fibrillation, or ventricular tachyarrhythmia), sustained for at least 1 minute after administration of study intervention. Worsening arrhythmia events may or may not have been considered an AE, as determined by investigator judgment.

    Measured: Up to approximately 35 minutes post-administration

  4. Percentage of Participants Experiencing an Adverse Event (AE) Up To 7 Days After Administration of Study Intervention

    As per the protocol primary analysis, the percentage of participants experiencing an AE up to 7 days after administration of study intervention was reported. An AE was defined as any untoward medical occurrence in a participant which did not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavourable and unintended sign, symptom, or disease temporally associated with the use of a medicinal product or protocol-specified procedure, whether or not considered related to the medicinal product or protocol-specified procedure. Any worsening (i.e., any clinically significant adverse change in frequency and/or intensity) of a pre-existing condition that was temporally associated with the use of the Sponsor's product was also an AE.

    Measured: Up to 7 days

  5. Percentage of Participants Experiencing a Serious Adverse Event (SAE) Up To 7 Days After Administration of Study Intervention

    As per the protocol primary analysis, the percentage of participants experiencing an SAE up to 7 days after administration of study intervention was reported. An SAE was an adverse event that: resulted in death; was life threatening; resulted in persistent or significant disability or incapacity; resulted in or prolonged an existing inpatient hospitalization; was a congenital anomaly or birth defect; was an other important medical event, was a cancer; or was associated with an overdose.

    Measured: Up to 7 days

  6. Percentage of Participants Experiencing an Event of Clinical Interest (ECI) Up To 7 Days After Administration of Study Intervention

    As per the protocol primary analysis, the percentage of participants experiencing an ECI up to 7 days after administration of study intervention was reported. ECIs were a discrete set of both AEs and SAEs, specifically designated as such for the trial. For the purposes of this investigation, ECIs included 1) drug-induced liver injury; 2) clinically-relevant arrhythmias, inclusive of bradycardia and tachycardia defined as events necessitating intervention, as determined by investigator judgment; and 3) instances of hypersensitivity and/or anaphylaxis adjudicated by an external expert Adjudication Committee. A participant could have experienced more than one type of ECI.

    Measured: Up to 7 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Nov 2017
  2. Study start20 Dec 2017
  3. Primary completion4 Sep 2019
  4. Study completion4 Sep 2019

Resources

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 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
344 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03346057
Sponsor's protocol ID
8616-145
Other IDs
2017-000187-15, MK-8616-145, 2017
Status last verified
Oct 2020
First submitted
15 Nov 2017
Last updated
8 Oct 2020
Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf

Publications

  • Herring WJ, Mukai Y, Wang A, Lutkiewicz J, Lombard JF, Lin L, Watkins M, Broussard DM, Blobner M. A randomized trial evaluating the safety profile of sugammadex in high surgical risk ASA physical class 3 or 4 participants. BMC Anesthesiol. 2021 Oct 28;21(1):259. doi: 10.1186/s12871-021-01477-5.

    PubMed 34711192

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Sugammadex 2 mg/kg, Sugammadex 4 mg/kg and Sugammadex 16 mg/kg in people with Reversal of Neuromuscular Blockade, run by Merck Sharp & Dohme LLC at 30 sites in 4 countries.

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 10 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 8 Oct 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 30 sites in United States, Denmark, Austria, Germany. 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. 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 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

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 8 Oct 2020). 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?

Percentage of Participants With Treatment-Emergent Sinus Bradycardia Events (time frame: Up to approximately 35 minutes post-administration). The study lists 6 primary outcomes in all. 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 NCT03346057, 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 8 Oct 2020; AzTrials last refreshed its copy on 8 Nov 2026.

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