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Supraventricular ArrhythmiaPhase 4SotalolNCT05418036

Safety Assessment for Sotalol Protocol in Outpatient Unit

A Phase 4 study testing Sotalol Oral Tablet in people with Supraventricular Arrhythmia and Ventricular Arrythmia, run by University of Sao Paulo General Hospital at 1 site in Brazil.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

Sotalol is an antiarrhythmic medication with proven effects for the suppression and prevention of supraventricular and ventricular arrhythmias. Due to its potential proarrhythmic effect, its introduction should be cautious, and several guidelines recommend starting the medication in hospital settings. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Sotalol Oral Tablet
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
110 participants
Where
1 siteBrazil
Study dates
26 Oct 2020to Jun 2023
Phase
Phase 4
Are there results?
None posted in the registry

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

  • Indication of sotalol for the treatment of any supraventricular or ventricular arrhythmias
  • Age ≥ 18 years
  • Provide written informed consent

Who cannot join

  • Complete bundle branch block
  • Bradycardia with a frequency less than or equal to 55 bpm
  • Ventricular pacing determined by artificial pacemaker
  • Corrected QT interval greater than or equal to 460ms
  • Heart failure with reduced ejection fraction, less than 40%
  • Lactation period
Show all 11Show fewer
  • Dose required greater than 160 mg/day
  • Estimated creatinine clearance less than 60mL/min
  • Hypokalemia and hypomagnesemia documented in a patient at risk of spoliation of these components.
  • Concomitant use of other drugs with proarrhythmic potential related to increased corrected QT interval (eg, tricyclic antidepressants, macrolide antibiotics, electrolyte-depleting diuretics, etc.).
  • Others formal contraindications to the use of sotalol (e.g.: asthma)

Trial locations and contacts

1 site in 1 country.

Francisco CC Darrieux contact

+ 55 11 26615341

frdarrieux@gmail.com

Alberto P Ferraz contact

albertopferraz@gmail.com

Brazil1 site, 1 recruiting
  • Clinical Research Center of the Heart Institute - University of São Paulo

    São Paulo, 05403-900

    Francisco CC Darrieux, MD, PhD, +55 11 26615712, frdarrieux@gmail.com

    Gabrielle D Pessente, BSc, Ms, +55 11 26615712, gabrielle.pessente@hc.fm.usp.br

    Recruiting

Other trials in Brazil

About this study

Sotalol is an antiarrhythmic medication with proven effects for the suppression and prevention of supraventricular and ventricular arrhythmias. Due to its potential proarrhythmic effect, its introduction should be cautious, and several guidelines recommend starting the medication in hospital settings. However, patients at low risk for a proarrhythmic effect start the medication in outpatient units, despite the lack of clinical studies in the literature that demonstrate the safety of introducing the medication outside the hospital environment.

This research project aims to assess the safety introduction of sotalol in an outpatient unit basis. Our hypothesis is that outpatient introduction of sotalol is safe for low-risk patients and an electrocardiographic analysis after 2 hours of the first dose of medication is a predictor of electrocardiographic changes found after 72 hours.

In this research, serial electrocardiographic analysis with measurements of the QT corrected intervals and its dispersion, as well as clinical and laboratory parameters will be performed in 110 patients.

Read the detailed description

Participants will be prospectively recruited with sequential electrocardiographic assessments .Their indication and dose will be prescribed at the discretion of the attending physician. The following data to be analyzed are: age, ethnicity, anthropometric data (height, weight and BMI), clinical indication for sotalol, prescribed dose, comorbidities, other concomitant drugs, biochemical analysis (urea, creatinine, estimated creatinine clearance as also sodium, potassium and magnesium serum levels), echocardiogram and Holter monitoring when indicated.

Participants must have a standard 12-lead electrocardiogram (25mm/s) available at the start of treatment, 2 hours after the first dose of medication, and after 3 days, to calculate the corrected QT interval (QTc) and to analyze the dispersion of this interval. The patient will remain in the hospital until the second electrocardiogram is performed.

The QT interval will be measured manually, from the beginning of the QRS to the end of the T wave, by the tangent method, in DII, V5 or V2, in this order of preference. The QTc interval dispersion will be calculated manually, considering the difference between the longest and the shortest QT interval measured in the conventional 12 leads ECG.

All measurements will be made by the same arrhythmologist and later confirmed by a second arrhythmologist. Any divergent measures will be resolved by consensus. If there is no agreement, a third arrhythmologist will analyse the data.

The clinical evolution of the patients (minimum period of 30 days) after the beginning of the medication will be evaluated via face-to-face consultation or by telephone contact. At that moment, the patient's medications, adherence to sotalol use and the occurrence of adverse events will be checked again.

Being tested
Sotalol Oral Tablet
Keywords
Sotalol, Drug Safety, Corrected QT interval, Outpatient Treatment

What participants receive

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

  • Sotalol Oral TabletDrug

    Also called sotalol choridrate

    Dose of sotalol is prescribed by the attending physician. Accepted for this protocol when the dose is no greater than 160 mg/day

Study groups in NCT05418036
Study groupRoleWhat they receive
Consecutive patients elegible for outpatient sotalol indicationOtherSingle Group
Receives: Drug: Sotalol Oral Tablet

What is being measured

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

  1. Concerns about corrected QT prolongation after 72 hours.

    Number of participants with corrected QT interval increase greater than 10% of the baseline or beyond 500 milliseconds after 72 hours of introduction of sotalol.

    Measured: 72 hours from the start of sotalol.

Secondary outcomes (2)
  1. Concerns about corrected QT prolongation after 2 hours.

    Number of participants with corrected QT interval increase greater than 10% of the baseline or beyond 500 milliseconds after 2 hours of introduction of sotalol.

    Measured: 2 hours after the initiation of sotalol.

  2. Side effects that can impair the maintenance of the drug.

    Side effects that can influence the maintenance of the drug during the 30 days of follow up.

    Measured: 30 days of follow up.

Timeline

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

  1. First posted14 Jun 2022
  2. Study start26 Oct 2020
  3. Primary completionFeb 2023 (estimated)
  4. Study completionJun 2023 (estimated)

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
Not applicable
Intervention model
Single group
Model description
Prospective study
Masking
None (open label)
Enrolment
110 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05418036
Sponsor's protocol ID
4947/19/166
Acronym
Sotalol
Status last verified
Jul 2022
First submitted
2 Jun 2022
Last updated
11 Jul 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Singh BN. Antiarrhythmic actions of DL-sotalol in ventricular and supraventricular arrhythmias. J Cardiovasc Pharmacol. 1992;20 Suppl 2:S75-90.

    PubMed 1279313
  • Mason JW. A comparison of seven antiarrhythmic drugs in patients with ventricular tachyarrhythmias. Electrophysiologic Study versus Electrocardiographic Monitoring Investigators. N Engl J Med. 1993 Aug 12;329(7):452-8. doi: 10.1056/NEJM199308123290702.

    PubMed 8332150
  • Jurkiewicz NK, Sanguinetti MC. Rate-dependent prolongation of cardiac action potentials by a methanesulfonanilide class III antiarrhythmic agent. Specific block of rapidly activating delayed rectifier K+ current by dofetilide. Circ Res. 1993 Jan;72(1):75-83. doi: 10.1161/01.res.72.1.75.

    PubMed 8417848
  • Sanguinetti MC. Modulation of potassium channels by antiarrhythmic and antihypertensive drugs. Hypertension. 1992 Mar;19(3):228-36. doi: 10.1161/01.hyp.19.3.228.

    PubMed 1548049
  • Sanguinetti MC, Jurkiewicz NK. Two components of cardiac delayed rectifier K+ current. Differential sensitivity to block by class III antiarrhythmic agents. J Gen Physiol. 1990 Jul;96(1):195-215. doi: 10.1085/jgp.96.1.195.

    PubMed 2170562
  • Kehoe RF, Zheutlin TA, Dunnington CS, Mattioni TA, Yu G, Spangenberg RB. Safety and efficacy of sotalol in patients with drug-refractory sustained ventricular tachyarrhythmias. Am J Cardiol. 1990 Jan 2;65(2):58A-64A; discussion 65A-66A. doi: 10.1016/0002-9149(90)90204-e.

    PubMed 2294689
  • Multicentre randomized trial of sotalol vs amiodarone for chronic malignant ventricular tachyarrhythmias. Amiodarone vs Sotalol Study Group. Eur Heart J. 1989 Aug;10(8):685-94.

    PubMed 2676535
  • Obel IW, Jardine R, Haitus B, Millar RN. Efficacy of oral sotalol in reentrant ventricular tachycardia. Cardiovasc Drugs Ther. 1990 Jun;4 Suppl 3:613-8. doi: 10.1007/BF00357039.

    PubMed 2275891
  • Link MS, Berkow LC, Kudenchuk PJ, Halperin HR, Hess EP, Moitra VK, Neumar RW, O'Neil BJ, Paxton JH, Silvers SM, White RD, Yannopoulos D, Donnino MW. Part 7: Adult Advanced Cardiovascular Life Support: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015 Nov 3;132(18 Suppl 2):S444-64. doi: 10.1161/CIR.0000000000000261. No abstract available.

    PubMed 26472995
  • Neumar RW, Otto CW, Link MS, Kronick SL, Shuster M, Callaway CW, Kudenchuk PJ, Ornato JP, McNally B, Silvers SM, Passman RS, White RD, Hess EP, Tang W, Davis D, Sinz E, Morrison LJ. Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2010 Nov 2;122(18 Suppl 3):S729-67. doi: 10.1161/CIRCULATIONAHA.110.970988.

    PubMed 20956224
  • Benditt DG, Williams JH, Jin J, Deering TF, Zucker R, Browne K, Chang-Sing P, Singh BN. Maintenance of sinus rhythm with oral d,l-sotalol therapy in patients with symptomatic atrial fibrillation and/or atrial flutter. d,l-Sotalol Atrial Fibrillation/Flutter Study Group. Am J Cardiol. 1999 Aug 1;84(3):270-7. doi: 10.1016/s0002-9149(99)00275-1.

    PubMed 10496434
  • Prystowsky EN, Benson DW Jr, Fuster V, Hart RG, Kay GN, Myerburg RJ, Naccarelli GV, Wyse DG. Management of patients with atrial fibrillation. A Statement for Healthcare Professionals. From the Subcommittee on Electrocardiography and Electrophysiology, American Heart Association. Circulation. 1996 Mar 15;93(6):1262-77. doi: 10.1161/01.cir.93.6.1262. No abstract available.

    PubMed 8653857
  • January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, Conti JB, Ellinor PT, Ezekowitz MD, Field ME, Murray KT, Sacco RL, Stevenson WG, Tchou PJ, Tracy CM, Yancy CW; American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol. 2014 Dec 2;64(21):e1-76. doi: 10.1016/j.jacc.2014.03.022. Epub 2014 Mar 28. No abstract available.

    PubMed 24685669
  • Knudson JD, Cannon BC, Kim JJ, Moffett BS. High-dose sotalol is safe and effective in neonates and infants with refractory supraventricular tachyarrhythmias. Pediatr Cardiol. 2011 Oct;32(7):896-903. doi: 10.1007/s00246-011-0010-0. Epub 2011 May 8.

    PubMed 21553267
  • van der Heijden LB, Oudijk MA, Manten GT, ter Heide H, Pistorius L, Freund MW. Sotalol as first-line treatment for fetal tachycardia and neonatal follow-up. Ultrasound Obstet Gynecol. 2013 Sep;42(3):285-93. doi: 10.1002/uog.12390.

    PubMed 23303470

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Sotalol Oral Tablet in people with Supraventricular Arrhythmia and Ventricular Arrythmia, run by University of Sao Paulo General Hospital at 1 site in Brazil.

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 3 inclusion and 11 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: status not confirmed, as of the sponsor's last update on 11 Jul 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. 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?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Francisco CC Darrieux (+ 55 11 26615341, frdarrieux@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Concerns about corrected QT prolongation after 72 hours. (time frame: 72 hours from the start of sotalol.). 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 NCT05418036, which also lists 31 linked publications.

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 11 Jul 2022.

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