MidazolamPhase 2RESTNCT06275594
Trial Evaluating the Efficacy of Remimazolam in Endobronchial Ultrasound Guided Transbronchial Needle Aspiration
A Phase 2 study testing Byfavo and Midazolam in people with Midazolam and Remimazolam, run by Yeungnam University Hospital at 1 site in South Korea.
Trial summary
Study to evaluate the efficacy and safety of remimazolam in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration Primary Outcome Evaluate and compare the success of the procedure in patients undergoing EBUS-TBNA (Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration) when… Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Midazolam, Remimazolam
- What is being tested?
- Byfavo and Midazolam
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 330 participants
- Where
- 1 siteSouth Korea
- Study dates
- 1 Mar 2024to 1 Feb 2025
- Phase
- Phase 2
- 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
- Adult males and females aged 18 and above
- ASA 1-3
- BMI 18.5~30.0
- Saturation pulse oximeter (SpO2) ≥ 90% in ambient air or with no more than 2 liters/min of O2 support
- Patients who can comply with the procedures according to this clinical study protocol and who have voluntarily signed the consent form themselves
Who cannot join
- Patients undergoing radial EBUS or electromagnetic navigation bronchoscopy (ENB) simultaneously
- ASA 4 or higher
- Mallampati score 4
- BMI < 18.5, BMI >30.0
- Known sensitivity to benzodiazepines, flumazenil, opioids, naloxone, or a medical condition in which these agents
- Bronchoscopy outside the bronchoscopy unit
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- chronic kidney disease on dialysis
- Patients with a current active acute infection or uncontrolled chronic inflammatory lung disease
- Patients considered inappropriate for the study at the investigator's discretion
Trial locations and contacts
1 site in 1 country.
South Korea1 site
Yeungnam University Hospital
Daegu, Namgu, 42415
June Hong Ahn, M.D. PhD, 821028562008, fireajh@gmail.com
About this study
Official title: A Prospective, Open-label, Randomized Clinical Trial to Evaluate the Efficacy and Safety of Remimazolam in patienTs Undergoing Endobronchial Ultrasound-guided Transbronchial Needle Aspiration: REST Trial
Study to evaluate the efficacy and safety of remimazolam in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration
Primary Outcome Evaluate and compare the success of the procedure in patients undergoing EBUS-TBNA (Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration) when administered with remimazolam in the experimental group, versus Real world midazolam (Control Group 1), and On label midazolam (Control Group 2).
Secondary Outcome In patients undergoing EBUS-TBNA, compare the following aspects when administered with remimazolam in the experimental group versus Real world midazolam (Control Group 1) and On label midazolam (Control Group 2): Procedure start time, Time taken to achieve full alertness, Need for flumazenil administration, Total dose of fentanyl used, Scale of coughing/discomfort/convenience, Changes in vital signs, Complications related to the procedure.
- Conditions
- Midazolam, Remimazolam
- Being tested
- Byfavo, Midazolam
- Keywords
- Remimazolam, Midazolam, Safety, Efficacy, EBUS-TBNA
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
ByfavoDrug
Also called Remimazolam
For induction and maintenance of sedation
MidazolamDrug
For induction and maintenance of sedation
| Study group | Role | What they receive |
|---|---|---|
| Remimazolam | Experimental | American Society of Anesthesiologists (ASA) I-II: initial dosing 5mg, maintenance dosing: 2.5mg, interval ≥2minutes ASA III: initial dosing 2.5mg, maintenance dosing: 1.25mg, interval ≥2minutes Remimazolam dose limitation: none Fentanyl: 25-50mcg, interval ≥5mintues, max: 200mcg Receives: Drug: Byfavo |
| Real world Midazolam | Active comparator | Initial dosing 2-3mg, maintenance dosing: 0.5-1mg, interval ≥2minutes Remimazolam dose limitation: 7.5mg Fentanyl: 25-50mcg, interval ≥5mintues, max: 200mcg Receives: Drug: Midazolam |
| On label Midazolam | Active comparator | <60years old and healthy: initial dosing 1.75mg, maintenance dosing: 1.0mg, interval ≥2minutes
≥60years old or debilitated/chronically ill: initial dosing 1.0mg, maintenance dosing: 0.5mg, interval v2minutes Remimazolam dose limitation: 7.5mg Fentanyl: 25-50mcg, interval ≥5mintues, max: 200mcg Receives: Drug: Midazolam |
What is being measured
The primary outcome is the main question the study is designed to answer.
Procedural success during EBUS-TBNA (composite outcome)
Success of the bronchoscopy procedure, Completion of the bronchoscopy procedure, No requirement for a rescue sedative medication, In the case of remimazolam and placebo, no requirement for more than 5 top-ups of study medication within any 15 minute period; in the case of midazolam, no requirement for more than 3 doses in any 12 minute window
Measured: Up to the end of the procedure (up to 1 hour)
Secondary outcomes (9)
Time to start of procedure after administration of the first dose of study medication
Modified Observer's Assessment of Alertness and Sedation (MOAA/S)≤3 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: Time from administration of the first dose of study medication to the start of procedure (MOAA/S ≤3) (up to 1 hour)
Time taken to achieve full alertness after the procedure
MOAA/S=5 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: Time from end of the procedure to first of three consecutive MOAA/S scores =5 (up to 1 hour)
Requirement for flumazenil dosage during the procedure
If MOAA/S score 5 is not reached after bronchoscopy, flumazenil will be administered. Total amount of flumazenil dosage during the procedure is measured.
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 end of procedure to discharge of bronchoscopy room (up to 1 hour)
Total fentanyl dose
Total amount of fentanyl during the procedure
Measured: From the start of procedure to the end of procedure (up to 1 hour)
Scale of coughing/discomfort/inconvenience
Coughing/discomfort/convenience visual analogue scale (Patients mark a point on a straight line corresponding to their perception of the severity of the cough, discomfort, and inconvenience. VAS ranges 0-100, with 0 representing minimal severity and 100 representing maximal severity)
Measured: After the end of procedure (up to 1 hour)
Changes in blood pressure
Changes of blood pressure (mmHg) assessed by 5 minutes
Measured: From the start of procedure to the end of procedure (up to 1 hour)
Changes of heart rate
Changes of heart rate (rates/minutes) assessed by 5 minutes
Measured: From the start of procedure to the end of procedure (up to 1 hour)
Changes in respiration rate
Changes of respiration rate (rates/minutes) assessed by 5 minutes
Measured: From the start of procedure to the end of procedure (up to 1 hour)
Complications related to the procedure
Procedure related complications during 1 month follow up
Measured: Up to 1 month
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted23 Feb 2024
- Study start1 Mar 2024 (estimated)
- Primary completion1 Feb 2025 (estimated)
- Study completion1 Feb 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for MidazolamStudies 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 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 330 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Yeungnam University Hospital
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, June Hong Ahn, Yeungnam University Hospital
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06275594
- Sponsor's protocol ID
- YUMC2023-12-017
- Acronym
- REST
- Status last verified
- Feb 2024
- First submitted
- 16 Jan 2024
- Last updated
- 23 Feb 2024
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Seol HY, Hong KS, Jang JG, Moon SM, Kim SH, Cho JY, Yang B, Kim S, Choi CM, Ji W, Ahn JH. A prospective, open-label, randomized clinical trial to evaluate the efficacy and safety of remimazolam in patients undergoing EBUS-TBNA: REST trial design. BMC Pulm Med. 2024 May 17;24(1):243. doi: 10.1186/s12890-024-03067-w.
PubMed 38760702
Study at a glance
From the registry record, last updated by the sponsor on 23 Feb 2024. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Prospective, Open-label, Randomized Clinical Trial to Evaluate the Efficacy and Safety of Remimazolam in patienTs Undergoing Endobronchial Ultrasound-guided Transbronchial Needle Aspiration: REST Trial
- ClinicalTrials.gov ID
- NCT06275594
- Acronym / sponsor ID
- REST / YUMC2023-12-017
- Conditions
- Midazolam, Remimazolam
- Keywords
- Remimazolam, Midazolam, Safety, Efficacy, EBUS-TBNA
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 330 participants (estimated)
- Lead sponsor
- Yeungnam University HospitalUniversity, hospital or other
- Study start
- 1 Mar 2024 (estimated)
- Primary completion
- 1 Feb 2025 (estimated)
- Study completion
- 1 Feb 2025 (estimated)
- First posted
- 23 Feb 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Study to evaluate the efficacy and safety of remimazolam in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration
Primary Outcome Evaluate and compare the success of the procedure in patients undergoing EBUS-TBNA (Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration) when administered with remimazolam in the experimental group, versus Real world midazolam (Control Group 1), and On label midazolam (Control Group 2).
Secondary Outcome In patients undergoing EBUS-TBNA, compare the following aspects when administered with remimazolam in the experimental group versus Real world midazolam (Control Group 1) and On label midazolam (Control Group 2): Procedure start time, Time taken to achieve full alertness, Need for flumazenil administration, Total dose of fentanyl used, Scale of coughing/discomfort/convenience, Changes in vital signs, Complications related to the procedure.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 3
| Arm | Type | Receives |
|---|---|---|
| Remimazolam | Experimental | Drug: ByfavoAmerican Society of Anesthesiologists (ASA) I-II: initial dosing 5mg, maintenance dosing: 2.5mg, interval ≥2minutes ASA III: initial dosing 2.5mg, maintenance dosing: 1.25mg, interval ≥2minutes Remimazolam dose limitation: none Fentanyl: 25-50mcg, interval ≥5mintues, max: 200mcg |
| Real world Midazolam | Active comparator | Drug: MidazolamInitial dosing 2-3mg, maintenance dosing: 0.5-1mg, interval ≥2minutes Remimazolam dose limitation: 7.5mg Fentanyl: 25-50mcg, interval ≥5mintues, max: 200mcg |
| On label Midazolam | Active comparator | Drug: Midazolam<60years old and healthy: initial dosing 1.75mg, maintenance dosing: 1.0mg, interval ≥2minutes ≥60years old or debilitated/chronically ill: initial dosing 1.0mg, maintenance dosing: 0.5mg, interval v2minutes Remimazolam dose limitation: 7.5mg Fentanyl: 25-50mcg, interval ≥5mintues, max: 200mcg |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- Adult males and females aged 18 and above
- ASA 1-3
- BMI 18.5~30.0
- Saturation pulse oximeter (SpO2) ≥ 90% in ambient air or with no more than 2 liters/min of O2 support
- Patients who can comply with the procedures according to this clinical study protocol and who have voluntarily signed the consent form themselves
Key exclusion criteria (9 listed)
- Patients undergoing radial EBUS or electromagnetic navigation bronchoscopy (ENB) simultaneously
- ASA 4 or higher
- Mallampati score 4
- BMI < 18.5, BMI >30.0
- Known sensitivity to benzodiazepines, flumazenil, opioids, naloxone, or a medical condition in which these agents
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 |
|---|---|---|
| ByfavoAlso: RemimazolamFor induction and maintenance of sedation | Drug | Remimazolam |
| MidazolamFor induction and maintenance of sedation | Drug | On label Midazolam, Real world Midazolam |
Primary outcome
Procedural success during EBUS-TBNA (composite outcome)
Time frame: Up to the end of the procedure (up to 1 hour)
Success of the bronchoscopy procedure, Completion of the bronchoscopy procedure, No requirement for a rescue sedative medication, In the case of remimazolam and placebo, no requirement for more than 5 top-ups of study medication within any 15 minute period; in the case of midazolam, no requirement for more than 3 doses in any 12 minute window
9 secondary outcomes
Time to start of procedure after administration of the first dose of study medication
Time frame: Time from administration of the first dose of study medication to the start of procedure (MOAA/S ≤3) (up to 1 hour)
Time taken to achieve full alertness after the procedure
Time frame: Time from end of the procedure to first of three consecutive MOAA/S scores =5 (up to 1 hour)
Requirement for flumazenil dosage during the procedure
Time frame: From the end of procedure to discharge of bronchoscopy room (up to 1 hour)
Total fentanyl dose
Time frame: From the start of procedure to the end of procedure (up to 1 hour)
Scale of coughing/discomfort/inconvenience
Time frame: After the end of procedure (up to 1 hour)
Changes in blood pressure
Time frame: From the start of procedure to the end of procedure (up to 1 hour)
Changes of heart rate
Time frame: From the start of procedure to the end of procedure (up to 1 hour)
Changes in respiration rate
Time frame: From the start of procedure to the end of procedure (up to 1 hour)
Complications related to the procedure
Time frame: Up to 1 month
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 23 Feb 2024.
- Derived from this study: PubMed 38760702Seol HY, Hong KS, Jang JG, Moon SM, Kim SH, Cho JY, Yang B, Kim S, Choi CM, Ji W, Ahn JH. A prospective, open-label, randomized clinical trial to evaluate the efficacy and safety of remimazolam in patients undergoing EBUS-TBNA: REST trial design. BMC Pulm Med. 2024 May 17;24(1):243. doi: 10.1186/s12890-024-03067-w.
- Individual participant dataSharing planned: No
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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.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Byfavo and Midazolam in people with Midazolam and Remimazolam, run by Yeungnam University Hospital at 1 site in South Korea.
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 5 inclusion and 9 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 23 Feb 2024. 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 South Korea. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
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 June Hong Ahn (821028562008, fireajh@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Procedural success during EBUS-TBNA (composite outcome) (time frame: Up to the end of the procedure (up to 1 hour)). 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 NCT06275594, 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 23 Feb 2024.