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AnalgesiaPhase 1AEROfenNCT06281951

Nebulized Fentanyl in Healthy Volunteers

A Phase 1 study testing Fentanyl - Inhalation by facial nebulization and Fentanyl - Nebulisation in people with Analgesia and Emergencies, run by University Hospital, Rouen at 1 site in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Pain constitutes the predominant motive prompting individuals to seek emergency medical attention, accounting for 80% of admissions to emergency departments. Presently, it is imperative to employ expeditious and efficacious analgesia-sedation methodologies, obviating the necessity for intravenous administration, while… Read more about this study

Who is it for?
Ages 18 to 68 yearsHealthy volunteers can take part
Conditions the study is for
Analgesia, Emergencies
What is being tested?
Fentanyl - Inhalation by facial nebulization and Fentanyl - Nebulisation
Could I receive a placebo?
No, everyone receives an active treatment
How many people
20 participants
Where
1 siteFrance
Study dates
26 Apr 2024to 1 Jun 2027
Phase
Phase 1
Are there results?
Not yet: the study is under way

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 to 68 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Age ≥ 18 years and < 68 years
  • BMI between 19 and 29 kg/m²
  • Affiliation to a social security scheme
  • Adult who has read and understood the information letter and signed the consent form
  • Woman capable of procreating (a woman is considered capable of procreating, i.e. fertile, after menarche and until she becomes menopausal, unless she is definitely sterile ) having very effective contraception (combined hormonal contraception (containing estrogens and progestins) associated with inhibition of ovulation, progestin-only hormonal contraception associated with inhibition of ovulation, intrauterine device, hormone-releasing intrauterine system (IUS), bilateral tubal occlusion, vasectomized partner, sexual abstinence) for 1 year and a negative urine pregnancy test at inclusion and during the duration of the study.
  • Woman definitely surgically sterile (hysterectomy, bilateral salpingectomy and bilateral oophorectomy). Postmenopausal woman: The postmenopausal state is defined by the absence of periods for 12 months without any other medical cause.

Who cannot join

  • Weight < 50 kg
  • Taking long-term painkillers or narcotics
  • Sharp pain
  • Stable chronic pain (>3 months, with or without long-term treatment)
  • Known chronic pathology stabilized or decompensated (hypertension, renal, cardiac, hepatic insufficiency, etc.)
  • Stable or decompensated chronic respiratory pathology
Show all 27Show fewer
  • Chronic neuropsychiatric pathology likely to modify the pain threshold
  • Long-term treatment with an action on the nervous system such as respiratory depression: benzodiazepines, neuroleptics, agonist/antagonist of the opioid system
  • Treatment or toxicant whose association is not recommended with fentanyl (alcohol, cannabis, etc.)
  • Central nervous system modulator treatment
  • Pathologies blocking the pupillary response: Claude-Bernard-Horner syndrome, Adie syndrome, Argyll-Robertson pupil, senile miosis, dysautonomic neuropathy (advanced diabetes, systemic amyloidosis), cataract
  • Treatment responsible for fluctuation in PUAL measurements: parasympathetic modulators (clonidine, dexmedetomidine, droperidol, metoclopramide)
  • No-indication to FENTANYL PIRAMAL 100µg/2mL, solution for injection in ampoule
  • No-indication to PROAMP SODIUM CHLORIDE 0.9%, solution for injection
  • Ongoing treatment with nasal vasoconstrictors
  • Peripheral oxygen saturation less than 93%
  • Alteration of cognitive state: comprehension disorder, language disorder, memory disorder, confusion
  • Deaf or mute patient
  • Usual heart rate such as HR< 40 bpm and/or hypotension with systolic blood pressure SBP< 100 mm Hg
  • Atrioventricular block on ECG
  • History of cataract surgery
  • Confirmed or suspected covid 19 / active flu infection less than 15 days old
  • Allergy to plastic
  • Pregnant or parturient or breastfeeding woman or proven absence of contraception
  • Person deprived of liberty by an administrative or judicial decision or person placed under judicial protection/under guardianship or curatorship
  • Person participating in research participating in another trial / having participated in another trial within 2 weeks
  • History of illness or psychological or sensory abnormality likely to prevent the subject from fully understanding the conditions required for participation in the protocol or preventing them from giving informed consent

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

France1 site, 1 recruiting
  • University Hospital, Rouen

    Rouen, France, 76031

    Recruiting

Other trials in France

About this study

Official title: Nebulized Fentanyl in Healthy Volunteers : Comparison of Facial Versus Intranasal Aerosol Administration by Pharmacometric Modeling

Pain constitutes the predominant motive prompting individuals to seek emergency medical attention, accounting for 80% of admissions to emergency departments. Presently, it is imperative to employ expeditious and efficacious analgesia-sedation methodologies, obviating the necessity for intravenous administration, while ensuring the secure delivery of pharmaceutical agents. The objective of this study is to assess the feasibility and comfort of nebulized intranasal or facial aerosol administration of Fentanyl through the implementation of a pharmacokinetic/pharmacodynamic (PK/PD) study

Read the detailed description

The prompt identification, assessment, and management of pain are imperative in the context of emergency medicine, necessitating rapid and effective interventions. In the realm of pain management, the investigators deemed it crucial to concentrate on non-invasive approaches, such as opioid nebulization, while ensuring the safe and controlled delivery of the pharmaceutical agent. Intranasal analgesia emerges as a particularly suitable option due to its non-invasiveness, painlessness, ease of administration, cost-effectiveness, and lack of stringent aseptic requirements, making it especially convenient for patients in pain. However, the administration of medications in nasal drop form lacks precise control over the quantity of the active drug, potentially resulting in a hepatic first-pass effect and inactivation before systemic absorption, particularly with large quantities and subsequent swallowing.

Facial nebulization of opiates presents an alternative method for analgesic administration. Traditional pneumatic nebulizers, readily available in emergency settings, are economical aerosol generators. However, they pose challenges related to the reproducibility of administration and the potential for infectious contamination due to the dispersion of nebulized particles in the air between inhalations. Palladium vibrating screen aerosols, designed to produce optimal particle sizes for drug delivery to the lungs, show promise due to their more occlusive system, offering enhanced performance. Yet, these devices lack evaluation in the realm of opioids, particularly in terms of objective nociception measurement.

Pupillometry, specifically PUAL (pupillary unrest in ambient light), stands out as an objective technique capable of quantifying nociception or opioid impregnation. PUAL monitors variations in pupil diameter over time, and previous studies have indicated an inverse correlation between the analgesic response to opioid treatment and PUAL amplitude, suggesting it could serve as a marker of central opioid impregnation. However, scientific evidence in alert emergency medicine patients remains lacking. Additionally, standard clinical pharmacodynamic evaluation criteria for opioids are not well-suited to the variability of therapeutic responses in emergency situations.

Pharmacometric models offer a quantitative approach to understanding relationships between administered drugs, clinico-biological covariates, exposure, and responses (biomarkers, efficacy, safety) as they evolve over time in individual patients and populations. This pilot study aims to evaluate the feasibility, safety, effects, and robustness of nebulized fentanyl administration via facial aerosol or intranasal routes in a population of adult healthy volunteers, employing equivalent analgesic doses. PUAL will serve as an objective pharmacodynamic marker of central opioid impregnation, coupled with pharmacokinetic modeling of nebulized fentanyl administered via facial aerosol or intranasally. The development of a pharmacometric model using a population-based approach aims to establish fentanyl titration strategies based on the objective of reducing PUAL while ensuring central opioid impregnation.

Being tested
Fentanyl - Inhalation by facial nebulization, Fentanyl - Nebulisation
Keywords
Severe acute pain, Pharmacometry, Fentanyl, Emergency medicine, Pupillometry (PUAL), Non-invasive analgesia (Intranasal, Facial aerosol)
Medical subject headings
Agnosia, Emergencies, Acute Pain

What participants receive

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

  • Fentanyl - Inhalation by facial nebulizationDrug

    Also called AEROGEN Nebulizer

    3 administrations based on a weight-dependent threshold (40 µg per administration for a weight < 70kg and 50 µg per administration for a weight ≥ 70kg).

  • Fentanyl - NebulisationDrug

    Also called Teleflex intranasal device

    3 administrations based on a weight-dependent threshold (20 µg/administration and for a weight < 70kg and 30 µg/administration for a weight ≥ 70kg). The dose of each bolus will be distributed at equivalent volume in both nasal pits

Study groups in NCT06281951
Study groupRoleWhat they receive
Facial NebulizationExperimentalFentanyl's facial nebulization in healthy volunteers.
Receives: Drug: Fentanyl - Inhalation by facial nebulization
IntranasalExperimentalFentanyl's intranasal inhalation in healthy volunteers.
Receives: Drug: Fentanyl - Nebulisation

What is being measured

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

  1. Measurement of [F] bioavailability via facial nebulization and intranasal inhalation.

    Bioavailability [F] will be expressed as percent mean +/- standard deviation for each group.

    Measured: 6 hours

Secondary outcomes (7)
  1. Measurement of maximum decrease in PUAL (pupillary under ambient light) between facial nebulization and intranasal inhalation.

    Maximum decrease in PUAL will be expressed as percent of baseline value +/- standard deviation for each group.

    Measured: 6 hours

  2. Measurement of the difference between observed and predicted PUAL values by a PK/PD model.

    The difference between observed and predicted values will be expressed as RMSE in percent.

    Measured: 6 hours

  3. Time required to achieve >30% decrease in PUAL compared to baseline.

    Time required for >30% decrease in PUAL will be expressed in minutes +/- standard deviation for each group.

    Measured: 6 hours

  4. To assess respiratory tolerance

    Using the respiratory rate and pulse oxygen saturation for respiratory tolerance

    Measured: 8 hours

  5. To assess neurological tolerance

    Using the Ramsay score for neurological tolerance

    Measured: 8 hours

  6. To assess hemodynamic tolerance

    Using the heart rate and blood pressure for hemodynamic tolerance

    Measured: 8 hours

  7. Measurement of administration comfort score using a visual analog scale ranging from 0 (maximum discomfort) to 10 (optimal comfort) (unitless).

    Administration comfort score will be expressed as mean +/- standard deviation for both groups.

    Measured: 6 hours

Timeline

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

  1. First posted28 Feb 2024
  2. Study start26 Apr 2024
  3. Primary completion1 Jun 2027 (estimated)
  4. Study completion1 Jun 2027 (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 1
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Crossover
Masking
None (open label)
Enrolment
20 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06281951
Sponsor's protocol ID
2022/0271/HP
Acronym
AEROfen
Status last verified
May 2026
First submitted
5 Feb 2024
Last updated
11 May 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Barksdale AN, Hackman JL, Williams K, Gratton MC. ED triage pain protocol reduces time to receiving analgesics in patients with painful conditions. Am J Emerg Med. 2016 Dec;34(12):2362-2366. doi: 10.1016/j.ajem.2016.08.051. Epub 2016 Aug 27.

    PubMed 27663766
  • Gueant S, Taleb A, Borel-Kuhner J, Cauterman M, Raphael M, Nathan G, Ricard-Hibon A. Quality of pain management in the emergency department: results of a multicentre prospective study. Eur J Anaesthesiol. 2011 Feb;28(2):97-105. doi: 10.1097/EJA.0b013e3283418fb0.

    PubMed 21119516
  • Lvovschi V, Aubrun F, Bonnet P, Bouchara A, Bendahou M, Humbert B, Hausfater P, Riou B. Intravenous morphine titration to treat severe pain in the ED. Am J Emerg Med. 2008 Jul;26(6):676-82. doi: 10.1016/j.ajem.2007.10.025.

    PubMed 18606320
  • Galinski M, Robledo JB, Tellier E, Catoire P, De La Riviere C, Lvovschi V, Gil-Jardine C. Are Patients with Chronic Pain Less Satisfied with Their ED Management Than Non-Chronic Pain Patients? Am J Emerg Med. 2022 Jun;56:7-9. doi: 10.1016/j.ajem.2022.03.032. Epub 2022 Mar 19. No abstract available.

    PubMed 35338897
  • Mudd S. Intranasal fentanyl for pain management in children: a systematic review of the literature. J Pediatr Health Care. 2011 Sep-Oct;25(5):316-22. doi: 10.1016/j.pedhc.2010.04.011. Epub 2010 Jun 17.

    PubMed 21867860
  • Adelgais KM, Brent A, Wathen J, Tong S, Massanari D, Deakyne S, Sills MR. Intranasal Fentanyl and Quality of Pediatric Acute Care. J Emerg Med. 2017 Nov;53(5):607-615.e2. doi: 10.1016/j.jemermed.2017.05.027. Epub 2017 Sep 28.

    PubMed 28967529
  • Hudson RJ, Thomson IR, Henderson BT, Singh K, Harding G, Peterson DJ. Validation of fentanyl pharmacokinetics in patients undergoing coronary artery bypass grafting. Can J Anaesth. 2002 Apr;49(4):388-92. doi: 10.1007/BF03017328.

    PubMed 11927479
  • Follet C, Dumont A, Roussel M, Gillibert A, Boedard C, Quillard M, Ruault S, Vallin F, Donnadieu N, Nunes Ferreira D, Pereira T, Joly LM, Lvovschi V, Duflot T. AEROfen: protocol for a phase I, open-label, randomised crossover study evaluating the efficiency of nebulised fentanyl in healthy volunteers - comparing facial versus intranasal administration via pharmacometric modelling. BMJ Open. 2025 Jul 3;15(7):e091125. doi: 10.1136/bmjopen-2024-091125.

    PubMed 40615143

Questions about this trial

What is this clinical trial studying?

A Phase 1 study testing Fentanyl - Inhalation by facial nebulization and Fentanyl - Nebulisation in people with Analgesia and Emergencies, run by University Hospital, Rouen at 1 site in France.

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 6 inclusion and 27 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: looking for participants now, as of the sponsor's last update on 11 May 2026. 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 France. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Cassandre Follet (+33232888990 ext. 60451, cassandre.follet@chu-rouen.fr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Measurement of [F] bioavailability via facial nebulization and intranasal inhalation. (time frame: 6 hours). 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 NCT06281951, which also lists 8 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 May 2026.

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