AzTrials
AzTrials

AnalgesiaPhase 3NCT05641909

Efficacy and Safety of Remifentanil for Mechanically Ventilated Patients in Intensive Care Unit

A Phase 3 study testing Remifentanil and Fentanyl in people with Analgesia, run by Southeast University, China at 18 sites in China.

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 The sponsor has not verified this record for over two years, so it may be out of date.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

Trial summary

Remifentanil has been approved by the FDA for continuation as an analgesic into the immediate postoperative period in adult patients under the direct supervision of an anesthesia practitioner in a postoperative anesthesia care unit or intensive care setting. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Analgesia
What is being tested?
Remifentanil and Fentanyl
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
138 participants
Where
18 sitesChina
Study dates
1 Aug 2021to 31 Dec 2022
Phase
Phase 3
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 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Intubated in the past 24 hours with invasive mechanical ventilation
  • Expected to continue mechanical ventilation for more than 48 hours
  • Informed consent/assent was obtained from all patients or their representatives

Who cannot join

  • Patients with a history of allergy to opioids, benzodiazepines, propofol, or alcohol/drug abuse were excluded from the study
  • Patients who are known or suspected to be allergic to the study drug
  • Patients whose expected survival time is less than 48h
  • Patients receiving deep sedation (RASS≥-4)
  • Patients using neuromuscular blocking agent
  • Patients who cannot be assessed by RASS
Show all 17Show fewer
  • Patients with myasthenia gravis
  • patients with bronchial asthma
  • patients with abdominal compartment syndrome
  • Patients who need surgery or tracheotomy during the study drug treatment period
  • Women during pregnancy and lactation
  • Patients who have used short-acting non-steroidal anti-inflammatory drugs within 6 hours
  • Patients who have used long-acting non-steroidal anti-inflammatory drugs within 12 hours
  • Patients with a history of chronic pain for more than 3 months or who are receiving regular analgesia for more than 3 months
  • Patients who have used monoamine oxidase inhibitors within two weeks
  • Patients who participate in any clinical trials as subjects within 1 month
  • Patients with a history of drug abuse, drug abuse, alcohol abuse* and long-term use of psychotropic drugs within 2 years Alcoholism: Drinking more than 14 times/week (1 time=150ml wine or 360ml beer or 45ml spirits)

Trial locations and contacts

18 sites in 1 country.

18 sites in 1 country

China18 sites, 18 recruiting
  • Beijing Tiantan Hospital, Capital Medical University

    Beijing, Beijing Municipality, 100000

    Zhou Jianxin, MD, +8613801183875

    Recruiting
  • The Third Xiangya Hospital of Central South University

    Changsha, Hunan, 410000

    Yang Mingshi, MD, +8613973139006

    Recruiting
  • Xiangya Hospital of Central South University

    Changsha, Hunan, 410000

    Zhang Lina, MD, +8615874875763

    Recruiting
  • The First Affiliated Hospital of Chongqing Medical University

    Chongqing, Chongqing Municipality, 404100

    Zhou Fachun, MD, +8618502388799

    Recruiting
  • Enshi Tujia and Miao Autonomous Prefecture Central Hospital

    Enshi, Hubei, 445000

    Li Dezhong, MD, +8615342885588

    Recruiting
  • Affiliated Hospital of Guizhou Medical University

    Guiyang, Guizhou, 550000

    Shen Feng, MD, +8613511999117

    Recruiting
  • Zhejiang Provincial People's Hospital

    Hangzhou, Zhejiang, 310000

    Sun Renhua, MD, +8613505710366

    Recruiting
  • Anhui Provincial People's Hospital

    Hefei, Anhui, 230000

    Pan Aijun, MD, +8613866668786

    Recruiting
  • Nanjing Zhong-Da Hospital, Southeast University

    Nanjing, 210009

    Liu Ling, MD, +86-25-83262550, liulingdoctor@gmail.com

    Yang Yi, MD, +86-25-83262552, yiyiyang2004@163.com

    Recruiting
  • Qingyuan People's Hospital

    Qingyuan, Guangdong, 511500

    Yang Jingwen, MD, +8613542498765

    Recruiting
  • The Fourth Hospital of Hebei Medical University

    Shijiazhuang, Hebei, 050000

    Hu Zhenjie, MD, +8613933856908

    Recruiting
  • Tianjin First Central Hospital

    Tianjin, Tianjin Municipality, 30000

    Wang Yongqiang, MD, +8613302048899

    Recruiting
  • Zhongnan Hospital of Wuhan University

    Wuhan, Hubei, 430000

    Peng Zhiyong, MD, +8618672396028

    Recruiting
  • The First Affiliated Hospital of Xi'an Jiaotong University

    Xi’an, Shanxi, 710000

    Shi Qindong, MD, +8618991232391

    Recruiting
  • Northern Jiangsu People's Hospital

    Yangzhou, Jiangsu, 225000

    Zheng Rui qiang, MD, +8613952721411

    Recruiting
  • First Affiliated Hospital of Zhengzhou University

    Zhengzhou, Henan, 450000

    Sun Tongwen, MD, +8613838516916

    Recruiting
  • Henan Provincial People's Hospital

    Zhengzhou, Henan, 450000

    Qin Bingyu, MD, +8613633810677

    Recruiting
  • Affiliated Hospital of Zunyi Medical University

    Zunyi, Guizhou, 563000

    Chen Tao, MD, +8615329112288

    Recruiting

Other trials in China

About this study

Official title: Efficacy and Safety of Remifentanil for Mechanically Ventilated Patients in Intensive Care: Multicenter, Random, Double-blind, Parallel, Positive Control Clinical Trials

Remifentanil has been approved by the FDA for continuation as an analgesic into the immediate postoperative period in adult patients under the direct supervision of an anesthesia practitioner in a postoperative anesthesia care unit or intensive care setting. However, National Medical Products Administration(NMPA) did not approve this indication. Therefore, the purpose of this study is to confirm the efficacy and safety of remifentanil in the analgesic therapy of critical ill patients in China.

Read the detailed description

The study was conducted in accordance with good clinical practice and with the guidelines set out in the Declaration of Helsinki. After approval from local and national ethics committees, patients from 18 centres in China were recruited. All patients were randomized, in a double-blind manner, to receive either a remifentanil-propofol regimen or a fentanyl-propofol regimen for analgesia and sedation in the ICU. The aim of the study was to achieve optimal sedation and patient comfort by maintaining an optimal Critical Care Pain Observation Tool (CPOT) score of 2, without clinically significant pain, until the start of the extubation process or for 72 hours, whichever occurred first. CPOT scoring criteria: Facial expressions(Relaxed, neutral=0; Tense=1; Grimacing=2); Body movements(Absence of movements or normal position=0; Protection=1; Restlessness/Agitation=2); Muscle tension(Relaxed=0; Tense, rigid=1; Very tense or rigid=2); Compliance with the ventilator or Vocalization(Tolerating ventilator or movement/Talking in normal tone or no sound=0; Coughing but tolerating/Sighing, moaning=1; Fighting ventilator/Crying out, sobbing=2).

Conditions
Analgesia
Being tested
Remifentanil, Fentanyl
Keywords
analgesia, analgesia based sedation, critical care, fentanyl, propofol, remifentanil, sedation
Medical subject headings
Agnosia

What participants receive

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

  • RemifentanilDrug

    Also called Remifentanil Hydrochloride for Injection

    Remifentanil

  • FentanylDrug

    Also called Fentanyl Citrate Injection

    Dosage forms and strengths: 50 mcg/mL Fentanyl base/10 mL ampules. Manufacturer: Yichang Humanwell Pharmaceutical Co.,Ltd

Study groups in NCT05641909
Study groupRoleWhat they receive
RemifentanilExperimentalRemifentanil analgesia combined with propofol sedation. Treatment was started in patients with an CPOT score of 2 or greater after completion of baseline assessments. All patients received an initial infusion of blinded opioid (placebo bolus dose(6ml) + 6ug/kg per hour infusion at 6 ml/hour). Optimal analgesia (CPOT score ≤2) was then targeted by titrating the infusion in 1.5 ml/hour increments (placebo bolus dose + 1.5ug/kg per hour rate increase). Only when the opioid infusion rate had reached the 'propofol trigger dose' (12ml/h; 12ug/ kg per hour) was propofol to be administered as an initial bolus dose of up to 0.5 mg/kg and an infusion of 0.5mg/kg per hour, and titrated in 25% increments (0.25mg/kg bolus dose + 0.125mg/kg per hour rate increase to treat agitation.
Receives: Drug: Remifentanil
FentanylActive comparatorFentanyl analgesia combined with propofol sedation. Treatment was started in patients with an CPOT score of 2 or greater after completion of baseline assessments. All patients received an initial infusion of blinded opioid (1ug/kg bolus(6ml) + 1ug/kg per hour infusion at 6ml/hour). Optimal analgesia (CPOT score ≤2) was then targeted by titrating the infusion in 1.5 ml/hour increments (1ug/kg bolus dose + 0.25ug/kg per hour rate increase). Only when the opioid infusion rate had reached the 'propofol trigger dose' (12ml/h; 2ug/kg per hour) was propofol to be administered as an initial bolus dose of up to 0.5 mg/kg and an infusion of 0.5mg/kg per hour, and titrated in 25% increments (0.25mg/kg bolus dose + 0.125mg/kg per hour rate increase to treat agitation.
Receives: Drug: Fentanyl

What is being measured

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

  1. analgesia success rate(the proportion of subjects with successful analgesia to the number of subjects in each group)

    Analgesia success is defined as: 1. No salvage analgesics were used during the administration of the study drug; 2 During the administration of the study drug, the time for the analgesia score of subjects to reach the standard (CPOT score ≤ 2) was greater than 70%. CPOT scoring criteria: Facial expressions(Relaxed, neutral=0; Tense=1; Grimacing=2); Body movements(Absence of movements or normal position=0; Protection=1; Restlessness/ Agitation=2); Muscle tension(Relaxed=0; Tense, rigid=1; Very tense or rigid=2); Compliance with the ventilator or Vocalization(Tolerating ventilator or movement/Talking in normal tone or no sound=0; Coughing but tolerating/Sighing, moaning=1; Fighting ventilator/Crying out, sobbing=2).

    Measured: From study drug administration to actual extubation , up to 72 hours

Secondary outcomes (17)
  1. During the study drug administration period, the subjects are in the proportion of optimal time(CPOT score≤2)

    CPOT scoring criteria: Facial expressions(Relaxed, neutral=0; Tense=1; Grimacing=2); Body movements(Absence of movements or normal position=0; Protection=1; Restlessness/Agitation=2); Muscle tension(Relaxed=0; Tense, rigid=1; Very tense or rigid=2); Compliance with the ventilator or Vocalization(Tolerating ventilator or movement/Talking in normal tone or no sound=0; Coughing but tolerating/Sighing, moaning=1; Fighting ventilator/Crying out, sobbing=2).

    Measured: From study drug administration to actual extubation , up to 72 hours

  2. The number of times the remedial sedative drug propofol was used

    Use the total times of propofol

    Measured: From study drug administration to actual extubation , up to 72 hours

  3. The proportion of subjects using the salvage sedative drug propofol

    The proportion of subjects who using the salvage sedative drug propofol to the total subjects.

    Measured: From study drug administration to actual extubation , up to 72 hours

  4. The dosage of the remedial sedative drug propofol

    Use the total dose of propofol

    Measured: From study drug administration to actual extubation , up to 72 hours

  5. Wearing time from mechanical ventilation

    Wearing time criteria: The primary disease is improved, and there is no new disease; no use of vasopressors or continuous application of sedative drugs; cough reflex during sputum suction; PEEP≤5cmH2O; PaO2/FiO2≥200mmHg; Minute ventilation less than 15L/min; 2-minute spontaneous breathing test and passed.

    Measured: From study drug administration to wearing from mechanical ventilation, up to 72 hours

  6. Extubation time

    The start of the extubation process until actual extubation

    Measured: From the start of the extubation process until actual extubation , up to 72 hours

  7. The success rate of wearing mechanical ventilator

    The proportion of subjects who successfully wearing from mechanical ventilator to the total subjects.

    Measured: From study drug administration to actual extubation , up to 72 hours

  8. Duration of study drug use in ICU

    The time from the start of the study drug administration to the time discharge ICU.

    Measured: Through study completion, an average of 1 month

  9. The proportion of subjects discharging the ICU

    The proportion of subjects who discharge ICU to the total subjects.

    Measured: Through study completion, an average of 1 month

  10. ICU mortality

    The proportion of subjects who died during ICU admission to the total subjects.

    Measured: Through study completion, an average of 1 month

  11. Hospital mortality

    The proportion of subjects who died during hospital admission to the total subjects.

    Measured: Through study completion, an average of 1 month

  12. Length of ICU stay

    The number of days the subject stayed in the ICU.

    Measured: Through study completion, an average of 1 month

  13. Length of hospital stay

    The number of days the subject stayed in the hospital.

    Measured: Through study completion, an average of 1 month

  14. The incidence of study drug-related Lower blood pressure

    Lower blood pressure: mean arterial pressure (MAP) drops more than 25% from the baseline level or requires additional vasopressors.

    Measured: From study drug administration to actual extubation , up to 72 hours

  15. The incidence of study drug-related slow heart rate

    Slow heart rate: heart rate less than 40bpm for less than 1 minute or heart rate less than 60 bpm for more than 1 minute.

    Measured: From study drug administration to actual extubation , up to 72 hours

  16. The incidence of study drug-related respiratory depression

    Respiratory depression: respiratory rate less than 10 bpm or oxygen saturation by pulse oximetry less than 90%

    Measured: From study drug administration to actual extubation , up to 72 hours

  17. Analysis of the cost-effectiveness between remifentanil and fentanyl

    Analyze the best analgesic plan based on the results of the best analgesic effect

    Measured: From study drug administration to actual extubation , up to 72 hours

Timeline

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

  1. First posted8 Dec 2022
  2. Study start1 Aug 2021
  3. Primary completion30 Dec 2022 (estimated)
  4. Study completion31 Dec 2022 (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 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
138 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05641909
Sponsor's protocol ID
ZDRFF
Status last verified
Nov 2022
First submitted
29 Nov 2022
Last updated
8 Dec 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Remifentanil and Fentanyl in people with Analgesia, run by Southeast University, China at 18 sites in China.

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 17 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 8 Dec 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 18 sites in China. 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 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?

Results are not available in the source record.

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

Contact Sonqiao Liu, MD (+86-25-83262552, liusongqiao@ymail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

analgesia success rate(the proportion of subjects with successful analgesia to the number of subjects in each group) (time frame: From study drug administration to actual extubation , up to 72 hours). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 Dec 2022.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in