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Delirium, PostoperativePhase 3NCT06361238

Liraglutide in Preventing Delirium in Diabetic Elderly After Cardiac Surgery

A Phase 3 study testing Liraglutide injection in people with Delirium, Postoperative, run by The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School at 1 site in China.

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

This study aims to clarify the preventive effect of perioperative liraglutide application on postoperative delirium in elderly patients with Type 2 diabetes undergoing cardiac surgery. Read more about this study

Who is it for?
Ages 60 years and older
Conditions the study is for
Delirium, Postoperative
What is being tested?
Liraglutide injection
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
260 participants
Where
1 siteChina
Study dates
19 Nov 2024to 31 Mar 2028
Phase
Phase 3
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 60 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Age ≥ 60 years
  • Type 2 diabetes
  • Patients undergoing elective cardiac surgery

Who cannot join

  • History of neurological or psychiatric disorders, such as schizophrenia, epilepsy, Parkinson's disease, severe dementia, etc
  • Patients with communication difficulties, such as severe visual, auditory, or speech impairments
  • History of central nervous system damage or surgery
  • Cardiac function NYHA Class IV
  • Severe liver dysfunction (Child-Pugh Class C)
  • Severe renal failure requiring renal replacement therapy
Show all 14Show fewer
  • History of pancreatitis
  • Type 1 diabetes
  • Patients whose blood sugar is difficult to control within 4-8 mmol/L during the screening period
  • Patients with medullary thyroid carcinoma or a family history of it
  • Pregnant or breastfeeding women
  • Intolerance or allergy to liraglutide
  • Previous use of GLP-1A and SGLT2i
  • Patients who refuse to sign the 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.

Wenxue Liu, PhD,MD contact

15751866806

diligent_hi@163.com

China1 site, 1 recruiting
  • Wenxue liu

    Nanjing, Jiangsu, 210000

    Wenxue NA Liu, MD$PHD, +8615751866806, diligent_hi@163.com

    Recruiting

Other trials in China

About this study

Official title: Perioperative Application of Liraglutide for the Prevention of Postoperative Delirium Among Elderly Patients with Type 2 Diabetes Undergoing Cardiac Surgery: a Single-Center Randomized Controlled Study

This study aims to clarify the preventive effect of perioperative liraglutide application on postoperative delirium in elderly patients with Type 2 diabetes undergoing cardiac surgery.

Read the detailed description

Delirium is the most prevalent neurological complication following cardiac surgery. It is characterized by an acute and fluctuating disturbance in consciousness, attention, and cognitive function. The incidence of delirium post-cardiac surgery ranges between 11% and 46%. It is closely linked to increased postoperative mortality, extended hospital stays, higher healthcare costs, and long-term cognitive impairment. Currently, it is widely recognized that the development of delirium is influenced by multiple factors, including advanced age, diabetes, surgical and anesthetic techniques, depression, baseline cognitive function, and infections, among others.

Inflammatory responses, crucial for protecting against external or internal threats, can, following surgery, lead to neuroinflammation and neurological damage due to elevated postoperative inflammatory markers and blood-brain barrier disruption. The involvement of microglia and astrocytes, key players in the central nervous system's immune response, has been identified in mediating postoperative delirium, making them potential targets for prevention.

Liraglutide, a Glucagon-like peptide-1 receptor agonist primarily used for treating Type 2 diabetes, has shown promise in mitigating neurocognitive damage associated with diabetes and Alzheimer's disease, suggesting its potential in preventing postoperative delirium in cardiac surgery patients with Type 2 diabetes. Preliminary animal studies and a randomized controlled trial indicate that perioperative liraglutide application could reduce the incidence of postoperative delirium by inhibiting glial activation and the subsequent neuroinflammatory response. However, differences in patient demographics, disease severity, and dosing in previous studies highlight the need for further investigation.

The study aims to investigate whether the perioperative administration of liraglutide can prevent the onset of postoperative delirium in elderly patients with Type 2 diabetes undergoing cardiac surgery. Secondary objectives include assessing the impact on the severity and duration of delirium, cognitive function, anxiety, depression, cardiac function, cardiovascular events, ICU stay, mechanical ventilation duration, and levels of serum markers for brain injury, inflammation, myocardial damage, and cardiac function.

Being tested
Liraglutide injection, Placebo injection
Medical subject headings
Emergence Delirium

What participants receive

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

  • Liraglutide injectionDrug

    Also called Victoza

    Subcutaneous injection of liraglutide: 0.6 mg administered the day before surgery, 1.8 mg administered post-anesthesia induction on the day of surgery, followed by 0.6 mg daily for the first three postoperative days.

  • Placebo injectionDrug

    Also called Normal saline

    Subcutaneous injection of Placebo: the same volume as liraglutide administrated at the corresponding times.

Study groups in NCT06361238
Study groupRoleWhat they receive
Liraglutide GroupExperimentalSubcutaneous injection of liraglutide
Receives: Drug: Liraglutide injection
Vehicle GroupPlacebo comparatorSubcutaneous injection of vehicle
Receives: Drug: Placebo injection

What is being measured

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

  1. The incidence of delirium

    Confusion Assessment Method (CAM), or its variant for the Intensive Care Unit, known as CAM-ICU, is the tool used to assess the incidence of delirium. For CAM, the scale ranges from a minimum value of 11 to a maximum of 44, with higher scores indicating a worse outcome. In contrast, CAM-ICU does not utilize a numerical scale; it is a qualitative assessment designed to evaluate confusion without assigning specific values.

    Measured: One day before surgery and within the first seven days after surgery.

Secondary outcomes (33)
  1. The severity of delirium

    The CAM-Severity Scale (CAM-S), available in both short-form and long-form versions, serves as a tool for assessing the severity of delirium. The scale extends from 0 to 7 in its short-form and from 0 to 19 in its long-form. Higher scores on the CAM-S are indicative of more severe outcomes.

    Measured: One day before surgery and within the first seven days after surgery.

  2. Cognitive function

    Minimum Mental State Examination (MMSE) is the tool used to assess cognitive function. The scale extends from 0 to 30, with higher scores indicating a better outcome.

    Measured: One day before surgery; one week after surgery or at the date of discharge; and at 3 months, 6 months, and 1 year postoperatively.

  3. Anxiety

    Generalized anxiety disorder-7 (GAD-7) is the tool used to assess anxiety. The scale extends from 0 to 21, with higher scores indicating a worse outcome.

    Measured: One day before surgery; one week after surgery or at the date of discharge; and at 3 months, 6 months, and 1 year postoperatively.

  4. Depression

    Patient Health Questionnaire-9 (PHQ-9) is the tool used to assess depression. The scale extends from 0 to 27, with higher scores indicating a worse outcome.

    Measured: One day before surgery; one week after surgery or at the date of discharge; and at 3 months, 6 months, and 1 year postoperatively.

  5. Duration of ICU stay

    By retrieving the Hospital Information System and ICU special care sheet

    Measured: The time from transfer into the ICU to discharge from the ICU, assessed up to 12months.

  6. Mechanical ventilation time

    By retrieving the Hospital Information System and ICU special care sheet

    Measured: The time from tracheal intubation to the removal of the tracheal tube, assessed up to 12months.

  7. Duration of hospital stay

    By retrieving the Hospital Information System

    Measured: The time from hospital admission to discharge, assessed up to 12months.

  8. In-hospital mortality

    By retrieving the Hospital Information System

    Measured: The time from hospital admission to discharge, assessed up to 12months.

  9. Incidence of adverse events

    By retrieving the Hospital Information System, ICU special care sheet and follow-up

    Measured: One day preoperatively to three days Postoperatively.

  10. Rate of major cardiovascular adverse events

    By retrieving the Hospital Information System, ICU special care sheet and follow-up

    Measured: Within 1 year post-surgery (including cardiovascular death, myocardial infarction, and stroke)

  11. Serum levels of NSE

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  12. Serum levels of CRP

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  13. Serum levels of IL-1α

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  14. Serum levels of TNF-α

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  15. Serum levels of C3

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  16. Serum levels of LDH

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  17. Serum levels of CK

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  18. Serum levels of CK-MB

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  19. Serum levels of AST

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  20. Serum levels of cTNT

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  21. Serum levels of BNP

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  22. Serum levels of C1q

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  23. Serum levels of IL-1β

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  24. Serum levels of IL-6

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  25. Serum levels of S100β

    ELISA

    Measured: One day preoperatively; immediately after admission to ICU; 3 days and 7 days postoperatively

  26. Left Ventricular Posterior Wall Thickness in Diastole (LVPWTd)

    The echocardiography is used to assess the LVPWTd.

    Measured: One day preoperatively; One week postoperatively or at the date of discharge; and at 3 months, 6 months, and 1 year postoperatively.

  27. Left Ventricular End-Diastolic Dimension (LVDd)

    The echocardiography is used to assess the LVDd.

    Measured: One day preoperatively; One week postoperatively or at the date of discharge; and at 3 months, 6 months, and 1 year postoperatively.

  28. Left Ventricular End-Systolic Diameter (LVDs)

    The echocardiography is used to assess the LVDs.

    Measured: One day preoperatively; One week postoperatively or at the date of discharge; and at 3 months, 6 months, and 1 year postoperatively.

  29. Left Atrial Diameter (LAD)

    The echocardiography is used to assess the LAD.

    Measured: One day preoperatively; One week postoperatively or at the date of discharge; and at 3 months, 6 months, and 1 year postoperatively.

  30. Ejection Fraction (EF)

    The echocardiography is used to assess the EF.

    Measured: One day preoperatively; One week postoperatively or at the date of discharge; and at 3 months, 6 months, and 1 year postoperatively.

  31. Fractional Shortening (FS)

    The echocardiography is used to assess the FS.

    Measured: One day preoperatively; One week postoperatively or at the date of discharge; and at 3 months, 6 months, and 1 year postoperatively.

  32. Early Diastolic Velocity/Atrial Diastolic Velocity (E/A)

    The echocardiography is used to assess the E/A.

    Measured: One day preoperatively; One week postoperatively or at the date of discharge; and at 3 months, 6 months, and 1 year postoperatively.

  33. Interventricular Septum Thickness in Diastolic (IVSTd)

    The echocardiography is used to assess the IVSTd.

    Measured: One day preoperatively; One week postoperatively or at the date of discharge; and at 3 months, 6 months, and 1 year postoperatively.

Timeline

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

  1. First posted11 Apr 2024
  2. Study start19 Nov 2024
  3. Primary completion31 Mar 2027 (estimated)
  4. Study completion31 Mar 2028 (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
Double blind
Who is masked
Participant, Investigator
Enrolment
260 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06361238
Sponsor's protocol ID
2023-LCYJ-PY-21
Status last verified
Dec 2024
First submitted
19 Mar 2024
Last updated
20 Dec 2024
Results posted
No
Data monitoring committee
No
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 Liraglutide injection in people with Delirium, Postoperative, run by The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School at 1 site 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 14 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 20 Dec 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 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. Some participants in this study may receive a placebo. 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?

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 Wenxue Liu, PhD,MD (15751866806, diligent_hi@163.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The incidence of delirium (time frame: One day before surgery and within the first seven days after surgery.). 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 20 Dec 2024.

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