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The Availability and Safety Study of Remimazolam Besylate for Injection on Sedation of ERAS Patients

Primary Purpose

Analgesia, Postoperative Pain

Status
Unknown status
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Remimazolam Besylate
Propofol
Sponsored by
Peking Union Medical College Hospital
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Analgesia focused on measuring sedative, Remimazolam Besylate, postoperative sedation

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria

  • Meet criteria of enhanced recovery after surgery (ERAS);
  • Mechanical ventilated when enrolled and have estimation of more than 10 hours of mechanical ventilation in ICU
  • Aged between 18-75 years old AND 18kg/m2 ≤ BMI ≤ 30 kg/m2;
  • Clearly know the purpose and objective of this clinical study and voluntarily enrolled.

Criteria of ERAS: (1) without dysfunction of nervous system or Glasgow Coma Score > 12; (2) a satisfied glucose level (random blood glucose<11.1mmol/L during screening stage) for diabetes mellitus patients; (3) Without acute coronary syndrome in recent 6 months; (4) Without bradycardia and third-degree atrioventricular block (except for patients with pacemaker) during screening stage; (5) systolic blood pressure>90mmHg with no usage of vasoactive agent during screening stage; (6) without mental illness (schizophrenia, depressive disorder), cognitive dysfunction (identified by MMSE), epilepsy, history of abuse of psychotropic or anesthesia medication; (7) without disorder of coagulation function (PT/INR/APTT > 1.5×upper limit), bleeding tendency (active peptic ulcer), under treatment of thrombolysis and anticoagulant; (8) without disorder of liver function (ALT/AST > 2×upper limit and total bilirubin>1.5×upper limit); (9) without disorder of renal function (Creatine or BUN/Urea>1.5×upper limit); without dialysis patients.

Exclusion criteria

  • Allergy to component of Remimazolam besylate for injection;
  • Woman in gestation and lactation period;
  • Enrolled in other clinical trails in recent 3 months;
  • Other circumstance that identified by researchers that do not suitable for this clinical trial.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Experimental

    Active Comparator

    Arm Label

    Experimental group: Remimazolam Besylate

    Positive control group: Propofol

    Arm Description

    Patients should be given study drugs as soon as possible after entering the ICU. Syringe pump is used to administer medication. Loading dose of Remimazolam is 0.2 mg/kg, which is administered for less than 1 min initially. Maintaining dose is 0.2-1 mg/kg/h. Sedative target is RASS between 0 and -2 points. Excepts for fentanyl and Remimazolam, no analgesic or sedative could be used during the experimental time period.

    Patients should be given study drugs as soon as possible after entering the ICU. Syringe pump is used to administer medication. Loading dose of propofol is 0.2 mg/kg, which is administered for less than 1 min initially. Maintaining dose is 0.3-4.0 mg/kg/h. Sedative target is RASS between 0 and -2 points. Excepts for fentanyl and propofol, no analgesic or sedative could be used during the experimental time period. Rescue therapy for experimental group During the treatment of the experimental group, if the RASS cannot be maintained at 0 to -2 points at the maximum Remimazolam maintenance dose of 1 mg/kg/h, a loading dose of propofol (0.2 mg/kg) can be given intravenously. If RASS fails to satisfied after three loading doses of propofol, Remimazolam is discarded and 0.3-4.0 mg/kg/h of propofol are used as rescue therapy for experimental group.

    Outcomes

    Primary Outcome Measures

    Satisfaction rate of sedation
    (number of subjects that meets satisfied RASS score under prescribed dose of sedative agents during study / total number of subjects) ×100%
    Rate of major clinical events
    (number of subjects that suffer from major clinical events during study / total number of subjects) ×100%. Major clinical events are defined as cardiac arrest, malignant arrhythmia, new onset of shock, new onset of sepsis and respirate failure unrelated to primary illness.

    Secondary Outcome Measures

    incidence of delirium
    (subjects with delirium / total number of subjects ×100%) by 12h and 24h after entering ICU
    Time to weaning and extubation
    Time to weaning and extubation
    Difficulty of nursing
    By Barthel index assessment
    28-days survival
    (number of subjects that alive in 28-days since ICU entry/ total number of subjects) ×100%
    incidence of rescue therapy in experimental group
    (number of subjects that receive rescue therapy in experimental group/ total number of subjects) ×100%

    Full Information

    First Posted
    June 14, 2021
    Last Updated
    June 23, 2021
    Sponsor
    Peking Union Medical College Hospital
    Collaborators
    Yichang Humanwell Pharmaceutical Co., Ltd., China
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    1. Study Identification

    Unique Protocol Identification Number
    NCT04947345
    Brief Title
    The Availability and Safety Study of Remimazolam Besylate for Injection on Sedation of ERAS Patients
    Official Title
    The Availability and Safety Study of Remimazolam Besylate for Injection on Sedation of ERAS Patients Under Mechanical Ventilation in ICU: Protocol for a Randomized, Open-label, Controlled Trial
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2021
    Overall Recruitment Status
    Unknown status
    Study Start Date
    September 1, 2021 (Anticipated)
    Primary Completion Date
    March 1, 2022 (Anticipated)
    Study Completion Date
    September 1, 2022 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Peking Union Medical College Hospital
    Collaborators
    Yichang Humanwell Pharmaceutical Co., Ltd., China

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    No
    Product Manufactured in and Exported from the U.S.
    No
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    This trial intends to evaluate Remimazolam Besylate's availability and safety compared with propofol.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Analgesia, Postoperative Pain
    Keywords
    sedative, Remimazolam Besylate, postoperative sedation

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Masking Description
    This is a open label clinical trial.
    Allocation
    Randomized
    Enrollment
    84 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Experimental group: Remimazolam Besylate
    Arm Type
    Experimental
    Arm Description
    Patients should be given study drugs as soon as possible after entering the ICU. Syringe pump is used to administer medication. Loading dose of Remimazolam is 0.2 mg/kg, which is administered for less than 1 min initially. Maintaining dose is 0.2-1 mg/kg/h. Sedative target is RASS between 0 and -2 points. Excepts for fentanyl and Remimazolam, no analgesic or sedative could be used during the experimental time period.
    Arm Title
    Positive control group: Propofol
    Arm Type
    Active Comparator
    Arm Description
    Patients should be given study drugs as soon as possible after entering the ICU. Syringe pump is used to administer medication. Loading dose of propofol is 0.2 mg/kg, which is administered for less than 1 min initially. Maintaining dose is 0.3-4.0 mg/kg/h. Sedative target is RASS between 0 and -2 points. Excepts for fentanyl and propofol, no analgesic or sedative could be used during the experimental time period. Rescue therapy for experimental group During the treatment of the experimental group, if the RASS cannot be maintained at 0 to -2 points at the maximum Remimazolam maintenance dose of 1 mg/kg/h, a loading dose of propofol (0.2 mg/kg) can be given intravenously. If RASS fails to satisfied after three loading doses of propofol, Remimazolam is discarded and 0.3-4.0 mg/kg/h of propofol are used as rescue therapy for experimental group.
    Intervention Type
    Drug
    Intervention Name(s)
    Remimazolam Besylate
    Intervention Description
    Remimazolam Besylate are used as sedatives for subjects in this arm.
    Intervention Type
    Drug
    Intervention Name(s)
    Propofol
    Intervention Description
    Propofol are used as sedatives for subjects in this arm.
    Primary Outcome Measure Information:
    Title
    Satisfaction rate of sedation
    Description
    (number of subjects that meets satisfied RASS score under prescribed dose of sedative agents during study / total number of subjects) ×100%
    Time Frame
    24 hours since injection of sedatives
    Title
    Rate of major clinical events
    Description
    (number of subjects that suffer from major clinical events during study / total number of subjects) ×100%. Major clinical events are defined as cardiac arrest, malignant arrhythmia, new onset of shock, new onset of sepsis and respirate failure unrelated to primary illness.
    Time Frame
    48 hours since injection of sedatives
    Secondary Outcome Measure Information:
    Title
    incidence of delirium
    Description
    (subjects with delirium / total number of subjects ×100%) by 12h and 24h after entering ICU
    Time Frame
    48 hours since injection of sedatives
    Title
    Time to weaning and extubation
    Description
    Time to weaning and extubation
    Time Frame
    48 hours since injection of sedatives
    Title
    Difficulty of nursing
    Description
    By Barthel index assessment
    Time Frame
    48 hours since injection of sedatives
    Title
    28-days survival
    Description
    (number of subjects that alive in 28-days since ICU entry/ total number of subjects) ×100%
    Time Frame
    28 days since injection of sedatives
    Title
    incidence of rescue therapy in experimental group
    Description
    (number of subjects that receive rescue therapy in experimental group/ total number of subjects) ×100%
    Time Frame
    24 hours since injection of sedatives

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Maximum Age & Unit of Time
    75 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion criteria Meet criteria of enhanced recovery after surgery (ERAS); Mechanical ventilated when enrolled and have estimation of more than 10 hours of mechanical ventilation in ICU Aged between 18-75 years old AND 18kg/m2 ≤ BMI ≤ 30 kg/m2; Clearly know the purpose and objective of this clinical study and voluntarily enrolled. Criteria of ERAS: (1) without dysfunction of nervous system or Glasgow Coma Score > 12; (2) a satisfied glucose level (random blood glucose<11.1mmol/L during screening stage) for diabetes mellitus patients; (3) Without acute coronary syndrome in recent 6 months; (4) Without bradycardia and third-degree atrioventricular block (except for patients with pacemaker) during screening stage; (5) systolic blood pressure>90mmHg with no usage of vasoactive agent during screening stage; (6) without mental illness (schizophrenia, depressive disorder), cognitive dysfunction (identified by MMSE), epilepsy, history of abuse of psychotropic or anesthesia medication; (7) without disorder of coagulation function (PT/INR/APTT > 1.5×upper limit), bleeding tendency (active peptic ulcer), under treatment of thrombolysis and anticoagulant; (8) without disorder of liver function (ALT/AST > 2×upper limit and total bilirubin>1.5×upper limit); (9) without disorder of renal function (Creatine or BUN/Urea>1.5×upper limit); without dialysis patients. Exclusion criteria Allergy to component of Remimazolam besylate for injection; Woman in gestation and lactation period; Enrolled in other clinical trails in recent 3 months; Other circumstance that identified by researchers that do not suitable for this clinical trial.
    Central Contact Person:
    First Name & Middle Initial & Last Name or Official Title & Degree
    Longxiang Su, M.D.
    Phone
    +8615652797257
    Email
    slx77@163.com
    First Name & Middle Initial & Last Name or Official Title & Degree
    Shengjun Liu, M.D.
    Phone
    +8618911952413
    Email
    liushengjun100@126.com

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided
    IPD Sharing Plan Description
    So far, we haven't decide if individual participant data are suitable to share with other researchers.
    Citations:
    PubMed Identifier
    34805204
    Citation
    Liu S, Su L, Zhang B, He H, Li Z, Li Q, Wang Q, Smith F, Long Y. The Availability and Safety Study of Remimazolam Besylate for Injection on Sedation of ERAS Patients Under Mechanical Ventilation in ICU: Protocol for a Randomized, Open-Label, Controlled Trial. Front Med (Lausanne). 2021 Nov 5;8:735473. doi: 10.3389/fmed.2021.735473. eCollection 2021.
    Results Reference
    derived

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    The Availability and Safety Study of Remimazolam Besylate for Injection on Sedation of ERAS Patients

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