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The primary objective of this study is to characterize the safety, and efficacy of Dexmedetomidine (DEX) administered as an intravenous (IV) loading dose followed by a continuous IV infusion in preterm subjects, ages ≥ 28 weeks through < 36 weeks gestational age.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Dexmedetomidine | Experimental | Dexmedetomidine Load 0.2 mcg/kg over 10 or 20 min Dexmedetomidine Maintenance 0.2 mcg/kg/hr (at least 6 and up to 24 hours) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Dexmedetomidine | Drug |
| ||
| Midazolam |
| Measure | Description | Time Frame |
|---|---|---|
| Percent of Subjects Requiring Rescue Midazolam for Sedation | During the study drug administration (ie., loading dose 10 or 20 minutes and maintenance infusion minimum of 6 hours up to 24 hours) and during the post drug administration (up to 24 hours). |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Rescue Medication (Fentanyl or Morphine) Use for Analgesia During DEX Infusion | During the study drug administration (ie., loading dose 10 or 20 minutes and maintenance infusion minimum of 6 hours up to 24 hours) and during the post drug administration (up to 24 hours). | |
| Amount of Rescue Medication (Midazolam) for Sedation During Dexmedetomidine Infusion |
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Inclusion Criteria:
Initially intubated and mechanically ventilated pediatric subjects in an intensive care setting anticipated to require at least 6 hours of continuous IV sedation.
Age: subjects must fit the following age range at screening:
Preterm subjects ≥28 weeks through <36 weeks, gestational age;
Note: Gestational age (in weeks) will be calculated as follows: the time elapsed between the first day of the last menstrual period and the day of enrollment.
Weight: subject's weight at the time of enrollment must be >1000 g.
Subject's parent(s) or legal guardian(s) has/have voluntarily signed and dated the informed consent document approved by the Institutional Review Board (IRB)/Independent Ethics Committee (IEC).
Exclusion Criteria:
Neonate subjects with neurological conditions that prohibit an evaluation of sedation such as:
Subjects with second degree or third degree heart block unless subject has a pacemaker or pacing wires are in situ.
Note: If subject's status-post Cardio Pulmonary Bypass (CPB) was managed without pacing wires in situ, the subject must not be suspected to be in second degree or third degree heart block at the time of DEX administration.
HR < 120 bpm prior to the initiation of DEX.
Exposure to any investigational drug within 30 days prior to DEX administration.
Previous exposure to DEX as part of an investigational study.
In subjects that are ex-utero for less than 72 hours, a maternal history of poly-substance drug abuse, based upon the Investigator's clinical judgment.
At the discretion of the Investigator, subjects in whom the risk of DEX treatment is expected to exceed its benefits.
Subjects who have a known allergy or contraindication to fentanyl, morphine, MDZ, DEX, or other α-2 agonists.
Requirement for medications other than DEX, MDZ, morphine, or fentanyl for sedation and pain control.
Screening ALT levels >115 U/L.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Louisville | Kentucky | 40202 | United States | |||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24238862 | Derived | Chrysostomou C, Schulman SR, Herrera Castellanos M, Cofer BE, Mitra S, da Rocha MG, Wisemandle WA, Gramlich L. A phase II/III, multicenter, safety, efficacy, and pharmacokinetic study of dexmedetomidine in preterm and term neonates. J Pediatr. 2014 Feb;164(2):276-82.e1-3. doi: 10.1016/j.jpeds.2013.10.002. Epub 2013 Nov 14. |
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Neonatal subjects enrolled from 3 centers in the United States
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| ID | Title | Description |
|---|---|---|
| FG000 | Dexmedetomidine | Dexmedetomidine Load 0.2 mcg/kg over 10 or 20 min Dexmedetomidine Maintenance 0.2 mcg/kg/hr (at least 6 and up to 24 hours) |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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|
| Fentanyl | Drug |
|
| Morphine | Drug |
|
| During the study drug administration (ie., loading dose 10 or 20 minutes and maintenance infusion minimum of 6 hours up to 24 hours) and during the post drug administration (up to 24 hours). |
| Amount of Rescue Medication for Analgesia During DEX Infusion | During the study drug administration (ie., loading dose 10 or 20 minutes and maintenance infusion minimum of 6 hours up to 24 hours) and during the post drug administration (up to 24 hours). |
| Time Spent With a Total N-PASS Score >3 During DEX Infusion | The N-PASS score >3 indicates adequately sedated and not manifesting signs of pain/agitation. | Predose, loading dose (LD) 5 & 10mins/if LD is 20mins (5, 10, 15 & 20mins); maintenance infusion: 0 min, every 15mins (1st hr); every 30mins (2hrs), then hourly; within 5mins of DEX discontinuation; 5mins pre and post rescue medication |
| Time to Successful Extubation | From the start of study drug infusion to the study completion/withdrawal (Approximately 48 hours) |
| Pittsburgh |
| Pennsylvania |
| 15224 |
| United States |
| Greenville | South Carolina | 29605 | United States |
| Morgantown | West Virginia | 26506 | United States |
| COMPLETED |
|
| NOT COMPLETED |
|
All subjects that received study drug.
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| ID | Title | Description |
|---|---|---|
| BG000 | Dexmedetomidine | Dexmedetomidine Load 0.2 mcg/kg over 10 or 20 min Dexmedetomidine Maintenance 0.2 mcg/kg/hr (at least 6 and up to 24 hours) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
| |||||||||||||||||||||||
| Age, Continuous | Mean | Standard Deviation | weeks |
| ||||||||||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
|
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Percent of Subjects Requiring Rescue Midazolam for Sedation | All Subjects who received study drug for at least 6 hours | Posted | Number | percentage of participants | During the study drug administration (ie., loading dose 10 or 20 minutes and maintenance infusion minimum of 6 hours up to 24 hours) and during the post drug administration (up to 24 hours). |
|
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| |||||||||||||||||||||||||||
| Secondary | Incidence of Rescue Medication (Fentanyl or Morphine) Use for Analgesia During DEX Infusion | All subjects who received DEX for at least 6 hours formed the Efficacy Evaluable Population. | Posted | Number | participant | During the study drug administration (ie., loading dose 10 or 20 minutes and maintenance infusion minimum of 6 hours up to 24 hours) and during the post drug administration (up to 24 hours). |
|
| ||||||||||||||||||||||||||||
| Secondary | Amount of Rescue Medication (Midazolam) for Sedation During Dexmedetomidine Infusion | No participants analyzed for this assessment since none required rescue Midazolam for sedation. | Posted | During the study drug administration (ie., loading dose 10 or 20 minutes and maintenance infusion minimum of 6 hours up to 24 hours) and during the post drug administration (up to 24 hours). |
|
| ||||||||||||||||||||||||||||||
| Secondary | Amount of Rescue Medication for Analgesia During DEX Infusion | Number of subject who received rescue medication for analgesia during DEX infusion | Posted | Number | mcg/kg | During the study drug administration (ie., loading dose 10 or 20 minutes and maintenance infusion minimum of 6 hours up to 24 hours) and during the post drug administration (up to 24 hours). |
|
| ||||||||||||||||||||||||||||
| Secondary | Time Spent With a Total N-PASS Score >3 During DEX Infusion | The N-PASS score >3 indicates adequately sedated and not manifesting signs of pain/agitation. | All subjects who received DEX for at least 6 hours formed the Efficacy Evaluable Population. | Posted | Mean | Standard Deviation | Hours | Predose, loading dose (LD) 5 & 10mins/if LD is 20mins (5, 10, 15 & 20mins); maintenance infusion: 0 min, every 15mins (1st hr); every 30mins (2hrs), then hourly; within 5mins of DEX discontinuation; 5mins pre and post rescue medication |
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| ||||||||||||||||||||||||||
| Secondary | Time to Successful Extubation | Subjects who had successful extubation alone (n=5) were included in this analysis. | Posted | Median | 95% Confidence Interval | Hours | From the start of study drug infusion to the study completion/withdrawal (Approximately 48 hours) |
|
|
Treatment Emergent Adverse Events
Treatment Emergent defined as start of study drug to 24 hours after discontinuation of study drug
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Dexmedetomidine | Dexmedetomidine Load 0.2 mcg/kg over 10 or 20 min Dexmedetomidine Maintenance 0.2 mcg/kg/hr (at least 6 and up to 24 hours) | 0 | 6 | 3 | 6 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Umbilcal hernia | Gastrointestinal disorders | Non-systematic Assessment |
| ||
| Hypernatraenia | Metabolism and nutrition disorders | Non-systematic Assessment |
| ||
| Blister | Skin and subcutaneous tissue disorders | Non-systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Marcelo Garcia da Rocha | Hospira | 224-212-4424 | marcelo.rocha@hospira.com |
| ID | Term |
|---|---|
| D020927 | Dexmedetomidine |
| D008874 | Midazolam |
| D005283 | Fentanyl |
| D009020 | Morphine |
| ID | Term |
|---|---|
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D001569 | Benzodiazepines |
| D001552 | Benzazepines |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D010880 | Piperidines |
| D009022 | Morphine Derivatives |
| D009019 | Morphinans |
| D053610 | Opiate Alkaloids |
| D000470 | Alkaloids |
| D006572 | Heterocyclic Compounds, Bridged-Ring |
| D006576 | Heterocyclic Compounds, 4 or More Rings |
| D010616 | Phenanthrenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D011083 | Polycyclic Compounds |
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