Safety, Efficacy and Pharmacokinetic Study of Dexmedetomidine in Pediatrics Ages ≥28 Weeks to ≤44 Weeks Gestational Age

NCT ID: NCT01159262

Last Updated: 2015-08-13

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE2/PHASE3

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-07-31

Study Completion Date

2011-08-31

Brief Summary

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The purpose of this study is to investigate the safety, efficacy and pharmacokinetics (PK) of dexmedetomidine (DEX) at 3 different dose levels in infants, ages ≥28 weeks to ≤44 weeks gestational age, administered as a loading dose followed by a continuous infusion for a minimum of 6 hours and up to 24 hours in the neonatal intensive care unit (NICU), cardiac intensive care unit (CICU), or pediatric intensive care unit (PICU).

Detailed Description

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Conditions

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Sedation

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Dexmedetomidine 0.05 mcg/kg

Dexmedetomidine loading dose 0.05 mcg/kg; maintenance infusion: 0.05 mcg/kg/hr.

Group Type EXPERIMENTAL

Midazolam

Intervention Type DRUG

Per package insert, N-PASS (Neonatal Pain, Agitation, and Sedation Scale) scores and investigator discretion

Fentanyl/Morphine

Intervention Type DRUG

Per package insert, N-PASS scores and investigator discretion.

Dexmedetomidine

Intervention Type DRUG

Dexmedetomidine 0.1 mcg/kg

Dexmedetomidine loading dose: 0.1 mcg/kg; maintenance infusion 0.1 mcg/kg/hr.

Group Type EXPERIMENTAL

Midazolam

Intervention Type DRUG

Per package insert, N-PASS (Neonatal Pain, Agitation, and Sedation Scale) scores and investigator discretion

Fentanyl/Morphine

Intervention Type DRUG

Per package insert, N-PASS scores and investigator discretion.

Dexmedetomidine

Intervention Type DRUG

Dexmedetomidine 0.2 mcg/kg

Dexmedetomidine loading dose 0.2 mcg/kg; maintenance infusion 0.2 mcg/kg/hr.

Group Type EXPERIMENTAL

Midazolam

Intervention Type DRUG

Per package insert, N-PASS (Neonatal Pain, Agitation, and Sedation Scale) scores and investigator discretion

Fentanyl/Morphine

Intervention Type DRUG

Per package insert, N-PASS scores and investigator discretion.

Dexmedetomidine

Intervention Type DRUG

Interventions

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Midazolam

Per package insert, N-PASS (Neonatal Pain, Agitation, and Sedation Scale) scores and investigator discretion

Intervention Type DRUG

Fentanyl/Morphine

Per package insert, N-PASS scores and investigator discretion.

Intervention Type DRUG

Dexmedetomidine

Intervention Type DRUG

Other Intervention Names

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Precedex

Eligibility Criteria

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Inclusion Criteria

1. Initially intubated and mechanically ventilated pediatric subjects in an intensive care setting anticipated to require a minimum of 6 hours of continuous IV sedation.
2. The ability to complete all PK sampling blood draws.
3. Age: subjects must fit into 1 of the following age ranges at screening:

* Preterm neonates ≥28 weeks through \<36 weeks, gestational age; this would constitute treatment Group I.
* Term neonates born at ≥36 weeks through ≤44 weeks gestational age; this would constitute treatment Group II.
4. Weight: subject's weight at the time of enrollment must be \>1000 g.
5. 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

1. Neonate subjects with neurological conditions that prohibit an evaluation of sedation such as:

* Diminished consciousness from increased intracranial pressure.
* The presence of catastrophic brain injury or other severe mental disorders that would make responses to sedatives unpredictable and/or measurement of the N-PASS unreliable.
* Subjects with immobility from neuromuscular disease or continuous infusion of neuromuscular blocking (NMB) agents.
2. Subjects with second degree or third degree heart block unless subject has a pacemaker or pacing wires are in situ.
3. Heart rate \<120 bpm prior to the initiation of study drug.
4. Exposure to any investigational drug within 30 days prior to study drug administration.
5. Previous exposure to Dexmedetomidine (DEX) as part of an investigational study.
6. Maternal history of poly-substance drug abuse, based upon the presence of 1) an abnormal urine drug screen for cocaine, opiates and/or benzodiazepines; or 2) Investigator's judgment.
7. At the discretion of the Investigator, subjects in whom the risk of DEX treatment is expected to exceed its benefits.
8. Subjects who have a known allergy or contraindication to fentanyl, morphine, Midazolam, DEX, or other α-2 agonists.
9. Requirement for medications other than DEX, Midazolam, morphine, or fentanyl for sedation and pain control.
10. Screening alanine aminotransferase (ALT) levels \>115 U/L.
Minimum Eligible Age

28 Weeks

Maximum Eligible Age

44 Weeks

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospira, now a wholly owned subsidiary of Pfizer

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Arkansas Children's Hospital

Little Rock, Arkansas, United States

Site Status

Miller Children's Hospital

Long Beach, California, United States

Site Status

Childrens Hospital Los Angeles

Los Angeles, California, United States

Site Status

University of California San Francisco, Department of Pediatrics, Division of Neonatology

San Francisco, California, United States

Site Status

Dept. of Anesthesia, SUMC

Stanford, California, United States

Site Status

University of Miami - Miller School of Medicine, Department of Anesthesiology

Miami, Florida, United States

Site Status

Georgia Health Sciences University

Augusta, Georgia, United States

Site Status

Kapiolani Medical Center for Women and Children

Honolulu, Hawaii, United States

Site Status

Loyola University Medical Center

Maywood, Illinois, United States

Site Status

Wichita, Kansas, United States

Site Status

Kosair Charities Pediatric Clinical Research Unit, University of Louisville

Louisville, Kentucky, United States

Site Status

Duke University Medical Center, Department of Anesthesiology

Durham, North Carolina, United States

Site Status

Akron Children's Hospital Medical Center

Akron, Ohio, United States

Site Status

Children's Hospital of Pittsburgh of UPMC

Pittsburgh, Pennsylvania, United States

Site Status

Medical University of South Carolina (MUSC)

Charleston, South Carolina, United States

Site Status

Greenville, South Carolina, United States

Site Status

West Virginia University School of Medicine

Morgantown, West Virginia, United States

Site Status

Zona 11 Guatemala, , Guatemala

Site Status

Countries

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United States Guatemala

References

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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.

Reference Type DERIVED
PMID: 24238862 (View on PubMed)

Other Identifiers

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DEX-09-08

Identifier Type: -

Identifier Source: org_study_id

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