Trial Outcomes & Findings for Dose Rate Range Finding Study of Propofol for minimal-to Moderate Sedation on Upper & Lower Endoscopic Tests (NCT NCT01189604)

NCT ID: NCT01189604

Last Updated: 2011-12-19

Results Overview

The MOAA/S is a 6-point ordinal scale measuring a patient's level of sedation. Scores range from 0 (No response to painful stimulus \[trapezius squeeze\]) to 5 (Responds readily to name spoken in normal tone \[awake\]). MOAA/S scores were classified as 0-1, 2-4 and 5.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

123 participants

Primary outcome timeframe

2 minutes from the beginning of the maintenance period

Results posted on

2011-12-19

Participant Flow

A total of 2 centers were initiated with first patient enrolled on 23 August 2010 and last patient completed on 17 November. A total of 129 patients were enrolled with 123 qualified patients allocated to randomized treatment.

The patients enrolled in this study were undergoing non-emergent standard esophagogastroduodenoscopy (EGD) or colonoscopy. Six patients were withdrawn from the study after enrollment but before randomization: 5 patients due to excess recruitment and one patient due to investigator's recommendation..

Participant milestones

Participant milestones
Measure
Arm 1 - Placebo
Infusion of placebo, same infusion rates as for arm 2
Arm 2 - ICI35,868 (Propofol)
Infusion of propofol: initiation with 0.17 mg/kg for 3 minutes followed by maintenance with 25 µg/kg/minute
Arm 3 - ICI35,868 (Propofol)
Infusion of propofol: initiation with 0.33 mg/kg for 3 minutes followed by maintenance with 50 µg/kg/minute
Arm 4 - ICI35,868 (Propofol)
Infusion of propofol: initiation with 0.5 mg/kg for 3 minutes followed by maintenance with 75 µg/kg/minute
Arm 5 - ICI35,868 (Propofol)
Infusion of propofol: initiation with 0.8 mg/kg for 3 minutes followed by maintenance with 120 µg/kg/minute
Arm 6 - ICI35,868 (Propofol)
Infusion of propofol: initiation with 0.5 mg/kg for 1 minutes followed by maintenance with 75 µg/kg/minute
Arm 7 - ICI35,868 (Propofol)
Infusion of propofol: initiation with 0.5 mg/kg for 5 minutes followed by maintenance with 75 µg/kg/minute
Overall Study
STARTED
21
21
20
20
20
11
10
Overall Study
Administered Study Drug
20
20
20
20
20
10
10
Overall Study
COMPLETED
20
20
20
20
18
10
9
Overall Study
NOT COMPLETED
1
1
0
0
2
1
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Arm 1 - Placebo
Infusion of placebo, same infusion rates as for arm 2
Arm 2 - ICI35,868 (Propofol)
Infusion of propofol: initiation with 0.17 mg/kg for 3 minutes followed by maintenance with 25 µg/kg/minute
Arm 3 - ICI35,868 (Propofol)
Infusion of propofol: initiation with 0.33 mg/kg for 3 minutes followed by maintenance with 50 µg/kg/minute
Arm 4 - ICI35,868 (Propofol)
Infusion of propofol: initiation with 0.5 mg/kg for 3 minutes followed by maintenance with 75 µg/kg/minute
Arm 5 - ICI35,868 (Propofol)
Infusion of propofol: initiation with 0.8 mg/kg for 3 minutes followed by maintenance with 120 µg/kg/minute
Arm 6 - ICI35,868 (Propofol)
Infusion of propofol: initiation with 0.5 mg/kg for 1 minutes followed by maintenance with 75 µg/kg/minute
Arm 7 - ICI35,868 (Propofol)
Infusion of propofol: initiation with 0.5 mg/kg for 5 minutes followed by maintenance with 75 µg/kg/minute
Overall Study
Impossible to visit
0
0
0
0
0
1
0
Overall Study
Adverse Event
0
1
0
0
2
0
1
Overall Study
Withdrawal by Subject
1
0
0
0
0
0
0

Baseline Characteristics

Dose Rate Range Finding Study of Propofol for minimal-to Moderate Sedation on Upper & Lower Endoscopic Tests

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm 1 - Placebo
n=20 Participants
Infusion of placebo, same infusion rates as for arm 2
Arm 2 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.17 mg/kg for 3 minutes followed by maintenance with 25 µg/kg/minute
Arm 3 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.33 mg/kg for 3 minutes followed by maintenance with 50 µg/kg/minute
Arm 4 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 3 minutes followed by maintenance with 75 µg/kg/minute
Arm 5 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.8 mg/kg for 3 minutes followed by maintenance with 120 µg/kg/minute
Arm 6 - ICI35,868 (Propofol)
n=10 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 1 minutes followed by maintenance with 75 µg/kg/minute
Arm 7 - ICI35,868 (Propofol)
n=10 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 5 minutes followed by maintenance with 75 µg/kg/minute
Total
n=120 Participants
Total of all reporting groups
Age Continuous
53.2 years
STANDARD_DEVIATION 17.3 • n=5 Participants
51.0 years
STANDARD_DEVIATION 16.4 • n=7 Participants
56.1 years
STANDARD_DEVIATION 14.4 • n=5 Participants
52.0 years
STANDARD_DEVIATION 14.9 • n=4 Participants
56.4 years
STANDARD_DEVIATION 12.7 • n=21 Participants
49.4 years
STANDARD_DEVIATION 14.2 • n=8 Participants
51.8 years
STANDARD_DEVIATION 8.5 • n=8 Participants
53.2 years
STANDARD_DEVIATION 14.5 • n=24 Participants
Sex: Female, Male
Female
6 Participants
n=5 Participants
10 Participants
n=7 Participants
10 Participants
n=5 Participants
6 Participants
n=4 Participants
9 Participants
n=21 Participants
2 Participants
n=8 Participants
5 Participants
n=8 Participants
48 Participants
n=24 Participants
Sex: Female, Male
Male
14 Participants
n=5 Participants
10 Participants
n=7 Participants
10 Participants
n=5 Participants
14 Participants
n=4 Participants
11 Participants
n=21 Participants
8 Participants
n=8 Participants
5 Participants
n=8 Participants
72 Participants
n=24 Participants
Procedures
Esophagogastroduodenoscopy (EGD)
10 participants
n=5 Participants
10 participants
n=7 Participants
10 participants
n=5 Participants
10 participants
n=4 Participants
10 participants
n=21 Participants
5 participants
n=8 Participants
5 participants
n=8 Participants
60 participants
n=24 Participants
Procedures
Colonoscopy
10 participants
n=5 Participants
10 participants
n=7 Participants
10 participants
n=5 Participants
10 participants
n=4 Participants
10 participants
n=21 Participants
5 participants
n=8 Participants
5 participants
n=8 Participants
60 participants
n=24 Participants

PRIMARY outcome

Timeframe: 2 minutes from the beginning of the maintenance period

The MOAA/S is a 6-point ordinal scale measuring a patient's level of sedation. Scores range from 0 (No response to painful stimulus \[trapezius squeeze\]) to 5 (Responds readily to name spoken in normal tone \[awake\]). MOAA/S scores were classified as 0-1, 2-4 and 5.

Outcome measures

Outcome measures
Measure
Arm 1 - Placebo
n=20 Participants
Infusion of placebo, same infusion rates as for arm 2
Arm 2 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.17 mg/kg for 3 minutes followed by maintenance with 25 µg/kg/minute
Arm 3 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.33 mg/kg for 3 minutes followed by maintenance with 50 µg/kg/minute
Arm 4 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 3 minutes followed by maintenance with 75 µg/kg/minute
Arm 5 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.8 mg/kg for 3 minutes followed by maintenance with 120 µg/kg/minute
Arm 6 - ICI35,868 (Propofol)
n=10 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 1 minutes followed by maintenance with 75 µg/kg/minute
Arm 7 - ICI35,868 (Propofol)
n=10 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 5 minutes followed by maintenance with 75 µg/kg/minute
Modified Observers Assessment of Alertness/Sedation (MOAA/S) Score 2 Minutes From Beginning of Maintenance Period
MOAA/S Score 0-1
0 Participants
0 Participants
0 Participants
1 Participants
1 Participants
1 Participants
0 Participants
Modified Observers Assessment of Alertness/Sedation (MOAA/S) Score 2 Minutes From Beginning of Maintenance Period
MOAA/S Score 2-4
0 Participants
2 Participants
6 Participants
6 Participants
14 Participants
5 Participants
3 Participants
Modified Observers Assessment of Alertness/Sedation (MOAA/S) Score 2 Minutes From Beginning of Maintenance Period
MOAA/S Score 5
20 Participants
18 Participants
14 Participants
13 Participants
5 Participants
4 Participants
7 Participants

PRIMARY outcome

Timeframe: 4 minutes from the beginning of the maintenance period

The MOAA/S is a 6-point ordinal scale measuring a patient's level of sedation. Scores range from 0 (No response to painful stimulus \[trapezius squeeze\]) to 5 (Responds readily to name spoken in normal tone \[awake\]). MOAA/S scores were classified as 0-1, 2-4 and 5.

Outcome measures

Outcome measures
Measure
Arm 1 - Placebo
n=20 Participants
Infusion of placebo, same infusion rates as for arm 2
Arm 2 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.17 mg/kg for 3 minutes followed by maintenance with 25 µg/kg/minute
Arm 3 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.33 mg/kg for 3 minutes followed by maintenance with 50 µg/kg/minute
Arm 4 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 3 minutes followed by maintenance with 75 µg/kg/minute
Arm 5 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.8 mg/kg for 3 minutes followed by maintenance with 120 µg/kg/minute
Arm 6 - ICI35,868 (Propofol)
n=10 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 1 minutes followed by maintenance with 75 µg/kg/minute
Arm 7 - ICI35,868 (Propofol)
n=10 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 5 minutes followed by maintenance with 75 µg/kg/minute
Modified Observers Assessment of Alertness/Sedation (MOAA/S) Score 4 Minutes From Beginning of Maintenance Period
MOAA/S Score 0-1
0 Participants
0 Participants
0 Participants
1 Participants
3 Participants
1 Participants
0 Participants
Modified Observers Assessment of Alertness/Sedation (MOAA/S) Score 4 Minutes From Beginning of Maintenance Period
MOAA/S Score 2-4
0 Participants
1 Participants
7 Participants
6 Participants
16 Participants
5 Participants
4 Participants
Modified Observers Assessment of Alertness/Sedation (MOAA/S) Score 4 Minutes From Beginning of Maintenance Period
MOAA/S Score 5
20 Participants
19 Participants
13 Participants
13 Participants
1 Participants
4 Participants
6 Participants

SECONDARY outcome

Timeframe: 24 - 48 hours after completion of the procedure

The PSSI is a 100-point visual analog scale measuring a patient's satisfaction with sedation. Scores range from 0 (Very dissatisfied) to 100 (Very satisfied).

Outcome measures

Outcome measures
Measure
Arm 1 - Placebo
n=20 Participants
Infusion of placebo, same infusion rates as for arm 2
Arm 2 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.17 mg/kg for 3 minutes followed by maintenance with 25 µg/kg/minute
Arm 3 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.33 mg/kg for 3 minutes followed by maintenance with 50 µg/kg/minute
Arm 4 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 3 minutes followed by maintenance with 75 µg/kg/minute
Arm 5 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.8 mg/kg for 3 minutes followed by maintenance with 120 µg/kg/minute
Arm 6 - ICI35,868 (Propofol)
n=10 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 1 minutes followed by maintenance with 75 µg/kg/minute
Arm 7 - ICI35,868 (Propofol)
n=10 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 5 minutes followed by maintenance with 75 µg/kg/minute
Patient Satisfaction With Sedation Instrument (PSSI) Questionnaire
62.5 Units on a scale
Standard Deviation 21.2
64.4 Units on a scale
Standard Deviation 23.8
74.5 Units on a scale
Standard Deviation 17.1
82.3 Units on a scale
Standard Deviation 17.9
86.0 Units on a scale
Standard Deviation 9.8
74.9 Units on a scale
Standard Deviation 16.2
75.1 Units on a scale
Standard Deviation 21.2

SECONDARY outcome

Timeframe: At the end of the initiation period and every 2 minutes during the maintenance period

Blood concentration of ICI35,868 (propofol)

Outcome measures

Outcome measures
Measure
Arm 1 - Placebo
Infusion of placebo, same infusion rates as for arm 2
Arm 2 - ICI35,868 (Propofol)
n=6 Participants
Infusion of propofol: initiation with 0.17 mg/kg for 3 minutes followed by maintenance with 25 µg/kg/minute
Arm 3 - ICI35,868 (Propofol)
n=6 Participants
Infusion of propofol: initiation with 0.33 mg/kg for 3 minutes followed by maintenance with 50 µg/kg/minute
Arm 4 - ICI35,868 (Propofol)
n=6 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 3 minutes followed by maintenance with 75 µg/kg/minute
Arm 5 - ICI35,868 (Propofol)
n=6 Participants
Infusion of propofol: initiation with 0.8 mg/kg for 3 minutes followed by maintenance with 120 µg/kg/minute
Arm 6 - ICI35,868 (Propofol)
n=4 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 1 minutes followed by maintenance with 75 µg/kg/minute
Arm 7 - ICI35,868 (Propofol)
n=4 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 5 minutes followed by maintenance with 75 µg/kg/minute
Blood Concentrations of Propofol
End of initiation period
0.2208 µg/mL
Standard Deviation 0.1409
0.7808 µg/mL
Standard Deviation 0.3765
1.5033 µg/mL
Standard Deviation 0.9468
2.3177 µg/mL
Standard Deviation 1.2459
1.1935 µg/mL
Standard Deviation 1.0758
1.0875 µg/mL
Standard Deviation 0.7553
Blood Concentrations of Propofol
2 minutes into maintenance period
0.2797 µg/mL
Standard Deviation 0.1320
0.6403 µg/mL
Standard Deviation 0.3087
1.1052 µg/mL
Standard Deviation 0.7197
2.1827 µg/mL
Standard Deviation 0.7832
1.3965 µg/mL
Standard Deviation 0.7796
0.8515 µg/mL
Standard Deviation 0.6399
Blood Concentrations of Propofol
4 minutes into maintenance period
0.3295 µg/mL
Standard Deviation 0.1474
0.7387 µg/mL
Standard Deviation 0.3000
1.2022 µg/mL
Standard Deviation 0.5612
2.4360 µg/mL
Standard Deviation 0.8500
1.4828 µg/mL
Standard Deviation 0.4286
1.0708 µg/mL
Standard Deviation 0.7864
Blood Concentrations of Propofol
6 minutes into maintenance period
0.3633 µg/mL
Standard Deviation 0.2340
0.8127 µg/mL
Standard Deviation 0.2716
1.4263 µg/mL
Standard Deviation 0.6700
2.4714 µg/mL
Standard Deviation 0.3901
1.4848 µg/mL
Standard Deviation 0.4056
1.0560 µg/mL
Standard Deviation 0.7915

SECONDARY outcome

Timeframe: Last measurement in maintenance period (3 minutes for arms 1-5; 1 minute for arm 6, 5 minute for arm 7)

The MOAA/S is a 6-point ordinal scale measuring a patient's level of sedation. Scores range from 0 (No response to painful stimulus \[trapezius squeeze\]) to 5 (Responds readily to name spoken in normal tone \[awake\]). MOAA/S scores were classified as 0-1, 2-4 and 5.

Outcome measures

Outcome measures
Measure
Arm 1 - Placebo
n=20 Participants
Infusion of placebo, same infusion rates as for arm 2
Arm 2 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.17 mg/kg for 3 minutes followed by maintenance with 25 µg/kg/minute
Arm 3 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.33 mg/kg for 3 minutes followed by maintenance with 50 µg/kg/minute
Arm 4 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 3 minutes followed by maintenance with 75 µg/kg/minute
Arm 5 - ICI35,868 (Propofol)
n=20 Participants
Infusion of propofol: initiation with 0.8 mg/kg for 3 minutes followed by maintenance with 120 µg/kg/minute
Arm 6 - ICI35,868 (Propofol)
n=10 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 1 minutes followed by maintenance with 75 µg/kg/minute
Arm 7 - ICI35,868 (Propofol)
n=10 Participants
Infusion of propofol: initiation with 0.5 mg/kg for 5 minutes followed by maintenance with 75 µg/kg/minute
Modified Observers Assessment of Alertness/Sedation (MOAA/S) at End of Initiation Period
MOAA/S Score 0-1
0 Participants
0 Participants
0 Participants
0 Participants
1 Participants
0 Participants
0 Participants
Modified Observers Assessment of Alertness/Sedation (MOAA/S) at End of Initiation Period
MOAA/S Score 2-4
0 Participants
2 Participants
0 Participants
4 Participants
9 Participants
0 Participants
1 Participants
Modified Observers Assessment of Alertness/Sedation (MOAA/S) at End of Initiation Period
MOAA/S Score 5
20 Participants
18 Participants
20 Participants
16 Participants
10 Participants
10 Participants
9 Participants

Adverse Events

Arm 1 - Placebo

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

Arm 2 - ICI35,868 (Propofol)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Arm 3 - ICI35,868 (Propofol)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Arm 4 - ICI35,868 (Propofol)

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Arm 5 - ICI35,868 (Propofol)

Serious events: 0 serious events
Other events: 6 other events
Deaths: 0 deaths

Arm 6 - ICI35,868 (Propofol)

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Arm 7 - ICI35,868 (Propofol)

Serious events: 0 serious events
Other events: 2 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Arm 1 - Placebo
n=20 participants at risk
Infusion of placebo, same infusion rates as for arm 2
Arm 2 - ICI35,868 (Propofol)
n=20 participants at risk
Infusion of propofol: initiation with 0.17 mg/kg for 3 minutes followed by maintenance with 25 µg/kg/minute
Arm 3 - ICI35,868 (Propofol)
n=20 participants at risk
Infusion of propofol: initiation with 0.33 mg/kg for 3 minutes followed by maintenance with 50 µg/kg/minute
Arm 4 - ICI35,868 (Propofol)
n=20 participants at risk
Infusion of propofol: initiation with 0.5 mg/kg for 3 minutes followed by maintenance with 75 µg/kg/minute
Arm 5 - ICI35,868 (Propofol)
n=20 participants at risk
Infusion of propofol: initiation with 0.8 mg/kg for 3 minutes followed by maintenance with 120 µg/kg/minute
Arm 6 - ICI35,868 (Propofol)
n=10 participants at risk
Infusion of propofol: initiation with 0.5 mg/kg for 1 minutes followed by maintenance with 75 µg/kg/minute
Arm 7 - ICI35,868 (Propofol)
n=10 participants at risk
Infusion of propofol: initiation with 0.5 mg/kg for 5 minutes followed by maintenance with 75 µg/kg/minute
Cardiac disorders
Ventricular Extrasystoles
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
5.0%
1/20
0.00%
0/10
10.0%
1/10
Gastrointestinal disorders
Abdominal Pain Lower
5.0%
1/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/10
0.00%
0/10
Gastrointestinal disorders
Diarrhoea
0.00%
0/20
0.00%
0/20
0.00%
0/20
5.0%
1/20
0.00%
0/20
0.00%
0/10
0.00%
0/10
Infections and infestations
Pharyngitis
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
5.0%
1/20
0.00%
0/10
0.00%
0/10
Investigations
Blood Pressure Decreased
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/10
10.0%
1/10
Investigations
Blood Pressure Increased
20.0%
4/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/10
0.00%
0/10
Investigations
C-Reactive Protein Increased
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
5.0%
1/20
0.00%
0/10
0.00%
0/10
Investigations
Heart Rate Increased
5.0%
1/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/10
0.00%
0/10
Investigations
Oxygen Saturation Decreased
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
5.0%
1/20
0.00%
0/10
0.00%
0/10
Metabolism and nutrition disorders
Decreased Appetite
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
10.0%
1/10
0.00%
0/10
Nervous system disorders
Headache
5.0%
1/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/10
0.00%
0/10
Psychiatric disorders
Restlessness
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
5.0%
1/20
0.00%
0/10
0.00%
0/10
Vascular disorders
Angiopathy
0.00%
0/20
0.00%
0/20
0.00%
0/20
0.00%
0/20
10.0%
2/20
0.00%
0/10
10.0%
1/10

Additional Information

Gerard Lynch

Astrazeneca

Results disclosure agreements

  • Principal investigator is a sponsor employee If the PI wants to publish the results, the PI must send the English documents to AZ beforehand. And AZ can review and revise the documents, after that, AZ will give the approval to the PI about the publication of the results.
  • Publication restrictions are in place

Restriction type: OTHER