Allergy to Neuromuscular Blocking Agents and Pholcodine Exposure

NCT ID: NCT02250729

Last Updated: 2018-12-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

1020 participants

Study Classification

INTERVENTIONAL

Study Start Date

2014-07-31

Study Completion Date

2020-07-31

Brief Summary

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The main objective of this study is to compare pholcodine exposure in patients having presented with a perianaesthetic anaphylactic reaction to a NMBA (cases) to pholcodine exposure in matched anaesthetised patients with injection of NMBA, who did not present with an anaphylactic reaction (controls).

The secondary objectives of the study are:

* To compare anti-pholcodine IgE, anti-ammonium IV IgE and total IgE levels between the case and control groups.
* To study the concordance between exposure to pholcodine in cases and controls, by means of a patient self-questionnaire on the one hand and, on the other hand, by a computerized drug history, supplemented where relevant by the drug master file.
* To study the impact of taking 1, 2 or 3 sources in account for pholcodine exposition.
* To study the association between exposure to pholcodine and the presence/levels of pholcodine-specific IgE, reflecting sensitisation to pholcodine.
* To study NMBA and pholcodine cross-sensitisation by testing skin reactions to pholcodine in case patients allergic to (at least) one NMBA.

Detailed Description

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Conditions

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Neuromuscular Blocking Agents Anaphylaxis

Keywords

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anaphylaxis pholcodine neuromuscular blocking agents

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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cases with NMBA anaphylaxis

Patients who experienced NMBA anaphylaxis during anesthesia

Group Type EXPERIMENTAL

intradermal pholcodine allergy test in cases

Intervention Type OTHER

Blood sampling

Intervention Type OTHER

controls

Patients who underwent anesthesia with NMBA injection but did not experience anaphylaxis

Group Type OTHER

Blood sampling

Intervention Type OTHER

Interventions

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intradermal pholcodine allergy test in cases

Intervention Type OTHER

Blood sampling

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Male or female, age ≥ 2 years old.
* Referred to anaesthesia-allergy consultation within (approximately) 6 to 12 weeks of occurrence of peranaesthetic anaphylactic reaction during anaesthesia with administration of NMBAs (only for case patient).
* Having given his/her consent (or the 2 parents consent for minors).
* Affiliated with a social security scheme or dependent.
* Able to answer a medicinal product intake questionnaire
* In a clinical condition compatible with skin tests (no skin disease or psychiatric illness, etc.) (only for case patient)
* Having stopped any anti-histamine treatment at least 8 days previously (only for case patient).
* With positive skin test for the suspected NMBA (ony for case patient).
* Patient anaesthetised in a control recruitment centre (only for control patients)
* Having undergone anaesthesia with NMBA injection, without onset of peranaesthetic anaphylactic reaction whatever his medical history (only for control patients)

Exclusion Criteria

* Patients who have refused, or are unable to give their consent
* Patients who have had negative control skin tests
* Anaphylaxis suspected to be related to other drugs given on induction of anaesthesia, eg. antibiotics
* Having presented with anaphylactic reaction during a previous anaesthesia without NMBA injection
* Pregnant females at inclusion or during 12 months before anaesthesia
Minimum Eligible Age

2 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Zambon SpA

INDUSTRY

Sponsor Role collaborator

Laboratoires URGO

INDUSTRY

Sponsor Role collaborator

THE BOOTS COMPANY PLC

UNKNOWN

Sponsor Role collaborator

Pierre Fabre Medicament

INDUSTRY

Sponsor Role collaborator

LABORATOIRE HEPATOUM

UNKNOWN

Sponsor Role collaborator

Biocodex

INDUSTRY

Sponsor Role collaborator

Sanofi

INDUSTRY

Sponsor Role collaborator

RECORDATI GROUP

INDUSTRY

Sponsor Role collaborator

GlaxoSmithKline

INDUSTRY

Sponsor Role collaborator

ALLIANCE PHARMACEUTICALS LIMITED

UNKNOWN

Sponsor Role collaborator

BELL SONS & COMPANY

UNKNOWN

Sponsor Role collaborator

PINEWOOD LABORATORIES LIMITED

UNKNOWN

Sponsor Role collaborator

THORNTON & ROSS & Ross Ltd

UNKNOWN

Sponsor Role collaborator

ERNEST JACKSON & Co. Ltd

UNKNOWN

Sponsor Role collaborator

Central Hospital, Nancy, France

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Pierre GILLET, PU-PH MD

Role: PRINCIPAL_INVESTIGATOR

Central Hospital, Nancy, France

Paul-Michel MERTES, PU-PH MD

Role: STUDY_DIRECTOR

CHU de Strasbourg

Locations

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CHU d' ANGERS

Angers, , France

Site Status RECRUITING

CHU de Besançon

Besançon, , France

Site Status NOT_YET_RECRUITING

CHU de Bordeaux

Bordeaux, , France

Site Status RECRUITING

CHU de Caen

Caen, , France

Site Status RECRUITING

CHU de Clermont-Ferrand

Clermont-Ferrand, , France

Site Status RECRUITING

CHU de Dijon

Dijon, , France

Site Status RECRUITING

CHRU de Lille

Lille, , France

Site Status RECRUITING

CHU de Limoges

Limoges, , France

Site Status RECRUITING

AP-HM

Marseille, , France

Site Status NOT_YET_RECRUITING

CHU de MONTPELLIER

Montpellier, , France

Site Status RECRUITING

CHRU de Nancy

Nancy, , France

Site Status RECRUITING

CHU de NANTES

Nantes, , France

Site Status RECRUITING

CHU de Nice

Nice, , France

Site Status RECRUITING

Fondation Hôpital St Joseph

Paris, , France

Site Status RECRUITING

AP-HP- Hôpital Bichat

Paris, , France

Site Status RECRUITING

AP-HP Paris TENON

Paris, , France

Site Status RECRUITING

Hospices Civils de Lyon

Pierre-Bénite, , France

Site Status RECRUITING

CHU de Poitiers

Poitiers, , France

Site Status RECRUITING

CHU de Reims

Reims, , France

Site Status RECRUITING

CHU de Rouen

Rouen, , France

Site Status RECRUITING

CHU de Saint Etienne

Saint-Etienne, , France

Site Status RECRUITING

CHU de Strasbourg

Strasbourg, , France

Site Status RECRUITING

CHU de Toulouse

Toulouse, , France

Site Status RECRUITING

CHU de TOURS

Tours, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Pierre Gillet, MD PhD

Role: CONTACT

Email: [email protected]

Facility Contacts

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Martine DROUET, Dr

Role: primary

Pascal GIRARDIN, MD

Role: primary

Maryline Bordes

Role: primary

Delphine MARIOTTEFAUSSART, MD

Role: primary

Omar OUTTAS, MD

Role: primary

Sandrine SELTZER, MD

Role: primary

FACON Alain, MD

Role: primary

Isabelle ORSEL, MD

Role: primary

Marion GOUITAA-DETTORI, MD

Role: primary

Pascal DEMOLY, Pr

Role: primary

Gérard AUDIBERT, MD-PHD

Role: primary

ANAIS PIPET, Dr

Role: primary

Sylvie LEROY, MD

Role: primary

Marie-Laure MEGRET-GABEAUD, Dr

Role: primary

Dan LONGROIS, MD- PHD

Role: primary

ANGELE SORIA, Dr

Role: primary

Vincent PIRIOU, MD

Role: primary

Marion VERDAGUER, MD

Role: primary

Jean-Marc MALINVOSKY, MD-PHD

Role: primary

Yannick MEUNIER, MD

Role: primary

Charles DZVIGA, MD

Role: primary

Fréderic DE BLAY, MD- PHD

Role: primary

Paul-Michel Mertes, MD- PHD

Role: backup

Alain DIDIER, MD-PHD

Role: primary

Cyrille HOARAU, Dr

Role: primary

References

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Mertes PM, Petitpain N, Tacquard C, Delpuech M, Baumann C, Malinovsky JM, Longrois D, Gouel-Cheron A, Le Quang D, Demoly P, Gueant JL, Gillet P; ALPHO Study Group. Pholcodine exposure increases the risk of perioperative anaphylaxis to neuromuscular blocking agents: the ALPHO case-control study. Br J Anaesth. 2023 Jul;131(1):150-158. doi: 10.1016/j.bja.2023.02.026. Epub 2023 Mar 24.

Reference Type DERIVED
PMID: 36967281 (View on PubMed)

Other Identifiers

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2012-A01735-38

Identifier Type: -

Identifier Source: org_study_id