A Pilot Study to Evaluate Barhemsys for the Prevention of Postoperative Nausea and Vomiting in the Bariatric Surgery Population

NCT ID: NCT06585540

Last Updated: 2024-09-26

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-09-13

Study Completion Date

2026-01-31

Brief Summary

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To assess the effectiveness of Amisulpride to treat Post Operative Nausea and Vomiting (PONV) and to assess the effectiveness of Amisulpride to prevent PONV following bariatric surgery.

Detailed Description

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This is a phase III/IV, randomized, placebo-controlled, patient-blinded cross-over pilot study to evaluate the effectiveness of Amisulpride in the treatment and prevention of Post Operative Nausea and Vomiting (PONV) in adult patients, 18-65 years of age, at a single surgery site in the pacific northwest who are undergoing bariatric surgery. Approximately 100 patients will be randomized in a 1:1 ratio to receive a single intravenous dose of Amisulpride (5mg IV single dose) or a placebo (saline control, 1mL IV single dose) at the induction of anesthesia. Those who initially receive placebo will undergo an additional randomization in the post-anesthesia care unit (PACU) to receive a dose of Amisulpride (10mg IV single dose) or placebo (saline control, 2mL IV single dose) in a 1:1 ratio as first line treatment for PONV.

Conditions

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Post Operative Nausea and Vomiting

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Prospective, randomized, subject blinded, placebo-controlled crossover pilot study.
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants

Study Groups

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Group Barhemsys

Interventional arm receiving Barhemsys during surgery

Group Type EXPERIMENTAL

Amisulpride IV Prevention

Intervention Type DRUG

Patients in this arm will receive Amisulpride 5mg IV as a preventative dose after the induction of anesthesia

Group Placebo

Placebo arm receiving Placebo during surgery

Group Type PLACEBO_COMPARATOR

Placebo Preventative

Intervention Type DRUG

Patients in this arm will receive placebo (Normal Saline) while under general anesthesia

Group Placebo Barhemsys

Of patients who are members of Group Placebo they will be able to receive Barhemsys in the Post Anesthesia Care Unit if they experience nausea or emesis

Group Type EXPERIMENTAL

Amisulpride IV Treatment

Intervention Type DRUG

Patients in this arm will receive Amisulpride 10mg IV for first-line treatment of Post-Operative Nausea and Vomiting in the post-anesthesia care unit.

Group Placebo Placebo

Of patients who are members of Group Placebo they will be able to receive Placebo in the Post Anesthesia Care Unit if they experience nausea or emesis

Group Type PLACEBO_COMPARATOR

Placebo Treatment

Intervention Type DRUG

Patients in this Arm will receive placebo as first line treatment of Post-Operative Nausea and Vomiting in the Post Anesthesia Care Unit

Interventions

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Amisulpride IV Prevention

Patients in this arm will receive Amisulpride 5mg IV as a preventative dose after the induction of anesthesia

Intervention Type DRUG

Amisulpride IV Treatment

Patients in this arm will receive Amisulpride 10mg IV for first-line treatment of Post-Operative Nausea and Vomiting in the post-anesthesia care unit.

Intervention Type DRUG

Placebo Preventative

Patients in this arm will receive placebo (Normal Saline) while under general anesthesia

Intervention Type DRUG

Placebo Treatment

Patients in this Arm will receive placebo as first line treatment of Post-Operative Nausea and Vomiting in the Post Anesthesia Care Unit

Intervention Type DRUG

Other Intervention Names

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Amisulpride IV Treatment

Eligibility Criteria

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Inclusion Criteria

Included Surgeries:

Robotic, Laparoscopic or Open Roux-en-Y Robotic, Laparoscopic or Open Gastric Sleeve Robotic, Laparoscopic or Open Gastrectomy Robotic, Laparoscopic or Open Revision Gastric Bypass

Exclusion Criteria

* Pregnant or breastfeeding
* Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data.
* Congenital QTc abnormalities
* Current use of droperidol
* Parkinson's disease
* Allergy to Barhemsys
* GFR \< 30 mL/min/1.73m2
* Emergency surgery or add-on cases
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Virginia Mason Hospital/Medical Center

OTHER

Sponsor Role collaborator

Benaroya Research Institute

OTHER

Sponsor Role lead

Responsible Party

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Justin Liberman

Staff Anesthesiologist, Department of Anesthesia

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Justin S Liberman, Medical Doctor

Role: PRINCIPAL_INVESTIGATOR

Virginia Mason Medical Center

Locations

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Virginia Mason Medical Center

Seattle, Washington, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Justin S Liberman, Medical Doctor

Role: CONTACT

206-341-1298

David B Auyong, Medical Doctor

Role: CONTACT

206-341-1298

Facility Contacts

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Justin S Liberman, MD MPH

Role: primary

206-341-1298

David B Auyong, MD

Role: backup

206-341-1298

Justin S Liberman, MD

Role: backup

David B Auyong, MD

Role: backup

References

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Wengritzky R, Mettho T, Myles PS, Burke J, Kakos A. Development and validation of a postoperative nausea and vomiting intensity scale. Br J Anaesth. 2010 Feb;104(2):158-66. doi: 10.1093/bja/aep370. Epub 2009 Dec 26.

Reference Type BACKGROUND
PMID: 20037151 (View on PubMed)

Berger ER, Huffman KM, Fraker T, Petrick AT, Brethauer SA, Hall BL, Ko CY, Morton JM. Prevalence and Risk Factors for Bariatric Surgery Readmissions: Findings From 130,007 Admissions in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Ann Surg. 2018 Jan;267(1):122-131. doi: 10.1097/SLA.0000000000002079.

Reference Type BACKGROUND
PMID: 27849660 (View on PubMed)

Habib AS, Kranke P, Bergese SD, Chung F, Ayad S, Siddiqui N, Motsch J, Leiman DG, Melson TI, Diemunsch P, Fox GM, Candiotti KA. Amisulpride for the Rescue Treatment of Postoperative Nausea or Vomiting in Patients Failing Prophylaxis: A Randomized, Placebo-controlled Phase III Trial. Anesthesiology. 2019 Feb;130(2):203-212. doi: 10.1097/ALN.0000000000002509.

Reference Type BACKGROUND
PMID: 30475232 (View on PubMed)

Candiotti KA, Kranke P, Bergese SD, Melson TI, Motsch J, Siddiqui N, Chung F, Rodriguez Y, Minkowitz HS, Ayad SS, Diemunsch P, Fox G. Randomized, Double-Blind, Placebo-Controlled Study of Intravenous Amisulpride as Treatment of Established Postoperative Nausea and Vomiting in Patients Who Have Had No Prior Prophylaxis. Anesth Analg. 2019 Jun;128(6):1098-1105. doi: 10.1213/ANE.0000000000003733.

Reference Type BACKGROUND
PMID: 31094774 (View on PubMed)

Fox GM, Albayaty M, Walker JL, Xue H, Darpo B. Intravenous Amisulpride Does Not Meaningfully Prolong the QTc Interval at Doses Effective for the Management of Postoperative Nausea and Vomiting. Anesth Analg. 2021 Jan;132(1):150-159. doi: 10.1213/ANE.0000000000004538.

Reference Type BACKGROUND
PMID: 31913911 (View on PubMed)

Apfel CC, Philip BK, Cakmakkaya OS, Shilling A, Shi YY, Leslie JB, Allard M, Turan A, Windle P, Odom-Forren J, Hooper VD, Radke OC, Ruiz J, Kovac A. Who is at risk for postdischarge nausea and vomiting after ambulatory surgery? Anesthesiology. 2012 Sep;117(3):475-86. doi: 10.1097/ALN.0b013e318267ef31.

Reference Type BACKGROUND
PMID: 22846680 (View on PubMed)

Carroll NV, Miederhoff P, Cox FM, Hirsch JD. Postoperative nausea and vomiting after discharge from outpatient surgery centers. Anesth Analg. 1995 May;80(5):903-9. doi: 10.1097/00000539-199505000-00009.

Reference Type BACKGROUND
PMID: 7726432 (View on PubMed)

White PF, O'Hara JF, Roberson CR, Wender RH, Candiotti KA; POST-OP Study Group. The impact of current antiemetic practices on patient outcomes: a prospective study on high-risk patients. Anesth Analg. 2008 Aug;107(2):452-8. doi: 10.1213/ane.0b013e31817b842c.

Reference Type BACKGROUND
PMID: 18633023 (View on PubMed)

Gan TJ, Belani KG, Bergese S, Chung F, Diemunsch P, Habib AS, Jin Z, Kovac AL, Meyer TA, Urman RD, Apfel CC, Ayad S, Beagley L, Candiotti K, Englesakis M, Hedrick TL, Kranke P, Lee S, Lipman D, Minkowitz HS, Morton J, Philip BK. Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting. Anesth Analg. 2020 Aug;131(2):411-448. doi: 10.1213/ANE.0000000000004833.

Reference Type BACKGROUND
PMID: 32467512 (View on PubMed)

Apfel CC, Laara E, Koivuranta M, Greim CA, Roewer N. A simplified risk score for predicting postoperative nausea and vomiting: conclusions from cross-validations between two centers. Anesthesiology. 1999 Sep;91(3):693-700. doi: 10.1097/00000542-199909000-00022.

Reference Type BACKGROUND
PMID: 10485781 (View on PubMed)

Related Links

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Other Identifiers

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CRP23057

Identifier Type: -

Identifier Source: org_study_id

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