Lidocaine for Opioid Sparing in Vaso-occlusive Crisis of Sickle Cell Disease

NCT ID: NCT07274254

Last Updated: 2025-12-26

Basic Information

• Recruitment Status: NOT_YET_RECRUITING
• Clinical Phase: PHASE3
• Total Enrollment: 104 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2026-03-01
• Study Completion Date: 2028-04-01

Brief Summary

The purpose of the study is to determine whether adding lidocaine to standard of care in pain management during severe vaso-occlusive crisis has an effect on the cumulative opioid consumption expressed as morphine milligram equivalent.

Conditions

Vaso-Occlusive Pain Episode in Sickle Cell Disease

Keywords

Sickle Cell disease; Sickle Cell Syndrome; Vaso-occlusive crisis; Acute Chest Syndrome; Painful crisis; Pain management; Opioid sparing; Lidocaine

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: QUADRUPLE

Study Groups

Experimental group: Lidocaine + standard of care

Lidocaine hydrochloride 20 mg/mL, solution, 20 mL ampoule for intravenous administration Administration : parenteral route on peripheral or central venous catheter.

• Bolus of 1.5 mg/kg bolus during 30 minutes, with a maximum dose of 180 mg (18mL)
• Immediately followed by a continuous infusion of 1 mg/kg/h (max 120mg/h =- 12mL/h) during 72 hours.

Group Type: EXPERIMENTAL

Lidocain

Intervention Type: DRUG

Lidocaine hydrochloride 20 mg/mL, solution, 20 mL ampoule for IV administration (25 ampoules) Administration : parenteral route on peripheral or central venous catheter. - Bolus of 1.5 mg/kg bolus dur

Standard of care

Intervention Type: DRUG

Standard of care

Control group: placebo + standard of care

Placebo is 20 mL ampoules of sodium chloride (NaCl 0.9%) for injection. Administration : parenteral route on peripheral or central venous catheter.

• Bolus of 1.5 mg/kg bolus during 30 minutes, with a maxium dose of 180 mg (18mL)
• Immediately followed by a continuous infusion of 1 mg/kg/h (max 120mg/h = 12mL/h) during 72 hours.

Group Type: PLACEBO_COMPARATOR

Placebo

Intervention Type: DRUG

Placebo is 20 mL ampoules of sodium chloride (NaCl 0.9%) for injection Administration : parenteral route on peripheral or central venous catheter.

• Bolus of 1.5 mg/kg bolus during 30 minutes, with a maxium dose of 180 mg (18mL)
• Immediately followed by a continuous infusion of 1 mg/kg/h (max 120mg/h = 12mL/h) during 72 hours.

Standard of care

Intervention Type: DRUG

Standard of care

Interventions

Lidocain

Lidocaine hydrochloride 20 mg/mL, solution, 20 mL ampoule for IV administration (25 ampoules) Administration : parenteral route on peripheral or central venous catheter. - Bolus of 1.5 mg/kg bolus dur

Intervention Type: DRUG

Placebo

Placebo is 20 mL ampoules of sodium chloride (NaCl 0.9%) for injection Administration : parenteral route on peripheral or central venous catheter.

• Bolus of 1.5 mg/kg bolus during 30 minutes, with a maxium dose of 180 mg (18mL)
• Immediately followed by a continuous infusion of 1 mg/kg/h (max 120mg/h = 12mL/h) during 72 hours.

Intervention Type: DRUG

Standard of care

Standard of care

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Age >= 18 years
• Known sickle cell disease with an SS, SC, Sβ, or Sβ+ genotype
• Patient admitted to the Intensive Care Unit for Vaso-Occlusive Crisis and/or ACS as the main reason for admission:

• Vaso-Occlusive Crisis defined by acute pain or tenderness, affecting at least one part of the body, including limbs, ribs, sternum, head (skull), spine, and/or pelvis, not attributable to other causes
• Acute Chest Syndrome defined by the association of clinical respiratory sign(s): dyspnea and/or chest pain and/or auscultatory abnormality (crepitants and/or bronchial breathing) with a new pulmonary infiltrate on chest X-ray, thoracic CT-scan, or lung ultrasound.
• Treatment with parenteral morphine or oxycodone started less than 72 hours prior to inclusion
• Patient or next of kin informed about the study and having consented to the participation of the patient in the study. If patient is no competent and no next of kin can be contacted during screening for the study, trial inclusion will be completed as an emergency procedure by the Intensive Care Unit physician, in compliance with French law.
• French speaking
• Patient with health care insurance

Exclusion Criteria

• Pregnant women or nursing mothers; Women of child bearing potential will be tested for pregnancy before inclusion
• Patients under guardianship, curatorship or under legal protection
• Prisoners or subjects who are involuntarily incarcerated
• Sickle Cell Disease acute complication other than Vaso-Occlusive Crisis or Acute Chest Syndrome as the main reason for admission:

priapism, stroke, acute splenic sequestration, acute hepatic sequestration, bone marrow necrosis…

• Patients wearing a lidocaine-medicated plaster at the time of screening for inclusion
• Known or assumed hypersensitivity to lidocaine hydrochloride, other local anaesthetics (e.g., bupivacaine or ropivacaine) or an excipient
• Patients treated with anti-arhythmic drugs known to induce torsade de pointe.
• Patients on chronic or occasional treatment with drugs that interact with the 3A cytochrome isoenzymes (CYP3A) and/or 1A2 cytochrome isoenzymes (CYP1A2)
• Patients with recurrent porphyria, porphyria in remission, or known asymptomatic carriage of gene mutations responsible for porphyria
• Epileptic patients
• Hypovolemic shock or shock of other cause at screening for inclusion
• Known atrioventricular block, QT prolongation or other heart conduction disorder or heart failure
• Chronic respiratory failure with long term non invasive ventilation (excluding Continuous Positive Air way pressure), or long term oxygen therapy at home
• Acute Respiratory Distress Syndrome according to The 2012 Berlin definition
• Acute or Chronic liver failure with MELD > 19 according to CKD-EPI
• Acute or Chronic kidney failure with clearance <30mL/min/m2
• Body weight <40kg and >120kg
• Prior inclusion in the study in the last 3 months
• Patient under invasive mechanical ventilation
• Altered consciousness with Glasgow coma scale <13

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Nantes University Hospital

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

CHU Bordeaux

Bordeaux, , France

CHU Lille

Lille, , France

CHU La Timone

Marseille, , France

CHU de Nantes

Nantes, , France

CHU Orléans

Orléans, , France

Hôpital Tenon APHP

Paris, , France

CHU Poitiers

Poitiers, , France

CHU Rouen

Rouen, , France

Oncopole Toulouse

Toulouse, , France

CHRU Tours - Hôpital Bretonneau

Tours, , France

CHU Guadeloupe

Les Abymes, , Guadeloupe

Countries

France; Guadeloupe

Central Contacts

Maïté AGBAKOU

Role: CONTACT

Phone: 02.44.76.80.54

Email: maite.agbakou@chu-nantes.fr

Facility Contacts

Arthur ORIEUX

Role: primary

Arthur DURAND

Role: primary

Maïté AGBAKOU

Role: primary

Marie SKARZYNSKI

Role: primary

Muriel FARTOUKH

Role: primary

Delphine CHATELLIER

Role: primary

Maximilien GRALL

Role: primary

Sihem BOUHARAOUA

Role: primary

Charlotte SALMONGANDONNIERE

Role: primary

Frédéric MARTINO

Role: primary

Other Identifiers

RC24_0427

Identifier Type: -

Identifier Source: org_study_id