A Phase 2 interventional study of sugammadex and Placebo in Anesthesia, General, sponsored by Merck Sharp & Dohme LLC. Completed. Open to participants aged 20 Years to 65 Years. Per ClinicalTrials.gov, last updated 2019-03-01.
Sponsored by Merck Sharp & Dohme LLC · Phase 2, Interventional, and Treatment
The objective of this trial was to establish the dose-response of T2 (the amplitude of the first response of second twitch to train of four (TOF) stimulation, expressed as percentage of control first twitch,T1) in Japanese and Caucasian participants. Part A: Japanese Participants
For most surgical procedures a depth of neuromuscular block of 1-2 twitches after TOF-stimulation is sufficient to avoid unwanted muscular activity. At reappearance of T2, the anesthesiologist might decide to either give (another) maintenance dose of rocuronium or vecuronium when surgery continues, to await spontaneous recovery of neuromuscular block or to reverse the neuromuscular block. Sugammadex (Org 25969) has been shown in previous trials to greatly reduce the time to full recovery when administered at reappearance of T2, both after rocuronium- and vecuronium-induced neuromuscular blockade. The current trial P05956 was conducted in Japan and set up to establish the dose-response relationship of sugammadex given during sevoflurane anesthesia at reappearance of T2 after rocuronium or vecuronium in Japanese participants. In addition to recovery time, also pharmacokinetics and safety of sugammadex were evaluated.
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After induction of anesthesia an intubation dose of 0.9 mg/kg rocuronium was administered intravenously (IV), followed by maintenance doses of 0.1-0.2 mg/kg rocuronium IV if necessary. At reappearance of T2 a single dose of placebo was administered IV.
Drug: Placebo
After induction of anesthesia an intubation dose of 0.9 mg/kg rocuronium was administered IV, followed by maintenance doses of 0.1-0.2 mg/kg rocuronium IV if necessary. At reappearance of T2 a single dose of 0.5 mg/kg sugammadex was administered IV.
Drug: sugammadex
After induction of anesthesia an intubation dose of 0.9 mg/kg rocuronium was administered IV, followed by maintenance doses of 0.1-0.2 mg/kg rocuronium IV if necessary. At reappearance of T2 a single dose of 1.0 mg/kg sugammadex was administered IV.
Drug: sugammadex
After induction of anesthesia an intubation dose of 0.9 mg/kg rocuronium was administered IV, followed by maintenance doses of 0.1-0.2 mg/kg rocuronium IV if necessary. At reappearance of T2 a single dose of 2.0 mg/kg sugammadex was administered IV.
Drug: sugammadex
After induction of anesthesia an intubation dose of 0.9 mg/kg rocuronium was administered IV, followed by maintenance doses of 0.1-0.2 mg/kg rocuronium IV if necessary. At reappearance of T2 a single dose of 4.0 mg/kg sugammadex was administered IV.
Drug: sugammadex
After induction of anesthesia an intubation dose of 0.1 mg/kg vecuronium was administered IV, followed by maintenance doses of 0.02-0.04 mg/kg vecuronium IV if necessary. At reappearance of T2 a single dose of placebo was administered IV.
Drug: Placebo
After induction of anesthesia an intubation dose of 0.1 mg/kg vecuronium was administered IV, followed by maintenance doses of 0.02-0.04 mg/kg vecuronium IV if necessary. At reappearance of T2 a single dose of 0.5 mg/kg sugammadex was administered IV.
Drug: sugammadex
After induction of anesthesia an intubation dose of 0.1 mg/kg vecuronium was administered IV, followed by maintenance doses of 0.02-0.04 mg/kg vecuronium IV if necessary. At reappearance of T2 a single dose of 1.0 mg/kg sugammadex was administered IV.
Drug: sugammadex
After induction of anesthesia an intubation dose of 0.1 mg/kg vecuronium was administered IV, followed by maintenance doses of 0.02-0.04 mg/kg vecuronium IV if necessary. At reappearance of T2 a single dose of 2.0 mg/kg sugammadex was administered IV.
Drug: sugammadex
After induction of anesthesia an intubation dose of 0.1 mg/kg vecuronium was administered IV, followed by maintenance doses of 0.02-0.04 mg/kg vecuronium IV if necessary. At reappearance of T2 a single dose of 4.0 mg/kg sugammadex was administered IV.
Drug: sugammadex
After induction of anesthesia an intubation dose of NMBA was administered IV: either 0.9 mg/kg rocuronium or 0.1 mg/kg vecuronium. Maintenance doses of 0.1-0.2 mg/kg rocuronium IV or 0.02-0.04 mg/kg vecuronium IV could be administered if necessary. At reappearance of T2 the randomized single dose of sugammadex (0.5 to 4 mg/kg) IV was administered.
Also known as: Org 25969
After induction of anesthesia an intubation dose of NMBA was administered IV: either 0.9 mg/kg rocuronium or 0.1 mg/kg vecuronium. Maintenance doses of 0.1-0.2 mg/kg rocuronium IV or 0.02-0.04 mg/kg vecuronium IV could be administered if necessary. At reappearance of T2 the randomized single dose of placebo IV was administered
Time From Start of Administration of Sugammadex or Placebo to Recovery of the Fourth Twitch/First Twitch (T4/T1) Ratio to 0.9
Neuromuscular functioning was monitored by applying repetitive Train-Of-Four (TOF) electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to the amplitudes (heights) of the first and fourth twitches, respectively, after TOF nerve stimulation. The T4/T1 Ratio (expressed as a decimal of up to 1.0) indicates the extent of recovery from neuromuscular blockade (NMB). In this study, twitch responses were recorded until the T4/T1 Ratio reached \>= 0.9, the minimum acceptable ratio that indicated recovery from NMB. A faster time to recovery of the T4/T1 Ratio to 0.9 indicates a faster recovery from NMB.
Time frame: Day 1: From start of sugammadex or placebo administration to recovery of T4/T1 ratio to 0.9 (up to 24 hours)
Time From Start of Administration of Sugammadex or Placebo to Recovery of the T4/T1 Ratio to 0.7
Neuromuscular functioning was monitored by applying repetitive TOF electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to the amplitudes (heights) of the first and fourth twitches, respectively, after TOF nerve stimulation. The T4/T1 Ratio (expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster time to recovery of the T4/T1 Ratio to 0.7 indicates a faster recovery from NMB.
Time frame: Day 1: From start of sugammadex or placebo administration to recovery of T4/T1 ratio to 0.7 (up to 24 hours)
Time From Start of Administration of Sugammadex or Placebo to Recovery of the T4/T1 Ratio to 0.8
Neuromuscular functioning was monitored by applying repetitive TOF electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to the amplitudes (heights) of the first and fourth twitches, respectively, after TOF nerve stimulation. The T4/T1 Ratio (expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster time to recovery of the T4/T1 Ratio to 0.8 indicates a faster recovery from NMB.
Time frame: Day 1: From start of sugammadex or placebo administration to recovery of T4/T1 ratio to 0.8 (up to 24 hours)
Japanese participants who had a surgical procedure using a general anesthesia of rocuronium or vecuronium for endotracheal intubation and maintenance of neuromuscular block were enrolled in this study.
| Milestone | Rocuronium + Placebo | Rocuronium + 0.5 mg/kg Sugammadex | Rocuronium + 1.0 mg/kg Sugammadex | Rocuronium + 2.0 mg/kg Sugammadex | Rocuronium + 4.0 mg/kg Sugammadex | Vecuronium + Placebo | Vecuronium + 0.5 mg/kg Sugammadex | Vecuronium + 1.0 mg/kg Sugammadex | Vecuronium + 2.0 mg/kg Sugammadex | Vecuronium + 4.0 mg/kg Sugammadex |
|---|---|---|---|---|---|---|---|---|---|---|
| Started | 10 | 10 | 10 | 10 | 10 | 10 | 10 | 10 | 9 | 11 |
| Treated | 10 | 10 | 10 | 10 | 9 | 10 | 10 | 10 | 9 | 10 |
| Completed | 10 | 10 | 10 | 10 | 9 | 10 | 10 | 10 | 9 | 10 |
| Not completed | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 1 |
| Withdrew: Not treated | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 1 |
Neuromuscular functioning was monitored by applying repetitive Train-Of-Four (TOF) electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to the amplitudes (heights) of the first and fourth twitches, respectively, after TOF nerve stimulation. The T4/T1 Ratio (expressed as a decimal of up to 1.0) indicates the extent of recovery from neuromuscular blockade (NMB). In this study, twitch responses were recorded until the T4/T1 Ratio reached \>= 0.9, the minimum acceptable ratio that indicated recovery from NMB. A faster time to recovery of the T4/T1 Ratio to 0.9 indicates a faster recovery from NMB.
| Minutes | Rocuronium + Placebo | Rocuronium + 0.5 mg/kg Sugammadex | Rocuronium + 1.0 mg/kg Sugammadex | Rocuronium + 2.0 mg/kg Sugammadex | Rocuronium + 4.0 mg/kg Sugammadex | Vecuronium + Placebo | Vecuronium + 0.5 mg/kg Sugammadex | Vecuronium + 1.0 mg/kg Sugammadex | Vecuronium + 2.0 mg/kg Sugammadex | Vecuronium + 4.0 mg/kg Sugammadex |
|---|---|---|---|---|---|---|---|---|---|---|
| Time From Start of Administration of Sugammadex or Placebo to Recovery of the Fourth Twitch/First Twitch (T4/T1) Ratio to 0.9 | 82.08 ± 27.57 | 3.95 ± 2.50 | 2.48 ± 1.28 | 2.17 ± 1.23 | 1.85 ± 1.17 | 83.20 ± 20.63 | 52.03 ± 64.92 | 10.63 ± 19.23 | 2.77 ± 0.83 | 2.08 ± 0.90 |
Neuromuscular functioning was monitored by applying repetitive TOF electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to the amplitudes (heights) of the first and fourth twitches, respectively, after TOF nerve stimulation. The T4/T1 Ratio (expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster time to recovery of the T4/T1 Ratio to 0.7 indicates a faster recovery from NMB.
| Minutes | Rocuronium + Placebo | Rocuronium + 0.5 mg/kg Sugammadex | Rocuronium + 1.0 mg/kg Sugammadex | Rocuronium + 2.0 mg/kg Sugammadex | Rocuronium + 4.0 mg/kg Sugammadex | Vecuronium + Placebo | Vecuronium + 0.5 mg/kg Sugammadex | Vecuronium + 1.0 mg/kg Sugammadex | Vecuronium + 2.0 mg/kg Sugammadex | Vecuronium + 4.0 mg/kg Sugammadex |
|---|---|---|---|---|---|---|---|---|---|---|
| Time From Start of Administration of Sugammadex or Placebo to Recovery of the T4/T1 Ratio to 0.7 | 52.60 ± 16.27 | 2.35 ± 0.70 | 1.73 ± 0.85 | 1.23 ± 0.38 | 1.20 ± 0.27 | 85.85 ± 75.12 | 12.52 ± 17.95 | 2.87 ± 1.13 | 2.30 ± 0.60 | 1.33 ± 0.43 |
Neuromuscular functioning was monitored by applying repetitive TOF electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to the amplitudes (heights) of the first and fourth twitches, respectively, after TOF nerve stimulation. The T4/T1 Ratio (expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster time to recovery of the T4/T1 Ratio to 0.8 indicates a faster recovery from NMB.
| Minutes | Rocuronium + Placebo | Rocuronium + 0.5 mg/kg Sugammadex | Rocuronium + 1.0 mg/kg Sugammadex | Rocuronium + 2.0 mg/kg Sugammadex | Rocuronium + 4.0 mg/kg Sugammadex | Vecuronium + Placebo | Vecuronium + 0.5 mg/kg Sugammadex | Vecuronium + 1.0 mg/kg Sugammadex | Vecuronium + 2.0 mg/kg Sugammadex | Vecuronium + 4.0 mg/kg Sugammadex |
|---|---|---|---|---|---|---|---|---|---|---|
| Time From Start of Administration of Sugammadex or Placebo to Recovery of the T4/T1 Ratio to 0.8 | 63.67 ± 21.77 | 2.70 ± 1.00 | 1.87 ± 0.98 | 1.50 ± 0.55 | 1.32 ± 0.35 | 68.40 ± 19.58 | 5.55 ± 1.90 | 3.75 ± 1.45 | 3.08 ± 1.68 | 1.63 ± 0.48 |
Collected over Up to 7 days after sugammadex or placebo treatment. Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Rocuronium + Placebo | 0/10 (0%) | 0/10 (0%) | 10/10 (100%) |
| Rocuronium + 0.5 mg/kg Sugammadex | 0/10 (0%) | 0/10 (0%) | 10/10 (100%) |
| Rocuronium + 1.0 mg/kg Sugammadex | 0/10 (0%) | 0/10 (0%) | 10/10 (100%) |
| Rocuronium + 2.0 mg/kg Sugammadex | 0/10 (0%) | 1/10 (10%) | 9/10 (90%) |
| Rocuronium + 4.0 mg/kg Sugammadex | 0/9 (0%) | 0/9 (0%) | 8/9 (88.9%) |
| Vecuronium + Placebo | 0/10 (0%) | 0/10 (0%) | 10/10 (100%) |
| Vecuronium + 0.5 mg/kg Sugammadex | 0/10 (0%) | 1/10 (10%) | 9/10 (90%) |
| Vecuronium + 1.0 mg/kg Sugammadex | 0/10 (0%) | 0/10 (0%) | 9/10 (90%) |
| Vecuronium + 2.0 mg/kg Sugammadex | 0/9 (0%) | 0/9 (0%) | 9/9 (100%) |
| Vecuronium + 4.0 mg/kg Sugammadex | 0/10 (0%) | 0/10 (0%) | 9/10 (90%) |
| Event | Rocuronium + Placebo | Rocuronium + 0.5 mg/kg Sugammadex | Rocuronium + 1.0 mg/kg Sugammadex | Rocuronium + 2.0 mg/kg Sugammadex | Rocuronium + 4.0 mg/kg Sugammadex | Vecuronium + Placebo | Vecuronium + 0.5 mg/kg Sugammadex | Vecuronium + 1.0 mg/kg Sugammadex | Vecuronium + 2.0 mg/kg Sugammadex | Vecuronium + 4.0 mg/kg Sugammadex |
|---|---|---|---|---|---|---|---|---|---|---|
| GlossodyniaGastrointestinal disorders | 0/10 | 0/10 | 0/10 | 0/10 | 0/9 | 0/10 | 1/10 | 0/10 | 0/9 | 0/10 |
| Swollen tongueGastrointestinal disorders | 0/10 | 0/10 | 0/10 | 0/10 | 0/9 | 0/10 | 1/10 | 0/10 | 0/9 | 0/10 |
| Intrauterine infectionInfections and infestations | 0/10 | 0/10 | 0/10 | 1/10 | 0/9 | 0/10 | 0/10 | 0/10 | 0/9 | 0/10 |
| Event | Rocuronium + Placebo | Rocuronium + 0.5 mg/kg Sugammadex | Rocuronium + 1.0 mg/kg Sugammadex | Rocuronium + 2.0 mg/kg Sugammadex | Rocuronium + 4.0 mg/kg Sugammadex | Vecuronium + Placebo | Vecuronium + 0.5 mg/kg Sugammadex | Vecuronium + 1.0 mg/kg Sugammadex | Vecuronium + 2.0 mg/kg Sugammadex | Vecuronium + 4.0 mg/kg Sugammadex |
|---|---|---|---|---|---|---|---|---|---|---|
| Procedural painInjury, poisoning and procedural complications | 8/10 | 7/10 | 7/10 | 6/10 | 8/9 | 9/10 | 7/10 | 9/10 | 5/9 | 8/10 |
| NauseaGastrointestinal disorders | 2/10 | 4/10 | 4/10 | 4/10 | 4/9 | 4/10 | 5/10 | 4/10 | 5/9 | 1/10 |
| PyrexiaGeneral disorders | 4/10 | 3/10 | 5/10 | 3/10 | 3/9 | 5/10 | 4/10 | 2/10 | 4/9 | 2/10 |
| Postoperative wound complicationInjury, poisoning and procedural complications | 1/10 | 0/10 | 2/10 | 1/10 | 4/9 | 2/10 | 1/10 | 2/10 | 1/9 | 2/10 |
| Back painMusculoskeletal and connective tissue disorders | 1/10 | 3/10 | 2/10 | 3/10 | 1/9 | 0/10 | 0/10 | 2/10 | 3/9 | 0/10 |
| Pharyngolaryngeal painRespiratory, thoracic and mediastinal disorders | 1/10 | 1/10 | 3/10 | 2/10 | 3/9 | 2/10 | 2/10 | 1/10 | 0/9 | 1/10 |
| VomitingGastrointestinal disorders | 0/10 | 2/10 | 2/10 | 1/10 | 2/9 | 1/10 | 2/10 | 3/10 | 2/9 | 0/10 |
| DizzinessNervous system disorders | 0/10 | 1/10 | 3/10 | 1/10 | 1/9 | 1/10 | 0/10 | 1/10 | 1/9 | 0/10 |
| HeadacheNervous system disorders | 1/10 | 2/10 | 0/10 | 0/10 | 1/9 | 3/10 | 1/10 | 1/10 | 0/9 | 2/10 |
| HypoaesthesiaNervous system disorders | 1/10 | 1/10 | 0/10 | 1/10 | 0/9 | 0/10 | 0/10 | 2/10 | 2/9 | 2/10 |
All Participants As Treated
| Age, Continuous(Years) | Rocuronium + Placebo | Rocuronium + 0.5 mg/kg Sugammadex | Rocuronium + 1.0 mg/kg Sugammadex | Rocuronium + 2.0 mg/kg Sugammadex | Rocuronium + 4.0 mg/kg Sugammadex | Vecuronium + Placebo | Vecuronium + 0.5 mg/kg Sugammadex | Vecuronium + 1.0 mg/kg Sugammadex | Vecuronium + 2.0 mg/kg Sugammadex | Vecuronium + 4.0 mg/kg Sugammadex | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Mean | 41 ± 10 | 44 ± 10 | 49 ± 9 | 45 ± 10 | 41 ± 15 | 49 ± 14 | 49 ± 8 | 46 ± 13 | 52 ± 13 | 44 ± 14 | 46 ± 12 |
| Sex: Female, Male(Participants) | Rocuronium + Placebo | Rocuronium + 0.5 mg/kg Sugammadex | Rocuronium + 1.0 mg/kg Sugammadex | Rocuronium + 2.0 mg/kg Sugammadex | Rocuronium + 4.0 mg/kg Sugammadex | Vecuronium + Placebo | Vecuronium + 0.5 mg/kg Sugammadex | Vecuronium + 1.0 mg/kg Sugammadex | Vecuronium + 2.0 mg/kg Sugammadex | Vecuronium + 4.0 mg/kg Sugammadex | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Female | 5 | 7 | 5 | 5 | 7 | 6 | 5 | 6 | 5 | 3 | 54 |
| Male | 5 | 3 | 5 | 5 | 2 | 4 | 5 | 4 | 4 | 7 | 44 |
| Ethnicity (NIH/OMB)(Participants) | Rocuronium + Placebo | Rocuronium + 0.5 mg/kg Sugammadex | Rocuronium + 1.0 mg/kg Sugammadex | Rocuronium + 2.0 mg/kg Sugammadex | Rocuronium + 4.0 mg/kg Sugammadex | Vecuronium + Placebo | Vecuronium + 0.5 mg/kg Sugammadex | Vecuronium + 1.0 mg/kg Sugammadex | Vecuronium + 2.0 mg/kg Sugammadex | Vecuronium + 4.0 mg/kg Sugammadex | Total |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Hispanic or Latino | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Not Hispanic or Latino | 10 | 10 | 10 | 10 | 9 | 10 | 10 | 10 | 9 | 10 | 98 |
| Unknown or Not Reported | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
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