ClinicalTrials.gg
CompletedNCT03346070Updated Jan 28, 2021Results posted

Efficacy and Safety of Sugammadex Dosed According to Actual Body Weight (ABW) or Ideal Body Weight (IBW) in Reversal of Neuromuscular Blockade (NMB) in Morbidly Obese Participants (MK-8616-146)

A Phase 4 interventional study of Sugammadex 2 mg/kg ABW and Sugammadex 2 mg/kg IBW in Neuromuscular Blockade, sponsored by Merck Sharp & Dohme LLC. Completed at 24 sites in 5 countries. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2021-01-28.

Sponsored by Merck Sharp & Dohme LLC (part of Merck & Co., Inc) · Phase 4, Interventional, and Treatment

Help build ClinicalTrials.gg — short surveys, remote interviews or testing, in your language. Take part →

Phase
Phase 4
Study type
Interventional
Enrollment
207
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The purpose of this trial is to evaluate the safety and efficacy of Sugammadex when administered according to actual body weight (ABW) as compared to ideal body weight (IBW) for the reversal of both moderate and deep neuromuscular blockade (NMB) induced by either Rocuronium or Vecuronium in morbidly obese participants. The primary hypothesis of this investigation is that, compared to obese participants dosed based on IBW, obese participants receiving Sugammadex according to ABW will demonstrate a faster time to recovery to a Train Of Four (TOF) ratio of ≥0.9 (i.e. faster NMB reversal), pooled across NMB depth and type of neuromuscular blocking agent (NMBA; Rocuronium or Vecuronium) administered.

02

Conditions studied

  • Neuromuscular Blockade
03

In context

Lead sponsor

Merck Sharp & Dohme LLC is the lead sponsor of 2,166 studies on the registry; 131 are open to participants now.

Of its 503 completed or terminated interventional studies of FDA-regulated products, 371 (74%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Have ≥40 kg/m² (morbidly obese).
  • Be categorized as (ASA) Physical Status Class 3
  • Have a planned surgical procedure that requires neuromuscular block with either rocuronium or vecuronium.
  • Have a planned surgical procedure (e.g., gastrointestinal, urologic, or laparoscopic procedures) that in the opinion of the investigator does not preclude maintenance of moderate or deep depth of NMB throughout the case (maintained by re-dosing or continuous infusion).
  • Have a planned surgical procedure that would allow objective neuromuscular monitoring techniques to be applied with access to the arm for neuromuscular transmission monitoring.
  • If female, who is not of , be one of the following: 1) (defined as at least 12 months with no menses in women ≥45 years of age; 2) has had a hysterectomy and/or bilateral oophorectomy, bilateral salpingectomy, or bilateral tubal ligation/occlusion at least 6 weeks prior to screening; 3) has a congenital or acquired condition that prevents childbearing; or 4) is undergoing surgical sterilization as the planned surgical procedure associated with participation in this study (e.g., hysterectomy or tubal ligation).
  • If female, who is sexually active and of , agrees to use a medically accepted method of through seven days after receiving protocol-specified medication. Please note the following: 1) Medically accepted methods of contraception include condoms (male or female) with a spermicidal agent, diaphragm or cervical cap with spermicide, medically prescribed intrauterine device (IUD), inert or copper-containing IUD, surgical sterilization (e.g., hysterectomy or tubal ligation); 2) Abstinence (relative to heterosexual activity) can be used as the sole method of contraception if it is consistently employed as the subject's preferred and usual lifestyle and if considered acceptable by local regulatory agencies and Human Subjects Protection Review Boards; 3 Periodic abstinence (e.g., calendar, ovulation, sympto-thermal, post-ovulation methods, etc.) and withdrawal are not acceptable methods of contraception; 4) If a contraceptive method listed above is restricted by local regulations/guidelines, then it does not qualify as an acceptable method of contraception for subjects participating at sites in this country/region.
  • Be able to provide (or the subject's legally authorized representative in accordance with local requirements), written for the trial. The participant or legally authorized representative may also provide consent for Future Biomedical Research.

Exclusion criteria

Exclusion Criteria:

  • Have an actual body weight \<100 kg.
  • Have a pacemaker or automatic implantable cardioverter-defibrillator that precludes the assessment of bradycardia or arrhythmias.
  • Have a medical condition or surgical procedure that precludes reversal of neuromuscular block at the end of surgery.
  • Have neuromuscular disorder(s) that may affect neuromuscular block and/or trial assessments.
  • Are dialysis-dependent or have severe renal insufficiency (defined as estimated of \<30 mL/min.).
  • Have or are suspected of having a personal history or family history (parents, grandparents, or siblings) of malignant hyperthermia.
  • Have or are suspected of having an allergy (e.g., and/or anaphylactic reaction) to study treatments or its/their , to opioids/opiates, muscle relaxants or their excipients, or other medication(s) used during general anesthesia.
  • Have received or are planning to receive toremifene within 24 hours before or within 24 hours after study medication administration.
  • Have any condition that would contraindicate the administration of study medication.
  • Are currently pregnant, attempting to become pregnant, or lactating.
  • Have any condition or situation (e.g., anatomical malformation that complicates intubation) other than the condition being studied that, in the opinion of the investigator, would interfere with the trial evaluations or optimal participation in the trial.
  • Are currently participating in or has participated in an interventional clinical trial with an compound (including any other current or ongoing trial with a Sugammadex treatment arm) or device within 30 days of signing the form of this current trial.
Terms in these criteria, in plain language(12)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

ASA physical status

The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.

Reproductive potential

Able to have children. For women this usually means from the first period until menopause, unless permanently unable to through surgery; for men, unless permanently sterile. Read who the line is about — participants, women, men, or their partners.

Criteria about it usually ask for contraception during the study and for a time after it.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Childbearing potential

Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).

Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Triple (Participant, Investigator, Outcomes assessor)
Enrollment
207 participants (actual)

Study arms

  • Experimental
    Sugammadex 2 mg/kg ABW

    Following administration of NMBA, participants received a single intravenous (i.v.) bolus of Sugammadex at 2 mg/kg as determined utilizing participant ABW. A treatment dose of 2 mg/kg was used for reversal of moderate NMB.

    Drug: Sugammadex 2 mg/kg ABW · Drug: Rocuronium or Vecuronium

  • Experimental
    Sugammadex 2 mg/kg IBW

    Following administration of NMBA, participants received a single i.v. bolus of Sugammadex at 2 mg/kg as determined utilizing participant IBW. A treatment dose of 2 mg/kg was used for reversal of moderate NMB.

    Drug: Sugammadex 2 mg/kg IBW · Drug: Rocuronium or Vecuronium

  • Experimental
    Sugammadex 4 mg/kg ABW

    Following administration of NMBA, participants received a single i.v. bolus of Sugammadex at 4 mg/kg as determined utilizing participant ABW. A treatment dose of 4 mg/kg was used for reversal of deep NMB.

    Drug: Sugammadex 4 mg/kg ABW · Drug: Rocuronium or Vecuronium

  • Experimental
    Sugammadex 4 mg/kg IBW

    Following administration of NMBA, participants received a single i.v. bolus of Sugammadex at 4 mg/kg as determined utilizing participant IBW. A treatment dose of 4 mg/kg was used for reversal of deep NMB.

    Drug: Sugammadex 4 mg/kg IBW · Drug: Rocuronium or Vecuronium

  • Active comparator
    Neostigmine/Glycopyrrolate

    Following administration of NMBA, participants received a single i.v. bolus containing both Neostigmine (50 µg/kg; up to 5 mg maximum dose) and Glycopyrrolate (10 µg/kg; up to 1 mg maximum dose) as determined utilizing participant ABW. Neostigmine/Glycopyrrolate was used for reversal of moderate NMB. Active comparator treatment for reversal for deep NMB was not available.

    Drug: Neostigmine + Glycopyrrolate · Drug: Rocuronium or Vecuronium

Interventions

  • DrugSugammadex 2 mg/kg ABW

    Drug page: Sugammadex

    Following administration of NMBA (Rocuronium or Vecuronium) to achieve moderate NMB, participants received a single i.v. bolus of Sugammadex (2 mg/kg by ABW) for reversal of moderate NMB. Moderate NMB is defined as the reappearance of a second twitch (T2) in response to TOF stimulations.

    Also known as: MK-8616

  • DrugSugammadex 2 mg/kg IBW

    Drug page: Sugammadex

    Following administration of NMBA (Rocuronium or Vecuronium) to achieve moderate NMB, participants received a single i.v. bolus of Sugammadex (2 mg/kg by IBW) for reversal of moderate NMB. Moderate NMB is defined as the reappearance of T2 in response to TOF stimulations.

    Also known as: MK-8616

  • DrugSugammadex 4 mg/kg ABW

    Drug page: Sugammadex

    Following administration of NMBA (Rocuronium or Vecuronium) to achieve deep NMB, participants received a single i.v. bolus of Sugammadex (4 mg/kg by ABW) for reversal of deep NMB. Deep NMB is defined as no response to TOF stimulations (TOF=0) and a detection target of 1-2 post-tetanic counts (PTCs).

    Also known as: MK-8616

  • DrugSugammadex 4 mg/kg IBW

    Drug page: Sugammadex

    Following administration of NMBA (Rocuronium or Vecuronium) to achieve deep NMB, participants will receive a single i.v. bolus of Sugammadex (4 mg/kg by IBW) for reversal of deep NMB. Deep NMB is defined as no response to TOF stimulations (TOF=0) and a detection target of 1-2 post-tetanic counts (PTCs).

    Also known as: MK-8616

  • DrugNeostigmine + Glycopyrrolate

    Drug pages: Neostigmine · Glycopyrrolate

    Following administration of NMBA (Rocuronium or Vecuronium) to achieve moderate NMB, participants received a single i.v. bolus of Neostigmine (50 µg/kg; 5 mg maximum) and Glycopyrrolate (10 µg/kg; 1 mg maximum), dosed according to participant ABW for reversal of moderate NMB. Moderate NMB is defined as the reappearance of T2 in response to TOF stimulations.

  • DrugRocuronium or Vecuronium

    To achieve NMB, participants received steroidal NMBA Rocuronium Bromide or Vecuronium Bromide administered via i.v. infusion and dosed according to participant ABW. NMBAs were concomitant medications used per label as adjunct to general anesthesia.

06

What researchers measure

Primary outcomes

  1. Time to Recovery (TTR) of Participant Train Of Four (TOF) Ratio to ≥0.9: Primary Kaplan-Meier Analysis

    The primary efficacy analysis of TTR of TOF ratio to ≥0.9 was performed by estimating event rates within each treatment group using the Kaplan-Meier method. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.9 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

    Time frame: Up to 76 minutes

  2. Percentage of Participants With Treatment-Emergent Sinus Bradycardia Events

    The percentage of participants experiencing treatment-emergent bradycardia events were identified with continuous electrocardiogram (ECG) monitoring. Treatment-emergent sinus bradycardia is defined as a heart rate \<60 bpm that has also decreased more than 20% compared to participant baseline heart rate value, sustained for at least 1 minute after administration of study intervention. Treatment-emergent sinus bradycardia events may or may not be considered an adverse event (AE), as determined by investigator judgment. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

    Time frame: Up to 35 minutes

  3. Percentage of Participants With Treatment-Emergent Sinus Tachycardia Events

    The percentage of participants experiencing treatment-emergent sinus tachycardia events were identified with continuous ECG monitoring. Treatment-emergent sinus tachycardia is defined as a heart rate ≥100 bpm that has also increased more than 20% compared to participant baseline heart rate value, sustained for at least 1 minute after administration of study intervention. Treatment-emergent sinus tachycardia events may or may not be considered an AE, as determined by investigator judgment. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

    Time frame: Up to 35 minutes

  4. Percentage of Participants With Other Treatment-Emergent Cardiac Arrhythmia Events

    The percentage of participants experiencing other treatment-emergent cardiac arrhythmia events were identified with continuous ECG monitoring. Other treatment-emergent cardiac arrhythmias are defined as new or worsening arrhythmias (e.g., atrial fibrillation, atrial tachyarrhythmia, ventricular fibrillation, or ventricular tachyarrhythmia), sustained for at least 1 minute after administration of study intervention. Worsening arrhythmia events may or may not be considered an AE, as determined by investigator judgment. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

    Time frame: Up to 35 minutes

  5. Percentage of Participants Experiencing an Adverse Event (AE) After Administration of Study Intervention

    The percentage of participants experiencing an AE following administration of study intervention was monitored. An AE is any unfavorable and unintended medical occurrence, symptom, or disease witnessed in a participant, regardless of whether or not a causal relationship with the study treatment can be demonstrated. Further, any worsening (i.e. any clinically significant adverse change in frequency and/or intensity) of a pre-existing condition that is temporally associated with the use of the study treatment is also considered an AE. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

    Time frame: Up to 7 days

  6. Percentage of Participants Experiencing a Serious Adverse Event (SAE) After Administration of Study Intervention

    The percentage of participants experiencing an SAE following administration of study intervention was monitored. An SAE is an adverse event that: results in death; is life threatening; results in persistent or significant disability or incapacity; results in or prolongs a hospitalization; is a congenital anomaly or birth defect; is a cancer; or may jeopardize the participant, potentially requiring medical or surgical intervention. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

    Time frame: Up to 7 days

  7. Percentage of Participants Experiencing an Event of Clinical Interest (ECI) After Administration of Study Intervention

    The percentage of participants experiencing an ECI following administration of study intervention was monitored. ECIs are a discrete set of both AEs and SAEs, specifically designated as such for the trial. For the purposes of this investigation, ECIs included 1) drug-induced liver injury; 2) clinically-relevant arrhythmias, inclusive of bradycardia and tachycardia defined as events necessitating intervention, as determined by investigator judgment; and 3) instances of hypersensitivity and/or anaphylaxis adjudicated by an external expert Adjudication Committee. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

    Time frame: Up to 7 days

Secondary outcomes

  1. Percentage of Participants With Prolonged (>10 Minutes) Time to Recovery (TTR) of the Train Of Four (TOF) Ratio to ≥0.9

    Following administration of study intervention, the percentage of participants experiencing prolonged (\>10 minutes) recovery to a TOF ratio ≥0.9 was calculated. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.9 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

    Time frame: Up to 76 minutes

  2. Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.9: Secondary Geometric Mean Analysis

    The secondary efficacy analysis of TTR of participant TOF ratio to ≥0.9 was performed by estimating the geometric mean of TTR within each treatment group. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.9 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

    Time frame: Up to 76 minutes

  3. Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.8: Geometric Mean Analysis

    The efficacy analysis of TTR of participant TOF ratio to ≥0.8 was performed by estimating the geometric mean of TTR within each treatment group. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.8 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

    Time frame: Up to 69 minutes

  4. Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.7: Geometric Mean Analysis

    The efficacy analysis of TTR of participant TOF ratio to ≥0.7 was performed by estimating the geometric mean of TTR within each treatment group. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.7 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

    Time frame: Up to 61 minutes

07

Results

Posted Dec 23, 2019

Participant flow

Participant flow — Overall Study
MilestoneSugammadex 2 mg/kg Actual Body Weight (ABW)Sugammadex 4 mg/kg ABWSugammadex 2 mg/kg Ideal Body Weight (IBW)Sugammadex 4 mg/kg IBWNeostigmine/Glycopyrrolate
Started4141414242
Treated3838383638
Completed3837373637
Not completed34465
Withdrew: Death00001
Withdrew: Lost to follow-up01200
Withdrew: Physician decision00011
Withdrew: Withdrawal by subject10010
Withdrew: Study medication not received as planned23232
Withdrew: Screen failure00011

Outcome measures

PrimaryTime to Recovery (TTR) of Participant Train Of Four (TOF) Ratio to ≥0.9: Primary Kaplan-Meier Analysis

The primary efficacy analysis of TTR of TOF ratio to ≥0.9 was performed by estimating event rates within each treatment group using the Kaplan-Meier method. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.9 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

Time frame:
Up to 76 minutes
Reported as:
Median · Minutes
Time to Recovery (TTR) of Participant Train Of Four (TOF) Ratio to ≥0.9: Primary Kaplan-Meier Analysis
MinutesSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)Sugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWSugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)Neostigmine/Glycopyrrolate
Time to Recovery (TTR) of Participant Train Of Four (TOF) Ratio to ≥0.9: Primary Kaplan-Meier Analysis1.7 (1.5 to 2.1)1.8 (1.5 to 2.1)1.8 (1.6 to 2.1)3.4 (2.2 to 4.4)3.3 (2.4 to 4.2)3.3 (2.6 to 4.1)34.5 (27.0 to 67.4)
Statistical analysis
  • Sugammadex 2 mg/kg ABW vs Sugammadex 2 mg/kg IBW · Log Rank · p = 0.0075 · Hazard ratio (hr): 1.92 · 95% CI 1.18 to 3.10Cox regression model
  • Sugammadex 2 mg/kg ABW vs Neostigmine/Glycopyrrolate · Log Rank · p = <0.0001 · Hazard ratio (hr): 25.90 · 95% CI 9.72 to 69.03Cox regression model
  • Sugammadex 2 mg/kg IBW vs Neostigmine/Glycopyrrolate · Log Rank · p = <0.0001 · Hazard ratio (hr): 61.40 · 95% CI 14.13 to 266.77Cox regression model
  • Sugammadex 4 mg/kg ABW vs Sugammadex 4 mg/kg IBW · Log Rank · p = 0.0005 · Hazard ratio (hr): 2.38 · 95% CI 1.44 to 3.93Cox regression model
  • Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW) vs Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW) · Log Rank · p = <0.0001 · Hazard ratio (hr): 2.13 · 95% CI 1.50 to 3.01Cox regression model
PrimaryPercentage of Participants With Treatment-Emergent Sinus Bradycardia Events

The percentage of participants experiencing treatment-emergent bradycardia events were identified with continuous electrocardiogram (ECG) monitoring. Treatment-emergent sinus bradycardia is defined as a heart rate \<60 bpm that has also decreased more than 20% compared to participant baseline heart rate value, sustained for at least 1 minute after administration of study intervention. Treatment-emergent sinus bradycardia events may or may not be considered an adverse event (AE), as determined by investigator judgment. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

Time frame:
Up to 35 minutes
Reported as:
Number · Percentage of participants
Percentage of Participants With Treatment-Emergent Sinus Bradycardia Events
Percentage of participantsSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)Sugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWSugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)Neostigmine/Glycopyrrolate
Percentage of Participants With Treatment-Emergent Sinus Bradycardia Events5.35.35.32.65.64.12.6
Statistical analysis
  • Sugammadex 2 mg/kg ABW vs Sugammadex 2 mg/kg IBW · Miettinen & Nurminen method · p = 0.602 · Difference in percentage: 2.3 · 95% CI -9.6 to 15.0
  • Sugammadex 4 mg/kg ABW vs Sugammadex 4 mg/kg IBW · Miettinen & Nurminen method · p = 0.969 · Difference in percentage: 0.2 · 95% CI -13.4 to 13.5
  • Sugammadex 2 mg/kg ABW vs Neostigmine/Glycopyrrolate · Miettinen & Nurminen method · p = 0.567 · Difference in percentage: 2.6 · 95% CI -8.7 to 15.0
  • Sugammadex 4 mg/kg ABW vs Neostigmine/Glycopyrrolate · Miettinen & Nurminen method · p = 0.571 · Difference in percentage: 2.6 · 95% CI -8.8 to 15.0
  • Sugammadex 2 mg/kg IBW vs Neostigmine/Glycopyrrolate · Miettinen & Nurminen method · p = 0.950 · Difference in percentage: -0.2 · 95% CI -11.6 to 10.9
  • Sugammadex 4 mg/kg IBW vs Neostigmine/Glycopyrrolate · Miettinen & Nurminen method · p = 0.528 · Difference in percentage: 2.9 · 95% CI -8.4 to 15.9
  • Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW) vs Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW) · Miettinen & Nurminen method · p = 0.709 · Difference in percentage: 1.3 · 95% CI -6.8 to 9.6
PrimaryPercentage of Participants With Treatment-Emergent Sinus Tachycardia Events

The percentage of participants experiencing treatment-emergent sinus tachycardia events were identified with continuous ECG monitoring. Treatment-emergent sinus tachycardia is defined as a heart rate ≥100 bpm that has also increased more than 20% compared to participant baseline heart rate value, sustained for at least 1 minute after administration of study intervention. Treatment-emergent sinus tachycardia events may or may not be considered an AE, as determined by investigator judgment. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

Time frame:
Up to 35 minutes
Reported as:
Number · Percentage of participants
Percentage of Participants With Treatment-Emergent Sinus Tachycardia Events
Percentage of participantsSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)Sugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWSugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)Neostigmine/Glycopyrrolate
Percentage of Participants With Treatment-Emergent Sinus Tachycardia Events10.513.211.87.92.85.47.9
Statistical analysis
  • Sugammadex 2 mg/kg ABW vs Sugammadex 2 mg/kg IBW · Miettinen & Nurminen method · p = 0.738 · Difference in percentage: 2.2 · 95% CI -12.3 to 17.4
  • Sugammadex 4 mg/kg ABW vs Sugammadex 4 mg/kg IBW · Miettinen & Nurminen method · p = 0.077 · Difference in percentage: 11.1 · 95% CI -1.7 to 26.3
  • Sugammadex 2 mg/kg ABW vs Neostigmine/Glycopyrrolate · Miettinen & Nurminen method · p = 0.717 · Difference in percentage: 2.4 · 95% CI -12.0 to 16.4
  • Sugammadex 4 mg/kg ABW vs Neostigmine/Glycopyrrolate · Miettinen & Nurminen method · p = 0.486 · Difference in percentage: 5.0 · 95% CI -9.9 to 19.7
  • Sugammadex 2 mg/kg IBW vs Neostigmine/Glycopyrrolate · Miettinen & Nurminen method · p = 0.849 · Difference in percentage: -1.2 · 95% CI -16.2 to 12.4
  • Sugammadex 4 mg/kg IBW vs Neostigmine/Glycopyrrolate · Miettinen & Nurminen method · p = 0.339 · Difference in percentage: -4.9 · 95% CI -18.2 to 6.7
  • Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW) vs Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW) · Miettinen & Nurminen method · p = 0.149 · Difference in percentage: 6.6 · 95% CI -2.6 to 16.8
PrimaryPercentage of Participants With Other Treatment-Emergent Cardiac Arrhythmia Events

The percentage of participants experiencing other treatment-emergent cardiac arrhythmia events were identified with continuous ECG monitoring. Other treatment-emergent cardiac arrhythmias are defined as new or worsening arrhythmias (e.g., atrial fibrillation, atrial tachyarrhythmia, ventricular fibrillation, or ventricular tachyarrhythmia), sustained for at least 1 minute after administration of study intervention. Worsening arrhythmia events may or may not be considered an AE, as determined by investigator judgment. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

Time frame:
Up to 35 minutes
Reported as:
Number · Percentage of participants
Percentage of Participants With Other Treatment-Emergent Cardiac Arrhythmia Events
Percentage of participantsSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)Sugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWSugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)Neostigmine/Glycopyrrolate
Percentage of Participants With Other Treatment-Emergent Cardiac Arrhythmia Events0.00.00.02.60.01.42.6
Statistical analysis
  • Sugammadex 2 mg/kg ABW vs Sugammadex 2 mg/kg IBW · Miettinen & Nurminen method · p = 0.299 · Difference in percentage: -2.7 · 95% CI -13.9 to 6.7
  • Sugammadex 4 mg/kg ABW vs Sugammadex 4 mg/kg IBW · Miettinen & Nurminen method · p = >0.999 · Difference in percentage: 0.0 · 95% CI -9.9 to 9.4
  • Sugammadex 2 mg/kg ABW vs Neostigmine/Glycopyrrolate · Miettinen & Nurminen method · p = 0.326 · Difference in percentage: -2.6 · 95% CI -13.7 to 7.0
  • Sugammadex 4 mg/kg ABW vs Neostigmine/Glycopyrrolate · Miettinen & Nurminen method · p = 0.335 · Difference in percentage: -2.5 · 95% CI -13.6 to 7.1
  • Sugammadex 2 mg/kg IBW vs Neostigmine/Glycopyrrolate · Miettinen & Nurminen method · p = 0.935 · Difference in percentage: 0.3 · 95% CI -11.1 to 11.9
  • Sugammadex 4 mg/kg IBW vs Neostigmine/Glycopyrrolate · Miettinen & Nurminen method · p = 0.326 · Difference in percentage: -2.7 · 95% CI -13.8 to 7.3
  • Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW) vs Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW) · Miettinen & Nurminen method · p = 0.299 · Difference in percentage: -1.4 · 95% CI -7.5 to 3.5
PrimaryPercentage of Participants Experiencing an Adverse Event (AE) After Administration of Study Intervention

The percentage of participants experiencing an AE following administration of study intervention was monitored. An AE is any unfavorable and unintended medical occurrence, symptom, or disease witnessed in a participant, regardless of whether or not a causal relationship with the study treatment can be demonstrated. Further, any worsening (i.e. any clinically significant adverse change in frequency and/or intensity) of a pre-existing condition that is temporally associated with the use of the study treatment is also considered an AE. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

Time frame:
Up to 7 days
Reported as:
Number · Percentage of participants
Percentage of Participants Experiencing an Adverse Event (AE) After Administration of Study Intervention
Percentage of participantsSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)Sugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWSugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)Neostigmine/Glycopyrrolate
Percentage of Participants Experiencing an Adverse Event (AE) After Administration of Study Intervention94.786.890.894.791.793.289.5
Statistical analysis
  • Sugammadex 2 mg/kg ABW vs Sugammadex 2 mg/kg IBW · Difference in percentage: 0.1 · 95% CI -12.7 to 13.1Miettinen and Nurminen method
  • Sugammadex 4 mg/kg ABW vs Sugammadex 4 mg/kg IBW · Difference in percentage: -3.6 · 95% CI -19.6 to 12.2Miettinen and Nurminen method
  • Sugammadex 2 mg/kg ABW vs Neostigmine/Glycopyrrolate · Difference in percentage: 5.1 · 95% CI -8.1 to 19.7Miettinen and Nurminen method
  • Sugammadex 4 mg/kg ABW vs Neostigmine/Glycopyrrolate · Difference in percentage: -2.6 · 95% CI -18.0 to 13.1Miettinen and Nurminen method
  • Sugammadex 2 mg/kg IBW vs Neostigmine/Glycopyrrolate · Difference in percentage: 4.4 · 95% CI -9.6 to 19.2Miettinen and Nurminen method
  • Sugammadex 4 mg/kg IBW vs Neostigmine/Glycopyrrolate · Difference in percentage: 2.2 · 95% CI -12.5 to 17.0Miettinen and Nurminen method
  • Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW) vs Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW) · Difference in percentage: -1.8 · 95% CI -11.4 to 7.8Miettinen and Nurminen method
PrimaryPercentage of Participants Experiencing a Serious Adverse Event (SAE) After Administration of Study Intervention

The percentage of participants experiencing an SAE following administration of study intervention was monitored. An SAE is an adverse event that: results in death; is life threatening; results in persistent or significant disability or incapacity; results in or prolongs a hospitalization; is a congenital anomaly or birth defect; is a cancer; or may jeopardize the participant, potentially requiring medical or surgical intervention. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

Time frame:
Up to 7 days
Reported as:
Number · Percentage of participants
Percentage of Participants Experiencing a Serious Adverse Event (SAE) After Administration of Study Intervention
Percentage of participantsSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)Sugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWSugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)Neostigmine/Glycopyrrolate
Percentage of Participants Experiencing a Serious Adverse Event (SAE) After Administration of Study Intervention2.60.01.35.38.36.87.9
Statistical analysis
  • Sugammadex 2 mg/kg ABW vs Sugammadex 2 mg/kg IBW · Difference in percentage: -2.6 · 95% CI -15.2 to 9.1Miettinen and Nurminen method
  • Sugammadex 4 mg/kg ABW vs Sugammadex 4 mg/kg IBW · Difference in percentage: -8.5 · 95% CI -22.3 to 1.3Miettinen and Nurminen method
  • Sugammadex 2 mg/kg ABW vs Neostigmine/Glycopyrrolate · Difference in percentage: -5.3 · 95% CI -18.8 to 6.8Miettinen and Nurminen method
  • Sugammadex 4 mg/kg ABW vs Neostigmine/Glycopyrrolate · Difference in percentage: -8.0 · 95% CI -21.2 to 1.8Miettinen and Nurminen method
  • Sugammadex 2 mg/kg IBW vs Neostigmine/Glycopyrrolate · Difference in percentage: -2.9 · 95% CI -17.0 to 10.5Miettinen and Nurminen method
  • Sugammadex 4 mg/kg IBW vs Neostigmine/Glycopyrrolate · Difference in percentage: 0.5 · 95% CI -14.0 to 15.5Miettinen and Nurminen method
  • Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW) vs Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW) · Difference in percentage: -5.5 · 95% CI -13.9 to 1.2Miettinen and Nurminen method
PrimaryPercentage of Participants Experiencing an Event of Clinical Interest (ECI) After Administration of Study Intervention

The percentage of participants experiencing an ECI following administration of study intervention was monitored. ECIs are a discrete set of both AEs and SAEs, specifically designated as such for the trial. For the purposes of this investigation, ECIs included 1) drug-induced liver injury; 2) clinically-relevant arrhythmias, inclusive of bradycardia and tachycardia defined as events necessitating intervention, as determined by investigator judgment; and 3) instances of hypersensitivity and/or anaphylaxis adjudicated by an external expert Adjudication Committee. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

Time frame:
Up to 7 days
Reported as:
Number · Percentage of participants
Percentage of Participants Experiencing an Event of Clinical Interest (ECI) After Administration of Study Intervention
Percentage of participantsSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)Sugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWSugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)Neostigmine/Glycopyrrolate
Percentage of Participants Experiencing an Event of Clinical Interest (ECI) After Administration of Study Intervention0.02.61.32.62.82.72.6
Statistical analysis
  • Sugammadex 2 mg/kg ABW vs Sugammadex 2 mg/kg IBW · Difference in percentage: -2.4 · 95% CI -13.4 to 7.3Miettinen and Nurminen method
  • Sugammadex 4 mg/kg ABW vs Sugammadex 4 mg/kg IBW · Difference in percentage: -0.4 · 95% CI -12.3 to 10.8Miettinen and Nurminen method
  • Sugammadex 2 mg/kg ABW vs Neostigmine/Glycopyrrolate · Difference in percentage: -2.6 · 95% CI -13.7 to 7.0Miettinen and Nurminen method
  • Sugammadex 4 mg/kg ABW vs Neostigmine/Glycopyrrolate · Difference in percentage: 0.2 · 95% CI -11.2 to 11.7Miettinen and Nurminen method
  • Sugammadex 2 mg/kg IBW vs Neostigmine/Glycopyrrolate · Difference in percentage: -0.2 · 95% CI -11.5 to 11.0Miettinen and Nurminen method
  • Sugammadex 4 mg/kg IBW vs Neostigmine/Glycopyrrolate · Difference in percentage: 0.2 · 95% CI -11.0 to 12.0Miettinen and Nurminen method
SecondaryPercentage of Participants With Prolonged (>10 Minutes) Time to Recovery (TTR) of the Train Of Four (TOF) Ratio to ≥0.9

Following administration of study intervention, the percentage of participants experiencing prolonged (\>10 minutes) recovery to a TOF ratio ≥0.9 was calculated. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.9 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

Time frame:
Up to 76 minutes
Reported as:
Number · Percentage of participants
Percentage of Participants With Prolonged (>10 Minutes) Time to Recovery (TTR) of the Train Of Four (TOF) Ratio to ≥0.9
Percentage of participantsSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)Sugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWSugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)Neostigmine/Glycopyrrolate
Percentage of Participants With Prolonged (>10 Minutes) Time to Recovery (TTR) of the Train Of Four (TOF) Ratio to ≥0.97.92.75.35.40.02.784.2
Statistical analysis
  • Sugammadex 2 mg/kg ABW vs Sugammadex 2 mg/kg IBW · Difference in percentage: 3.0 · 95% CI -10.8 to 16.9Miettinen and Nurminen method
  • Sugammadex 2 mg/kg ABW vs Neostigmine/Glycopyrrolate · Difference in percentage: -76.1 · 95% CI -87.2 to -57.6Miettinen and Nurminen method
  • Sugammadex 2 mg/kg IBW vs Neostigmine/Glycopyrrolate · Difference in percentage: -78.7 · 95% CI -88.8 to -61.1Miettinen and Nurminen method
  • Sugammadex 4 mg/kg ABW vs Sugammadex 4 mg/kg IBW · Difference in percentage: 2.8 · 95% CI -7.2 to 14.2Miettinen and Nurminen method
  • Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW) vs Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW) · Difference in percentage: 2.9 · 95% CI -4.8 to 11.0Miettinen and Nurminen method
SecondaryTime to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.9: Secondary Geometric Mean Analysis

The secondary efficacy analysis of TTR of participant TOF ratio to ≥0.9 was performed by estimating the geometric mean of TTR within each treatment group. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.9 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

Time frame:
Up to 76 minutes
Reported as:
Geometric mean · Minutes
Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.9: Secondary Geometric Mean Analysis
MinutesSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)Sugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWSugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)Neostigmine/Glycopyrrolate
Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.9: Secondary Geometric Mean Analysis2.0 (1.7 to 2.5)1.9 (1.5 to 2.3)2.0 (1.7 to 2.3)3.2 (2.6 to 3.9)3.5 (2.9 to 4.3)3.3 (2.9 to 3.8)23.1 (18.3 to 29.2)
Statistical analysis
  • Sugammadex 2 mg/kg ABW vs Sugammadex 2 mg/kg IBW · Ratio of geometric means: 0.64 · 95% CI 0.48 to 0.86Log transformation and t-distribution
  • Sugammadex 2 mg/kg ABW vs Neostigmine/Glycopyrrolate · Ratio of geometric means: 0.09 · 95% CI 0.06 to 0.12Log transformation and t-distribution
  • Sugammadex 2 mg/kg IBW vs Neostigmine/Glycopyrrolate · Ratio of geometric means: 0.14 · 95% CI 0.10 to 0.19Log transformation and t-distribution
  • Sugammadex 4 mg/kg ABW vs Sugammadex 4 mg/kg IBW · Ratio of geometric means: 0.54 · 95% CI 0.40 to 0.71Log transformation and t-distribution
  • Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW) vs Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW) · Ratio of geometric means: 0.59 · 95% CI 0.48 to 0.72Log transformation and t-distribution
SecondaryTime to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.8: Geometric Mean Analysis

The efficacy analysis of TTR of participant TOF ratio to ≥0.8 was performed by estimating the geometric mean of TTR within each treatment group. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.8 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

Time frame:
Up to 69 minutes
Reported as:
Geometric mean · Minutes
Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.8: Geometric Mean Analysis
MinutesSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)Sugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWSugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)Neostigmine/Glycopyrrolate
Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.8: Geometric Mean Analysis1.6 (1.3 to 1.8)1.5 (1.2 to 1.7)1.5 (1.3 to 1.7)2.5 (2.1 to 2.9)2.6 (2.1 to 3.1)2.5 (2.2 to 2.8)16.6 (12.8 to 21.7)
Statistical analysis
  • Sugammadex 2 mg/kg ABW vs Sugammadex 2 mg/kg IBW · Ratio of geometric means: 0.63 · 95% CI 0.50 to 0.80Log transformation and t-distribution
  • Sugammadex 2 mg/kg ABW vs Neostigmine/Glycopyrrolate · Ratio of geometric means: 0.09 · 95% CI 0.07 to 0.13Log transformation and t-distribution
  • Sugammadex 2 mg/kg IBW vs Neostigmine/Glycopyrrolate · Ratio of geometric means: 0.15 · 95% CI 0.11 to 0.20Log transformation and t-distribution
  • Sugammadex 4 mg/kg ABW vs Sugammadex 4 mg/kg IBW · Ratio of geometric means: 0.56 · 95% CI 0.44 to 0.72Log transformation and t-distribution
  • Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW) vs Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW) · Ratio of geometric means: 0.60 · 95% CI 0.51 to 0.70Log transformation and t-distribution
SecondaryTime to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.7: Geometric Mean Analysis

The efficacy analysis of TTR of participant TOF ratio to ≥0.7 was performed by estimating the geometric mean of TTR within each treatment group. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.7 indicates faster recovery from NMB. As specified by the protocol, analyses for this outcome measure were conducted in participants pooled by dosing method across depth of NMB (Sugammadex ABW \[2 mg/kg ABW plus 4 mg/kg ABW\] and Sugammadex IBW \[2 mg/kg IBW plus 4 mg/kg IBW\]) as well as in all randomized treatment arms separated by depth of NMB (Sugammadex 2 mg/kg ABW, Sugammadex 4 mg/kg ABW, Sugammadex 2 mg/kg IBW, and Sugammadex 4 mg/kg IBW).

Time frame:
Up to 61 minutes
Reported as:
Geometric mean · Minutes
Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.7: Geometric Mean Analysis
MinutesSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW)Sugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWSugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW)Neostigmine/Glycopyrrolate
Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.7: Geometric Mean Analysis1.4 (1.2 to 1.6)1.3 (1.2 to 1.6)1.4 (1.2 to 1.5)2.1 (1.8 to 2.4)2.0 (1.7 to 2.5)2.1 (1.8 to 2.3)10.9 (8.1 to 14.6)
Statistical analysis
  • Sugammadex 2 mg/kg ABW vs Sugammadex 2 mg/kg IBW · Ratio of geometric means: 0.66 · 95% CI 0.54 to 0.81Log transformation and t-distribution
  • Sugammadex 2 mg/kg ABW vs Neostigmine/Glycopyrrolate · Ratio of geometric means: 0.13 · 95% CI 0.09 to 0.17Log transformation and t-distribution
  • Sugammadex 2 mg/kg IBW vs Neostigmine/Glycopyrrolate · Ratio of geometric means: 0.19 · 95% CI 0.14 to 0.27Log transformation and t-distribution
  • Sugammadex 4 mg/kg ABW vs Sugammadex 4 mg/kg IBW · Ratio of geometric means: 0.66 · 95% CI 0.52 to 0.83Log transformation and t-distribution
  • Sugammadex ABW (2 mg/kg ABW Plus 4 mg/kg ABW) vs Sugammadex IBW (2 mg/kg IBW Plus 4 mg/kg IBW) · Ratio of geometric means: 0.66 · 95% CI 0.57 to 0.77Log transformation and t-distribution

Adverse events

Collected over Up to 14 days. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Sugammadex 2 mg/kg ABW0/38 (0%)1/38 (2.6%)36/38 (94.7%)
Sugammadex 4 mg/kg ABW0/38 (0%)0/38 (0%)32/38 (84.2%)
Sugammadex 2 mg/kg IBW0/38 (0%)3/38 (7.9%)36/38 (94.7%)
Sugammadex 4 mg/kg IBW0/36 (0%)4/36 (11.1%)32/36 (88.9%)
Neostigmine + Glycopyrrolate1/38 (2.6%)3/38 (7.9%)32/38 (84.2%)
Most frequent serious events
Showing 10 of 11
Most frequent serious events
EventSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWNeostigmine + Glycopyrrolate
Impaired healingGeneral disorders0/380/380/381/360/38
PneumoniaInfections and infestations0/380/381/381/360/38
Postoperative wound complicationInjury, poisoning and procedural complications0/380/380/381/360/38
Borderline ovarian tumourNeoplasms benign, malignant and unspecified (incl cysts and polyps)0/380/380/381/360/38
Cardiovascular insufficiencyCardiac disorders0/380/380/380/361/38
Myocardial infarctionCardiac disorders0/380/380/380/361/38
TachyarrhythmiaCardiac disorders0/380/381/380/360/38
Abdominal painGastrointestinal disorders0/380/380/380/361/38
Device related infectionInfections and infestations0/380/381/380/360/38
Postoperative wound infectionInfections and infestations1/380/380/380/360/38
Most frequent other events
Showing 10 of 35
Most frequent other events
EventSugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWNeostigmine + Glycopyrrolate
Procedural painInjury, poisoning and procedural complications28/3823/3828/3827/3624/38
NauseaGastrointestinal disorders6/389/3810/386/367/38
Procedural nauseaInjury, poisoning and procedural complications9/388/384/384/365/38
Incision site painInjury, poisoning and procedural complications6/381/384/382/363/38
ConstipationGastrointestinal disorders4/381/385/384/362/38
HyperglycaemiaMetabolism and nutrition disorders2/382/385/381/362/38
TachycardiaCardiac disorders2/384/383/382/361/38
BradycardiaCardiac disorders1/381/381/383/361/38
Sinus tachycardiaCardiac disorders1/380/383/381/361/38
Short-bowel syndromeGastrointestinal disorders1/381/383/380/361/38

Baseline characteristics

Age, Continuous
Age, Continuous(Years)Sugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWNeostigmine/GlycopyrrolateTotal
Mean47.7 ± 14.446.4 ± 11.247.6 ± 14.549.2 ± 11.747.7 ± 13.347.7 ± 13.0
Sex: Female, Male
Sex: Female, Male(Participants)Sugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWNeostigmine/GlycopyrrolateTotal
Female3424303229149
Male71711101358
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Sugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWNeostigmine/GlycopyrrolateTotal
Hispanic or Latino1415213
Not Hispanic or Latino3837403739191
Unknown or Not Reported200013
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Sugammadex 2 mg/kg ABWSugammadex 4 mg/kg ABWSugammadex 2 mg/kg IBWSugammadex 4 mg/kg IBWNeostigmine/GlycopyrrolateTotal
American Indian or Alaska Native000000
Asian000000
Native Hawaiian or Other Pacific Islander000101
Black or African American2243314
White3939373838191
More than one race000011
Unknown or Not Reported000000
08

Study locations

24 sites
  • University California / Davis ( Site 2001)
    Sacramento, California 95817, United States
  • Jackson Memorial Hospital/University of Miami ( Site 2007)
    Miami, Florida 33136, United States
  • University of Kansas Medical Center ( Site 2049)
    Kansas City, Kansas 66160, United States
  • William Beaumont Hospital - Royal Oak ( Site 2033)
    Royal Oak, Michigan 48073, United States
  • University Hospital- Columbia MO ( Site 2060)
    Columbia, Missouri 65212, United States
  • Robert Wood Johnson University Hospital ( Site 2037)
    New Brunswick, New Jersey 08901, United States
  • Mission Hospital - St. Joseph ( Site 2015)
    Asheville, North Carolina 28801, United States
  • Cleveland Clinic Foundation ( Site 2031)
    Cleveland, Ohio 44195, United States
  • Temple University Hospital ( Site 2004)
    Philadelphia, Pennsylvania 19140, United States
  • Vanderbilt University Medical Center ( Site 2032)
    Nashville, Tennessee 37232, United States
  • Hermann Drive Surgical Center ( Site 2020)
    Houston, Texas 77004, United States
  • Hermann Drive Surgical Center ( Site 2059)
    Houston, Texas 77004, United States
  • Zablocki VA Medical Center ( Site 2011)
    Milwaukee, Wisconsin 53295, United States
  • Sozialmedizinisches Zentrum Ost - Donauspital ( Site 2150)
    Wien, 1220, Austria
  • Universitaire Ziekenhuis Antwerpen - UZA ( Site 2200)
    Edegem, 2650, Belgium
  • Bispebjerg og Frederiksberg Hospital ( Site 2250)
    Copenhagen NV, 2400, Denmark
  • Rigshospitalet ( Site 2253)
    Copenhagen, 2100, Denmark
  • Johanniter Krankenhaus Bonn ( Site 2353)
    Bonn, 53113, Germany
  • Diakovere Annastift gGmbH ( Site 2355)
    Hannover, 30625, Germany
  • Universitatsklinikum Giessen und Marburg GmbH ( Site 2356)
    Marburg, 35043, Germany
  • Klinikum Rechts der Isar Technische Universitaet Muenchen ( Site 2350)
    Muenchen, 81675, Germany
  • St. Franziskus-Hospital ( Site 2354)
    Muenster, 48145, Germany
  • Klinikum am Steinenberg Reutlingen ( Site 2352)
    Reutlingen, 72764, Germany
  • Josephs-Hospitals Warendorf ( Site 2351)
    Warendorf, 48231, Germany
09

References and documents

Publications

  • Mostoller K, Wrishko R, Maganti L, Herring WJ, van Zutphen-van Geffen M. Pharmacokinetics of Sugammadex Dosed by Actual and Ideal Body Weight in Patients With Morbid Obesity Undergoing Surgery. Clin Transl Sci. 2021 Mar;14(2):737-744. doi: 10.1111/cts.12941. Epub 2020 Dec 16. PubMed 33278332 ↗
  • Horrow JC, Li W, Blobner M, Lombard J, Speek M, DeAngelis M, Herring WJ. Actual versus ideal body weight dosing of sugammadex in morbidly obese patients offers faster reversal of rocuronium- or vecuronium-induced deep or moderate neuromuscular block: a randomized clinical trial. BMC Anesthesiol. 2021 Feb 27;21(1):62. doi: 10.1186/s12871-021-01278-w. PubMed 33639839 ↗

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Yes — http://engagezone.msd.com/doc/ProcedureAccessClinicalTrialData.pdf

Data sharing details ↗ · engagezone.msd.com

10

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Jan 2018 to primary completion in Jan 2019, 12 months.

Results were first posted in Dec 2019, 10 months after primary completion.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 15, 2017
First posted
Nov 17, 2017
StartActual
Jan 1, 2018
Primary completionActual
Jan 29, 2019
CompletionActual
Jan 29, 2019
Results first posted
Dec 23, 2019
Last update
Jan 28, 2021
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jan 28, 2021, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03346070
Responsible party
Sponsor
First posted
Nov 17, 2017
Start date
Jan 1, 2018
Primary completion
Jan 29, 2019
Completion
Jan 29, 2019
Results posted
Dec 23, 2019
Last update
Jan 28, 2021

Study contacts

Medical Director
study director · Merck Sharp & Dohme LLC

Oversight

Data monitoring committee
No
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Jan 2021. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Studies of the drug tested here: Sugammadex

Start the discussion