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Effect of reversing muscle relaxation with sugammadex compared with usual care on bleeding risk in patients on blood thinners undergoing major joint surgery

A randomized, controlled, parallel-group, double-blind trial of sugammadex or usual care (neostigmine or spontaneous recovery) for reversal of rocuronium- or vecuronium-induced neuromuscular blockade in patients receiving thromboprophylaxis and undergoing hip fracture surgery or joint (hip/knee) replacement. (Protocol No. P07038) - Reversal of nmb with sugammadex or usual care in hip fracture surgery or joint (hip/knee)replacement

Status
Active, not recruiting
Phases
Unknown
Study type
Interventional
Source
EU CTR
Registry ID
EUCTR2011-001201-27-DE
Enrollment
860
Registered
2011-08-08
Start date
2011-11-07
Completion date
Unknown
Last updated
2013-01-07

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Interventions

Trade Name: Bridion Pharmaceutical Form: Solution for injection INN or Proposed INN: sugammadex CAS Number: 343306-79-6 Current Sponsor code: SCH 900616, Org 25969 Concentration unit: mg/ml milligram(

Sponsors

Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., USA
Lead Sponsor

Eligibility

Sex/Gender
All

Inclusion criteria

Inclusion criteria: 1. Each patient must be willing and able to provide written informed consent for the trial. 2. Each patient must be =18 years of age. A patient may be of either sex, any race/ethnicity. 3. Each patient must be ASA (American Society of Anesthesiologists) Class 1 or 2 or 3. 4. Each patient must be scheduled for a surgical procedure of hip fracture surgery or joint (hip or knee) replacement surgery under general anesthesia including the use of rocuronium or vecuronium for neuromuscular blockade with/without endotracheal intubation and with accessibility for blood draws as specified for the duration of the planned procedure. 5. At screening, patients must be: a. Currently receiving ongoing thromboprophylactic therapy with LMWH or UFH; or b. Planned to initiate thromboprophylactic therapy with LMWH or UFH prior to or during surgery (ie, prior to administration of study medication); or c. Currently receiving thromboprophylactic therapy with a vitamin K antagonist (or other thromboprophylactic agent) which has been temporarily substituted with peri-operative LMWH or UFH; and/or d. Currently receiving ongoing thromboprophylaxis with low-dose aspirin or other antiplatelet therapy (eg, clopidogrel, ticlopidine, dipyridamole); Ongoing therapy is defined as therapy which has not been discontinued in anticipation of surgery; brief, temporary (ie, less than 2 days prior to surgery) interruption of antiplatelet therapy, such as for the purposes of preoperative fasting, does not constitute discontinuation of therapy. 6. Locally-obtained platelet count screening value (and central laboratory value, if results already received by investigator) must be above the lower limit of normal range. 7. Must be an appropriate candidate for rapid reversal of neuromuscular blockade (eg, planned extubation in operating room). 8. Each patient must be able to adhere to visit schedules. 9. Each sexually active female patient of child-bearing potential must agree to use a medically accepted method of contraception through seven days after receiving protocol-specified medication. 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 (eg, hysterectomy or tubal ligation). Further, for patients using hormonal contraceptives, if study medication is administered on the same day an oral contraceptive is taken, the patient must follow the missed dose advice in the package leaflet of the oral contraceptive. In the case of non-oral hormonal contraceptives, the patient must use an additional non-hormonal contraceptive method and refer to the advice in the package leaflet of the product. Postmenopausal women are not required to use contraception. Postmenopausal is defined as at least 12 consecutive months without a spontaneous menstrual period. 10. To participate in the pharmacogenetic analysis, the patient must be willing to give written informed consent for the pharmacogenetic testing and able to adhere to dose and visit schedules. Note: A patient unwilling to sign the informed consent for pharmacogenetic testing may be included in the trial; however, pharmacogenetic samples must not be obtained. Are the trial subjects under 18? no Number of subjects for this age range: F.1.2 Adults (18-64 years) yes F.1.2.1 Number of subjects for this age range 500 F.1.3

Exclusion criteria

Exclusion criteria: 1. Has or is suspected to have anatomical malformations that may lead to difficult intubation. 2. Has or is suspected to have a neuromuscular disorder that may affect neuromuscular blockade. 3. Has or is suspected to have a medical history that includes a coagulation disorder, bleeding diathesis, systemic lupus erythematosus or antiphospholipid syndrome. 4. Has a history or evidence of active abnormal bleeding or blood clotting (eg, thrombosis) within the 30 days prior to screening. 5. Has or is suspected to have significant hepatic dysfunction that would prevent participation in the trial as determined by the Investigator. 6. Has or is suspected to have severe renal insufficiency (eg, estimated creatinine clearance of 35). 12. Has or is suspected to have any condition that would contraindicate the administration of sugammadex (for all patients screened) or neostigmine/ glycopyrrolate (or neostigmine/atropine at sites using atropine) (for patients planned for Usual Care Group 1). 13. Is a premenopausal female of childbearing potential who is pregnant or intends to become pregnant between randomization and the Day 30 pregnancy follow-up visit. 14. Is a female patient who is breast-feeding. 15. Is known to have been previously treated with sugammadex or has participated in a sugammadex clinical trial. 16. Has participated in any other clinical trial within the 30 days (inclusive) prior to signing the informed consent form for this current trial. 17. Has direct involvement with this current study and is employed by or is a family member of an individual employed by the Investigator, the investigational site, or the Sponsor.

Design outcomes

Primary

MeasureTime frame
Primary end point(s): suspected, unanticipated post-surgical events of bleeding that are subsequently confirmed by adjudication ;Timepoint(s) of evaluation of this end point: 24 hours after administration;Main Objective: To assess the effect of reversal of neuromuscular blockade with sugammadex 4 mg.kg-1 compared with reversal according to usual care (neostigmine or spontaneous reversal) on the incidence of adjudicated post-surgical events of bleeding over 24 hours, in patients receiving thromboprophylaxis and undergoing hip fracture surgery or joint (hip/knee) replacement with neuromuscular blockade induced by rocuronium or vecuronium.;Secondary Objective: To assess the effect of reversal of neuromuscular blockade with sugammadex 4 mg.kg-1 compared with reversal according to usual care (neostigmine or spontaneous reversal) on activated partial thromboplastin time (aPTT) (with values over a period of up to 2 hours in a subset of patients). To assess the safety of reversal of neuromuscular blockade with sugammadex 4 mg.kg-1 compared with reversal according to usual care (neostigmine or spontaneous reversal).

Secondary

MeasureTime frame
Timepoint(s) of evaluation of this end point: after study medication (10 and 60 min after study medication, also at 3, 20, 30,120 minutes post study medication in subset for pK sampling), unscheduled visit ;Secondary end point(s): coagulation endpoints: aPTT, PT(INR)

Countries

Austria, Germany, Netherlands

Contacts

Public ContactMiriam Wuntke

MSD SHARP & DOHME GMBH

miriam.wuntke@msd.de+4908945611109

Outcome results

None listed

Source: EU CTR (via WHO ICTRP) · Data processed: Feb 4, 2026