Safety and Efficacy of Sugammadex (Org 25969, MK-8616) in Participants With or Having a Past History of Pulmonary Disease (19.4.308) (P05932) (MK-8616-017)

Merck Sharp & Dohme LLC86 enrolled

Overview

The purpose of the trial is to research the safety and to show faster recovery after administration of 2.0 mg/kg or 4.0 mg/kg sugammadex (Org 25969, MK-8616) given as a reversal agent for 0.6 mg/kg (0.15 mg/kg maintenance dose) rocuronium (Zemuron®) in participants diagnosed with or having a history of pulmonary disease. All drug administration will be via the intravenous (IV) route.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Anesthesia, General

Interventions

SugammadexDRUG

Sugammadex solution for injection.

RocuroniumDRUG

Rocuronium bromide solution for injection.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * American Society of Anesthesiologists (ASA) Class 1 to 3; * Has been diagnosed with or having a past history of pulmonary disease; * Is scheduled for elective surgical procedure under general anesthesia requiring neuromuscular block with the use of rocuronium; * Is scheduled for surgery in supine position; * Has given written informed consent; Exclusion Criteria: * Is expected to have a difficult intubation due to anatomical malformations; * Has known or suspected of having neuromuscular disorders impairing neuromuscular blockade and/or significant renal dysfunction; * Has known or suspected of having a (family) history of malignant hyperthermia; * Has known or suspected of having an allergy to narcotics, muscle relaxants or other medications used during surgery; * Is receiving medication known to interfere with neuromuscular blocking agents such as anticonvulsants, antibiotics and Mg2+; * Is a female who is pregnant or breast-feeding; * Is a female of childbearing potential not using an acceptable method of birth control \[condom or diaphragm with spermicide, vasectomized partner (\> 6 months), IUD, abstinence\] or using only hormonal contraception as birth control; * Has already participated in a sugammadex trial including Protocol 19.4.308; * Has participated in another clinical trial, not pre-approved by Organon, within 30 days of entering into Protocol 19.4.308.

Outcomes

Primary Outcomes

Time From Start of Sugammadex Administration to Recovery of T4/T1 Ratio to 0.9 in Participants With or Having a Past History of Pulmonary Disease

The mean time from the start of sugammadex administration to recovery of the T4/T1 ratio to 0.9 was determined. Less time indicates faster recovery from neuromuscular blockade. The ratio of T4 (fourth twitch; amplitude of fourth response to train of four \[TOF\] stimulation is expressed as percent of control T4) over T1 (first twitch; amplitude of first response to TOF stimulation is expressed as percent of control T1) ranges from 0 (complete loss of T4 twitch response) to 1.0 (complete recovery of T4 twitch response). For TOF stimulation, 4 consecutive square wave supra-maximal stimuli of 0.2 msec duration were delivered at 2 Hz every 15 seconds. Neuromuscular monitoring was performed with the TOF-Watch® SX.

Time frame: Up to 90 minutes

Percentage of Participants Experiencing ≥1 Adverse Event(s) (AE)

The percentage of participants experiencing ≥1 AE(s) was determined for each arm. An AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.

Time frame: Up to 7 days

Percentage of Participants Discontinuing Study Treatment Due to an Adverse Event (AE)

The percentage of participants discontinuing from study treatment due to an AE was determined for each arm. An AE is any untoward medical occurrence in a participant administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An AE could therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not related to the medicinal (investigational) product.

Time frame: Up to 7 days

Secondary Outcomes

Data from ClinicalTrials.gov

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Time From Start of Sugammadex Administration to Recovery of T4/T1 Ratio to 0.7 in Participants With or Having a Past History of Pulmonary Disease

The mean time from the start of sugammadex administration to recovery of the T4/T1 ratio to 0.7 was determined. Less time indicates faster recovery from neuromuscular blockade. The ratio of T4 (fourth twitch; amplitude of fourth response to train of four \[TOF\] stimulation is expressed as percent of control T4) over T1 (first twitch; amplitude of first response to TOF stimulation is expressed as percent of control T1) ranges from 0 (complete loss of T4 twitch response) to 1.0 (complete recovery of T4 twitch response). For TOF stimulation, 4 consecutive square wave supra-maximal stimuli of 0.2 msec duration were delivered at 2 Hz every 15 seconds. Neuromuscular monitoring was performed with the TOF-Watch® SX.

Time frame: Up to 90 minutes

Time From Start of Sugammadex Administration to Recovery of T4/T1 Ratio to 0.8 in Participants With or Having a Past History of Pulmonary Disease

The mean time from the start of sugammadex administration to recovery of the T4/T1 ratio to 0.8 was determined. Less time indicates faster recovery from neuromuscular blockade. The ratio of T4 (fourth twitch; amplitude of fourth response to train of four \[TOF\] stimulation is expressed as percent of control T4) over T1 (first twitch; amplitude of first response to TOF stimulation is expressed as percent of control T1) ranges from 0 (complete loss of T4 twitch response) to 1.0 (complete recovery of T4 twitch response). For TOF stimulation, 4 consecutive square wave supra-maximal stimuli of 0.2 msec duration were delivered at 2 Hz every 15 seconds. Neuromuscular monitoring was performed with the TOF-Watch® SX.

Time frame: Up to 90 minutes

Level of Consciousness Assessment 1: Prior to Transfer to the Recovery Room Following Extubation

The level of consciousness prior to transfer to the recovery room was determined by the clinician for each participant. Each participants was assigned 1 of 3 potential levels of consciousness: 1) awake and oriented; 2) arousable with minimal stimulation; or 3) responsive only to tactile stimulation.

Time frame: Up to 6 hours (prior to transfer to the recovery room after extubation)

Level of Consciousness Assessment 2: Prior to Discharge From the Recovery Room

The level of consciousness prior to discharge from the recovery room was determined by the clinician for each participant. Each participants was assigned 1 of 3 potential levels of consciousness: 1) awake and oriented; 2) arousable with minimal stimulation; or 3) responsive only to tactile stimulation.

Time frame: Up to 6 hours (prior to discharge from the recovery room)

Five-Second Head Lift Assessment 1: Prior to Transfer to the Recovery Room Following Extubation

The ability of each cooperative (based on clinician determination) participant to perform a 5-second head lift was determined by the clinician. Participants were rated as either able or not able to complete the head lift task.

Time frame: Up to 6 hours (prior to transfer to the recovery room after extubation)

Five-Second Head Lift Assessment 2: Prior to Discharge From the Recovery Room

Time frame: Up to 6 hours (prior to discharge from the recovery room)

General Muscle Weakness Assessment 1: Prior to Transfer to the Recovery Room Following Extubation

Each cooperative (based on clinician determination) participant was assessed by a clinician to determine if there was muscle weakness. Participants were rated as having or not having muscle weakness by the clinician.

Time frame: Up to 6 hours (prior to transfer to the recovery room after extubation)

General Muscle Weakness Assessment 2: Prior to Discharge From the Recovery Room

Time frame: Up to 6 hours (prior to discharge from the recovery room)