- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03216525
Alvimopan Versus Placebo in Patients Undergoing Radical Cystectomy on an Enhanced Recovery Protocol
September 26, 2023 updated by: Mark Preston, Brigham and Women's Hospital
A Randomized, Double-blind, Single-Center Trial of Alvimopan (Entereg) Versus Placebo in Patients Undergoing Radical Cystectomy and Urinary Diversion on an Enhanced Recovery After Surgery ERAS Protocol
To determine if Alvimopan during open or robotic radical cystectomy with urinary diversion results in quicker return of bowel function (GI-2 recovery = time to upper [first toleration of solid food] and lower [first bowel movement] gastrointestinal recovery) compared to placebo.
Study Overview
Detailed Description
A prospective, randomized, single-center double blind trial of Alvimopan versus placebo for improving patient outcomes and cost during radical cystectomy and urinary diversion will be performed.
A randomized trial is necessary to control for all the known and unknown confounders associated with instituting this novel intervention into a surgical procedure.
We will recruit 136 subjects (63 patients in each arm of the study per sample size calculation below, plus additional 10 subjects to account for drop outs).
A control group will be administered a placebo in order to directly compare if the Alvimopan intervention is effective.
Study Type
Interventional
Enrollment (Estimated)
136
Phase
- Phase 3
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Martin Barylak
- Phone Number: 6175258274
- Email: mbarylak@bwh.harvard.edu
Study Contact Backup
- Name: Anjali Vasavada
- Phone Number: 6175258274
- Email: AVASAVADA@BWH.HARVARD.EDU
Study Locations
-
-
Massachusetts
-
Boston, Massachusetts, United States, 02115
- Recruiting
- Brigham and Women's Hospital
-
Contact:
- Martin Barylak
- Phone Number: 617-525-8274
- Email: mbarylak@bwh.harvard.edu
-
Principal Investigator:
- Mark A Preston, MD
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years to 85 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
- Patients undergoing radical cystectomy and urinary diversion via open or robotic approach.
- Man or woman between the ages of 18 and 85.
- American Society of Anesthesiologists (ASA) Physical Status Score of class 1-4
- Ileal conduit or ileal neobladder urinary diversion
- Able to understand the study procedures, agreed to participate in the study program, and voluntarily provided informed consent
Exclusion criteria:
- Patients who met any of the following criteria were excluded from participating in the study:
- Scheduled for a partial cystectomy
- Previous total colectomy, gastrectomy, or gastric bypass, or functional colostomy or ileostomy
- More than three doses of opioids (oral or parenteral) within 7 days before the day of surgery
- Chemotherapy for bladder cancer within 1 month of scheduled surgery; prior neoadjuvant chemotherapy allowed.
- Pregnant (identified by a positive serum pregnancy test administered after the initial screening process and before the commencement of study activities) or lactating, or not postmenopausal (no menses for at least 1 year) and of childbearing potential and not using an accepted method of birth control (i.e, surgical sterilization; intrauterine contraceptive device; oral contraceptive, diaphragm, or condom in combination with contraceptive cream, jelly, or foam; or abstinence) (Participants will be asked to use birth control for the entire study and for at least 2 weeks after the last dose of study drug.)
- Participated in another investigational drug or medical device study within 30 days of surgery or planning to be enrolled in another investigational drug or medical device study or any study in which active patient participation was required outside normal hospital data collection during the course of this study
- Clinically significant laboratory abnormalities at screening that would have resulted in the cancellation of surgery
- Using illicit drugs or abusing alcohol
- History of previous surgeries, illness, or behavior (eg, depression, psychosis) that in the opinion of the investigator might have confounded the study results or might have posed additional risk in administering the study procedures
- Patients with severe dementia (as determined from medical records and history. Severe dementia will be defined as dementia that impacts daily functioning.)
- Patients with severe hepatic impairment.
- Patients with end-stage renal disease.
- Patients with heart failure. .
- Patients with complete gastrointestinal obstruction.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Oral Alvimopan
Oral Alvimopan (Entereg, Merck) 12 mg between 30 minutes and 3 hours before surgery start and twice-daily oral doses postoperatively beginning on day one (AM and PM dosing) until hospital discharge or a maximum of 7 days (15 in-hospital doses).
|
To determine if Alvimopan during radical cystectomy with urinary diversion results in faster return of bowel function.
Other Names:
|
Placebo Comparator: Matching Placebo
Matching placebo between 30 minutes and 3 hours before surgery start and twice-daily oral doses postoperatively beginning on day one (AM and PM dosing) until hospital discharge or a maximum of 7 days (15 in-hospital doses).
|
To determine if placebo during radical cystectomy with urinary diversion results in faster return of bowel function.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to Return of Bowel Function
Time Frame: From Day of surgery (Day 0) to Day 30
|
To achieve quicker time to return bowel function measured by a composite endpoint of both upper GI recovery (GI-2 recovery = [first toleration of solid food] and lower (first bowel movement) gastrointestinal recovery, taking Alvimopan during radical cystectomy, compared to placebo.
|
From Day of surgery (Day 0) to Day 30
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Post-operative Length of Stay
Time Frame: Day of surgery (Day 0) to Day of Discharge (Up to Day 30)
|
Post operative LOS was determined by the difference between the date of hospital discharge and the date of surgery; that is the postoperative LOS for a participant was calculated as follows:(date of discharge)-(date of surgery).
|
Day of surgery (Day 0) to Day of Discharge (Up to Day 30)
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Post-operative Morbidity
Time Frame: During hospitalization up to 7 days after surgery
|
POM defined as need for nasogastric (NG) tube insertion, hospital stay prolonged because of post-operative ileus (POI) beyond 10 days, or readmission to hospital for POI within 7 days after discharge.
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During hospitalization up to 7 days after surgery
|
30 Day Complications
Time Frame: Day of surgery (Day 0) to Day 30
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Any Clavien Grade II-V complication.
|
Day of surgery (Day 0) to Day 30
|
Readmission to Hospital
Time Frame: Day of Discharge (Up to Day 30)
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Any readmission to hospital for > 24 hours after discharge.
|
Day of Discharge (Up to Day 30)
|
Open vs Robotic Radical Cystectomy
Time Frame: Day of Surgery (Day 0)
|
To determine if Alvimopan during open or robotic radical cystectomy with urinary diversion results in decreased time to GI2 recovery
|
Day of Surgery (Day 0)
|
Cost Analysis
Time Frame: Day of surgery (Day 0) to Day 30
|
To evaluate costs of surgery and post-operative care between alvimopan and placebo in patients having a radical cystectomy and urinary diversion.
|
Day of surgery (Day 0) to Day 30
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Principal Investigator: Mark A Preston, MD, Brigham and Women's Hospital
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
October 1, 2018
Primary Completion (Estimated)
December 1, 2023
Study Completion (Estimated)
June 1, 2024
Study Registration Dates
First Submitted
March 13, 2017
First Submitted That Met QC Criteria
July 11, 2017
First Posted (Actual)
July 13, 2017
Study Record Updates
Last Update Posted (Actual)
September 28, 2023
Last Update Submitted That Met QC Criteria
September 26, 2023
Last Verified
September 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2017P000330
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
IPD Plan Description
There is no plan to share IPD.
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
product manufactured in and exported from the U.S.
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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