- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05388188
DSUVIA in Patients With SCD VOC Present in the ED
Throughput and Disposition Metrics When Using Dsuvia as a Bridging Medication to Decrease Time to Analgesia and Hospital Admissions in Patients With Sickle Cell Disease Vaso-Occlusive Crisis That Present to the Emergency Department
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Patients with SCD VOC may present to the ED after oral home medications fail to relieve acute pain. Patients with SCD VOC may require parenteral analgesia for pain relief but, upon arrival to the ED these patients often undergo long wait times until receiving first parenteral medication dose. Oral opioid pain medications are not adequate as most adult patients with SCD and history of SCD VOC have already tried utilizing oral opioids out of the hospital. Intravenous access is challenging in this population with venous scarring or central ports that require sterile access. The need to establish IV access and to, eventually, provide parenteral opioids results in long delays in the time to first dose of drug (time to analgesia) in patients with SCD VOC that present to the ED. Delays in analgesia increase the likelihood of hospital admission in patients with SCD VOC that present to the ED. Patients with SCD VOC that are admitted to the hospital often have a long LOS. A bridge medication or intervention is needed for patients with SCD VOC upon entry into the ED that provides adequate and timely analgesia. In 2020, our ED began utilizing Dsuvia in patients with SCD VOC as a bridging medication. Data has not been collected to specifically examine the impact of Dsuvia use on patient throughput metrics and disposition.
Use of Dsuvia in ED patients with SCD VOC will decrease door to first analgesic time (time to analgesia). Decrease of door to first analgesic time will decrease the overall admission rate for patients with SCD VOC without decreasing patient or staff satisfaction. Use of STL Dsuvia will not lead to an increase in adverse patient safety events. Patients that receive Dsuvia early in the ED encounter may also require a lower overall amount of opioids, represented by morphine milligram equivalents (MME) than patients in a historical control group that did not receive Dsuvia. In addition, this study extends evidence for efficacy of Dsuvia in patients with acute pain but a history of opioid tolerance (unlike prior studies with Dsuvia that excluded patients with opioid tolerance). Since 2020, our ED standard of care for patients with SCD VOC is to utilize Dsuvia as early as possible in the ED course.
Study Type
Enrollment (Anticipated)
Contacts and Locations
Study Contact
- Name: Ashley Barnes, RN
- Phone Number: 813-660-6035
- Email: ashleynbarnes@tgh.org
Study Locations
-
-
Florida
-
Tampa, Florida, United States, 33606
- Recruiting
- Tampa General Hospital
-
Contact:
- Ashley Barnes, RN
- Phone Number: 813-660-6035
- Email: ashleybarnes@tgh.org
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Sampling Method
Study Population
Description
Inclusion Criteria:
- Age >= 18
- Known history/self-reported history of Sickle Cell Disease
- Participant has self-described sickle cell related pain
- Patient has attempted to utilize oral opioid pain medications in the last 24 hours
Exclusion Criteria:
- Unable to provide informed consent to participate in the study, such as a mental condition rendering the participant unable to understand the nature, scope, and possible consequences of the study
- Participant has a temperature of > 100.4 F
- Participant has heart rate > 120
- Participant has systolic blood pressure < 90
- Clinical provider or investigator states that patient has "Acute Chest Syndrome"
- Participant unlikely to comply with protocol as determined by Investigator
- Clinically relevant cardiovascular, hepatic, neurological, endocrine, or other major systemic disease making implementation of the protocol or interpretation of the study results difficult or that would put the participant at risk by participating in the study
- Persistent significant or severe infection, either acute or chronic
- No prior oral opioid use for SCD VOC pain control
- Participation in this study within the past 30 days.
Study Plan
How is the study designed?
Design Details
Cohorts and Interventions
Group / Cohort |
Intervention / Treatment |
---|---|
Sickle Cell Disease Vaso-Occlusive (SCD VOC) crisis
Adult patients with known sickle cell disease present in the ED with a SCD VOC and ED provider has ordered as part of the patient's standard of care, sublingual opioid called sufentanil [Dsuvia] (a strong pain medicine that dissolves under your tongue) for the patient.
|
Dsuvia in patients with SCD VOC as a bridging medication.
Other Names:
|
Historical Sample
collection of retrospective data of SCD VOC patients.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time to Analgesia
Time Frame: 1 hour
|
pain onset to inability to feel pain
|
1 hour
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Time at Hospital
Time Frame: through study completion, an average of 1 week
|
Length of time in the ED and/or length of stay in the hospital
|
through study completion, an average of 1 week
|
Measurement of morphine milligram equivalents (MME)
Time Frame: 3 hours
|
Total MME in patients receiving Dsuvia during ED encounter
|
3 hours
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Jason Wilson, MD, Tampa General Hospital
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
- Hematologic Diseases
- Genetic Diseases, Inborn
- Anemia
- Anemia, Hemolytic, Congenital
- Anemia, Hemolytic
- Hemoglobinopathies
- Anemia, Sickle Cell
- Physiological Effects of Drugs
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Anesthetics, Intravenous
- Anesthetics, General
- Anesthetics
- Analgesics, Opioid
- Narcotics
- Adjuvants, Anesthesia
- Sufentanil
Other Study ID Numbers
- 20-0412
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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.
Clinical Trials on Sickle-Cell Disease With Crisis
-
St. Louis UniversityJanssen Services, LLCWithdrawnSickle Cell Disease | Hb-SS Disease With Vasoocclusive Pain | Hemoglobin SS Disease With Vasoocclusive Crisis | Other Sickle Cell Disease With Vaso-Occlusive Pain | Hemoglobin SS Disease With CrisisUnited States
-
University Hospital, BordeauxRecruitingSickle Cell CrisisFrance, French Guiana, Guadeloupe
-
Centre Hospitalier Intercommunal CreteilRecruitingSickle-Cell Disease Nos With CrisisFrance
-
Essen BiotechNot yet recruitingSickle Cell Disease | Sickle-Cell Disease With CrisisChina
-
Oman Medical Speciality BoardArmed Forces Hospital, OmanNot yet recruitingSickle-Cell Disease With Crisis
-
GlycoMimetics IncorporatedTerminatedSickle Cell Disease | Sickle Cell Anemia | Vaso-occlusive Crisis | Pain Crisis | Sickle Cell DisordersUnited States, Canada
-
University of Mississippi Medical CenterNot yet recruiting
-
Medical College of WisconsinPediatric Emergency Care Applied Research Network; Nemours Children's Health...RecruitingSickle Cell CrisisUnited States
-
GlycoMimetics IncorporatedCompletedSickle Cell Disease | Vaso-occlusive Crisis | Pain CrisisUnited States, Canada
-
University of NebraskaRecruitingVaso-occlusive Crisis | Sickle Cell Anemia CrisisUnited States
Clinical Trials on sublingual sufentanil
-
AcelRx Pharmaceuticals, Inc.Completed
-
AcelRx Pharmaceuticals, Inc.Completed
-
AcelRx Pharmaceuticals, Inc.Completed
-
University Hospital, GhentCompleted
-
Brigham and Women's HospitalActive, not recruitingPain, Postoperative | Opioid Use | Spine FusionUnited States
-
AcelRx Pharmaceuticals, Inc.U.S. Army Medical Research and Development CommandCompletedModerate-to-severe Acute PainUnited States
-
University of MinnesotaCompletedPain | Pain, Acute | AnesthesiaUnited States
-
University of MinnesotaCompletedPain | Pain, Acute | AnesthesiaUnited States
-
Frank GuyetteUnited States Department of DefenseCompleted
-
AcelRx Pharmaceuticals, Inc.CompletedAcute Moderate-to-severe PainUnited States