- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT03936205
Dexmedetomidine Addition to Morphine in Patients With Metastatic Cancer
Does the Addition of Dexmedetomidine to Morphine Improve the Treatment of Pain in Patients With Metastatic Cancer? A Pilot Study
Pain is a common symptom in patients nearing the end of life. Its prevalence varies between 30 and 75%. Nowadays, morphine is the most used molecule as first line treatment of moderate to severe pain. However, this molecule, considering its side effects, may contribute in part to the discomfort of these patients and may increase the pre-existing agitation or delirium. There is therefore a need to find new agents, other than morphine, for pain control at the end of life, without the limitations that the morphine molecule has. The author reviewed the literature on the role of dexmedetomidine in the treatment of refractory symptoms in palliative care, including pain. It is an agonist of the adrenergic alpha 2 receptor having a sedative, analgesic action and a morphine sparing effect demonstrated postoperatively.
This study aims primarily at demonstrating that dexmedetomidine has a beneficial role in the treatment of pain in patients with metastatic cancer.
Studieoversigt
Status
Betingelser
Intervention / Behandling
Undersøgelsestype
Tilmelding (Faktiske)
Fase
- Fase 2
- Fase 3
Deltagelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
Tager imod sunde frivillige
Køn, der er berettiget til at studere
Beskrivelse
Inclusion Criteria:
- Any painful patient with metastatic cancer
- Whatever type of pain: nociceptive, neuropathic, or mixed
- Age > 18 and <75 years
- Patient under analgesic Tier III treatment: with moderate to severe pain and not relieved by non-opioid conventional treatment
- Patient cooperating capable of responding to the pain assessment by providing a number from 0 to 10 at the VAS
- Patient providing his explicit consent to participate in the study before inclusion (regardless of his inclusion in C or D Group)
- Patients with systolic blood pressure (SBP) ≥ 100 mmHg and a diastolic blood pressure (DBP) ≥ 50 mmHg
- Patients with a heart rate ≥ 50/min
Exclusion Criteria:
- Patient refusal to participate in the study or patient unable to give consent
- Age <18 or > 75 years
- Comatose uncooperative patient unable to respond to the assessment of pain by VAS
- Hypotensive patients with SBP < 100 mmHg and DBP < 60 mmHg or bradycardic with a heart rate < 50/min
- Patient with a heart rhythm disorder, or a disorder of the atrial-ventricular conduction
- Patients under beta-blocker
- Patient with heart failure with an ejection fraction < 40%
- Patient suffering from allergy or previous intolerance to morphine or dexmedetomidine
- Patient with renal impairment with a creatinine clearance <3 0ml/min/1.73m2, or patient under hemodialysis or peritoneal dialysis.
- Patient with severe hepatic impairment with Child-Pugh score at C.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Sundhedstjenesteforskning
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Firedobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
---|---|
Ingen indgriben: Styring
|
|
Eksperimentel: Dexmedetomidin
|
Patients allocated to this group receive a combination of Morphine and Dexmedetomidine
|
Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
---|---|---|
Pain score
Tidsramme: 48 hours
|
The visual analogue score is used to asses for pain score, the scale varies between 0 and 10 where 0 is no pain and 10 is worst pain encountered
|
48 hours
|
Morfinforbrug
Tidsramme: 48 timer
|
48 timer
|
Samarbejdspartnere og efterforskere
Sponsor
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Primær færdiggørelse (Faktiske)
Studieafslutning (Faktiske)
Datoer for studieregistrering
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
- Patologiske processer
- Smerte
- Neurologiske manifestationer
- Neoplastiske processer
- Neoplasmer
- Neoplasma Metastase
- Neoplasmer, Anden Primær
- Smerte, uoverskuelig
- Lægemidlers fysiologiske virkninger
- Adrenerge midler
- Neurotransmittermidler
- Molekylære mekanismer for farmakologisk virkning
- Depressive midler til centralnervesystemet
- Agenter fra det perifere nervesystem
- Analgetika
- Sensoriske systemagenter
- Analgetika, ikke-narkotisk
- Adrenerge alfa-2-receptoragonister
- Adrenerge alfa-agonister
- Adrenerge agonister
- Hypnotika og beroligende midler
- Dexmedetomidin
Andre undersøgelses-id-numre
- FM315
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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