Amisulpride for Postoperative Nausea and Vomiting

No longer recruiting at 14 trial locations
GF
Overseen ByGabriel Fox, MB BChir
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial
Approved in 1 JurisdictionThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a medication called amisulpride (Amisulpride Injection [Barhemsys]) to determine if it can prevent nausea and vomiting after surgery in children. It focuses on children undergoing non-emergency surgeries, such as eye surgery or ear and throat procedures. The trial divides participants into two groups, each receiving different doses of amisulpride along with dexamethasone. Suitable candidates are children having these surgeries under general anesthesia, not using certain other specific medications, and without certain medical conditions like dizziness or allergies to the drugs being tested. As a Phase 2, Phase 3 trial, this research evaluates the treatment's effectiveness and represents the final step before FDA approval, offering participants a chance to contribute to important medical advancements.

Do I need to stop my current medications to join the trial?

The trial does not specify if you need to stop all current medications, but you cannot be on regular anti-emetic therapy or certain medications like levodopa. It's best to discuss your current medications with the trial team.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research shows that amisulpride, sold as Barhemsys, is approved for adults to prevent nausea and vomiting after surgery, indicating thorough safety testing in adults. In these studies, amisulpride was generally well-tolerated, with common mild side effects like dizziness and headache, while serious side effects were rare.

In this trial, children receive amisulpride at two different doses, along with dexamethasone, which reduces inflammation and prevents nausea. Since amisulpride is already used safely in adults, this offers some reassurance about its safety. However, because this trial is in an earlier stage, monitoring for any new side effects in children is crucial. Researchers will closely monitor participants to ensure their safety.12345

Why are researchers excited about this trial's treatments?

Most treatments for postoperative nausea and vomiting (PONV) focus on blocking specific receptors tied to vomiting, like serotonin or histamine. But Amisulpride, the study drug, works differently by blocking dopamine receptors, offering a fresh angle for tackling PONV. Researchers are excited because this unique mechanism might help patients who don't respond well to existing options. Moreover, the combination with dexamethasone could potentially enhance its effectiveness, providing a more robust solution for managing PONV.

What evidence suggests that amisulpride might be an effective treatment for postoperative nausea and vomiting?

Research has shown that amisulpride helps prevent nausea and vomiting after surgery. In this trial, participants will receive amisulpride through an IV in combination with dexamethasone. Studies have found that IV amisulpride works well both on its own and with other medications. Specifically, trials comparing it to a placebo (a substance with no active drug) showed that patients who received amisulpride experienced significantly less nausea and vomiting. These patients had fewer episodes of nausea, highlighting the medication's potential benefits. Therefore, amisulpride has a strong record in managing these symptoms after surgery.56789

Who Is on the Research Team?

KB

Kumar Belani, MD

Principal Investigator

University of Minnesota Masonic Children's Hospital

Are You a Good Fit for This Trial?

This trial is for children from birth to 17 years old who are having non-emergency surgeries like eye surgery, adenotonsillectomy, or otoplasty. They must be healthy enough for anesthesia (ASA I-III) and girls able to have babies must use strong contraception.

Inclusion Criteria

American Society of Anesthesiologists (ASA) risk score I-III
I am 17 years old or younger.
Signed informed consent form and/or assent and willingness of patient and parents to participate in the trial
See 2 more

Exclusion Criteria

I am scheduled for a transplant or brain surgery.
I will need a feeding tube after my surgery.
I am expected to receive corticosteroids for reasons other than preventing nausea.
See 14 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2 weeks
1 visit (in-person)

Treatment

Participants receive IV amisulpride and IV dexamethasone to prevent post-operative nausea and vomiting

1 day
1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment, including adverse events and ECG abnormalities

7 days
Continuous monitoring and assessments

What Are the Treatments Tested in This Trial?

Interventions

  • Amisulpride Injection [Barhemsys]
Trial Overview The study tests Amisulpride Injection vs Dexamethasone in preventing sickness after surgery in kids. It's a randomized, double-blind trial meaning neither the doctors nor patients know who gets which treatment.
How Is the Trial Designed?
2Treatment groups
Experimental Treatment
Group I: Stage 1 - Group 2: IV amisulpride 0.07 mg/kg + IV dexamethasoneExperimental Treatment2 Interventions
Group II: Stage 1 - Group 1: IV amisulpride 0.035 mg/kg + IV dexamethasoneExperimental Treatment2 Interventions

Amisulpride Injection [Barhemsys] is already approved in United States for the following indications:

🇺🇸
Approved in United States as Barhemsys for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

Acacia Pharma Ltd

Lead Sponsor

Trials
18
Recruited
4,700+

Premier Research

Collaborator

Amicus CD LLC

Collaborator

Trials
1
Recruited
410+

Premier Research Group plc

Industry Sponsor

Trials
65
Recruited
74,200+

John Ratliff

Premier Research Group plc

Chief Executive Officer since 2024

MBA

Dr. Milena Kanova-Petrova

Premier Research Group plc

Chief Medical Officer since 2024

MD

Published Research Related to This Trial

In a study involving 560 surgical patients experiencing postoperative nausea and vomiting (PONV), intravenous amisulpride at doses of 5 and 10 mg significantly improved the complete response rate compared to placebo, with 31.4% of patients in both amisulpride groups achieving no vomiting and not requiring rescue medication.
Amisulpride was found to be safe, with an adverse event profile similar to that of placebo, indicating it can be an effective treatment option for established PONV in patients who did not receive prior prophylaxis.
Randomized, Double-Blind, Placebo-Controlled Study of Intravenous Amisulpride as Treatment of Established Postoperative Nausea and Vomiting in Patients Who Have Had No Prior Prophylaxis.Candiotti, KA., Kranke, P., Bergese, SD., et al.[2023]
In a study involving 689 surgical patients, intravenous amisulpride significantly reduced the incidence of postoperative nausea and vomiting compared to placebo, with a complete response rate of 46.9% in the U.S. trial and 57.4% in the European trial.
Amisulpride was found to have a similar safety profile to placebo, with no significant differences in side effects such as QT prolongation or sedation, indicating it is a safe option for preventing postoperative nausea and vomiting.
Intravenous Amisulpride for the Prevention of Postoperative Nausea and Vomiting: Two Concurrent, Randomized, Double-blind, Placebo-controlled Trials.Gan, TJ., Kranke, P., Minkowitz, HS., et al.[2018]
Amisulpride significantly improves the prevention and treatment of postoperative nausea and vomiting (PONV) compared to placebo, with a relative risk of complete response at 1.30 based on a systematic review of five studies involving 3243 patients.
The safety profile of amisulpride is comparable to that of placebo, indicating that low-dose intravenous amisulpride is a safe option for managing PONV, although further research is needed to determine the best dosing and timing.
Efficacy of amisulpride on postoperative nausea and vomiting: a systematic review and meta-analysis.Zhang, LF., Zhang, CF., Tang, WX., et al.[2021]

Citations

Post Operative Nausea and Vomiting (PONV) Rescue ...Effectiveness and safety outcomes will be analyzed using standard statistical methods for observational studies. Comparison of deidentified patient EHRs in ...
2.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/33656662/
Amisulpride: A Review in Post-Operative Nausea and ...Results from placebo-controlled phase III trials showed that IV amisulpride is efficacious both in the prevention of PONV (used either alone or in combination ...
3.barhemsys.combarhemsys.com/
Barhemsys® (amisulpride) | Proven Antiemetic Medication ...Amisulpride for the rescue treatment of postoperative nausea or vomiting in patients failing prophylaxis: a randomized, placebo-controlled phase III trial.
News DetailsThis analysis details pooled data on nausea-related outcomes from two Phase III trials. We are pleased to share that the proportion of patients ...
A Pilot Study to Evaluate Barhemsys for the Prevention of ...This is a phase III/IV, randomized, placebo-controlled, patient-blinded cross-over pilot study to evaluate the effectiveness of Amisulpride in the treatment ...
6.barhemsys.combarhemsys.com/safety
Safety and Side Effect Profile | Barhemsys® (amisulpride)Barhemsys is a selective dopamine-2 (D2) and dopamine-3 (D3) receptor antagonist indicated in adults for: prevention of postoperative nausea and vomiting (PONV) ...
BARHEMSYS is amisulpride - accessdata.fda.govBARHEMSYS® is indicated in adults for: • prevention of postoperative nausea and vomiting (PONV), either alone or in combination with an antiemetic of a ...
Adverse Impact of PONV | Barhemsys® (amisulpride)Amisulpride for the rescue treatment of postoperative nausea or vomiting in patients failing prophylaxis: a randomized, placebo-controlled phase III trial.
Barhemsys (amisulpride) dosing, indications, interactions, ...Postoperative Nausea & Vomiting. Prevention. Indicated for prevention of postoperative nausea and vomiting (PONV), either alone or in combination with an ...
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