Clinical trial • Phase IV • Cardiology

FENTANYL for Acute decompensated heart failure | Refractory dyspnea

Phase IV trial of FENTANYL for Acute decompensated heart failure | Refractory dyspnea.

Overview

Trial Therapeutic Area
Cardiology
Trial Disease
Acute decompensated heart failure | Refractory dyspnea
Trial Stage
Phase IV
Drug Modality
Small molecule

Key dates

Initial CTIS Submission Date
27-01-2025
First CTIS Authorization Date
27-01-2025

Trial design

Randomised, morphine: subcutaneous bolus on demand; prior requirement in inclusion: two or more doses of 3 mg sc morphine on demand in the previous 24 hours. (comparator described as 'on-demand bolus of morphine' in study title.)-controlled Phase IV trial across 1 site in Spain.

Randomised
Yes
Comparator
Morphine: subcutaneous bolus on demand; prior requirement in inclusion: two or more doses of 3 mg SC morphine on demand in the previous 24 hours. (Comparator described as 'on-demand bolus of morphine' in study title.)
Target Sample Size
28
Trial Duration For Participant
72

Eligibility

Recruits 28 The protocol allows that if the patient, due to personal conditions or clinical situation, cannot grant consent, a family member or primary caregiver will receive explanations and grant consent on the patient's behalf. It is also expected that, if the patient cannot complete questionnaires, a family member or main reference caregiver will complete them. (No other specific vulnerable-population or assent procedures are described.).

Vulnerable Population
The protocol allows that if the patient, due to personal conditions or clinical situation, cannot grant consent, a family member or primary caregiver will receive explanations and grant consent on the patient's behalf. It is also expected that, if the patient cannot complete questionnaires, a family member or main reference caregiver will complete them. (No other specific vulnerable-population or assent procedures are described.)

Inclusion criteria

  • {"criterion_text":"- 1. Age equal to or greater than 18 years."}
  • {"criterion_text":"- 2. Hospitalized at the Mútua Terrassa University Hospital in the internal medicine units and complex chronic patient unit, due to HF decompensation, of any etiology. Patients may be included only once during each hospital admission; In case of re-entry for the same reason, they may be included again."}
  • {"criterion_text":"- 3. In optimized treatment of their HF decompensation at the discretion of the specialist doctor responsible for the case."}
  • {"criterion_text":"- 4. Refractory dyspnea persists despite treatment."}
  • {"criterion_text":"- 5. Has received two or more doses of 3 mg of SC morphine on demand for dyspnea in the previous 24 hours, as indicated by the responsible physician."}
  • {"criterion_text":"- 6. The patient gives informed consent that attests to his or her correct understanding of the purposes and procedures of the study and his desire to voluntarily participate in the study. In the event that the patient, due to his or her personal conditions or clinical situation, cannot grant consent, it will be the family member or primary caregiver who receives the explanations and grants consent."}
  • {"criterion_text":"- 7. It is expected that the patient will be able to complete questionnaires on the effectiveness and tolerability of the drugs administered. Otherwise, it is expected that the family member or the main reference caregiver will be able to complete these questionnaires."}

Exclusion criteria

  • {"criterion_text":"- 1. History of alcohol or drug abuse."}
  • {"criterion_text":"- 2. Allergy to fentanyl or morphine"}
  • {"criterion_text":"- 3. Contraindication to opioid use: Known hypersensitivity to morphine. Patients with respiratory depression or severe obstructive respiratory disease. Patients with acute bronchial asthma. Patients treated with monoamine oxidase inhibitors or during the 14 days following the suspension of such treatment. Patients with acute and/or severe liver disease. Patients with head injury; increased intracranial pressure. Patients in coma. Patients with spasms of the renal and biliary tract. Patients with acute alcoholism. Patients at risk of paralytic ileus. Patients with ulcerative colitis. Patients in shock. In case of infection at the injection site and in patients with severe coagulation disorders, epidural or intrathecal administration is contraindicated."}
  • {"criterion_text":"- 4. Concomitant treatment with opioids for other causes."}
  • {"criterion_text":"- 5. Simultaneous participation in another study or clinical trial."}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Reduction in the average daily intensity of dyspnea is the main criterion of effectiveness. The intensity of dyspnea is evaluated by the patient himself using a Verbal Numerical Scale (EVN) and a Visual Analogue Scale (VAS) of dyspnea 56. The effectiveness of the treatment is evaluated by comparing the EVN and VAS of dyspnea in the first evaluation or 0h with the EVN and VAS of dyspnea in the following consecutive evaluations or 24h, 48h and 72h.","definition_or_measurement_approach":"Intensity of dyspnea is patient-reported using a Verbal Numerical Scale (EVN) and a Visual Analogue Scale (VAS); effectiveness is assessed by comparing EVN and VAS at baseline (0h) versus 24h, 48h and 72h."}

Recruitment

Planned Sample Size
28
Recruitment Window Months
92
Consent Approach
Adults (age ≥18) provide informed consent. If the patient cannot grant consent due to personal conditions or clinical status, a family member or primary caregiver receives explanations and provides consent on the patient's behalf. If the patient cannot complete questionnaires, a family member or main reference caregiver will complete them. No age‑specific assent forms or languages are specified in the record.

Geography

Total Number Of Sites
1
Total Number Of Participants
28

Spain

Earliest CTIS Part Ii Submission Date
22-01-2025
Latest Decision Or Authorization Date
27-01-2025
Processing Time Days
5
Number Of Sites
1
Number Of Participants
28

Sites

Site Name
Fundacio Assistencial De Mutua De Terrassa Fpc
Department Name
PADES
Contact Person Name
veronica Romani
Number Of Participants
28

Sponsor

Primary sponsor

Full Name
Fundacio Assistencial De Mutua De Terrassa Fpc
Organisation Type
Hospital/Clinic/Other health care facility
Country Of Registered Address
Spain

Investigational products

Investigational Product Name
FENTANYL
Active Substance
FENTANYL
Modality
Small molecule
Routes Of Administration
Intravenous
Route
Intravenous
Authorisation Status
No marketing authorisation listed (marketingAuthNumber: '-')
Frequency
Continuous parenteral perfusion (as per trial comparison arm)
Investigational Product Name
Fentanilo Medlink 50 microgramas/ml solução injetável
Active Substance
FENTANYL
Modality
Small molecule
Routes Of Administration
Intravenous
Route
Intravenous
Authorisation Status
Marketing authorisation: 5847942 (authorisationCountryCode: PT; mrpNumber: PT/H/2726/001)
Frequency
Continuous parenteral perfusion (as per trial comparison arm)

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