Clinical trial
Efficacy of Suvorexant to Improve Postoperative Sleep and Reduce Delirium Severity in Older Surgical Patients: A Double-blinded, Randomized, Placebo-controlled Trial
Name
Pro00111869
Description
This research study will evaluate the effectiveness of postoperative administration of a drug called suvorexant, to improve postoperative sleep and decrease the severity of delirium (serious confusion) in adults 65 years and older undergoing non-cardiac surgery.
Trial arms
Trial start
2023-06-28
Estimated PCD
2025-09-01
Trial end
2025-10-01
Status
Recruiting
Phase
Early phase I
Treatment
Suvorexant 20 mg
Administer Suvorexant versus placebo every evening for Post-Operative Day (POD) 0,1, \&2
Arms:
Suvorexant Arm
Placebo
Administer Suvorexant versus placebo every evening for Post-Operative Day (POD) 0,1, \&2
Arms:
Placebo Arm
Size
130
Primary endpoint
Total Sleep Time
Post operative Day 0-2
Eligibility criteria
Inclusion Criteria:
1. Age 65 and older
2. Undergoing non-cardiac, non-intracranial surgery, any surgical procedure not involving the skull, brain, cerebrovascular structures
3. Scheduled postoperative inpatient overnight stay
4. Able to give informed consent or has legally authorized representative able to give informed consent on their behalf
5. English-speaking
Exclusion Criteria:
1. Inmate of correctional facility
2. Body mass index\> 40
3. Legal blindness
4. Unable to perform study related questionnaires and assessments
5. Use of outpatient sedating sleep aids \> 2 times per any week in 1 month preceding day of surgery. Sedating sleep aids, \*See list Below.
6. History of psychotic disorder, including schizophrenia, schizoaffective disorder, schizophreniform or brief psychotic disorder.
7. History of liver failure with documented international normalized ratio (INR) of \>1.2 or with history of hepatic encephalopathy
8. History of severe sleep apnea or obesity hypoventilation syndrome requiring home bilevel positive airway pressure therapy or home ventilator or other forms of noninvasive ventilation
9. Chronic lung disease requiring home oxygen therapy
10. History of narcolepsy
11. Use of systemic (oral, intravenous, intramuscular, subcutaneous) moderate or strong CYP3A inhibitors within 1 week prior to surgery, \*See list below
12. Use of systemic (oral, intravenous, intramuscular, subcutaneous) moderate or strong CYP3A inducers within 1 week prior to surgery, \*See list below.
13. Current or planned administration of digoxin, or is currently experiencing digoxin toxicity
14. Undergoing surgery that will result in inability to take medications by mouth including laryngectomy, tracheostomy, and oral resection/reconstructive surgery
15. Undergoing surgery that will require postoperative strict bowel rest, including gastrectomy, esophagectomy, and pancreaticoduodenectomy
16. Undergoing surgery in an area that will make it unsafe to wear a headband, such as scalp or forehead procedures.
17. Inappropriate for study inclusion based on the judgement of the principal investigator
Exclusionary Medications:
Moderate CYP3A inhibitors: Amprenavir, Aprepitant, Atazanavir, Ciprofloxacin, Diltiazem, Erythromycin, Fluconazole, Fosamprenavir, Imatinib, Verapamil, grapefruit juice.
Strong CYP3A inhibitors: Ketoconazole, Itraconazole, Posaconazole, Clarithromycin, Nefazodone, Ritonavir, Saquinavir, Nelfinavir, Indinavir, Boceprevir, Telaprevir, Telithromycin, Conivaptan
Moderate/Strong CYP3A inducers: Apalutamide, Carbamazepine, Enzalutamide, Ivosidenib, lumacaftor, Mitotane, Phenytoin, Rifampin, St. John's wort, Bosentan, Cenobamate, Dabrafenib, Efavirenz, Etravirine, Lorlatinib, Pexidartinib, Phenobarbital, Primidone, Sotorasib.
Sedating sleep aids: Mirtazapine, Trazodone, Flurazepam, Temazepam, Triazolam, Estazolam, Quazepam, Clonazepam, Lorazepam, Midazolam, Alprazolam, Diazepam, Zolpidem, Zaleplon, Eszopiclone, Diphenhydramine, Doxylamine, Hydroxyzine, Suvorexant, Doxepin
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE2'], 'designInfo': {'allocation': 'RANDOMIZED', 'interventionModel': 'PARALLEL', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'TRIPLE', 'maskingDescription': 'Dosing labels will be attached to each study drug dose and include pre-printed fields with\n\n* Protocol number\n* Personal ID number\n* Participant initials\n* Date\n* Time', 'whoMasked': ['PARTICIPANT', 'CARE_PROVIDER', 'INVESTIGATOR']}}, 'enrollmentInfo': {'count': 130, 'type': 'ESTIMATED'}}
Updated at
2023-07-14
1 organization
1 product
1 drug
1 indication
Organization
Duke UniversityProduct
SuvorexantIndication
DeliriumDrug
Varlilumab