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Clinical trial information and results are updated daily from ClinicalTrials.gov. The latest data update was conducted on 01/21/2021.

Adjunctive Granisetron Therapy in Patients With Sepsis or Septic Shock

Clinicaltrials.gov identifier NCT03924518

Recruitment Status Recruiting

First Posted April 23, 2019

Last update posted August 20, 2019

Study Description

Brief summary:

In this prospective, single-center,randomized,controlled,single-blind clinical trial,Patients will be randomly assigned to receive granisetron or placebo for 4 days or until leaving the ICU(death or transfer from ICU to general ward or discharge). The primary outcome is all-cause death rate at 28 days.

  • Condition or Disease:Sepsis
  • Intervention/Treatment: Drug: Granisetron Hydrochloride
    Drug: Placebo(Normal saline)
  • Phase: Phase 2
Detailed Description

Investigational drug:Granisetron hydrochloride for injection Study title:Adjunctive Granisetron Therapy in Patients with Sepsis or Septic Shock:A Single-center,Randomized,Controlled,Single-blind Clinical trial. Principal Investigator:Professor Ping Chang ,Professor Zhanguo Liu, professor Peng Chen,Department of Critical Care Unit, Zhujiang Hospital, Southern Medical University Study subjects:Adult septic/septic shock patients with procalcitonin(PCT≥2ng/ml when entering the ICU. Study phase: Investigator Initiated Trial(IIT) Study objectives:The objective of the study is to determine whether granisetron, compared to placebo, improve the prognosis of sepsis or septic shock,including the reduction in mortality, the protection of organ function and reduction of inflammatory response,and to determine the safety of granisetron in patients with sepsis. Study design:A Single-center,Randomized,Controlled,Single-blind Clinical trial. Medication method: Granisetron treatment group: Follow the guidelines for sepsis in 2016 and recommend routine treatment + 3mg granisetron in 22 ml normal saline every 8 h for 4 days or until leaving the ICU(death or transfer from ICU to general ward or discharge), whichever come first. Placebo control group:Follow the guidelines for sepsis in 2016 and recommend routine treatment + 25ml normal saline every 8 h for 4 days or until leaving the ICU(death or transfer from ICU to general ward or discharge), whichever come first. Course:4days Sample size:154. Sites:1 Primary endpoint:all-cause death at 28 days Secondary endpoints: 1. The state of liver function: the serum level of transaminase(AST、ALT)、total bilirubin、direct bilirubin at 1,2,3,4,5 days after randomization 2. The state of lung function:oxygenation index(PaO2/FiO2) at 1,2,3,4,5 days after randomization (the patients treated with extracorporeal membrane oxygenation will not collect this indicator). 3. The state of kidney function:serum level of Creatinine (Cr)、blood urea nitrogen(BUN)、Cystatin(Cys) at 1,2,3,4,5 days after randomization 4. The state of inflammatory response:the serum level of interleukin-6(IL-6) 、C-reactive protein 、Superoxide dismutase(SOD) and erythrocyte sedimentation rate(ESR) at 1,3,5 days after randomization. 5. The state of circulation system: the serum level of lactic acid at 1,2,3,4,5 days after randomization 6. The state of immune function:the serum level of white blood cell(WBC)、lymphocyte at 1, 3, 5 days after randomization,the serum level of cluster of differentiation 4 Tcell(CD4+ Tcell) and cluster of differentiation 8 Tcell(CD8+ Tcell) at 1,5days after randomization. 7. The level of plasma 5-hydroxytryptamine(5-HT) at 1,5 days after randomization. 8. Organ dysfunction assessed by Sequential Organ Failure Assessment (SOFA) score at 1, 3, 5 after randomization 9. Incidence and duration of supportive care for organ dysfunction including vasoactive agents, mechanical ventilation, continuous renal replacement therapy(CRRT)、daily condition of fuid balance 10. The length of stay in ICU Safety endpoints: 1. adverse events 2. Serious adverse events

Study Design
  • Study Type: Interventional
  • Estimated Enrollment: 154 participants
  • Allocation: Randomized
  • Intervention Model: Parallel Assignment
  • Intervention Model Description: The participants in treatment group receive intravenous granisetron. The participants in control group receive normal saline.
  • Masking: Double (Participant, Outcomes Assessor)
  • Primary Purpose: Treatment
  • Official Title: Adjunctive Granisetron Therapy in Patients With Sepsis or Septic Shock:A Single-center, Randomized, Controlled, Single-blind Clinical Trial
  • Actual Study Start Date: April 2019
  • Estimated Primary Completion Date: December 2020
  • Estimated Study Completion Date: December 2020
Arms and interventions
Arm Intervention/treatment
Experimental: granisetron group
3ml granisetron(3mg) will be diluted in 22 mL of 0.9% normal saline,and the granisetron diluted will be intravenously injected for at 10 minutes, every 8 hours for 4 days or until leaving the ICU(death or transfer from ICU to general ward or discharge), whichever come first.
Drug: Granisetron Hydrochloride
Granisetron will be diluted with 0.9% saline to ensure that the therapeutic drug and placebo are identical in appearance, and 50 ml syringes will serve as the containers for all intravenous drugs.
Placebo Comparator: placebo group
Normal saline 25ml every 8h for 4 days or until leaving the ICU(death or transfer from ICU to general ward or discharge), whichever come first.
Drug: Placebo(Normal saline)
therapeutic drug and placebo are identical in appearance, and 50 ml syringes will serve as the containers for all intravenous drugs.
Outcome Measures
  • Primary Outcome Measures: 1. all-cause mortality rate [ Time Frame: 28 days ]
    All-cause mortality rate from the enrollment to the 28th days
  • Secondary Outcome Measures: 1. immune function(4) [ Time Frame: Day at 1, 5 after randomization for test the the serum level of CD8+Tcell. ]
    the serum level of CD8+Tcell
  • 2. The level of 5-hydroxytryptamine (5-HT) [ Time Frame: Day at 1,5 after randomization. ]
    The level of plasma 5-HT
  • 3. immune function(1) [ Time Frame: Day at 1, 3, 5 after randomization for test the the serum level of white blood cell(WBC). ]
    the serum level of white blood cell(WBC)
  • 4. immune function(2) [ Time Frame: Day at 1, 3, 5 after randomization for test the the serum level of lymphocyte. ]
    the serum level of lymphocyte
  • 5. immune function(3) [ Time Frame: Day at 1,5 after randomization for test the the serum level of CD4+ Tcell. ]
    the serum level of CD4+ Tcell
  • 6. liver function(1) [ Time Frame: Day at 1,2,3,4,5 after randomization ]
    the serum level of Alanine transaminase(ALT)
  • 7. liver function(2) [ Time Frame: Day at 1,2,3,4,5 after randomization ]
    the serum level of Aspartate transaminase (AST)
  • 8. liver function(3) [ Time Frame: Day at 1,2,3,4,5 after randomization ]
    the serum level of total bilirubin
  • 9. liver function(4) [ Time Frame: Day at 1,2,3,4,5 after randomization ]
    the serum level of direct bilirubin
  • 10. lung function [ Time Frame: Day at 1,2,3,4,5 after randomization ]
    oxygenation index(PaO2/FiO2),the patients treated with extracorporeal membrane oxygenation will not collect this indicator
  • 11. kidney function(1) [ Time Frame: Day at 1,2,3,4,5 after randomization ]
    serum level of Creatinine (Cr)
  • 12. kidney function(2) [ Time Frame: Day at 1,2,3,4,5 after randomization ]
    serum level of blood urea nitrogen(BUN)
  • 13. kidney function(3) [ Time Frame: Day at 1,2,3,4,5 after randomization ]
    serum level of Cystatin(Cys)
  • 14. inflammatory response(1) [ Time Frame: Day at 1,3,5 after randomization. ]
    the serum level of interleukin-6(IL-6)
  • 15. inflammatory response(2) [ Time Frame: Day at 1,3,5 after randomization. ]
    the serum level of C-reactive protein(CRP)
  • 16. inflammatory response(3) [ Time Frame: Day at 1,3,5 after randomization. ]
    the serum level of superoxide dismutase(SOD)
  • 17. inflammatory response(4) [ Time Frame: Day at 1,3,5 after randomization. ]
    the serum level of erythrocyte sedimentation rate(ESR)
  • 18. The level of lactic acid [ Time Frame: Day at 1,2,3,4,5 after randomization ]
    the serum level of lactic acid
  • 19. Sequential Organ Failure Assessment (SOFA) score [ Time Frame: Day at 1, 3, 5 after randomization ]
    Organ dysfunction assessed by Sequential Organ Failure Assessment (SOFA) score.SOFA score is based on six different scores, one each for the respiratory, cardiovascular, hepatic, coagulation, renal and neurological systems.The highest score for each of the six items is 4 points, and the lowest score is 0 points.Finally, the scores of the six items are summed to get the value of the sofa score.The range of the sofa score is 0-24.Higher values represent a worse outcome.
  • 20. The proportion of patients receiving mechanical ventilation [ Time Frame: 28 days ]
    The proportion of patients receiving mechanical ventilation within 28 days after randomization
  • 21. The proportion of patients receiving vasoactive drugs [ Time Frame: 28 days ]
    The proportion of patients receiving vasoactive drugs within 28 days after randomization
  • 22. The proportion of patients receiving renal replacement therapy(CRRT) [ Time Frame: 28 days ]
    The proportion of patients receiving CRRT within 28 days after randomization
  • 23. The duration of mechanical ventilation [ Time Frame: 28 days ]
    The the duration of mechanical ventilation therapy in hours( This outcome measure is intended only for patients receiving mechanical ventilation)
  • 24. The duration of vasoactive drugs [ Time Frame: 28 days ]
    The the duration of vasoactive drugs therapy in hours( This outcome measure is intended only for patients receiving vasoactive drugs)
  • 25. The duration of CRRT [ Time Frame: 28 days ]
    The the duration of CRRT therapy in hours( This outcome measure is intended only for patients receiving CRRT)
  • 26. ICU length of stay [ Time Frame: 28 days ]
    ICU length of stay
  • Other Outcome Measures: 1. Incidence of adverse events [ Time Frame: 28 days ]
    A adverse event refers to any adverse medical event that occur after the intervention of trial. The adverse events are not necessarily causally related to the trial treatment.
  • 2. Incidence of serious adverse events [ Time Frame: 28 days ]
    Any adverse medical event occurs at any dose that meets one or more of the following criteria: 1. causes death 2. life-threatening 3. requires hospitalization or hospitalization for an extended period of time 4. causes permanent or significant disability and functional defects 5. causes deformity
Eligibility Criteria
  • Ages Eligible for Study: 18 to 80 Years (Adult, Older Adult)
  • Sexes Eligible for Study: All
  • Accepts Healthy Volunteers: No
Criteria

Inclusion Criteria(Only patients who fully meet the following criteria are eligible to
participate in the trial):

- Meets the diagnostic criteria for sepsis-3 developed by the American Society of
Critical Care Medicine (SCCM)/European Critical Care Medicine Association (ESICM)

- Age ≥18 years old and age ≤80years old.

- Procalcitonin ≥2ng/ml

Exclusion Criteria:

- Age<18 years, or age>80 years.

- Pregnancy or lactating

- A solid-organ or bone marrow transplant patients.

- Patients with myocardial infarction within the past 3 months.

- Advanced pulmonary fibrosis .

- Patients with cardiopulmonary resuscitation before enrollment.

- HIV-positive patients.

- granulocyte-deficient patients.

- blood/lymphatic system tumors are not remission.

- patients with limited care (lack of commitment to full,aggressive life support).

- patients with long-term use of immunosuppressive drugs or with immunodeficiency.

- patients with advanced tumors.

- patients combined with non-infectious factors leading to the death(uncontrollable
major bleeding, brain hernia, etc.).

- surgically unresolved infection sources(such as some intraperitoneal infection etc.)

- patients allergic to granisetron.

- patients with intestinal obstruction.

Contacts and Locations
Contacts

Contact: zhanguo Liu, M.D.PhD +86-2062782927 zhguoliu@163.com

Contact: ping Chang, M.D.PhD +86-2062782927 changp963@163.com

Locations

China, Guangdong
Department of Critical Care Medicine of Zhujiang Hospital,Southern Medical University
Guangzhou

Sponsors and Collaborators

Zhujiang Hospital

Investigators

Principal Investigator: ping Chang, M.D.PhD Department of Critical Care Medicine of Zhujiang Hospital

More Information