Amiodarone, Lidocaine or Neither for Out-Of-Hospital Cardiac Arrest Due to Ventricular Fibrillation or Tachycardia (ALPS)
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| ClinicalTrials.gov Identifier: NCT01401647 |
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Recruitment Status :
Completed
First Posted : July 25, 2011
Results First Posted : January 30, 2017
Last Update Posted : April 17, 2017
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Sponsor:
University of Washington
Collaborators:
National Heart, Lung, and Blood Institute (NHLBI)
Canadian Institutes of Health Research (CIHR)
Heart and Stroke Foundation of Canada
American Heart Association
Defence Research and Development Canada
U.S. Army Medical Research and Materiel Command
Information provided by (Responsible Party):
Susanne May, University of Washington
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Brief Summary:
The primary objective of the trial is to determine if survival to hospital discharge is improved with early therapeutic administration of a new Captisol-Enabled formulation of IV amiodarone (Nexterone-PM101) compared to placebo.
| Condition or disease | Intervention/treatment | Phase |
|---|---|---|
| Cardiac Arrest | Drug: amiodarone Drug: Lidocaine Other: Normal saline | Phase 3 |
The primary objective of the trial is to determine if survival to hospital discharge is improved with early therapeutic administration of a new Captisol-Enabled formulation of IV amiodarone (PM101) compared to placebo.
The corresponding null hypothesis is that survival to hospital discharge is identically distributed when out-of-hospital VF/VT arrest is treated with PM101 or placebo.
The secondary objectives of the trial are to determine if survival to hospital discharge is improved with early therapeutic administration of:
- Lidocaine compared to placebo
- PM101 compared to lidocaine The corresponding null hypotheses are that survival to hospital admission is identically distributed when out-of-hospital VF/VT arrest is treated with lidocaine as compared with placebo, and with PM101 as compared with lidocaine.
| Study Type : | Interventional (Clinical Trial) |
| Actual Enrollment : | 3024 participants |
| Allocation: | Randomized |
| Intervention Model: | Parallel Assignment |
| Masking: | Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) |
| Primary Purpose: | Treatment |
| Official Title: | Amiodarone, Lidocaine or Neither for Out-Of-Hospital Cardiac Arrest Due to Ventricular Fibrillation (VF) or Ventricular Tachycardia (VT) |
| Study Start Date : | May 2012 |
| Actual Primary Completion Date : | December 2015 |
| Actual Study Completion Date : | January 2016 |
Resource links provided by the National Library of Medicine
| Arm | Intervention/treatment |
|---|---|
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Active Comparator: Amiodarone
Intravenous (IV) or intraosseous (IO) administration of amiodarone if VF/pulseless VT reoccurs after initial defibrillation.
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Drug: amiodarone
300 mg will be given IV/IO push for reoccurrence of ventricular fibrillation or pulseless ventricular tachycardia after 1 or more shocks. A second dose of 150 mg will be given if VF/pulseless VT reoccurs after initial dose and a subsequent shock. The initial dose for patients estimated to be less than 100 pounds will be 150 mg, followed by a second dose of 150 mg if the VF/pulseless VT persists.
Other Name: PM 101, Nexterone |
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Active Comparator: Lidocaine
IV or IO administration of lidocaine if VF/pulseless VT reoccurs after initial defibrillation.
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Drug: Lidocaine
120 mg will be given IV/IO push with reoccurrence of ventricular fibrillation or pulseless ventricular tachycardia after 1 or more shocks. A second dose of 60 mg will be given if VF/pulseless VT reoccurs after initial dose and a subsequent shock. The initial dose for patients estimated to be less than 100 pounds will be 60 mg, followed by a second dose of 60 mg if the VF/pulseless VT persists.
Other Name: lidocaine hydrochloride |
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Placebo Comparator: Normal saline
IV or IO administration of normal saline if VF/pulseless VT reoccurs after initial defibrillation.
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Other: Normal saline
6 cc of normal saline (NS) will be given IV/IO push for reoccurrence of ventricular fibrillation or pulseless ventricular tachycardia after 1 or more shocks. A second dose of 3 cc will be given if VF/pulseless VT reoccurs after initial dose and a subsequent shock. The initial dose for patients estimated to be less than 100 pounds will be 3 cc, followed by a second dose of 3 cc if the VF/pulseless VT persists. |
Primary Outcome Measures :
- Number of Participants Who Survive From the Time of Cardiac Arrest to Hospital Discharge [ Time Frame: Patients will be followed from the time of the cardiac arrest until death, hospital discharge, or December 31, 2015, whichever occurs first. ]Patients may die in the field (outside of the hospital at the time of the cardiac arrest), at the emergency room, in the hospital, or they are discharged alive from the hospital.
Secondary Outcome Measures :
- Number of Participants Scoring at or Below a 3 on the MRS Scale [ Time Frame: Patients will be followed from the time of the cardiac arrest until death, hospital discharge, or December 31, 2015, whichever occurs first. ]Neurologic status at discharge will be assessed using the modified Rankin Score (MRS). A higher value indicates a worse outcome. 0-No symptoms at all; 1-No significant disability despite symptoms; able to carry out all usual duties and activities, 2-Slight disability; unable to carry out all previous activities, but able to look after own affairs without assistance, 3-Moderate disability; requiring some help, but able to walk without assistance; 4-Moderately severe disability; unable to walk without assistance and unable to attend to own bodily needs without assistance, 5-Severe disability; bedridden, incontinent and requiring constant nursing care and attention; 6-Dead
Information from the National Library of Medicine
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| Ages Eligible for Study: | 18 Years and older (Adult, Older Adult) |
| Sexes Eligible for Study: | All |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- Age at least 18 years or local age of consent
- Non-traumatic out-of-hospital cardiac arrest treated by Resuscitation Outcomes Consortium (ROC) emergency medical services (EMS) with advanced life support capability
- VF or pulseless VT presenting as the initial arrest arrhythmia or results from conversion of another arrhythmia (such as transient asystole or pulseless electrical activity)
- Incessant or recurrent VF/VT after receipt of ≥ 1 shocks
- Established vascular access
Exclusion Criteria:
- Asystole or pulseless electrical activity (PEA) as the initial arrest rhythm who never transition to VF or pulseless VT
- Written advance directive to not attempt resuscitation (DNAR)
- Blunt, penetrating, or burn-related injury
- Exsanguination
- Protected populations (prisoners, pregnancy, children under local age of consent)
- Treated exclusively by non-ROC EMS agency/provider, or by basic life support-only capable ROC EMS providers
- Prior receipt of open label lidocaine or amiodarone during resuscitation
Information from the National Library of Medicine
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT01401647
Locations
| United States, Alabama | |
| Alabama Resuscitation Center | |
| Birmingham, Alabama, United States, 35294 | |
| United States, California | |
| UCSD-San Diego Resuscitation Center | |
| San Diego, California, United States, 92103 | |
| United States, Oregon | |
| Portland Resuscitation Outcomes Consortium, Oregon Health & Sciences University | |
| Portland, Oregon, United States, 97239 | |
| United States, Pennsylvania | |
| The Pittsburgh Resuscitation Network, University of Pittsburgh | |
| Pittsburgh, Pennsylvania, United States, 15261 | |
| United States, Texas | |
| Dallas Center for Resuscitation Research, University of Texas Southwestern Medical Center | |
| Dallas, Texas, United States, 75390 | |
| United States, Washington | |
| Seattle-King County Center for Resuscitation Research, University of Washington | |
| Seattle, Washington, United States, 98195 | |
| United States, Wisconsin | |
| Milwaukee Resuscitation Network, Medical College of Wisconsin | |
| Milwaukee, Wisconsin, United States, 53226 | |
| Canada, Ontario | |
| University of Ottawa/University of British Columbia Collaborative RCC, Ottawa Health Research | |
| Ottawa, Ontario, Canada | |
| Toronto Regional Resuscitation Research Out-of-Hospital Network, University of Toronto | |
| Toronto, Ontario, Canada | |
Sponsors and Collaborators
University of Washington
National Heart, Lung, and Blood Institute (NHLBI)
Canadian Institutes of Health Research (CIHR)
Heart and Stroke Foundation of Canada
American Heart Association
Defence Research and Development Canada
U.S. Army Medical Research and Materiel Command
Investigators
| Study Chair: | Myron Weisfeldt, MD | Johns Hopkins University |
Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
| Responsible Party: | Susanne May, Associate Professor, Biostatistics, University of Washington |
| ClinicalTrials.gov Identifier: | NCT01401647 History of Changes |
| Other Study ID Numbers: |
40605-D 5U01HL077863-07 ( U.S. NIH Grant/Contract ) |
| First Posted: | July 25, 2011 Key Record Dates |
| Results First Posted: | January 30, 2017 |
| Last Update Posted: | April 17, 2017 |
| Last Verified: | March 2017 |
Keywords provided by Susanne May, University of Washington:
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cardiac arrest cardiopulmonary resuscitation ventricular fibrillation pulseless ventricular tachycardia Non-traumatic Out of Hospital Cardiac Arrest (OOHCA) |
Additional relevant MeSH terms:
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Heart Arrest Tachycardia Tachycardia, Ventricular Out-of-Hospital Cardiac Arrest Ventricular Fibrillation Heart Diseases Cardiovascular Diseases Arrhythmias, Cardiac Pathologic Processes Lidocaine Amiodarone Anesthetics, Local Anesthetics Central Nervous System Depressants Physiological Effects of Drugs |
Sensory System Agents Peripheral Nervous System Agents Anti-Arrhythmia Agents Voltage-Gated Sodium Channel Blockers Sodium Channel Blockers Membrane Transport Modulators Molecular Mechanisms of Pharmacological Action Vasodilator Agents Potassium Channel Blockers Cytochrome P-450 CYP1A2 Inhibitors Cytochrome P-450 Enzyme Inhibitors Enzyme Inhibitors Cytochrome P-450 CYP2C9 Inhibitors Cytochrome P-450 CYP2D6 Inhibitors Cytochrome P-450 CYP3A Inhibitors |