Clinical trial: a dose-response study of fospropofol disodium for moderate sedation during colonoscopy

Aliment Pharmacol Ther. 2008 Apr 1;27(7):597-608. doi: 10.1111/j.1365-2036.2008.03598.x. Epub 2008 Jan 10.

Abstract

Background: An effective agent is needed that provides rapid onset of sedation and quick recovery for patients undergoing colonoscopy.

Aim: To assess the efficacy and safety of fospropofol disodium in providing sedation in patients undergoing colonoscopy.

Methods: A randomized, double-blind, multicentre trial evaluated 127 adult patients who received fospropofol (2, 5, 6.5 or 8 mg/kg) or midazolam 0.02 mg/kg following pre-treatment with fentanyl. Supplemental doses of study medication were allowed to reach a Modified Observer's Assessment of Alertness/Sedation scale score < or =4. Efficacy end points included sedation success, measures of clinical benefit, sedation, and recovery as well as patient- and doctor-rated satisfaction.

Results: Fospropofol produced a significant dose-dependent increase in sedation success from 24% (2 mg/kg), 35% (5 mg/kg) and 69% (6.5 mg/kg) to 96% (8 mg/kg; P < 0.001). There were also dose-dependent trends for time to sedation, requirements for alternative sedative medication, supplemental doses of sedative and fentanyl, time to ready for discharge and doctor-rated satisfaction scores. Fospropofol was well tolerated, with most adverse events mild-to-moderate in severity.

Conclusion: The 6.5 mg/kg dose of fospropofol provides the ideal balance of efficacy and safety for patients undergoing colonoscopy and has been selected for phase 3 clinical development.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anticonvulsants / administration & dosage*
  • Anticonvulsants / adverse effects
  • Colonoscopy
  • Conscious Sedation*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Midazolam
  • Middle Aged
  • Patient Satisfaction
  • Phenytoin / administration & dosage
  • Phenytoin / adverse effects
  • Phenytoin / analogs & derivatives*

Substances

  • Anticonvulsants
  • Phenytoin
  • fosphenytoin
  • Midazolam