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比较西普鲁福(HSK3486)与异丙酚用于胃镜和结肠镜检查中深度镇静诱导的效果:一项多中心、非劣效性、随机、对照 3 期临床试验。

Comparison of ciprofol (HSK3486) versus propofol for the induction of deep sedation during gastroscopy and colonoscopy procedures: A multi-centre, non-inferiority, randomized, controlled phase 3 clinical trial.

机构信息

Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China.

Department of Anesthesiology, Pi du District People's Hospital, Chengdu, China.

出版信息

Basic Clin Pharmacol Toxicol. 2022 Aug;131(2):138-148. doi: 10.1111/bcpt.13761. Epub 2022 Jun 10.

DOI:10.1111/bcpt.13761
PMID:35653554
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9543620/
Abstract

Ciprofol is a propofol analogue with improved pharmacokinetic properties. A multi-centre, non-inferiority trial was conducted to compare the deep sedation properties of ciprofol and propofol with a non-inferiority margin of 8% in patients undergoing gastroscopy and colonoscopy. In total, 289 patients were randomly allocated for surgery (259 colonoscopy and 30 gastroscopy) at a 1:1 ratio to be given intravenous injections of ciprofol (0.4 mg/kg) or propofol (1.5 mg/kg). The primary outcome was the success rate of colonoscopy defined as colonoscopy completion with no need for an alternative sedative or >5 ciprofol or propofol top up doses within any 15-min time period. The success rate of colonoscopy was 100% in the ciprofol group vs. 99.2% in the propofol group (mean difference 0.8%, 95% CI: -2.2% to 4.2%). Except for the gastrointestinal lesions found during the gastroscopy and colonoscopy procedures, the occurrence rates of adverse drug reactions in the ciprofol and propofol groups were 31.3% and 62.8%, respectively (P < 0.001). Pain on injection was less common in the ciprofol group (4.9% vs. 52.4%, P < 0.001). The outcomes demonstrated that ciprofol was non-inferior to propofol with regard to successful sedation for gastroscopy or colonoscopy procedures and no obvious important adverse events occurred.

摘要

西普罗酚是一种具有改良药代动力学特性的丙泊酚类似物。一项多中心、非劣效性试验旨在比较西普罗酚和丙泊酚在接受胃镜和结肠镜检查的患者中进行深度镇静的效果,非劣效性边界为 8%。共有 289 名患者按 1:1 的比例随机分配接受手术(259 例结肠镜检查和 30 例胃镜检查),分别静脉注射西普罗酚(0.4mg/kg)或丙泊酚(1.5mg/kg)。主要结局是结肠镜检查的成功率,定义为结肠镜检查完成,无需使用替代镇静剂,或在任何 15 分钟时间段内无需补充超过 5 次西普罗酚或丙泊酚。西普罗酚组的结肠镜检查成功率为 100%,丙泊酚组为 99.2%(平均差异 0.8%,95%CI:-2.2%至 4.2%)。除了在胃镜和结肠镜检查过程中发现的胃肠道病变外,西普罗酚组和丙泊酚组不良反应的发生率分别为 31.3%和 62.8%(P<0.001)。注射部位疼痛在西普罗酚组更为少见(4.9% vs. 52.4%,P<0.001)。结果表明,西普罗酚在胃镜或结肠镜检查的镇静成功率方面非劣效于丙泊酚,且未发生明显的重要不良事件。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4eb5/9543620/6a92f2cb3f4e/BCPT-131-138-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4eb5/9543620/460da33d8ada/BCPT-131-138-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4eb5/9543620/6a92f2cb3f4e/BCPT-131-138-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4eb5/9543620/460da33d8ada/BCPT-131-138-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4eb5/9543620/6a92f2cb3f4e/BCPT-131-138-g001.jpg

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本文引用的文献

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Am J Transl Res. 2021 Dec 15;13(12):13791-13802. eCollection 2021.
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Efficacy and safety of ciprofol for the sedation/anesthesia in patients undergoing colonoscopy: Phase IIa and IIb multi-center clinical trials.西普罗尔在结肠镜检查镇静/麻醉中的疗效和安全性:Ⅱa 期和Ⅱb 期多中心临床试验。
Eur J Pharm Sci. 2021 Sep 1;164:105904. doi: 10.1016/j.ejps.2021.105904. Epub 2021 Jun 8.
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