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    Clinical Trial Results:
    A Phase 4 Randomised, Active-Comparator Controlled Trial to Study the Efficacy and Safety of Sugammadex (MK-8616) for the Reversal of Neuromuscular Blockade Induced by Either Rocuronium Bromide or Vecuronium Bromide in Morbidly Obese Subjects

    Summary
    EudraCT number
    2017-000188-33
    Trial protocol
    DK   BE   AT  
    Global end of trial date
    29 Jan 2019

    Results information
    Results version number
    v1(current)
    This version publication date
    20 Dec 2019
    First version publication date
    20 Dec 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    MK-8616-146
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03346070
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Merck Sharp & Dohme Corp.
    Sponsor organisation address
    2000 Galloping Hill Road, Kenilworth, NJ, United States, 07033
    Public contact
    Clinical Trials Disclosure, Merck Sharp & Dohme Corp., ClinicalTrialsDisclosure@merck.com
    Scientific contact
    Clinical Trials Disclosure, Merck Sharp & Dohme Corp., ClinicalTrialsDisclosure@merck.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    29 Jan 2019
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    29 Jan 2019
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The purpose of this trial is to evaluate the safety and efficacy of Sugammadex when administered according to actual body weight (ABW) as compared to ideal body weight (IBW) for the reversal of both moderate and deep neuromuscular blockade (NMB) induced by either Rocuronium or Vecuronium in morbidly obese participants
    Protection of trial subjects
    This study was conducted in conformance with Good Clinical Practice standards and applicable country and/or local statutes and regulations regarding ethical committee review, informed consent, and the protection of human subjects participating in biomedical research.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    01 Jan 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Austria: 3
    Country: Number of subjects enrolled
    Belgium: 9
    Country: Number of subjects enrolled
    Denmark: 10
    Country: Number of subjects enrolled
    Germany: 115
    Country: Number of subjects enrolled
    United States: 70
    Worldwide total number of subjects
    207
    EEA total number of subjects
    137
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    1
    Adults (18-64 years)
    184
    From 65 to 84 years
    22
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    -

    Pre-assignment
    Screening details
    Potential subjects were evaluated to determine if they fulfill entry requirements.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator, Monitor, Carer, Assessor

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Sugammadex 2 mg/kg Actual Body Weight (ABW)
    Arm description
    Following administration of neuromuscular blocking agent (NMBA), participants received a single intravenous (i.v.) bolus of Sugammadex at 2 mg/kg as determined utilising participant ABW. A treatment dose of 2 mg/kg was used for reversal of moderate NMB.
    Arm type
    Experimental

    Investigational medicinal product name
    Sugammadex 2 mg/kg ABW
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous bolus use
    Dosage and administration details
    Following administration of NMBA (Rocuronium or Vecuronium) to achieve moderate NMB, participants received a single i.v. bolus of Sugammadex (2 mg/kg by ABW) for reversal of moderate NMB. Moderate NMB is defined as the reappearance of a second twitch (T2) in response to Train of Four (TOF) stimulations.

    Investigational medicinal product name
    Rocuronium or Vecuronium
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    To achieve NMB, participants received steroidal NMBA Rocuronium Bromide or Vecuronium Bromide administered via i.v. infusion and dosed according to participant ABW. NMBAs were concomitant medications used per label as adjunct to general anesthesia.

    Arm title
    Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Arm description
    Following administration of NMBA, participants received a single i.v. bolus of Sugammadex at 2 mg/kg as determined utilising participant IBW. A treatment dose of 2 mg/kg was used for reversal of moderate NMB.
    Arm type
    Experimental

    Investigational medicinal product name
    Sugammadex 2 mg/kg IBW
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous bolus use
    Dosage and administration details
    Following administration of NMBA (Rocuronium or Vecuronium) to achieve moderate NMB, participants received a single i.v. bolus of Sugammadex (2 mg/kg by IBW) for reversal of moderate NMB. Moderate NMB is defined as the reappearance of T2 in response to TOF stimulations.

    Investigational medicinal product name
    Rocuronium or Vecuronium
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    To achieve NMB, participants received steroidal NMBA Rocuronium Bromide or Vecuronium Bromide administered via i.v. infusion and dosed according to participant ABW. NMBAs were concomitant medications used per label as adjunct to general anesthesia.

    Arm title
    Sugammadex 4 mg/kg ABW
    Arm description
    Following administration of NMBA, participants received a single i.v. bolus of Sugammadex at 4 mg/kg as determined utilising participant ABW. A treatment dose of 4 mg/kg was used for reversal of deep NMB.
    Arm type
    Experimental

    Investigational medicinal product name
    Sugammadex 4 mg/kg ABW
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous bolus use
    Dosage and administration details
    Following administration of NMBA (Rocuronium or Vecuronium) to achieve deep NMB, participants received a single i.v. bolus of Sugammadex (4 mg/kg by ABW) for reversal of deep NMB. Deep NMB is defined as no response to TOF stimulations (TOF=0) and a detection target of 1-2 post-tetanic counts (PTCs).

    Investigational medicinal product name
    Rocuronium or Vecuronium
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    To achieve NMB, participants received steroidal NMBA Rocuronium Bromide or Vecuronium Bromide administered via i.v. infusion and dosed according to participant ABW. NMBAs were concomitant medications used per label as adjunct to general anesthesia.

    Arm title
    Sugammadex 4 mg/kg IBW
    Arm description
    Following administration of NMBA, participants received a single i.v. bolus of Sugammadex at 4 mg/kg as determined utilising participant IBW. A treatment dose of 4 mg/kg was used for reversal of deep NMB.
    Arm type
    Experimental

    Investigational medicinal product name
    Sugammadex 4 mg/kg IBW
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous bolus use
    Dosage and administration details
    Following administration of NMBA (Rocuronium or Vecuronium) to achieve deep NMB, participants received a single i.v. bolus of Sugammadex (4 mg/kg by IBW) for reversal of deep NMB. Deep NMB is defined as no response to TOF stimulations (TOF=0) and a detection target of 1-2 post-tetanic counts (PTCs).

    Investigational medicinal product name
    Rocuronium or Vecuronium
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    To achieve NMB, participants received steroidal NMBA Rocuronium Bromide or Vecuronium Bromide administered via i.v. infusion and dosed according to participant ABW. NMBAs were concomitant medications used per label as adjunct to general anesthesia.

    Arm title
    Neostigmine/Glycopyrrolate
    Arm description
    Following administration of NMBA, participants received a single i.v. bolus containing both Neostigmine (50 µg/kg; up to 5 mg maximum dose) and Glycopyrrolate (10 µg/kg; up to 1 mg maximum dose) as determined utilising participant ABW. Neostigmine/Glycopyrrolate was used for reversal of moderate NMB. Active comparator treatment for reversal for deep NMB was not available.
    Arm type
    Active comparator

    Investigational medicinal product name
    Neostigmine + Glycopyrrolate
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous bolus use
    Dosage and administration details
    Following administration of NMBA (Rocuronium or Vecuronium) to achieve moderate NMB, participants received a single i.v. bolus of Neostigmine (50 μg/kg; 5 mg maximum) and Glycopyrrolate (10 μg/kg; 1 mg maximum), dosed according to participant ABW for reversal of moderate NMB. Moderate NMB is defined as the reappearance of T2 in response to TOF stimulations.

    Investigational medicinal product name
    Rocuronium or Vecuronium
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection
    Routes of administration
    Intravenous use
    Dosage and administration details
    To achieve NMB, participants received steroidal NMBA Rocuronium Bromide or Vecuronium Bromide administered via i.v. infusion and dosed according to participant ABW. NMBAs were concomitant medications used per label as adjunct to general anesthesia.

    Number of subjects in period 1
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate
    Started
    41
    41
    41
    42
    42
    Treated
    38
    38
    38
    36
    38
    Completed
    38
    37
    37
    36
    37
    Not completed
    3
    4
    4
    6
    5
         Adverse event, serious fatal
    -
    -
    -
    -
    1
         Consent withdrawn by subject
    1
    -
    -
    1
    -
         Physician decision
    -
    -
    -
    1
    1
         Screen Failure
    -
    -
    -
    1
    1
         Study medication not received as planned
    2
    2
    3
    3
    2
         Lost to follow-up
    -
    2
    1
    -
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Sugammadex 2 mg/kg Actual Body Weight (ABW)
    Reporting group description
    Following administration of neuromuscular blocking agent (NMBA), participants received a single intravenous (i.v.) bolus of Sugammadex at 2 mg/kg as determined utilising participant ABW. A treatment dose of 2 mg/kg was used for reversal of moderate NMB.

    Reporting group title
    Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Reporting group description
    Following administration of NMBA, participants received a single i.v. bolus of Sugammadex at 2 mg/kg as determined utilising participant IBW. A treatment dose of 2 mg/kg was used for reversal of moderate NMB.

    Reporting group title
    Sugammadex 4 mg/kg ABW
    Reporting group description
    Following administration of NMBA, participants received a single i.v. bolus of Sugammadex at 4 mg/kg as determined utilising participant ABW. A treatment dose of 4 mg/kg was used for reversal of deep NMB.

    Reporting group title
    Sugammadex 4 mg/kg IBW
    Reporting group description
    Following administration of NMBA, participants received a single i.v. bolus of Sugammadex at 4 mg/kg as determined utilising participant IBW. A treatment dose of 4 mg/kg was used for reversal of deep NMB.

    Reporting group title
    Neostigmine/Glycopyrrolate
    Reporting group description
    Following administration of NMBA, participants received a single i.v. bolus containing both Neostigmine (50 µg/kg; up to 5 mg maximum dose) and Glycopyrrolate (10 µg/kg; up to 1 mg maximum dose) as determined utilising participant ABW. Neostigmine/Glycopyrrolate was used for reversal of moderate NMB. Active comparator treatment for reversal for deep NMB was not available.

    Reporting group values
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate Total
    Number of subjects
    41 41 41 42 42 207
    Age categorical
    As a result of the data convention used for calculation of age for this study, one subject is displayed in the "Adolescents [12-17 years]" reporting group. It was confirmed that this subject was 18 years of age at the time of signing informed consent and was eligible to be enrolled into the study.
    Units: Subjects
        In utero
    0 0 0 0 0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0 0 0 0 0
        Newborns (0-27 days)
    0 0 0 0 0 0
        Infants and toddlers (28 days-23 months)
    0 0 0 0 0 0
        Children (2-11 years)
    0 0 0 0 0 0
        Adolescents (12-17 years)
    0 1 0 0 0 1
        Adults (18-64 years)
    36 35 39 37 37 184
        From 65-84 years
    5 5 2 5 5 22
        85 years and over
    0 0 0 0 0 0
    Age Continuous
    Units: Years
        arithmetic mean (standard deviation)
    47.7 ( 14.4 ) 47.6 ( 14.5 ) 46.4 ( 11.2 ) 49.2 ( 11.7 ) 47.7 ( 13.3 ) -
    Sex: Female, Male
    Units: Subjects
        Female
    34 30 24 32 29 149
        Male
    7 11 17 10 13 58
    Race (NIH/OMB)
    Units: Subjects
        American Indian or Alaska Native
    0 0 0 0 0 0
        Asian
    0 0 0 0 0 0
        Native Hawaiian or Other Pacific Islander
    0 0 0 1 0 1
        Black or African American
    2 4 2 3 3 14
        White
    39 37 39 38 38 191
        More than one race
    0 0 0 0 1 1
        Unknown or Not Reported
    0 0 0 0 0 0
    Ethnicity (NIH/OMB)
    Units: Subjects
        Hispanic or Latino
    1 1 4 5 2 13
        Not Hispanic or Latino
    38 40 37 37 39 191
        Unknown or Not Reported
    2 0 0 0 1 3

    End points

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    End points reporting groups
    Reporting group title
    Sugammadex 2 mg/kg Actual Body Weight (ABW)
    Reporting group description
    Following administration of neuromuscular blocking agent (NMBA), participants received a single intravenous (i.v.) bolus of Sugammadex at 2 mg/kg as determined utilising participant ABW. A treatment dose of 2 mg/kg was used for reversal of moderate NMB.

    Reporting group title
    Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Reporting group description
    Following administration of NMBA, participants received a single i.v. bolus of Sugammadex at 2 mg/kg as determined utilising participant IBW. A treatment dose of 2 mg/kg was used for reversal of moderate NMB.

    Reporting group title
    Sugammadex 4 mg/kg ABW
    Reporting group description
    Following administration of NMBA, participants received a single i.v. bolus of Sugammadex at 4 mg/kg as determined utilising participant ABW. A treatment dose of 4 mg/kg was used for reversal of deep NMB.

    Reporting group title
    Sugammadex 4 mg/kg IBW
    Reporting group description
    Following administration of NMBA, participants received a single i.v. bolus of Sugammadex at 4 mg/kg as determined utilising participant IBW. A treatment dose of 4 mg/kg was used for reversal of deep NMB.

    Reporting group title
    Neostigmine/Glycopyrrolate
    Reporting group description
    Following administration of NMBA, participants received a single i.v. bolus containing both Neostigmine (50 µg/kg; up to 5 mg maximum dose) and Glycopyrrolate (10 µg/kg; up to 1 mg maximum dose) as determined utilising participant ABW. Neostigmine/Glycopyrrolate was used for reversal of moderate NMB. Active comparator treatment for reversal for deep NMB was not available.

    Subject analysis set title
    Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW)
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    Following administration of NMBA, participants who received a single i.v. bolus of Sugammadex at 2 mg/kg as determined utilising participant ABW, and those who received a single i.v. bolus of Sugammadex at 4 mg/kg as determined utilising participant ABW were pooled by dosing method across depth of NMB. Treatment doses of 2 mg/kg and 4 mg/kg were used for reversal of moderate NMB and deep NMB respectively.

    Subject analysis set title
    Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    Following administration of NMBA, participants who received a single i.v. bolus of Sugammadex at 2 mg/kg as determined utilising participant IBW, and those who received a single i.v. bolus of Sugammadex at 4 mg/kg as determined utilising participant IBW were pooled by dosing method across depth of NMB. Treatment doses of 2 mg/kg and 4 mg/kg were used for reversal of moderate NMB and deep NMB respectively.

    Subject analysis set title
    Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW)
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    Following administration of NMBA, participants who received a single i.v. bolus of Sugammadex at 2 mg/kg as determined utilising participant ABW, and those who received a single i.v. bolus of Sugammadex at 4 mg/kg as determined utilising participant ABW were pooled by dosing method across depth of NMB. Treatment doses of 2 mg/kg and 4 mg/kg were used for reversal of moderate NMB and deep NMB respectively.

    Subject analysis set title
    Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    Following administration of NMBA, participants who received a single i.v. bolus of Sugammadex at 2 mg/kg as determined utilising participant IBW, and those who received a single i.v. bolus of Sugammadex at 4 mg/kg as determined utilising participant IBW were pooled by dosing method across depth of NMB. Treatment doses of 2 mg/kg and 4 mg/kg were used for reversal of moderate NMB and deep NMB respectively.

    Primary: Time to Recovery (TTR) of Participant Train Of Four (TOF) Ratio to ≥0.9: Primary Kaplan-Meier Analysis

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    End point title
    Time to Recovery (TTR) of Participant Train Of Four (TOF) Ratio to ≥0.9: Primary Kaplan-Meier Analysis
    End point description
    The primary efficacy analysis of TTR of TOF ratio to ≥0.9 was performed by estimating event rates within each treatment group using the Kaplan-Meier method. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.9 indicates faster recovery from NMB. Analysis population consisted of all randomised participants dosed with both an NMBA and an NMB reversal agent (study treatment) with ≥1 post-randomisation efficacy assessment. As specified by the protocol, analysis was performed in treatment arms pooled by dosing method across depth of NMB as well as in all randomised treatment arms separated by depth of NMB.
    End point type
    Primary
    End point timeframe
    Up to 76 minutes
    End point values
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects analysed
    38
    37
    37
    36
    38
    75
    73
    Units: Minutes
        median (confidence interval 95%)
    1.7 (1.5 to 2.1)
    3.4 (2.2 to 4.4)
    1.8 (1.5 to 2.1)
    3.3 (2.4 to 4.2)
    34.5 (27.0 to 67.4)
    1.8 (1.6 to 2.1)
    3.3 (2.6 to 4.1)
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Number of subjects included in analysis
    75
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0075
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    1.92
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.18
         upper limit
    3.1
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    25.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    9.72
         upper limit
    69.03
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 2 mg/kg Ideal Body Weight (IBW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    75
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    61.4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    14.13
         upper limit
    266.77
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 4 mg/kg ABW v Sugammadex 4 mg/kg IBW
    Number of subjects included in analysis
    73
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0005
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    2.38
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.44
         upper limit
    3.93
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) v Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects included in analysis
    148
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    < 0.0001
    Method
    Logrank
    Parameter type
    Hazard ratio (HR)
    Point estimate
    2.13
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    1.5
         upper limit
    3.01

    Primary: Percentage of Participants with Treatment-Emergent Sinus Bradycardia Events

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    End point title
    Percentage of Participants with Treatment-Emergent Sinus Bradycardia Events
    End point description
    The percentage of participants experiencing treatment-emergent bradycardia events were identified with continuous electrocardiogram (ECG) monitoring. Treatment-emergent sinus bradycardia is defined as a heart rate <60 bpm that has also decreased more than 20% compared to participant baseline heart rate value, sustained for at least 1 minute after administration of study intervention. Treatment-emergent sinus bradycardia events may or may not be considered an adverse event (AE), as determined by investigator judgment. Analysis population consisted of all randomised participants who received at least one dose of study treatment. As specified by the protocol, analysis was performed in treatment arms pooled by dosing method across depth of NMB as well as in all randomised treatment arms separated by depth of NMB.
    End point type
    Primary
    End point timeframe
    Up to 35 minutes
    End point values
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects analysed
    38
    38
    38
    36
    38
    76
    74
    Units: Percentage of participants
        number (not applicable)
    5.3
    2.6
    5.3
    5.6
    2.6
    5.3
    4.1
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.602
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    2.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -9.6
         upper limit
    15
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg ABW v Sugammadex 4 mg/kg IBW
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.969
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    0.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -13.4
         upper limit
    13.5
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.567
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    2.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -8.7
         upper limit
    15
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg ABW v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.571
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    2.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -8.8
         upper limit
    15
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Ideal Body Weight (IBW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.95
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    -0.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -11.6
         upper limit
    10.9
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg IBW v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.528
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    2.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -8.4
         upper limit
    15.9
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) v Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects included in analysis
    150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.709
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    1.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -6.8
         upper limit
    9.6

    Primary: Percentage of Participants with Treatment-Emergent Sinus Tachycardia Events

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    End point title
    Percentage of Participants with Treatment-Emergent Sinus Tachycardia Events
    End point description
    The percentage of participants experiencing treatment-emergent sinus tachycardia events were identified with continuous ECG monitoring. Treatment-emergent sinus tachycardia is defined as a heart rate ≥100 bpm that has also increased more than 20% compared to participant baseline heart rate value, sustained for at least 1 minute after administration of study intervention. Treatment-emergent sinus tachycardia events may or may not be considered an AE, as determined by investigator judgment. Analysis population consisted of all randomised participants who received at least one dose of study treatment. As specified by the protocol, analysis was performed in treatment arms pooled by dosing method across depth of NMB as well as in all randomised treatment arms separated by depth of NMB.
    End point type
    Primary
    End point timeframe
    Up to 35 minutes
    End point values
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects analysed
    38
    38
    38
    36
    38
    76
    74
    Units: Percentage of participants
        number (not applicable)
    10.5
    7.9
    13.2
    2.8
    7.9
    11.8
    5.4
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.738
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    2.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -12.3
         upper limit
    17.4
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg ABW v Sugammadex 4 mg/kg IBW
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.077
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    11.1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.7
         upper limit
    26.3
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.717
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    2.4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -12
         upper limit
    16.4
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg ABW v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.486
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -9.9
         upper limit
    19.7
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Ideal Body Weight (IBW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.849
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    -1.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -16.2
         upper limit
    12.4
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg IBW v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.339
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    -4.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -18.2
         upper limit
    6.7
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) v Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects included in analysis
    150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.149
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    6.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -2.6
         upper limit
    16.8

    Primary: Percentage of Participants with Other Treatment-Emergent Cardiac Arrhythmia Events

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    End point title
    Percentage of Participants with Other Treatment-Emergent Cardiac Arrhythmia Events
    End point description
    The percentage of participants experiencing other treatment-emergent cardiac arrhythmia events were identified with continuous ECG monitoring. Other treatment-emergent cardiac arrhythmias are defined as new or worsening arrhythmias (e.g., atrial fibrillation, atrial tachyarrhythmia, ventricular fibrillation, or ventricular tachyarrhythmia), sustained for at least 1 minute after administration of study intervention. Worsening arrhythmia events may or may not be considered an AE, as determined by investigator judgment. Analysis population consisted of all randomised participants who received at least one dose of study treatment. As specified by the protocol, analysis was performed in treatment arms pooled by dosing method across depth of NMB as well as in all randomised treatment arms separated by depth of NMB.
    End point type
    Primary
    End point timeframe
    Up to 35 minutes
    End point values
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects analysed
    38
    38
    38
    36
    38
    76
    74
    Units: Percentage of participants
        number (not applicable)
    0.0
    2.6
    0.0
    0.0
    2.6
    0.0
    1.4
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.299
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    -2.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -13.9
         upper limit
    6.7
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg ABW v Sugammadex 4 mg/kg IBW
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    > 0.999
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    0
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -9.9
         upper limit
    9.4
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.326
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    -2.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -13.7
         upper limit
    7
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg ABW v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    P-value
    = 0.335
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    -2.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -13.6
         upper limit
    7.1
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Ideal Body Weight (IBW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.935
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    0.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -11.1
         upper limit
    11.9
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg IBW v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.326
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    -2.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -13.8
         upper limit
    7.3
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) v Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects included in analysis
    150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.299
    Method
    Miettinen & Nurminen method
    Parameter type
    Difference in percentage
    Point estimate
    -1.4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -7.5
         upper limit
    3.5

    Primary: Percentage of Participants Experiencing an Adverse Event (AE) after Administration of Study Intervention

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    End point title
    Percentage of Participants Experiencing an Adverse Event (AE) after Administration of Study Intervention
    End point description
    The percentage of participants experiencing an AE following administration of study intervention was monitored. An AE is any unfavorable and unintended medical occurrence, symptom, or disease witnessed in a participant, regardless of whether or not a causal relationship with the study treatment can be demonstrated. Further, any worsening (i.e. any clinically significant adverse change in frequency and/or intensity) of a pre-existing condition that is temporally associated with the use of the study treatment is also considered an AE. Analysis population consisted of all randomised participants who received at least one dose of study treatment. As specified by the protocol, analysis was performed in treatment arms pooled by dosing method across depth of NMB as well as in all randomised treatment arms separated by depth of NMB.
    End point type
    Primary
    End point timeframe
    Up to 7 days
    End point values
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects analysed
    38
    38
    38
    36
    38
    76
    74
    Units: Percentage of participants
        number (not applicable)
    94.7
    94.7
    86.8
    91.7
    89.5
    90.8
    93.2
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    0.1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -12.7
         upper limit
    13.1
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg ABW v Sugammadex 4 mg/kg IBW
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -3.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -19.6
         upper limit
    12.2
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    5.1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -8.1
         upper limit
    19.7
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg ABW v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -2.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -18
         upper limit
    13.1
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Ideal Body Weight (IBW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    4.4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -9.6
         upper limit
    19.2
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg IBW v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    2.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -12.5
         upper limit
    17
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) v Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects included in analysis
    150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -1.8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -11.4
         upper limit
    7.8

    Primary: Percentage of Participants Experiencing a Serious Adverse Event (SAE) after Administration of Study Intervention

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    End point title
    Percentage of Participants Experiencing a Serious Adverse Event (SAE) after Administration of Study Intervention
    End point description
    The percentage of participants experiencing an SAE following administration of study intervention was monitored. An SAE is an adverse event that: results in death; is life threatening; results in persistent or significant disability or incapacity; results in or prolongs a hospitalization; is a congenital anomaly or birth defect; is a cancer; or may jeopardize the participant, potentially requiring medical or surgical intervention. Analysis population consisted of all randomised participants who received at least one dose of study treatment. As specified by the protocol, analysis was performed in treatment arms pooled by dosing method across depth of NMB as well as in all randomised treatment arms separated by depth of NMB.
    End point type
    Primary
    End point timeframe
    Up to 7 days
    End point values
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects analysed
    38
    38
    38
    36
    38
    76
    74
    Units: Percentage of participants
        number (not applicable)
    2.6
    5.3
    0.0
    8.3
    7.9
    1.3
    6.8
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -2.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -15.2
         upper limit
    9.1
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg ABW v Sugammadex 4 mg/kg IBW
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -8.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -22.3
         upper limit
    1.3
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -5.3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -18.8
         upper limit
    6.8
    Statistical analysis title
    Difference in percentage
    Comparison groups
    Sugammadex 4 mg/kg ABW v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -21.2
         upper limit
    1.8
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Ideal Body Weight (IBW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -2.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -17
         upper limit
    10.5
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg IBW v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    0.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -14
         upper limit
    15.5
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) v Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects included in analysis
    150
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -5.5
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -13.9
         upper limit
    1.2

    Primary: Percentage of Participants Experiencing an Event of Clinical Interest (ECI) after Administration of Study Intervention

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    End point title
    Percentage of Participants Experiencing an Event of Clinical Interest (ECI) after Administration of Study Intervention
    End point description
    The percentage of participants experiencing an ECI following administration of study intervention was monitored. ECIs are a discrete set of both AEs and SAEs, specifically designated as such for the trial. For the purposes of this investigation, ECIs included 1) drug-induced liver injury; 2) clinically-relevant arrhythmias, inclusive of bradycardia and tachycardia defined as events necessitating intervention, as determined by investigator judgment; and 3) instances of hypersensitivity and/or anaphylaxis adjudicated by an external expert Adjudication Committee. Analysis population consisted of all randomised participants who received at least one dose of study treatment. As specified by the protocol, analysis was performed in treatment arms pooled by dosing method across depth of NMB as well as in all randomised treatment arms separated by depth of NMB.
    End point type
    Primary
    End point timeframe
    Up to 7 days
    End point values
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects analysed
    38
    38
    38
    36
    38
    76
    74
    Units: Percentage of participants
        number (not applicable)
    0.0
    2.6
    2.6
    2.8
    2.6
    1.3
    2.7
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -2.4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -13.4
         upper limit
    7.3
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg ABW v Sugammadex 4 mg/kg IBW
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -0.4
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -12.3
         upper limit
    10.8
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -2.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -13.7
         upper limit
    7
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg ABW v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    other
    Method
    Parameter type
    Difference in percentage
    Point estimate
    0.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -11.2
         upper limit
    11.7
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Ideal Body Weight (IBW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -0.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -11.5
         upper limit
    11
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg IBW v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    74
    Analysis specification
    Pre-specified
    Analysis type
    other
    Method
    Parameter type
    Difference in percentage
    Point estimate
    0.2
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -11
         upper limit
    12

    Secondary: Percentage of Participants with Prolonged (>10 minutes) Time to Recovery (TTR) of the Train Of Four (TOF) ratio to ≥0.9

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    End point title
    Percentage of Participants with Prolonged (>10 minutes) Time to Recovery (TTR) of the Train Of Four (TOF) ratio to ≥0.9
    End point description
    Following administration of study intervention, the percentage of participants experiencing prolonged (>10 minutes) recovery to a TOF ratio ≥0.9 was calculated. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.9 indicates faster recovery from NMB. Analysis population consisted of all randomised participants dosed with both an NMBA and an NMB reversal agent (study treatment) with ≥1 post-randomisation efficacy assessment. As specified by the protocol, analysis was performed in treatment arms pooled by dosing method across depth of NMB as well as in all randomised treatment arms separated by depth of NMB.
    End point type
    Secondary
    End point timeframe
    Up to 76 minutes
    End point values
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects analysed
    38
    37
    37
    36
    38
    75
    73
    Units: Percentage of participants
        number (not applicable)
    7.9
    5.4
    2.7
    0.0
    84.2
    5.3
    2.7
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Number of subjects included in analysis
    75
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    3
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -10.8
         upper limit
    16.9
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -76.1
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -87.2
         upper limit
    -57.6
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 2 mg/kg Ideal Body Weight (IBW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    75
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    -78.7
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -88.8
         upper limit
    -61.1
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex 4 mg/kg ABW v Sugammadex 4 mg/kg IBW
    Number of subjects included in analysis
    73
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    2.8
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -7.2
         upper limit
    14.2
    Statistical analysis title
    Difference in percentage of participants
    Comparison groups
    Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) v Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects included in analysis
    148
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Difference in percentage
    Point estimate
    2.9
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -4.8
         upper limit
    11

    Secondary: Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.9: Secondary Geometric Mean Analysis

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    End point title
    Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.9: Secondary Geometric Mean Analysis
    End point description
    The secondary efficacy analysis of TTR of participant TOF ratio to ≥0.9 was performed by estimating the geometric mean of TTR within each treatment group. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.9 indicates faster recovery from NMB. Analysis population consisted of all randomised participants dosed with both an NMBA and an NMB reversal agent (study treatment) with ≥1 post-randomisation efficacy assessment. As specified by the protocol, analysis was performed in treatment arms pooled by dosing method across depth of NMB as well as in all randomised treatment arms separated by depth of NMB.
    End point type
    Secondary
    End point timeframe
    Up to 76 minutes
    End point values
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects analysed
    38
    37
    37
    36
    38
    75
    73
    Units: Minutes
        geometric mean (confidence interval 95%)
    2.0 (1.7 to 2.5)
    3.2 (2.6 to 3.9)
    1.9 (1.5 to 2.3)
    3.5 (2.9 to 4.3)
    23.1 (18.3 to 29.2)
    2.0 (1.7 to 2.3)
    3.3 (2.9 to 3.8)
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Number of subjects included in analysis
    75
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.64
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.48
         upper limit
    0.86
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.09
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.06
         upper limit
    0.12
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 2 mg/kg Ideal Body Weight (IBW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    75
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.14
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.1
         upper limit
    0.19
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 4 mg/kg ABW v Sugammadex 4 mg/kg IBW
    Number of subjects included in analysis
    73
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.54
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.4
         upper limit
    0.71
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) v Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects included in analysis
    148
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.59
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.48
         upper limit
    0.72

    Secondary: Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.8: Geometric Mean Analysis

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    End point title
    Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.8: Geometric Mean Analysis
    End point description
    The efficacy analysis of TTR of participant TOF ratio to ≥0.8 was performed by estimating the geometric mean of TTR within each treatment group. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.8 indicates faster recovery from NMB. Analysis population consisted of all randomised participants dosed with both an NMBA and an NMB reversal agent (study treatment) with ≥1 post-randomisation efficacy assessment. As specified by the protocol, analysis was performed in treatment arms pooled by dosing method across depth of NMB as well as in all randomised treatment arms separated by depth of NMB.
    End point type
    Secondary
    End point timeframe
    Up to 69 minutes
    End point values
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects analysed
    38
    37
    37
    36
    38
    75
    73
    Units: Minutes
        geometric mean (confidence interval 95%)
    1.6 (1.3 to 1.8)
    2.5 (2.1 to 2.9)
    1.5 (1.2 to 1.7)
    2.6 (2.1 to 3.1)
    16.6 (12.8 to 21.7)
    1.5 (1.3 to 1.7)
    2.5 (2.2 to 2.8)
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Number of subjects included in analysis
    75
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.63
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.5
         upper limit
    0.8
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.09
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.07
         upper limit
    0.13
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 2 mg/kg Ideal Body Weight (IBW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    75
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.15
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.11
         upper limit
    0.2
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 4 mg/kg ABW v Sugammadex 4 mg/kg IBW
    Number of subjects included in analysis
    73
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.56
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.44
         upper limit
    0.72
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) v Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects included in analysis
    148
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.6
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.51
         upper limit
    0.7

    Secondary: Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.7: Geometric Mean Analysis

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    End point title
    Time to Recovery (TTR) of Participant Train of Four (TOF) Ratio to ≥0.7: Geometric Mean Analysis
    End point description
    The efficacy analysis of TTR of participant TOF ratio to ≥0.7 was performed by estimating the geometric mean of TTR within each treatment group. TTR was monitored by applying electrical stimulations to the ulnar nerve every 15 seconds and assessing twitch response at the adductor pollicis muscle. T1 and T4 refer to magnitudes of the first and fourth twitches respectively, after nerve stimulation. The T4/T1 ratio (TOF; expressed as a decimal of up to 1.0) indicates the extent of recovery from NMB. A faster TTR of the TOF ratio to 0.7 indicates faster recovery from NMB. Analysis population consisted of all randomised participants dosed with both an NMBA and an NMB reversal agent (study treatment) with ≥1 post-randomisation efficacy assessment. As specified by the protocol, analysis was performed in treatment arms pooled by dosing method across depth of NMB as well as in all randomised treatment arms separated by depth of NMB.
    End point type
    Secondary
    End point timeframe
    Up to 61 minutes
    End point values
    Sugammadex 2 mg/kg Actual Body Weight (ABW) Sugammadex 2 mg/kg Ideal Body Weight (IBW) Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine/Glycopyrrolate Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects analysed
    38
    37
    37
    36
    38
    75
    73
    Units: Minutes
        geometric mean (confidence interval 95%)
    1.4 (1.2 to 1.6)
    2.1 (1.8 to 2.4)
    1.3 (1.2 to 1.6)
    2.0 (1.7 to 2.5)
    10.9 (8.1 to 14.6)
    1.4 (1.2 to 1.5)
    2.1 (1.8 to 2.3)
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Sugammadex 2 mg/kg Ideal Body Weight (IBW)
    Number of subjects included in analysis
    75
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.66
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.54
         upper limit
    0.81
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 2 mg/kg Actual Body Weight (ABW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    76
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.13
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.09
         upper limit
    0.17
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 2 mg/kg Ideal Body Weight (IBW) v Neostigmine/Glycopyrrolate
    Number of subjects included in analysis
    75
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.19
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.14
         upper limit
    0.27
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex 4 mg/kg ABW v Sugammadex 4 mg/kg IBW
    Number of subjects included in analysis
    73
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.66
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.52
         upper limit
    0.83
    Statistical analysis title
    Difference in time to recovery
    Comparison groups
    Sugammadex ABW (2 mg/kg ABW plus 4 mg/kg ABW) v Sugammadex IBW (2 mg/kg IBW plus 4 mg/kg IBW)
    Number of subjects included in analysis
    148
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    Method
    Parameter type
    Ratio of geometric means
    Point estimate
    0.66
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    0.57
         upper limit
    0.77

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Up to 14 days
    Adverse event reporting additional description
    Analysis population consisted of all randomised participants who received at least one dose of study treatment.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    21.1
    Reporting groups
    Reporting group title
    Sugammadex 2 mg/kg ABW
    Reporting group description
    -

    Reporting group title
    Sugammadex 2 mg/kg IBW
    Reporting group description
    -

    Reporting group title
    Sugammadex 4 mg/kg ABW
    Reporting group description
    -

    Reporting group title
    Sugammadex 4 mg/kg IBW
    Reporting group description
    -

    Reporting group title
    Neostigmine + Glycopyrrolate
    Reporting group description
    -

    Serious adverse events
    Sugammadex 2 mg/kg ABW Sugammadex 2 mg/kg IBW Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine + Glycopyrrolate
    Total subjects affected by serious adverse events
         subjects affected / exposed
    1 / 38 (2.63%)
    3 / 38 (7.89%)
    0 / 38 (0.00%)
    4 / 36 (11.11%)
    3 / 38 (7.89%)
         number of deaths (all causes)
    0
    0
    0
    0
    1
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Borderline ovarian tumour
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    1 / 36 (2.78%)
    0 / 38 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Postoperative wound complication
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    1 / 36 (2.78%)
    0 / 38 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Myocardial infarction
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    Tachyarrhythmia
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 38 (2.63%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    0 / 38 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiovascular Insufficiency
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Impaired healing
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    1 / 36 (2.78%)
    0 / 38 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Asthma
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    1 / 38 (2.63%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Device related infection
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 38 (2.63%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    0 / 38 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 38 (2.63%)
    0 / 38 (0.00%)
    1 / 36 (2.78%)
    0 / 38 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Postoperative wound infection
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    0 / 38 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Sugammadex 2 mg/kg ABW Sugammadex 2 mg/kg IBW Sugammadex 4 mg/kg ABW Sugammadex 4 mg/kg IBW Neostigmine + Glycopyrrolate
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    36 / 38 (94.74%)
    36 / 38 (94.74%)
    32 / 38 (84.21%)
    32 / 36 (88.89%)
    32 / 38 (84.21%)
    Vascular disorders
    Hypertension
         subjects affected / exposed
    1 / 38 (2.63%)
    2 / 38 (5.26%)
    3 / 38 (7.89%)
    2 / 36 (5.56%)
    3 / 38 (7.89%)
         occurrences all number
    1
    2
    3
    2
    4
    General disorders and administration site conditions
    Oedema peripheral
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    2 / 38 (5.26%)
         occurrences all number
    1
    0
    0
    0
    2
    Pyrexia
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 38 (2.63%)
    1 / 38 (2.63%)
    2 / 36 (5.56%)
    1 / 38 (2.63%)
         occurrences all number
    0
    1
    1
    2
    1
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    1 / 38 (2.63%)
    0 / 36 (0.00%)
    2 / 38 (5.26%)
         occurrences all number
    0
    0
    1
    0
    2
    Dyspnoea
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    1 / 38 (2.63%)
    2 / 36 (5.56%)
    0 / 38 (0.00%)
         occurrences all number
    0
    0
    1
    2
    0
    Psychiatric disorders
    Insomnia
         subjects affected / exposed
    1 / 38 (2.63%)
    2 / 38 (5.26%)
    1 / 38 (2.63%)
    2 / 36 (5.56%)
    3 / 38 (7.89%)
         occurrences all number
    1
    2
    1
    2
    3
    Investigations
    Blood pressure increased
         subjects affected / exposed
    0 / 38 (0.00%)
    2 / 38 (5.26%)
    1 / 38 (2.63%)
    1 / 36 (2.78%)
    0 / 38 (0.00%)
         occurrences all number
    0
    2
    1
    1
    0
    Heart rate increased
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    2 / 38 (5.26%)
         occurrences all number
    0
    0
    0
    0
    3
    Oxygen saturation decreased
         subjects affected / exposed
    0 / 38 (0.00%)
    2 / 38 (5.26%)
    1 / 38 (2.63%)
    0 / 36 (0.00%)
    1 / 38 (2.63%)
         occurrences all number
    0
    2
    1
    0
    1
    Injury, poisoning and procedural complications
    Anaemia postoperative
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    1 / 38 (2.63%)
    2 / 36 (5.56%)
    0 / 38 (0.00%)
         occurrences all number
    0
    0
    1
    2
    0
    Incision site pain
         subjects affected / exposed
    6 / 38 (15.79%)
    4 / 38 (10.53%)
    1 / 38 (2.63%)
    2 / 36 (5.56%)
    3 / 38 (7.89%)
         occurrences all number
    6
    4
    1
    2
    3
    Neuromuscular block prolonged
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    2 / 38 (5.26%)
         occurrences all number
    0
    0
    0
    0
    2
    Procedural nausea
         subjects affected / exposed
    9 / 38 (23.68%)
    4 / 38 (10.53%)
    8 / 38 (21.05%)
    4 / 36 (11.11%)
    5 / 38 (13.16%)
         occurrences all number
    10
    4
    8
    4
    5
    Procedural pain
         subjects affected / exposed
    28 / 38 (73.68%)
    28 / 38 (73.68%)
    23 / 38 (60.53%)
    27 / 36 (75.00%)
    24 / 38 (63.16%)
         occurrences all number
    30
    31
    23
    27
    25
    Procedural vomiting
         subjects affected / exposed
    2 / 38 (5.26%)
    2 / 38 (5.26%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    2 / 38 (5.26%)
         occurrences all number
    3
    2
    0
    0
    2
    Cardiac disorders
    Bradycardia
         subjects affected / exposed
    1 / 38 (2.63%)
    1 / 38 (2.63%)
    1 / 38 (2.63%)
    3 / 36 (8.33%)
    1 / 38 (2.63%)
         occurrences all number
    1
    1
    1
    3
    1
    Cardiovascular disorder
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 38 (2.63%)
    2 / 38 (5.26%)
    1 / 36 (2.78%)
    1 / 38 (2.63%)
         occurrences all number
    0
    1
    2
    1
    1
    Sinus tachycardia
         subjects affected / exposed
    1 / 38 (2.63%)
    3 / 38 (7.89%)
    0 / 38 (0.00%)
    1 / 36 (2.78%)
    1 / 38 (2.63%)
         occurrences all number
    1
    3
    0
    1
    1
    Tachycardia
         subjects affected / exposed
    2 / 38 (5.26%)
    3 / 38 (7.89%)
    4 / 38 (10.53%)
    2 / 36 (5.56%)
    1 / 38 (2.63%)
         occurrences all number
    2
    3
    4
    2
    1
    Nervous system disorders
    Dizziness
         subjects affected / exposed
    1 / 38 (2.63%)
    1 / 38 (2.63%)
    3 / 38 (7.89%)
    1 / 36 (2.78%)
    1 / 38 (2.63%)
         occurrences all number
    1
    1
    3
    1
    1
    Headache
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    2 / 36 (5.56%)
    1 / 38 (2.63%)
         occurrences all number
    0
    0
    0
    2
    2
    Syncope
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    2 / 36 (5.56%)
    0 / 38 (0.00%)
         occurrences all number
    0
    0
    0
    2
    0
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    2 / 38 (5.26%)
    2 / 38 (5.26%)
    0 / 38 (0.00%)
    2 / 36 (5.56%)
    1 / 38 (2.63%)
         occurrences all number
    2
    2
    0
    2
    1
    Leukocytosis
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    2 / 36 (5.56%)
    0 / 38 (0.00%)
         occurrences all number
    0
    0
    0
    2
    0
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    4 / 38 (10.53%)
    5 / 38 (13.16%)
    1 / 38 (2.63%)
    4 / 36 (11.11%)
    2 / 38 (5.26%)
         occurrences all number
    4
    5
    1
    4
    2
    Diarrhoea
         subjects affected / exposed
    1 / 38 (2.63%)
    2 / 38 (5.26%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    0 / 38 (0.00%)
         occurrences all number
    1
    2
    0
    0
    0
    Nausea
         subjects affected / exposed
    6 / 38 (15.79%)
    10 / 38 (26.32%)
    9 / 38 (23.68%)
    6 / 36 (16.67%)
    7 / 38 (18.42%)
         occurrences all number
    6
    13
    10
    6
    7
    Short-bowel syndrome
         subjects affected / exposed
    1 / 38 (2.63%)
    3 / 38 (7.89%)
    1 / 38 (2.63%)
    0 / 36 (0.00%)
    1 / 38 (2.63%)
         occurrences all number
    1
    3
    1
    0
    1
    Vomiting
         subjects affected / exposed
    0 / 38 (0.00%)
    1 / 38 (2.63%)
    1 / 38 (2.63%)
    2 / 36 (5.56%)
    0 / 38 (0.00%)
         occurrences all number
    0
    1
    1
    2
    0
    Skin and subcutaneous tissue disorders
    Pruritus
         subjects affected / exposed
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    2 / 38 (5.26%)
    0 / 36 (0.00%)
    0 / 38 (0.00%)
         occurrences all number
    0
    0
    2
    0
    0
    Renal and urinary disorders
    Urinary retention
         subjects affected / exposed
    1 / 38 (2.63%)
    1 / 38 (2.63%)
    1 / 38 (2.63%)
    0 / 36 (0.00%)
    3 / 38 (7.89%)
         occurrences all number
    1
    2
    1
    0
    3
    Metabolism and nutrition disorders
    Hyperglycaemia
         subjects affected / exposed
    2 / 38 (5.26%)
    5 / 38 (13.16%)
    2 / 38 (5.26%)
    1 / 36 (2.78%)
    2 / 38 (5.26%)
         occurrences all number
    2
    5
    2
    1
    2
    Hypokalaemia
         subjects affected / exposed
    1 / 38 (2.63%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    2 / 38 (5.26%)
         occurrences all number
    1
    0
    0
    0
    2
    Hypomagnesaemia
         subjects affected / exposed
    1 / 38 (2.63%)
    2 / 38 (5.26%)
    0 / 38 (0.00%)
    1 / 36 (2.78%)
    1 / 38 (2.63%)
         occurrences all number
    1
    2
    0
    1
    1
    Metabolic acidosis
         subjects affected / exposed
    2 / 38 (5.26%)
    0 / 38 (0.00%)
    0 / 38 (0.00%)
    0 / 36 (0.00%)
    0 / 38 (0.00%)
         occurrences all number
    2
    0
    0
    0
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    07 Aug 2018
    Primary reason for amendment was to incorporate revisions to the trial flow chart to provide flexibility to trial sites.

    Interruptions (globally)

    Were there any global interruptions to the trial? Yes
    Date
    Interruption
    Restart date
    24 Aug 2018
    There was a brief stoppage of enrollment in the EU (Austria, Belgium, Denmark, and Germany) due to a recall of glycopyrronium bromide. The recall was initiated as a precaution due to the risk of capillary cracks of the ampules. The sponsor initiated Clinical Stock Recovery Action at EU investigative sites which included halting enrollment. Glycopyrronium bromide originally distributed was retrieved and new glycopyrronium bromide was sourced and distributed, upon which enrollment resumed.
    07 Nov 2018

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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