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Last Updated: March 20, 2025

CLINICAL TRIALS PROFILE FOR SEVOFLURANE


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505(b)(2) Clinical Trials for Sevoflurane

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
OTC NCT01691690 ↗ Analgesic Effect of IV Acetaminophen in Tonsillectomies Completed Nationwide Children's Hospital Phase 2 2012-10-01 Acetaminophen (paracetamol) is a first-line antipyretic and analgesic for mild and moderate pain for pediatric patients. Its common use (particularly in oral form) is underscored by its wide therapeutic window, safety profile, over the counter accessibility, lack of adverse systemic effects (as compared with NSAIDS and opioids) when given in appropriate doses. Although the exact anti-nociceptive mechanisms of acetaminophen continue to be elucidated, these mechanisms appear to be multi-factorial and include central inhibition of the cyclo-oxygenase (COX) enzyme leading to decreased production of prostaglandins from arachidonic acid, interference with serotonergic descending pain pathways, indirect activation of cannabinoid 1 (CB1) receptors and inhibition of nitric oxide pathways through N-methyl-D-aspartate (NMDA) or substance P. Of the above mechanisms, the most commonly known is that of central inhibition of COX enzymes by which the decreased production of prostaglandins diminish the release of excitatory transmitters of substance P and glutamate which are both involved in nociceptive transmission (Anderson, 2008; Smith, 2011). To date, several studies have shown acetaminophen's opioid sparing effect in the pediatric population when given by the rectal or intravenous routes (Korpela et al, 1999; Dashti et al, 2009; Hong et al, 2010).
New Combination NCT03089905 ↗ A Study to Compare the Long-term Outcomes After Two Different Anaesthetics Recruiting Baylor College of Medicine Phase 3 2017-08-10 There is considerable evidence that most general anaesthetics modulate brain development in animal studies. The impact is greater with longer durations of exposure and in younger animals. There is great controversy over whether or not these animal data are relevant to human clinical scenarios. The changes seen in preclinical studies are greatest with GABA agonists and NMDA antagonists such as volatile anaesthetics (eg sevoflurane), propofol, midazolam, ketamine, and nitrous oxide. There is less evidence for an effect with opioid (such as remifentanil) or with alpha 2 agonists (such as dexmedetomidine). Some, but not all, human cohort studies show an association between exposure to anaesthesia in infancy or early childhood and later changes in cognitive tests, school performance or risk of developing neurodevelopmental disorders. The evidence is weak due to possible confounding. A recent well designed cohort study (the PANDA study) comparing young children that had hernia repair to their siblings found no evidence for a difference in a range of detailed neuropsychological tests. In that study most children were exposed to up to two hours of anaesthesia. The only trial (the GAS trial) has compared children having hernia repair under regional or general anesthesia and has found no evidence for a difference in neurodevelopment when tested at two years of age. The GAS and PANDA studies confirm the animal data that short exposure is unlikely to cause any neurodevelopmental impact. The impact of longer exposures is still unknown. In humans the strongest evidence for an association between surgery and poor neurodevelopmental outcome is in infants having major surgery. However, this is also the group where confounding is most likely. The aim of our study is to see if a new combination of anaesthetic drugs results in a better long-term developmental outcome than the current standard of care for children having anaesthesia expected to last 2 hours or longer. Children will be randomised to receive either a low dose sevoflurane/remifentanil/dexmedetomidine or standard dose sevoflurane anaesthetic. They will receive a neurodevelopmental assessment at 3 years of age to assess global cognitive function.
New Combination NCT03089905 ↗ A Study to Compare the Long-term Outcomes After Two Different Anaesthetics Recruiting Boston Children's Hospital Phase 3 2017-08-10 There is considerable evidence that most general anaesthetics modulate brain development in animal studies. The impact is greater with longer durations of exposure and in younger animals. There is great controversy over whether or not these animal data are relevant to human clinical scenarios. The changes seen in preclinical studies are greatest with GABA agonists and NMDA antagonists such as volatile anaesthetics (eg sevoflurane), propofol, midazolam, ketamine, and nitrous oxide. There is less evidence for an effect with opioid (such as remifentanil) or with alpha 2 agonists (such as dexmedetomidine). Some, but not all, human cohort studies show an association between exposure to anaesthesia in infancy or early childhood and later changes in cognitive tests, school performance or risk of developing neurodevelopmental disorders. The evidence is weak due to possible confounding. A recent well designed cohort study (the PANDA study) comparing young children that had hernia repair to their siblings found no evidence for a difference in a range of detailed neuropsychological tests. In that study most children were exposed to up to two hours of anaesthesia. The only trial (the GAS trial) has compared children having hernia repair under regional or general anesthesia and has found no evidence for a difference in neurodevelopment when tested at two years of age. The GAS and PANDA studies confirm the animal data that short exposure is unlikely to cause any neurodevelopmental impact. The impact of longer exposures is still unknown. In humans the strongest evidence for an association between surgery and poor neurodevelopmental outcome is in infants having major surgery. However, this is also the group where confounding is most likely. The aim of our study is to see if a new combination of anaesthetic drugs results in a better long-term developmental outcome than the current standard of care for children having anaesthesia expected to last 2 hours or longer. Children will be randomised to receive either a low dose sevoflurane/remifentanil/dexmedetomidine or standard dose sevoflurane anaesthetic. They will receive a neurodevelopmental assessment at 3 years of age to assess global cognitive function.
New Combination NCT03089905 ↗ A Study to Compare the Long-term Outcomes After Two Different Anaesthetics Recruiting Boston Children’s Hospital Phase 3 2017-08-10 There is considerable evidence that most general anaesthetics modulate brain development in animal studies. The impact is greater with longer durations of exposure and in younger animals. There is great controversy over whether or not these animal data are relevant to human clinical scenarios. The changes seen in preclinical studies are greatest with GABA agonists and NMDA antagonists such as volatile anaesthetics (eg sevoflurane), propofol, midazolam, ketamine, and nitrous oxide. There is less evidence for an effect with opioid (such as remifentanil) or with alpha 2 agonists (such as dexmedetomidine). Some, but not all, human cohort studies show an association between exposure to anaesthesia in infancy or early childhood and later changes in cognitive tests, school performance or risk of developing neurodevelopmental disorders. The evidence is weak due to possible confounding. A recent well designed cohort study (the PANDA study) comparing young children that had hernia repair to their siblings found no evidence for a difference in a range of detailed neuropsychological tests. In that study most children were exposed to up to two hours of anaesthesia. The only trial (the GAS trial) has compared children having hernia repair under regional or general anesthesia and has found no evidence for a difference in neurodevelopment when tested at two years of age. The GAS and PANDA studies confirm the animal data that short exposure is unlikely to cause any neurodevelopmental impact. The impact of longer exposures is still unknown. In humans the strongest evidence for an association between surgery and poor neurodevelopmental outcome is in infants having major surgery. However, this is also the group where confounding is most likely. The aim of our study is to see if a new combination of anaesthetic drugs results in a better long-term developmental outcome than the current standard of care for children having anaesthesia expected to last 2 hours or longer. Children will be randomised to receive either a low dose sevoflurane/remifentanil/dexmedetomidine or standard dose sevoflurane anaesthetic. They will receive a neurodevelopmental assessment at 3 years of age to assess global cognitive function.
New Combination NCT03089905 ↗ A Study to Compare the Long-term Outcomes After Two Different Anaesthetics Recruiting Children's Hospital of Philadelphia Phase 3 2017-08-10 There is considerable evidence that most general anaesthetics modulate brain development in animal studies. The impact is greater with longer durations of exposure and in younger animals. There is great controversy over whether or not these animal data are relevant to human clinical scenarios. The changes seen in preclinical studies are greatest with GABA agonists and NMDA antagonists such as volatile anaesthetics (eg sevoflurane), propofol, midazolam, ketamine, and nitrous oxide. There is less evidence for an effect with opioid (such as remifentanil) or with alpha 2 agonists (such as dexmedetomidine). Some, but not all, human cohort studies show an association between exposure to anaesthesia in infancy or early childhood and later changes in cognitive tests, school performance or risk of developing neurodevelopmental disorders. The evidence is weak due to possible confounding. A recent well designed cohort study (the PANDA study) comparing young children that had hernia repair to their siblings found no evidence for a difference in a range of detailed neuropsychological tests. In that study most children were exposed to up to two hours of anaesthesia. The only trial (the GAS trial) has compared children having hernia repair under regional or general anesthesia and has found no evidence for a difference in neurodevelopment when tested at two years of age. The GAS and PANDA studies confirm the animal data that short exposure is unlikely to cause any neurodevelopmental impact. The impact of longer exposures is still unknown. In humans the strongest evidence for an association between surgery and poor neurodevelopmental outcome is in infants having major surgery. However, this is also the group where confounding is most likely. The aim of our study is to see if a new combination of anaesthetic drugs results in a better long-term developmental outcome than the current standard of care for children having anaesthesia expected to last 2 hours or longer. Children will be randomised to receive either a low dose sevoflurane/remifentanil/dexmedetomidine or standard dose sevoflurane anaesthetic. They will receive a neurodevelopmental assessment at 3 years of age to assess global cognitive function.
New Combination NCT03089905 ↗ A Study to Compare the Long-term Outcomes After Two Different Anaesthetics Recruiting Erasmus Medical Center Phase 3 2017-08-10 There is considerable evidence that most general anaesthetics modulate brain development in animal studies. The impact is greater with longer durations of exposure and in younger animals. There is great controversy over whether or not these animal data are relevant to human clinical scenarios. The changes seen in preclinical studies are greatest with GABA agonists and NMDA antagonists such as volatile anaesthetics (eg sevoflurane), propofol, midazolam, ketamine, and nitrous oxide. There is less evidence for an effect with opioid (such as remifentanil) or with alpha 2 agonists (such as dexmedetomidine). Some, but not all, human cohort studies show an association between exposure to anaesthesia in infancy or early childhood and later changes in cognitive tests, school performance or risk of developing neurodevelopmental disorders. The evidence is weak due to possible confounding. A recent well designed cohort study (the PANDA study) comparing young children that had hernia repair to their siblings found no evidence for a difference in a range of detailed neuropsychological tests. In that study most children were exposed to up to two hours of anaesthesia. The only trial (the GAS trial) has compared children having hernia repair under regional or general anesthesia and has found no evidence for a difference in neurodevelopment when tested at two years of age. The GAS and PANDA studies confirm the animal data that short exposure is unlikely to cause any neurodevelopmental impact. The impact of longer exposures is still unknown. In humans the strongest evidence for an association between surgery and poor neurodevelopmental outcome is in infants having major surgery. However, this is also the group where confounding is most likely. The aim of our study is to see if a new combination of anaesthetic drugs results in a better long-term developmental outcome than the current standard of care for children having anaesthesia expected to last 2 hours or longer. Children will be randomised to receive either a low dose sevoflurane/remifentanil/dexmedetomidine or standard dose sevoflurane anaesthetic. They will receive a neurodevelopmental assessment at 3 years of age to assess global cognitive function.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for Sevoflurane

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000259 ↗ Sevoflurane vs Nitrous Oxide Inhalation at Subanesthetic Concentrations - 11 Completed National Institute on Drug Abuse (NIDA) N/A 1996-08-01 The purpose of this study is to conduct experiments to examine subjective and reinforcing effects of nitrous oxide. Mood altering and psychomotor effects will be tested on non-drug abusers and preference procedures will be used to assess reinforcing effects. Comparisons between nitrous oxide, opiates, and benzodiazepine antagonists will be made. To examine sevoflurane versus isoflurane inhalation at subanesthetic concentrations on mood, pain, and psychomotor performance.
NCT00000259 ↗ Sevoflurane vs Nitrous Oxide Inhalation at Subanesthetic Concentrations - 11 Completed University of Chicago N/A 1996-08-01 The purpose of this study is to conduct experiments to examine subjective and reinforcing effects of nitrous oxide. Mood altering and psychomotor effects will be tested on non-drug abusers and preference procedures will be used to assess reinforcing effects. Comparisons between nitrous oxide, opiates, and benzodiazepine antagonists will be made. To examine sevoflurane versus isoflurane inhalation at subanesthetic concentrations on mood, pain, and psychomotor performance.
NCT00000261 ↗ Effects of Alcohol History on Effects of Sevoflurane and Nitrous Oxide - 13 Completed National Institute on Drug Abuse (NIDA) Phase 2 1997-11-01 The purpose of this study is to evaluate the effects of alcohol history on the subjective and reinforcing effects of sevoflurane and nitrous oxide in healthy volunteers. All subjects underwent psychomotor testing during 4 sessions of placebo, drug/placebo, and choice of intervention.
NCT00000261 ↗ Effects of Alcohol History on Effects of Sevoflurane and Nitrous Oxide - 13 Completed University of Chicago Phase 2 1997-11-01 The purpose of this study is to evaluate the effects of alcohol history on the subjective and reinforcing effects of sevoflurane and nitrous oxide in healthy volunteers. All subjects underwent psychomotor testing during 4 sessions of placebo, drug/placebo, and choice of intervention.
NCT00000262 ↗ Effects of Combined Sevoflurane and Nitrous Oxide Inhalation - 14 Completed National Institute on Drug Abuse (NIDA) N/A 1996-11-01 The purpose of this study is to determine the effects of combined sevoflurane and nitrous oxide inhalation on mood, psychomotor performance, and the pain response in humans.
NCT00000262 ↗ Effects of Combined Sevoflurane and Nitrous Oxide Inhalation - 14 Completed University of Chicago N/A 1996-11-01 The purpose of this study is to determine the effects of combined sevoflurane and nitrous oxide inhalation on mood, psychomotor performance, and the pain response in humans.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for Sevoflurane

Condition Name

Condition Name for Sevoflurane
Intervention Trials
Anesthesia 77
Postoperative Pain 45
Pain, Postoperative 23
Emergence Agitation 19
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Condition MeSH

Condition MeSH for Sevoflurane
Intervention Trials
Pain, Postoperative 85
Emergence Delirium 58
Psychomotor Agitation 44
Delirium 43
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Clinical Trial Locations for Sevoflurane

Trials by Country

Trials by Country for Sevoflurane
Location Trials
United States 117
China 116
Egypt 106
Korea, Republic of 82
Turkey 48
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Trials by US State

Trials by US State for Sevoflurane
Location Trials
Ohio 13
Illinois 13
Texas 13
New York 11
Massachusetts 10
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Clinical Trial Progress for Sevoflurane

Clinical Trial Phase

Clinical Trial Phase for Sevoflurane
Clinical Trial Phase Trials
Phase 4 308
Phase 3 64
Phase 2/Phase 3 28
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Clinical Trial Status

Clinical Trial Status for Sevoflurane
Clinical Trial Phase Trials
Completed 474
Unknown status 126
Recruiting 121
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Clinical Trial Sponsors for Sevoflurane

Sponsor Name

Sponsor Name for Sevoflurane
Sponsor Trials
Yonsei University 22
Assiut University 18
Mansoura University 17
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Sponsor Type

Sponsor Type for Sevoflurane
Sponsor Trials
Other 1112
Industry 43
U.S. Fed 4
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Sevoflurane: Clinical Trials, Market Analysis, and Projections

Introduction to Sevoflurane

Sevoflurane is a widely used inhalation anesthetic known for its rapid induction and fine controllability. It is an ether compound with fluoromethyl and 1,1,1,3,3,3-hexafluoroisopropyl as alkyl groups, making it a preferred choice for surgeries due to its excellent respiratory tolerance and hemodynamic stability[1][3][5].

Clinical Trials and Research

Postoperative Cognitive Dysfunction (POCD)

Clinical trials and research have focused on the potential cognitive side effects of sevoflurane, particularly postoperative cognitive dysfunction (POCD). Studies indicate that sevoflurane treatment may increase the incidence of POCD, especially in elderly patients. This condition is associated with lower cognitive abilities post-surgery and can significantly impact patients' lives and their families[1].

Mechanisms and Treatment

Research has delved into the mechanisms behind sevoflurane-induced POCD, suggesting that neuroinflammation, neurotransmitter imbalance, and a reduction in brain-derived neurotrophic factor (BDNF) concentration may play key roles. Animal models have been used to study these effects, revealing that sevoflurane can induce neuroinflammation and mitochondrial injury, leading to cognitive impairment[1].

Neuroprotective Effects

Despite the potential for cognitive dysfunction, some studies have shown that sevoflurane can exert neuroprotective effects under certain conditions. For example, in a rat model of focal cerebral ischemia, sevoflurane pre-treatment reduced Akt signaling activity and activated autophagy, providing neuroprotection. Additionally, post-treatment with sevoflurane has been shown to reduce apoptosis and attenuate neuroinflammation[1].

Market Analysis

Global Market Trends

The global sevoflurane market is projected to grow significantly over the next few years. From 2024 to 2030, the market is expected to increase from $1.262 billion to $1.612 billion, with a Compound Annual Growth Rate (CAGR) of 4.17%[2].

Regional Market Insights

  • North America: This region is expected to grow at a CAGR of 3.43% from 2024 to 2030, driven by increasing demand for surgical procedures and growth in hospital infrastructure[2].
  • China: The Chinese market is anticipated to grow from $525.87 million in 2024 to $706.44 million by 2030, with a CAGR of 5.04%. This growth is fueled by the prevalence of chronic diseases, improvements in the medical system, and an aging population[2][5].

Key Manufacturers

The global market is dominated by a few key players, including Hengrui, Baxter, Maruishi, AbbVie, Piramal, PT Novell Pharmaceutical, and Lunan Pharma. These manufacturers held approximately 91.92% of the market share in terms of revenue in 2023[2].

Market Projections

End-Use Industry

The demand for sevoflurane is highest in hospitals, which are expected to grow with a CAGR of over 1.5% during the forecast period. The rise in surgical procedures, development in hospital infrastructure, and the need for general anesthesia in various medical settings are driving this growth[3].

Geographic Expansion

North America is the fastest-growing region in the sevoflurane source market, expected to grow at a CAGR of around 2.7% during the forecast period. This growth is driven by the surge in applications for surgical procedures, emergency cases, and the treatment of chronic diseases[3].

Impact of COVID-19

The COVID-19 pandemic had a significant impact on the sevoflurane market, particularly in 2020 when the number of surgeries decreased due to lockdowns and healthcare system disruptions. However, as the pandemic has improved, the market is expected to recover and grow steadily from 2021 to 2025[3][5].

Challenges and Opportunities

Environmental Concerns

One of the challenges facing the sevoflurane market is its hazardous environmental effects. Efforts to mitigate these effects and develop more sustainable practices are crucial for the long-term viability of the market[3].

Growing Healthcare Sector

The rapid development and advancement in the healthcare sector, particularly in regions like India, are creating significant opportunities for the growth of the sevoflurane market. The increasing number of surgical procedures and the need for advanced medical technologies are driving demand for inhalation anesthetics like sevoflurane[3].

Key Takeaways

  • Clinical Trials: Ongoing research focuses on the cognitive side effects of sevoflurane, particularly POCD, and its potential neuroprotective effects.
  • Market Growth: The global sevoflurane market is projected to grow at a CAGR of 4.17% from 2024 to 2030, driven by increasing demand in North America and China.
  • End-Use Industry: Hospitals remain the largest consumers of sevoflurane, with growing demand driven by surgical procedures and hospital infrastructure development.
  • Geographic Expansion: North America is the fastest-growing region, with a CAGR of around 2.7% during the forecast period.
  • COVID-19 Impact: The market experienced a decline in 2020 but is expected to recover and grow steadily from 2021 to 2025.

FAQs

What are the potential cognitive side effects of sevoflurane?

Sevoflurane treatment may increase the incidence of postoperative cognitive dysfunction (POCD), particularly in elderly patients, leading to lower cognitive abilities post-surgery[1].

Which regions are driving the growth of the sevoflurane market?

North America and China are the key regions driving the growth of the sevoflurane market, with North America growing at a CAGR of 3.43% and China at a CAGR of 5.04% from 2024 to 2030[2][5].

How has COVID-19 impacted the sevoflurane market?

The COVID-19 pandemic led to a decrease in the number of surgeries in 2020, resulting in a decline in sevoflurane sales. However, the market is expected to recover and grow as the pandemic improves[3][5].

What are the environmental concerns associated with sevoflurane?

Sevoflurane has hazardous environmental effects, which pose a challenge for the market. Efforts to mitigate these effects are necessary for sustainable market growth[3].

Which companies dominate the global sevoflurane market?

The global market is dominated by companies such as Hengrui, Baxter, Maruishi, AbbVie, Piramal, PT Novell Pharmaceutical, and Lunan Pharma, which held approximately 91.92% of the market share in terms of revenue in 2023[2].

Sources

  1. Frontiers in Aging Neuroscience: "Update on the Mechanism and Treatment of Sevoflurane-Induced Postoperative Cognitive Dysfunction" - https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2021.702231/full
  2. QYResearch: "Global Sevoflurane Anesthesia Drugs Market Insights, Forecast to 2030" - https://www.giiresearch.com/report/qyr1559190-global-sevoflurane-anesthesia-drugs-market.html
  3. IndustryARC: "Sevoflurane Source Market Report, 2022-2027" - https://www.industryarc.com/Research/Global-Sevoflurane-Source-Market-Research-511774
  4. ClinicalTrials.gov: "Clinical Trials - Sevoflurane" - https://www.clinicaltrials.gov/ct/search?submit=Search&term=Sevoflurane
  5. Business Wire: "China Sevoflurane Investigation Market Report 2021-2025" - https://www.businesswire.com/news/home/20210428005604/en/China-Sevoflurane-Investigation-Market-Report-2021-2025-Featuring-Shanghai-Hengrui-Pharma-Maruishi-Pharma-Lunan-Pharma-Group-Baxter-Healthcare-Hebei-Yipin-Pharma---ResearchAndMarkets.com

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