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Last Updated: December 12, 2025

CLINICAL TRIALS PROFILE FOR ULTIVA


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505(b)(2) Clinical Trials for ULTIVA

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
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.
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for ULTIVA

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00158873 ↗ Pharmaco-Economic Study Of Ultiva In Intensive Care Unit(ICU)Subjects Completed GlaxoSmithKline Phase 4 2004-09-01 The study will evaluate the pharmaco-economic consequences of the use of a remifentanil based regimen compared with a conventional sedative based regimen in terms of duration of mechanical ventilation, length of stay in ICU, difference in extubation time and use of concomitant sedative agents.
NCT00202722 ↗ Remifentanil as Intravenous Patient-controlled Analgesia (IVPCA) During Labour Completed Sorlandet Hospital HF Phase 4 2004-01-01 Remifentanil is a ultra short-acting synthetic opioid. It is rapidly metabolized by non-specific blood and tissue esterases. We wanted to investigate the efficacy and safety of remifentanil used as analgesia during labour. Intravenous patient controlled analgesia (ivpca) were used to administer remifentanil. Doses used were 0,15-1,05 mikrogr/kg, with a lock-out time of 2 minutes. 41 women were included in the study. Blood-pressure, heartrate, SaO2, respiration rate and sedation were recorded every 15.minute. Fetal heart rate was recorded for the whole periode of treatment (CTG, STAN). Vaginal contraction pain were assessed by the parturients every 15.minute using a Visual Analogue Scale (VAS). Midwives also recorded their impression of the parturients pain. The parturients level of sedation were recorded by anesthesiologist and midwife every 15.minute. Apgar scores were registered at 1, 5 and 10 min after delivery. Umbilical cord blood analysis regarding blood gases and concentration of remifentanil were performed. After delivery, both mother and midwife evaluated efficacy and safety; Global satisfaction score, if the remifentanil doses were sufficient, nausea, vomiting, level of sedation and dizziness.
NCT00567957 ↗ Remifentanil for General Anesthesia in Preeclamptics Unknown status Istanbul University Phase 4 2008-02-01 The purpose of this study is to determine whether remifentanil use in preeclamptic patients may blunt hemodynamic response to intubation during general anesthesia for cesarean section.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for ULTIVA

Condition Name

Condition Name for ULTIVA
Intervention Trials
Anesthesia 15
Pain 8
Drug Usage 4
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Condition MeSH

Condition MeSH for ULTIVA
Intervention Trials
Hyperalgesia 5
Coronary Artery Disease 3
Pain, Postoperative 3
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Clinical Trial Locations for ULTIVA

Trials by Country

Trials by Country for ULTIVA
Location Trials
Korea, Republic of 19
United States 16
Turkey 12
Sweden 7
Norway 7
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Trials by US State

Trials by US State for ULTIVA
Location Trials
Massachusetts 2
Texas 2
Oregon 2
Ohio 2
Pennsylvania 2
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Clinical Trial Progress for ULTIVA

Clinical Trial Phase

Clinical Trial Phase for ULTIVA
Clinical Trial Phase Trials
PHASE4 1
Phase 4 56
Phase 3 5
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Clinical Trial Status

Clinical Trial Status for ULTIVA
Clinical Trial Phase Trials
Completed 70
Unknown status 12
Recruiting 8
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Clinical Trial Sponsors for ULTIVA

Sponsor Name

Sponsor Name for ULTIVA
Sponsor Trials
Ajou University School of Medicine 8
Region Örebro County 4
KK Women's and Children's Hospital 4
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Sponsor Type

Sponsor Type for ULTIVA
Sponsor Trials
Other 174
Industry 6
NIH 1
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Clinical Trials Update, Market Analysis, and Projection for Ultiva (Remifentanil)

Last updated: October 30, 2025

Introduction

Ultiva, the brand name for Remifentanil, is an ultra-short-acting opioid analgesic primarily used during anesthesia and intensive care settings. Its rapid onset and offset of action, combined with predictable pharmacokinetics, have established it as a vital tool in modern anesthetic protocols. As demand for safer, swiftly reversible analgesics grows amid evolving surgical practices, understanding Ultiva’s current clinical landscape, market positioning, and future projections becomes essential for stakeholders.

This analysis explores recent clinical trial developments, assesses current market dynamics, and forecasts the trajectory of Ultiva over the next five years, providing strategic insights for pharmaceutical developers, investors, and healthcare providers.


Clinical Trials Landscape for Ultiva

Recent and Ongoing Clinical Trials

Remifentanil’s unique pharmacology has prompted numerous investigations into expanding its applications. The clinical pipeline primarily focuses on:

  • Enhanced Safety Profiles in Difficult Airway Management: Multiple trials, such as NCT04567234, evaluate remifentanil's efficacy in rapid sequence induction, especially for patients at risk of hemodynamic instability. These studies aim to solidify its safety margins and optimal dosing strategies.

  • Use in Emergency and Field Medicine: Investigations like the NCT04121009 are assessing remifentanil’s utility in pre-hospital trauma care, emphasizing its rapid clearance to prevent prolonged respiratory depression.

  • Combination with Other Agents: Trials exploring the synergistic effects of remifentanil with alternative anesthetics or adjuncts, such as dexmedetomidine, aim to optimize anesthesia protocols while minimizing opioid exposure.

  • Pediatric and Geriatric Applications: Studies like NCT03975310 are examining age-specific dosing and safety in pediatric and elderly populations, critical as anesthetic practices diversify.

Key Clinical Developments

Recent peer-reviewed publications reinforce remifentanil’s status as a superior intraoperative analgesic, citing lower incidences of postoperative nausea and quicker recovery times compared to traditional opioids. The FDA continues to approve its use in specialized anesthesia contexts, although some studies highlight the need for meticulous titration due to its potency and rapid clearance.

Regulatory and Safety Considerations

Ongoing trials are also investigating remifentanil's safety profile, focusing on adverse events like hypotension and respiratory depression. The findings influence guidelines on optimal dosing and monitoring, reinforcing its profile as a high-precision anesthetic.


Market Analysis

Current Market Size and Growth Drivers

The global anesthetic agents market was valued at approximately USD 12 billion in 2022, with opioids comprising a significant segment. Remifentanil, as a premium, mechanistically distinct agent, holds a substantial share within intraoperative analgesics.

Key growth drivers include:

  • Rising Surgical Volumes: The increasing number of outpatient and minimally invasive procedures sustains demand for rapid-acting anesthetics like remifentanil.

  • Advancements in Anesthetic Protocols: A shift toward personalized anesthesia, emphasizing rapid recovery, enhances remifentanil’s appeal.

  • Expansion into New Indications: Ongoing trials exploring its role in enhanced recovery after surgery (ERAS) protocols and in ICU sedation bolster potential market penetration.

Competitive Landscape

Ultiva faces competition from other opioids and anesthetic agents, notably fentanyl, sufentanil, and newer agents like remimazolam. Notably:

  • Fentanyl and Sufentanil: Widely used, with extensive clinical experience but longer duration, leading to slower recovery.

  • Remimazolam: A benzodiazepine sedative with rapid clearance, emerging as a competitor in sedation protocols.

Despite competition, Ultiva’s rapid onset and short duration remain advantageous in specific surgical contexts.

Market Challenges

  • Opioid Regulations: Heightened scrutiny on opioid prescribing due to addiction concerns complicates market growth.

  • Cost Factors: Ultiva’s pricing, often higher than traditional opioids, influences adoption, especially in resource-constrained markets.

  • Safety Profile Concerns: Risks of rapid respiratory depression necessitate skilled administration, limiting routine use in less controlled environments.

Distribution and Market Penetration

The drug enjoys widespread use in North America and Europe, driven by high surgical volumes and established clinical protocols. Emerging markets in Asia-Pacific and Latin America present growth opportunities, contingent upon regulatory approvals and healthcare infrastructure development.


Market Projection and Future Outlook

Forecast Overview (2023-2028)

Based on epidemiological data, ongoing clinical trials, and market dynamics, the following projections are made:

  • Compound Annual Growth Rate (CAGR): Estimated at 5-7% through 2028, driven by expanding surgical procedures and protocol integrations.

  • Market Expansion: Entry into new therapeutic areas like ICU sedation and ERAS programs could enlarge market share.

  • Pipeline Influence: Pending results from ongoing trials could reinforce or challenge current projections; positive outcomes may accelerate adoption.

Key Factors Influencing Growth

  • Regulatory Approvals: Potential approvals for new indications or formulations (e.g., longer-acting variants) could significantly impact market size.

  • Technological Advancements: Novel delivery systems, such as continuous infusion pumps with integrated monitoring, could enhance safety and ease of use.

  • Healthcare Policies: Regulations promoting opioid-sparing strategies may boost or hinder usage, depending on regional policies.

  • Emerging Competitors: The development of non-opioid analgesics or ultra-fast agents like remimazolam may refine the competitive landscape.

Risks and Opportunities

While growth prospects are promising, challenges remain in differentiating Ultiva amidst evolving treatment protocols and regulatory frameworks. Nonetheless, its pharmacokinetic advantages position it favorably for continued adoption in advanced anesthesia practices.


Conclusion

Ultiva remains a critical component of modern anesthesia, supported by a robust clinical trial portfolio and favorable market dynamics. Its rapid onset and offset continue to meet the demand for precise, reversible analgesia, particularly in high-acuity surgical settings. Ongoing clinical trials focusing on expanding its applications and confirming safety profiles will shape its future positioning.

Market projections indicate steady growth, bolstered by technological innovations and increased procedural volumes globally. Strategic engagement with regulatory developments and targeted marketing emphasizing its unique pharmacological benefits will be pivotal for stakeholders aiming to capitalize on this trajectory.


Key Takeaways

  • Remifentanil (Ultiva) retains a leading role in anesthesia, with ongoing trials expanding its indications and optimizing dosing protocols.

  • The global anesthetic market is expected to grow at 5-7% annually, with Ultiva benefitting from its pharmacokinetic superiority and procedural demand.

  • Competitive pressures include emerging agents like remimazolam and non-opioid alternatives; however, Ultiva’s rapid recovery profile sustains its relevance.

  • Advancements in infusion technology and procedural integration offer opportunities for market expansion, especially in ERAS and ICU sedation.

  • Regulatory considerations and opioid scrutiny may influence market access, necessitating strategic positioning emphasizing safety and clinical benefits.


FAQs

1. What are the latest advancements in clinical research for Ultiva?
Recent trials focus on expanding its use in difficult airway management, ICU sedation, and pediatric anesthesia. Studies aim to optimize dosing, improve safety profiles, and evaluate new combination therapies.

2. How does Ultiva compare to other opioids in surgical settings?
Ultiva’s ultra-short action enables rapid recovery, making it ideal for outpatient procedures. Unlike fentanyl, it minimizes residual sedation, reducing postoperative complications.

3. What regulatory hurdles impact Ultiva’s market growth?
Stringent opioid regulations, particularly concerning addiction and misuse, challenge wider adoption. Safety concerns necessitate skilled administration and monitoring.

4. Which emerging markets offer growth opportunities for Ultiva?
Asia-Pacific and Latin America are promising, driven by increasing surgical volumes, improving healthcare infrastructure, and evolving anesthetic protocols.

5. What future developments could influence Ultiva’s market projection?
Successful trial outcomes, novel delivery systems, and regulatory approvals for new indications like ERAS or pediatric use could significantly accelerate growth.


References

  1. [ClinicalTrials.gov entries related to remifentanil, e.g., NCT04567234, NCT04121009, NCT03975310]
  2. Market research reports on anesthetic agents: Mordor Intelligence, GlobalData.
  3. Peer-reviewed publications on remifentanil’s efficacy and safety profiles.
  4. FDA and EMA regulatory documents concerning opioid analgesics.

More… ↓

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