dexmedetomidine IV (IV Dex) / BioXcel - LARVOL DELTA

Clinical Classification of Radiation Maculopathy as a Predictor of Functional Response to Intravitreal Dexamethasone Implant. (PubMed, J Clin Med) - "Intravitreal dexamethasone (IV DEX) is effective for macular edema (ME) resolution, but functional outcomes remain highly heterogeneous. The CEA classification effectively stratifies functional response in RM. EZ disruption and RPE atrophy identify eyes unlikely to achieve visual improvement despite a reduction in ME, aiding clinical decision-making and establishing functional expectations while promoting a fundamental shift from an edema-driven management to a biomarker-centered approach."

Journal • Eye Cancer • Macular Degeneration • Macular Edema • Melanoma • Ocular Melanoma • Oncology • Ophthalmology • Retinal Disorders • Solid Tumor • Uveal Melanoma

Mezigdomide (MEZI) Plus Dexamethasone (DEX) and Daratumumab (DARA) or Elotuzumab (ELO) in Patients (pts) with Relapsed/Refractory Multiple Myeloma (RRMM): Results from the CC-92480-MM-002 Trial (ASH 2023) - P1/2 | "Intravenous (IV; 16 mg/kg) or subcutaneous (1800 mg) DARA was given weekly (C1–2), then biweekly (C3–6), and monthly (≥ C7) for subcohorts B1 and B3, and weekly (C1–3) then on D1 of each 21-D (C4–8) or 28-D (≥ C9) cycle for subcohort B2; with weekly oral/IV DEX (40 mg; 20 mg > 75 y or body mass index < 18.5 kg/m2). MeziDd showed promising efficacy and a manageable safety profile in pts with RRMM and 2–4 prior lines of therapy, as did MeziEd in pts with prior anti-CD38 mAb therapy. The immune activity of MEZI was consistent with previous preclinical reports. Improved safety and efficacy may be achieved by schedule and dose adjustments."

Clinical • Cardiovascular • Hematological Malignancies • Infectious Disease • Multiple Myeloma • Neutropenia • Plasmacytoma • Pulmonary Embolism • Respiratory Diseases • Targeted Protein Degradation • Thrombocytopenia • CRBN

A phase 3, two-stage, randomized study of mezigdomide, carfilzomib, and dexamethasone (MeziKd) versus carfilzomib and dexamethasone (Kd) in relapsed/refractory multiple myeloma (RRMM): SUCCESSOR-2. (ASCO 2023) - P3 | "MeziKd has shown potent synergistic antiproliferative activity in MM cell lines resistant to lenalidomide (LEN), and in a phase 1/2 study showed promising preliminary efficacy and safety in RRMM...Tx in the Kd arm consists of 28-D cycles with 20 mg/m2 IV CFZ on D1 and 2 of C1, then 56 mg/m2 on D8, 9, 15, and 16 of C1, and on D1, 2, 8, 9, 15, and 16 of ≥ C2; and 20 mg oral/IV DEX (10 mg optional in certain pt groups) on D1, 2, 8, 9, 15, 16, 22, and 23...Enrollment began in October 2022 and is ongoing. Clinical trial information: NCT05552976."

Clinical • P3 data • Hematological Malignancies • Multiple Myeloma • Oncology • Targeted Protein Degradation • CRBN • IKZF1

Final results of a phase II study of lenalidomide-elotuzumab as maintenance therapy post-autologous stem cell transplant (AuSCT) in patients (Pts) with multiple myeloma (MM). (ASCO 2024) - P2 | "For the 1 st 8 weeks, pts <75 yrs received 28 mg of dexamethasone (DEX) 3-24 hours pre-infusion and pts ≥75yrs received 8 mg; pts received 4-10 mg iv DEX pre-infusion for all cycles. ELO-LEN is a well-tolerated maintenance therapy on which 53% of patients had improved quality of response. Median PFS and 5-year OS compare favorably with results from CALGB 100104 and IFM 2005-02 trials of lenalidomide alone. SPM incidence is similar to rates reported in these trials."

Clinical • P2 data • Anemia • Bone Marrow Transplantation • Cardiovascular • Fatigue • Hematological Malignancies • Herpes Zoster • Infectious Disease • Multiple Myeloma • Musculoskeletal Pain • Neutropenia • Oncology • Pain • Renal Disease • Respiratory Diseases • Solid Tumor • Thrombocytopenia • Transplantation

Effects of Intranasal Dexmedetomidine on the Night Before Surgery on Postoperative Delirium in Elderly Patients Undergoing Total Knee/Hip Arthroplasty. A Parallel-Arm, Randomized Controlled, Non-Inferiority Trial. (PubMed, Drug Des Devel Ther) - "To evaluate whether preoperative intranasal dexmedetomidine administration for preventing postoperative delirium is non-inferior to intravenous dexmedetomidine infusion on the operative day before induction for elderly patients undergoing elective knee/hip arthroplasty...For elderly patients undergoing major joint arthroplasty, intranasal dexmedetomidine administered the night before surgery is non-inferior to pre-induction intravenous infusion for preventing postoperative delirium. The intranasal route offers additional benefits, including improved preoperative sleep, reduced anxiety, and superior hemodynamic stability."

Clinical • Head-to-Head • Journal • Anesthesia • CNS Disorders • Geriatric Disorders • Orthopedics • Pain • Psychiatry

Effects of Preoperative Stellate Ganglion Block Combined with Dexmedetomidine on Postoperative Sleep Quality in Patients Undergoing Laparoscopic Gynecological Surgery (ChiCTR) - P=N/A | N=100 | Completed | Sponsor: Huai'an Second People's Hospital; Huai'an Second People's Hospital

New trial • Gynecology

Dexmedetomidine Versus Lidocaine for Optic Nerve Sheath Diameter During Craniotomy Intubation (clinicaltrials.gov) - P4 | N=90 | Not yet recruiting | Sponsor: Benha University

Intubation • New P4 trial

Efficacy and safety of preoperative intranasal dexmedetomidine in adults: a systematic review and meta-analysis of randomized controlled trials. (PubMed, Braz J Anesthesiol) - "Preoperative IN dexmedetomidine may improve sedation and blunt peri-induction hemodynamic responses compared with controls, with broadly similar hemodynamic effects and fewer observed cardiovascular adverse events versus IV administration. However, certainty was low or very low for several efficacy outcomes, and larger well-designed trials are needed."

Journal • Retrospective data • Review • Anesthesia • Cardiovascular • Hypotension

Dexmedetomidine vs Midazolam Premedication: Effects on Perioperative Stress in Elective Laparoscopic Cholecystectomy-A Randomized Double-Blind Trial. (PubMed, J Perianesth Nurs) - "No statistically significant differences were observed between low-dose dexmedetomidine and midazolam in the measured perioperative clinical outcomes. Although midazolam resulted in lower pre-induction ACTH concentrations, this isolated finding was not accompanied by differences in postoperative ACTH concentrations or clinical outcomes. These findings suggest that the measured psychological, neuroendocrine, and inflammatory components of the perioperative stress response may not be directly correlated, and provide one of the first direct comparisons of pre-induction ACTH responses between dexmedetomidine and midazolam."

Clinical • Journal • Anesthesia • Cardiovascular • Hypotension • Mood Disorders • Pain • Psychiatry

STB-DEX: Intravenous Dexamethasone Added to Dexmedetomidine After Superior Trunk Block (clinicaltrials.gov) - P4 | N=70 | Not yet recruiting | Sponsor: Gaziantep City Hospital

New P4 trial • Anesthesia • Orthopedics • Pain

Intravenous dexmedetomidine dose and analgesic outcomes after femoral nerve block for anterior cruciate ligament reconstruction: a single-centre retrospective cohort study in China. (PubMed, BMJ Open) - "Intravenous DEX (0.5-1 μg/kg) was associated with prolonged early postoperative analgesia in ACL reconstruction. Within this cohort, the 0.75 μg/kg dose showed analgesic results similar to 1 μg/kg, with a numerically lower bradycardia incidence. No neurological deficits, sensory abnormalities or between-group differences in muscle strength and motor recovery were detected at 6 months within this cohort. These findings are based on a retrospective design and reflect associations rather than causal relationships, requiring verification by prospective randomised controlled trials."

Journal • Retrospective data • Anesthesia • Cardiovascular • Orthopedics • Pain

Creating Receptor-Specific & Reversible Intravenous Dexmedetomidine Based General Anesthesia (ASA 2026) - "Abstract is embargoed at this time."

Acute hyperactive delirium-like episode during dexmedetomidine sedation after recent discontinuation of long-term reserpine therapy: a case report. (PubMed, Front Med (Lausanne)) - "After satisfactory anesthesia, she was given intravenous dexmedetomidine for stress sedation...Immediately after an intravenous bolus of remimazolam 2 mg, the symptoms rapidly subsided, the patient returned to a sedated state, and the surgery was successfully completed...This case suggests that rare acute hyperactive delirium-like episodes may occur in patients who have recently discontinued long-term reserpine therapy and are receiving dexmedetomidine sedation during the perioperative period. Clinically, careful titration and close monitoring of mental status and hemodynamics are necessary."

Journal • Anesthesia • CNS Disorders • Orthopedics • Psychiatry

Adjunctive Intravenous Dexmedetomidine's Effect on Surgical Visualization and Analgesia in Arthroscopic Bankart Repair: A Retrospective Cohort Study. (PubMed, J Clin Med) - " In this retrospective cohort, adjunctive intravenous dexmedetomidine added to ISBPB was associated with improved surgeon-rated visualization, lower postoperative pain scores, and prolonged analgesia, without an increase in adverse events. Due to the retrospective design and historical control group, these findings should be interpreted as associations; prospective randomized trials are required to confirm them."

Journal • Retrospective data • Hypotension • Musculoskeletal Pain • Orthopedics • Pain

Intravenous Dexmedetomidine as a Perioperative Autonomic-Immune Neuromodulator (clinicaltrials.gov) - P=N/A | N=90 | Not yet recruiting | Sponsor: Poznan University of Medical Sciences

New trial • Immunology • Orthopedics • Osteoarthritis • Rheumatology

Role of perioperative diaphragmatic point-of-care ultrasound in assessing postoperative pulmonary complications in brachial plexus repair surgeries with preexisting hemidiaphragm paresis: A prospective observational study. (PubMed, J Anaesthesiol Clin Pharmacol) - "PDPOCUS reliably assesses perioperative diaphragmatic dysfunction in brachial plexus repair surgeries with preexisting hemidiaphragm paresis. PPC incidence is low with propofol-dexmedetomidine TIVA and meticulous microsurgical techniques, which preserve diaphragm integrity and promote safe extubation under POCUS guidance, despite chronic paresis, but large trials are needed."

Journal • Observational data • Anesthesia

Comparison on the Effectiveness of Intravenous Magnesium Sulphate and Intravenous Dexmedetomidine in Reducing Emergence Agitation in Adults Undergoing Otorhinolaryngology Surgery. (PubMed, Anesthesiol Res Pract) - P4 | "We measured the proportion of EA, onset, and duration of EA, intraoperative ephedrine dose, perioperative heart rate and mean arterial pressure (MAP), pain scores, perioperative fentanyl use, intraoperative sevoflurane use, and extubation time. Intravenous MgSO4 and dexmedetomidine showed no statistically significant difference in the incidence of EA in adult patients undergoing otorhinolaryngologic surgery. Trial Registration: ClinicalTrials.gov: NCT07544173."

Journal • Cardiovascular • Hypotension • Otorhinolaryngology • Pain

Epidural Analgesia in Sepsis and Delirium: A Risk-Benefit Dilemma in Necrotizing Fasciitis (ASA 2026) - "He had undergone source-control surgery, and was responding to antibiotics, but intense pain and hyperactive delirium persisted, with limited benefit from morphine and ketamine. A decision was made to place an epidural catheter under general anesthesia, and start an intravenous dexmedetomidine infusion. The patient improved and ultimately had cancer surgery five weeks later. Necrotizing fasciitis poses multiple perioperative challenges: individualized risk-benefit assessment of interventions is paramount for optimal outcomes."

CNS Disorders • Colorectal Cancer • Infectious Disease • Rectal Cancer • Septic Shock • Solid Tumor

Perineural or intravenous administration of dexmedetomidine combined with anterior quadratus lumborum block for analgesia after retroperitoneal laparoscopic surgery: a prospective, randomized controlled trial. (PubMed, BMC Anesthesiol) - P=N/A | "Perineural administration of 1 µg/kg dexmedetomidine combined with anterior QLB could provide better postoperative analgesia, which reduced 48-hour postoperative sufentanil consumption and improved pain scores at several time points. However, intravenous dexmedetomidine at the same dose did not confer comparable benefits in this setting."

Journal • Anesthesia • Cardiovascular • Hypotension • Pain

Perioperative Dexmedetomidine to Reduce Post-procedure Grief Following Second-trimester Dilation and Evacuation (clinicaltrials.gov) - P2/3 | N=0 | Withdrawn | Sponsor: Stanford University | N=100 ➔ 0 | Not yet recruiting ➔ Withdrawn

Enrollment change • Trial withdrawal • CNS Disorders • Post-traumatic Stress Disorder

Comparative effectiveness of dexmedetomidine and meperidine for the treatment of postanesthetic shivering: a propensity score-matched retrospective cohort study. (PubMed, BMC Anesthesiol) - "In patients with PAS in the PACU, dexmedetomidine was associated with a lower risk of treatment failure than meperidine, but a higher risk of hypotension. Dexmedetomidine may be an effective alternative when appropriate hemodynamic monitoring is available."

HEOR • Journal • Retrospective data • Anesthesia • Cardiovascular • CNS Disorders • Depression • Hypotension • Psychiatry

Effect of Intravenous Dexmedetomidine Versus Dexamethasone for Management of Repound Pain After Supraclavicular Brachial Plexus Block (clinicaltrials.gov) - P1 | N=111 | Completed | Sponsor: Assiut University | Not yet recruiting ➔ Completed

Trial completion • Pain

DEX-MICRO: Effects of Dexmedetomidine on Sublingual Microcirculation and Vascular Waterfall Phenomenon in Patients With Septic Shock (clinicaltrials.gov) - P=N/A | N=20 | Not yet recruiting | Sponsor: First Affiliated Hospital of Wannan Medical College

New trial • Infectious Disease • Septic Shock

Dexmedetomidine for Reducing Mortality in Patients with Sepsis and Concomitant Heart Failure: A Retrospective Cohort Study. (PubMed, J Intensive Care Med) - "A low dose of DEX (2472.306mcg).ConclusionIn this cohort, DEX use was not associated with a lowered 30-day or 90-day mortality rate among patients with sepsis and concomitant HF. Nevertheless, shorter exposure to DEX (in terms of dose and duration) may be associated with ameliorated outcomes."

Journal • Retrospective data • Cardiovascular • Congestive Heart Failure • Critical care • Heart Failure • Infectious Disease • Septic Shock

Dexamethasone vs Dexmedetomidine in Pediatric Peripheral Nerve Blocks for Postoperative Analgesia: A Systematic Review and Network Meta-analysis. (PubMed, J Perianesth Nurs) - "Interventions included perineural and intravenous dexmedetomidine or dexamethasone versus control. Clinical priorities should guide the choice of adjuvant. Further high-quality trials are needed to validate these findings and explore long-term safety."

Journal • Retrospective data • Review • Anesthesia • Pain • Pediatrics