Evidence map›Paper›PMID 35065662›Full record

ArticlePilot and feasibility studies2022

Phenobarbital for the management of severe acute alcohol withdrawal (the PHENOMANAL trial): a pilot randomized controlled trial.

Niall Filewod, Stephen Hwang, Christian J Turner, Leena Rizvi, Sara Gray, Michelle Klaiman, Danielle Buell, Johnathan Ailon, Alexander Caudarella, Galo F Ginocchio and 5 more

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in Pilot and feasibility studies, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03586089 (PHENObarbital for the MANagement of Severe Acute ALcohol Withdrawal Syndrome), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 36% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03586089 naterminatednot on this map

PHENObarbital for the MANagement of Severe Acute ALcohol Withdrawal Syndrome (PHENOMANAL): a Prospective Randomized Feasibility Study.

TypeinterventionalSponsorUnity Health TorontoRan2021 to 2023Enrolled8ConditionsAlcohol Withdrawal Delirium, Alcohol Withdrawal, Alcohol Withdrawal SeizuresArmsPhenobarbital Sodium, Inactive placebo
3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 3 institutions in 3 countries.

Niall FilewodTrillium Health Partners, Mississauga, Ontario, Canada.
Stephen HwangUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Christian J TurnerUniversity of British Columbia, Vancouver, British Columbia, Canada.
Leena RizviUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Sara GrayUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Michelle KlaimanUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Danielle BuellUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Johnathan AilonUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Alexander CaudarellaUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Galo F GinocchioUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Marlene SantosUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Gyan SandhuUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Norman DewhurstUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Kelly SequeiraUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada.
Karen E A BurnsUnity Health Toronto - St. Michael's Hospital, Toronto, Ontario, Canada. Karen.Burns@unityhealth.to.ORCID http://orcid.org/0000-0002-9967-5424
St. Michael's Hospital · CATrillium Health Centre · CAUniversity of British Columbia · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBenzodiazepines are considered first-line treatment for patients experiencing severe acute alcohol withdrawal syndrome (sAAWS). Although several medications have been evaluated as potential adjuvant treatments for sAAWS, barbiturates show particular promise.

objectiveIn the PHENOMANAL trial, we will assess the feasibility of conducting an allocation-concealed, quadruple-blinded, randomized controlled trial (RCT) comparing symptom-triggered benzodiazepine therapy with either a single dose of adjuvant intravenous (IV) phenobarbital (7.5 mg/kg of ideal body weight) or a single dose of matching IV placebo for patients with sAAWS.

methodsWe will recruit adult patients from the Emergency Department, Intensive Care Unit, or hospital wards with a Clinical Institute of Withdrawal - Adult revised (CIWA-Ar) score of 16 or more after receipt of at least 60 mg of diazepam or equivalent within 16 h of diagnosis of sAAWS, and an anticipated need for hospitalization. We will randomize participants (n=39) in a 2:1 manner to treatment and placebo groups, respectively. The primary objective of the PHENOMANAL pilot trial will be to demonstrate our ability to recruit the desired population over the trial period. As secondary objectives, we will evaluate clinician compliance with the treatment protocols, assess crossover rates from the placebo arm to the treatment arm, and obtain preliminary estimates of treatment effect. All trial participants will be followed for 7 days or until hospital discharge. RELEVANCE: The PHENOMANAL trial is novel in investigating a new treatment for a common and understudied condition, repurposing an existing medication for a novel indication, and addressing an important evidence gap. Through conduct of the multidisciplinary pilot trial, we aim to advance methodology in acute care research through the use of a hybrid consent model and inform the design of a large-scale trial.

trial registrationClinicalTrials.gov Registration NCT03586089 ; first registered July 13, 2018.

Indexed as

Delirium tremensPhenobarbital; Alcohol withdrawalTreatment

Identifiers

PMID35065662
PMCPMC8783453
OpenAlexW4206995190

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.