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| ID | Type | Description | Link |
|---|---|---|---|
| 2010-021954-21 | EudraCT Number |
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The purpose of this study is to characterize the safety, PK, and efficacy of BTDS in patients of ages 7 to 16 years.
A study of safety, PK, and efficacy of BTDS in patients of ages 7 to 16 years, inclusive, who require continuous opioid analgesia for moderate to severe pain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Overall BTDS | Experimental | Buprenorphine transdermal system |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Buprenorphine transdermal system | Drug | Buprenorphine transdermal system 2.5 mcg/h, 5 mcg/h, 10 mcg/h or 20 mcg/h applied transdermally for 7-day wear. |
|
| Measure | Description | Time Frame |
|---|---|---|
| The Number of Participants With Adverse Events as a Measure of Safety | Safety assessments consisted of reports of AEs, vital signs (blood pressure, pulse rate, respiratory rate, and temperature), weight, hemoglobin-oxygen saturation measured by pulse oximetry (SpO2), clinical laboratory tests, somnolence (assessed by the University of Michigan Sedation Scale [UMSS]), conventional 12-lead electrocardiograms (ECGs), and 24-hour digital 12-lead ECGs (Holter monitor). Safety variables were summarized descriptively within age group for the safety population. | Up to 28 weeks |
| Pharmacokinetics (PK) of Buprenorphine Following Transdermal Administration: Apparent Clearance (CL/F) | The population PK (PopPK) of BTDS buprenorphine in pediatric patients ages 7 to 16 years was described by a 2-compartment model with sequential zero- and first-order absorption from the patch. A fixed allometric relationship was used to describe the effects of changes in ideal body weight (IBW) across pediatric patients on all clearance and volume parameters. Given the sparse sample collections, small sample size, and complexity of the absorption process with the patch formulation, this PopPK model was fit to the pediatric data using nonlinear mixed effects modeling (NONMEM) Bayes method with selective use of priors from previous adult PopPK results. Estimates of fixed effects from the final model were used to calculate the CL/F after patch dosing given the covariate distribution in the PopPK dataset and the typical weights from children in the National Health and Nutrition Examination Survey (NHANES) dataset. | Day 1, end of week 1, days 9/10, end of week 2, and end of week 4 or at discontinuation prior to end of study visit |
| Pharmacokinetics (PK) of Buprenorphine Following Transdermal Administration: Apparent Volume of Distribution (Vc/F) | The population PK (PopPK) of BTDS buprenorphine in pediatric patients ages 7 to 16 years was described by a 2-compartment model with sequential zero- and first-order absorption from the patch. A fixed allometric relationship was used to describe the effects of changes in ideal body weight (IBW) across pediatric patients on all clearance and volume parameters. Given the sparse sample collections, small sample size, and complexity of the absorption process with the patch formulation, this PopPK model was fit to the pediatric data using nonlinear mixed effects modeling (NONMEM) Bayes method with selective use of priors from previous adult PopPK results. Estimates of fixed effects from the final model were used to calculate the Vc/F after patch dosing given the covariate distribution in the PopPK dataset and the typical weights from children in the National Health and Nutrition Examination Survey (NHANES) dataset. |
| Measure | Description | Time Frame |
|---|---|---|
| Pain Right Now Assessment by Patients Aged 7 to 11 Years, Inclusive | Pain right now was assessed using the Faces of Pain Scale-Revised (FPS-R). The FPS-R is a horizontal row of 6 faces representing pain intensity, with "no hurt" at the far left and "hurts worst" at the far right; the intensities are scored as 0, 2, 4, 6, 8, or 10. A score of 0=no pain, and 10=very much pain. For screening to week 4, pain right now was assessed at 30 minutes before initial BTDS application on day 1; one hour after initial BTDS application on day 1; thereafter, once daily at approximately 8 PM for the first 4 weeks. Baseline score was the last assessment prior to the first dose. For weeks 1-4, weekly averages of the pain right now scores were calculated using the sum of all available pain right now scores recorded daily during a given week divided by the number of available scores. The study measured pain right now for weeks 6-24 once a week at approximately 8 PM while on treatment; however, no patients in this age group were treated beyond week 12. |
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Inclusion Criteria include:
Exclusion Criteria include:
Other protocol-specific inclusion/exclusion criteria may apply.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Long Beach Memorial Medical Center | Long Beach | California | 90806 | United States | ||
| Children's Hospital of Los Angeles |
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First Patient First Visit: 23-July-2012; Last Patient Last Visit: 23-May-2016. The study was conducted at 33 study centers in the United States
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| ID | Title | Description |
|---|---|---|
| FG000 | 7 to 11 Years | Children 7 to 11 years of age |
| FG001 | 12 to 16 Years | Children 12 to 16 years of age |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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|
| Day 1, end of week 1, days 9/10, end of week 2, and end of week 4 or at discontinuation prior to end of study visit |
| Up to 24 weeks |
| Pain Right Now Assessment by Patients Aged 12 to 16 Years, Inclusive | Pain right now was assessed using a 100-mm visual analogue scale (VAS). The 100-mm VAS is a 100-mm line with 1 end marked as "no pain" and the other marked as "pain as bad as it could be." The patient was asked to make a mark on that line indicating his or her level of pain. Pain right now score was defined as the distance (in mm) from the "no pain" end to the patient's mark; 0=no pain and bigger numbers indicate more pain. For screening to week 4, pain right now was assessed 30 minutes before initial BTDS application on day 1; one hour after initial BTDS application on day 1; thereafter, once daily at approximately 8 PM for the first 4 weeks. Baseline was the last assessment prior to the first dose. For weeks 1-4, weekly averages of the pain right now scores were calculated using the sum of all available pain right now scores recorded daily during a given week divided by the number of available scores. For weeks 6-24, pain right now was measured once a week at approximately 8 PM. | Up to 24 weeks |
| Parent/Caregiver-assessed Global Impression of Change (PGIC) | The PGIC rating score variable was collected on a 7-point scale ranging from 1 to 7 (where 1 = very much improved; and 7 = very much worse). The PGIC is designed to assess overall satisfaction with the treatment. The PGIC score was summarized using the number and percent of patients in each of the 7 possible response categories overall and by age group. PGIC was assessed by the parent/caregiver at the end of treatment visit or early discontinuation visit. | End of treatment (week 24) or early discontinuation visit |
| Los Angeles |
| California |
| 90027 |
| United States |
| Children's Health Center | Los Angeles | California | 90095-1752 | United States |
| Children's Hospital Colorado | Aurora | Colorado | 80045 | United States |
| Connecticut Children's Medical Center | Hartford | Connecticut | 06106 | United States |
| Howard University Hospital | Washington D.C. | District of Columbia | 20060 | United States |
| Jackson Memorial Hospital / University of Miami | Miami | Florida | 33136 | United States |
| Children's Healthcare of Atlanta at Egleston | Atlanta | Georgia | 30322 | United States |
| University of Illinois Hospital and Health Sciences System | Chicago | Illinois | 60612 | United States |
| Kosair Charities Pediatric Clinical Research Unit - University of Louisville | Louisville | Kentucky | 40202 | United States |
| Willis-Knighton Physician Network | Shreveport | Louisiana | 71118 | United States |
| Saint Peter's University Hospital | New Brunswick | New Jersey | 08901 | United States |
| WCMC, Department of Pediatrics - Hematology/Oncology | New York | New York | 10065 | United States |
| Stony Brook University Hospital | Stony Brook | New York | 11794 | United States |
| Children's Hospital at Montefiore | The Bronx | New York | 10467 | United States |
| Vidant Medical Center | Greenville | North Carolina | 27834 | United States |
| The Center for Clinical Research - Carolina Pain Institute | Winston-Salem | North Carolina | 27103 | United States |
| Children's Hospital of Pittsburgh of UPMC | Pittsburgh | Pennsylvania | 15224 | United States |
| Rhode Island Hospital, Department of Pediatrics | Providence | Rhode Island | 02903 | United States |
| Medical University of South Carolina | Charleston | South Carolina | 29425 | United States |
| Children's Blood and Cancer Center | Austin | Texas | 78723 | United States |
| Road Runner Research, Ltd. | San Antonio | Texas | 78258 | United States |
| COMPLETED |
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| NOT COMPLETED |
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The safety population (N=41) was the group of patients who received at least 1 dose of study drug during the study.
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| ID | Title | Description |
|---|---|---|
| BG000 | 7 to 11 Years | Children 7 to 11 years of age |
| BG001 | 12 to 16 Years | Children 12 to 16 years of age |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | years |
| |||||||||||||||
| Sex: Female, Male | Count of Participants | Participants |
| ||||||||||||||||
| Race/Ethnicity, Customized | Count of Participants | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | The Number of Participants With Adverse Events as a Measure of Safety | Safety assessments consisted of reports of AEs, vital signs (blood pressure, pulse rate, respiratory rate, and temperature), weight, hemoglobin-oxygen saturation measured by pulse oximetry (SpO2), clinical laboratory tests, somnolence (assessed by the University of Michigan Sedation Scale [UMSS]), conventional 12-lead electrocardiograms (ECGs), and 24-hour digital 12-lead ECGs (Holter monitor). Safety variables were summarized descriptively within age group for the safety population. | The safety population (N=41) was the group of patients who received at least 1 dose of study drug during the study. | Posted | Count of Participants | Participants | Up to 28 weeks |
|
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| ||||||||||||||||||||||||||||||||||||
| Primary | Pharmacokinetics (PK) of Buprenorphine Following Transdermal Administration: Apparent Clearance (CL/F) | The population PK (PopPK) of BTDS buprenorphine in pediatric patients ages 7 to 16 years was described by a 2-compartment model with sequential zero- and first-order absorption from the patch. A fixed allometric relationship was used to describe the effects of changes in ideal body weight (IBW) across pediatric patients on all clearance and volume parameters. Given the sparse sample collections, small sample size, and complexity of the absorption process with the patch formulation, this PopPK model was fit to the pediatric data using nonlinear mixed effects modeling (NONMEM) Bayes method with selective use of priors from previous adult PopPK results. Estimates of fixed effects from the final model were used to calculate the CL/F after patch dosing given the covariate distribution in the PopPK dataset and the typical weights from children in the National Health and Nutrition Examination Survey (NHANES) dataset. | The full analysis population (FAP) for PK consisted of patients who received study drug and had at least 1 valid quantifiable PK blood sample (N=41).Three patients had no quantifiable plasma buprenorphine concentration measurements and were not included in the PK analysis.The final buprenorphine pediatric PK analysis dataset comprised 38 patients. | Posted | Mean | 95% Confidence Interval | Liters/hour | Day 1, end of week 1, days 9/10, end of week 2, and end of week 4 or at discontinuation prior to end of study visit |
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| Secondary | Pain Right Now Assessment by Patients Aged 7 to 11 Years, Inclusive | Pain right now was assessed using the Faces of Pain Scale-Revised (FPS-R). The FPS-R is a horizontal row of 6 faces representing pain intensity, with "no hurt" at the far left and "hurts worst" at the far right; the intensities are scored as 0, 2, 4, 6, 8, or 10. A score of 0=no pain, and 10=very much pain. For screening to week 4, pain right now was assessed at 30 minutes before initial BTDS application on day 1; one hour after initial BTDS application on day 1; thereafter, once daily at approximately 8 PM for the first 4 weeks. Baseline score was the last assessment prior to the first dose. For weeks 1-4, weekly averages of the pain right now scores were calculated using the sum of all available pain right now scores recorded daily during a given week divided by the number of available scores. The study measured pain right now for weeks 6-24 once a week at approximately 8 PM while on treatment; however, no patients in this age group were treated beyond week 12. | The full analysis population (FAP) was the group of patients who received at least 1 dose of the study drug during the study. | Posted | Mean | Standard Error | units on a scale | Up to 24 weeks |
|
| ||||||||||||||||||||||||||||||||||||
| Secondary | Pain Right Now Assessment by Patients Aged 12 to 16 Years, Inclusive | Pain right now was assessed using a 100-mm visual analogue scale (VAS). The 100-mm VAS is a 100-mm line with 1 end marked as "no pain" and the other marked as "pain as bad as it could be." The patient was asked to make a mark on that line indicating his or her level of pain. Pain right now score was defined as the distance (in mm) from the "no pain" end to the patient's mark; 0=no pain and bigger numbers indicate more pain. For screening to week 4, pain right now was assessed 30 minutes before initial BTDS application on day 1; one hour after initial BTDS application on day 1; thereafter, once daily at approximately 8 PM for the first 4 weeks. Baseline was the last assessment prior to the first dose. For weeks 1-4, weekly averages of the pain right now scores were calculated using the sum of all available pain right now scores recorded daily during a given week divided by the number of available scores. For weeks 6-24, pain right now was measured once a week at approximately 8 PM. | The FAP was the group of patients who received at least 1 dose of the study drug during the study. | Posted | Mean | Standard Error | units on a scale | Up to 24 weeks |
|
| ||||||||||||||||||||||||||||||||||||
| Secondary | Parent/Caregiver-assessed Global Impression of Change (PGIC) | The PGIC rating score variable was collected on a 7-point scale ranging from 1 to 7 (where 1 = very much improved; and 7 = very much worse). The PGIC is designed to assess overall satisfaction with the treatment. The PGIC score was summarized using the number and percent of patients in each of the 7 possible response categories overall and by age group. PGIC was assessed by the parent/caregiver at the end of treatment visit or early discontinuation visit. | The full analysis population (FAP) (N=40) was the group of patients who received at least 1 dose of the study drug during the study; however data was provided for only 38 patients for this outcome measure. | Posted | Count of Participants | Participants | No | End of treatment (week 24) or early discontinuation visit |
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| Primary | Pharmacokinetics (PK) of Buprenorphine Following Transdermal Administration: Apparent Volume of Distribution (Vc/F) | The population PK (PopPK) of BTDS buprenorphine in pediatric patients ages 7 to 16 years was described by a 2-compartment model with sequential zero- and first-order absorption from the patch. A fixed allometric relationship was used to describe the effects of changes in ideal body weight (IBW) across pediatric patients on all clearance and volume parameters. Given the sparse sample collections, small sample size, and complexity of the absorption process with the patch formulation, this PopPK model was fit to the pediatric data using nonlinear mixed effects modeling (NONMEM) Bayes method with selective use of priors from previous adult PopPK results. Estimates of fixed effects from the final model were used to calculate the Vc/F after patch dosing given the covariate distribution in the PopPK dataset and the typical weights from children in the National Health and Nutrition Examination Survey (NHANES) dataset. | The full analysis population (FAP) for PK consisted of patients who received study drug and had at least 1 valid quantifiable PK blood sample (N=41).Three patients had no quantifiable plasma buprenorphine concentration measurements and were not included in the PK analysis.The final buprenorphine pediatric PK analysis dataset comprised 38 patients. | Posted | Mean | 95% Confidence Interval | Liters | Day 1, end of week 1, days 9/10, end of week 2, and end of week 4 or at discontinuation prior to end of study visit |
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Non-serious treatment-emergent adverse events (TEAEs) were collected from the initiation of treatment with study drug up to 7 days after the last dose of study drug. Serious adverse events (SAEs) were collected from the signing of the informed consent form through 30 days of the last dose of study drug.
For the assessment of SAEs and TEAEs, the analysis population included all patients exposed to at least 1 dose of study drug (ie, safety population).
An SAE of pneumohemothorax occurred in 1 patient during screening and an SAE of sickle cell pain crisis occurred in 1 patient during screening. Both patients were considered screen failures, were not treated with study drug, and were not included in the safety population.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | 7 to 11 Years | Children 7 to 11 years of age | 0 | 6 | 5 | 6 | 6 | 6 |
| EG001 | 12 to 16 Years | Children 12 to 16 years of age | 0 | 35 | 5 | 35 | 20 | 35 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Anaemia | Blood and lymphatic system disorders | MedDRA (15.0) | Systematic Assessment |
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| Atrioventricular Block First Degree | Cardiac disorders | MedDRA (15.0) | Systematic Assessment |
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| Hereditary Angioedema | Congenital, familial and genetic disorders | MedDRA (15.0) | Systematic Assessment |
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| Sickle Cell Anaemia With Crisis | Congenital, familial and genetic disorders | MedDRA (15.0) | Systematic Assessment |
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| Crohn's Disease | Gastrointestinal disorders | MedDRA (15.0) | Systematic Assessment |
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| Fatigue | General disorders | MedDRA (15.0) | Systematic Assessment |
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| Appendicitis | Infections and infestations | MedDRA (15.0) | Systematic Assessment |
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| Osteomyelitis Chronic | Infections and infestations | MedDRA (15.0) | Systematic Assessment |
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| Malnutrition | Metabolism and nutrition disorders | MedDRA (15.0) | Systematic Assessment |
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| Osteonecrosis | Musculoskeletal and connective tissue disorders | MedDRA (15.0) | Systematic Assessment |
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| Hypersomnia | Nervous system disorders | MedDRA (15.0) | Systematic Assessment |
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| Migraine | Nervous system disorders | MedDRA (15.0) | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Leukocytosis | Blood and lymphatic system disorders | MedDRA (15.0) | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA (15.0) | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA (15.0) | Systematic Assessment |
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| Application Site Pruritus | General disorders | MedDRA (15.0) | Systematic Assessment |
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| Back Pain | Musculoskeletal and connective tissue disorders | MedDRA (15.0) | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA (15.0) | Systematic Assessment |
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| Pain in Extremity | Musculoskeletal and connective tissue disorders | MedDRA (15.0) | Systematic Assessment |
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| Juvenile Arthritis | Musculoskeletal and connective tissue disorders | MedDRA (15.0) | Systematic Assessment |
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| Migraine | Nervous system disorders | MedDRA (15.0) | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA (15.0) | Systematic Assessment |
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| Epistaxis | Respiratory, thoracic and mediastinal disorders | MedDRA (15.0) | Systematic Assessment |
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| Neutropenia | Blood and lymphatic system disorders | MedDRA (15.0) | Systematic Assessment |
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| Sinus Tachycardia | Cardiac disorders | MedDRA (15.0) | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA (15.0) | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA (15.0) | Systematic Assessment |
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| Application Site Irritation | General disorders | MedDRA (15.0) | Systematic Assessment |
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| Fatigue | General disorders | MedDRA (15.0) | Systematic Assessment |
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| Clostridium Difficile Colitis | Infections and infestations | MedDRA (15.0) | Systematic Assessment |
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| Electrocardiogram QT Prolonged | Investigations | MedDRA (15.0) | Systematic Assessment |
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| Somnolence | Nervous system disorders | MedDRA (15.0) | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA (15.0) | Systematic Assessment |
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| Paresthesia | Nervous system disorders | MedDRA (15.0) | Systematic Assessment |
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| Sedation | Nervous system disorders | MedDRA (15.0) | Systematic Assessment |
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| Sickle Cell Anaemia With Crisis | Congenital, familial and genetic disorders | MedDRA (15.0) | Systematic Assessment |
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Patient recruitment in the younger age group was difficult and the sample size is smaller than the older age group. This limitation should be a consideration when interpreting the data.
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Clinical Leader | Purdue Pharma L.P. | 800-733-1333 | stacy.baldridge@pharma.com |
| ID | Term |
|---|---|
| D010146 | Pain |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D002047 | Buprenorphine |
| ID | Term |
|---|---|
| D009019 | Morphinans |
| D053610 | Opiate Alkaloids |
| D000470 | Alkaloids |
| D006571 | Heterocyclic Compounds |
| D006572 | Heterocyclic Compounds, Bridged-Ring |
| D006576 | Heterocyclic Compounds, 4 or More Rings |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D010616 | Phenanthrenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D011083 | Polycyclic Compounds |
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| Male |
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| Black or African American |
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| Other |
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