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This is a Phase 3, multicenter, randomized, double-blind, parallel-group, placebo-controlled efficacy and safety study of postoperative pain in adults who are scheduled for unilateral inguinal hernioplasty via open laparotomy (tension-free technique).
Patients will assess their postoperative pain intensity (PI) using an 11-point numerical rating scale (NRS) from 0 hour through 72 hours postoperatively.
The expected maximum study duration for each patient will be up to 60 days, including a maximum 30-day screening period, the day of surgery and implantation, and a 30-day post implantation period including treatment and follow-up.
This is a Phase 3, multicenter, randomized, double-blind, parallel-group, placebo-controlled study in adults who are scheduled for unilateral inguinal hernioplasty via open laparotomy (tension-free technique). Patients will receive either 3 XaraColl Bupivacaine Implants each containing 100 mg of bupivacaine hydrochloride, for a 300 mg total dose; or 3 placebo-sponges.
Three test article sponges will be implanted according to the patient's blinded treatment assignment. Following surgery, patients will be transferred to a postanesthesia care unit (PACU) and/or other postoperative recovery area for observation where they may receive parenteral morphine as needed (rescue medication for breakthrough pain) and on request for pain control. Once patients can tolerate oral medication, they will commence a standardized oral analgesic regimen with additional PRN medication to manage breakthrough pain only when it occurs.
Patients will assess their postoperative pain intensity (PI) using an 11-point numerical rating scale (NRS) from 0 hour through 72 hours postoperatively.
Patients will be observed postoperatively for a minimum of 3 hours and may be discharged at any time following completion of their 3-hour vital sign and PI assessments. Patients will be contacted at approximately 6, 24 and 48 hours after implantation to ensure protocol compliance and to perform safety assessments (including AEs and concomitant medications). At 72 hours, patients will return to the clinic to perform their final PI assessment, complete a categorical assessment of their overall pain control, and for follow-up safety assessments. They will also be asked to record the incidence of any ongoing or subsequent AEs (and any associated treatment) through Day 7. Additional follow-up assessments for safety will be performed at postoperative Day 7 (telephone call) and Days 15 and 30 (clinic visits).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| XaraColl | Experimental | 3 XaraColl Bupivacaine Implants each containing 100 mg of bupivacaine hydrochloride, for a 300 mg total dose |
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| Placebo | Placebo Comparator | 3 placebo implants |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| XaraColl | Drug | Surgical implantation of 3 bupivacaine collagen implants |
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| Measure | Description | Time Frame |
|---|---|---|
| SPI24 | The primary efficacy variable (time-weighted sum of pain intensity from Time 0 through 24 hours [SPI24]) was compared once at a 2-sided 0.05 level. Therefore, no multiplicity adjustment was necessary for the primary efficacy analysis. Pain Intensity was assessed by the subject using the 11-point NRS, where 0 indicated "no pain" and 10 indicated "worst pain possible". Minimum value would be "0" and Maximum value would be 240. Time-weighted SPI is calculated as the sum of the pain intensities between successive time points (i.e., if SPI24 = ∑[PI x (time t - time t-1)], where "t" represents a given time point,"t-1" represents the previous time point, and time is expressed in hours). This represents the AUC (Area Under the Curve) of the pain intensities when calculated with the trapezoidal rule. | 0 to 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| TOpA24 | Total use of opioid analgesia (TOpA) from Time 0 through 24 hours (TOpA24) This is a basic measurement of counting in total the number of morphine tablets (15 mg) patients had to use within a 24-hour period (typically called "rescue" to help manage pain. Zero (0) is the "lowest" score. The lower the number of tablets the better outcome. | Time 0 through 24 hours |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gwendolyn Niebler, D.O. | Innocoll | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Anniston | Alabama | 36207 | United States | |||
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30467808 | Derived | Velanovich V, Rider P, Deck K, Minkowitz HS, Leiman D, Jones N, Niebler G. Safety and Efficacy of Bupivacaine HCl Collagen-Matrix Implant (INL-001) in Open Inguinal Hernia Repair: Results from Two Randomized Controlled Trials. Adv Ther. 2019 Jan;36(1):200-216. doi: 10.1007/s12325-018-0836-4. Epub 2018 Nov 22. |
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| ID | Title | Description |
|---|---|---|
| FG000 | XaraColl | 3 XaraColl Bupivacaine Implants each containing 100 mg of bupivacaine hydrochloride, for a 300 mg total dose XaraColl: Surgical implantation of 3 bupivacaine collagen implants |
| FG001 | Placebo |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
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| Placebo | Other | Plain collagen implant (vehicle) |
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| TOpA48 | Total use of opioid analgesia (TOpA) from Time 0 through 48 hours (TOpA48) This is a basic measurement of counting in total the number of morphine tablets (15 mg) patients had use within a 48-hour period (typically called "rescue" to help manage pain. Zero (0) is the "lowest" score. The lower the number of tablets the better outcome. | Time 0 through 48 hours |
| TOpA72 | Total use of opioid analgesia (TOpA) from Time 0 through 72 hours (TOpA72) This is a basic measurement of counting in total the number of morphine tablets (15 mg) patients had use within a 72-hour period (typically called "rescue" to help manage pain. Zero (0) is the "lowest" score. The lower the number of tablets the better outcome. | Time 0 through 72 hours |
| SPI48 | Time-weighted sum of pain intensity from Time 0 through 48 hours (SPI48). Lower score has a better outcome. Pain Intensity was assessed by the subject using the 11-point NRS, where 0 indicated "no pain" and 10 indicated "worst pain possible". Minimum value would be "0" and Maximum value would be 480. Time-weighted SPI is calculated as the sum of the pain intensities between successive time points (i.e., if SPI48 = ∑[PI x (time t - time t-1)], where "t" represents a given time point,"t-1" represents the previous time point, and time is expressed in hours). This represents the AUC (Area Under the Curve) of the pain intensities when calculated with the trapezoidal rule. | 0 to 48 hours |
| SPI72 | Time-weighted sum of pain intensity from Time 0 through 72 hours (SPI72) A lower score is a better outcome. Pain Intensity was assessed by the subject using the 11-point NRS, where 0 indicated "no pain" and 10 indicated "worst pain possible" Minimum value would be "0" and Maximum value would be 720. Time-weighted SPI is calculated as the sum of the pain intensities between successive time points (i.e., if SPI72 = ∑[PI x (time t - time t-1)], where "t" represents a given time point,"t-1" represents the previous time point, and time is expressed in hours). This represents the AUC (Area Under the Curve) of the pain intensities when calculated with the trapezoidal rule. | 0 to 72 hours |
| Birmingham |
| Alabama |
| 35216 |
| United States |
| Anaheim | California | 92801 | United States |
| Laguna Hills | California | 92653 | United States |
| Pasadena | California | 91105 | United States |
| Placentia | California | 92870 | United States |
| Aurora | Colorado | 80045 | United States |
| Miami | Florida | 33134 | United States |
| Miami | Florida | 33155 | United States |
| Pembroke Pines | Florida | 33028 | United States |
| Pensacola | Florida | 32503 | United States |
| Columbus | Georgia | 31904 | United States |
| Chicago | Illinois | 60645 | United States |
| Las Vegas | Nevada | 89104 | United States |
| Durham | North Carolina | 27710 | United States |
| Cleveland | Ohio | 44106 | United States |
| Columbus | Ohio | 43210 | United States |
| Oklahoma City | Oklahoma | 73104 | United States |
| Philadelphia | Pennsylvania | 19104 | United States |
| Houston | Texas | 77004 | United States |
| Houston | Texas | 77024 | United States |
| Salt Lake City | Utah | 84124 | United States |
| Newport News | Virginia | 23606 | United States |
| Madison | Wisconsin | 53792 | United States |
3 placebo implants
Placebo: Plain collagen implant (vehicle)
| Randomized But Not Treated |
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| COMPLETED |
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| NOT COMPLETED |
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The modified intent-to-treat (mITT) population consisted of all randomized subjects who received any dose of INL-001 or placebo and who had at least 1 NRS PI score prior to hospital discharge
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| ID | Title | Description |
|---|---|---|
| BG000 | XaraColl | 3 XaraColl Bupivacaine Implants each containing 100 mg of bupivacaine hydrochloride, for a 300 mg total dose XaraColl: Surgical implantation of 3 bupivacaine collagen implants |
| BG001 | Placebo | 3 placebo implants Placebo: Plain collagen implant (vehicle) |
| BG002 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| 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 |
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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 | SPI24 | The primary efficacy variable (time-weighted sum of pain intensity from Time 0 through 24 hours [SPI24]) was compared once at a 2-sided 0.05 level. Therefore, no multiplicity adjustment was necessary for the primary efficacy analysis. Pain Intensity was assessed by the subject using the 11-point NRS, where 0 indicated "no pain" and 10 indicated "worst pain possible". Minimum value would be "0" and Maximum value would be 240. Time-weighted SPI is calculated as the sum of the pain intensities between successive time points (i.e., if SPI24 = ∑[PI x (time t - time t-1)], where "t" represents a given time point,"t-1" represents the previous time point, and time is expressed in hours). This represents the AUC (Area Under the Curve) of the pain intensities when calculated with the trapezoidal rule. | modified intent-to-treat - The mITT population consisted of randomized subjects who received any dose of INL-001 or placebo and who had at least 1 NRS PI score prior to hospital discharge, as needed, to compute SPI. | Posted | Mean | Standard Deviation | units on a scale | 0 to 24 hours |
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| Secondary | TOpA24 | Total use of opioid analgesia (TOpA) from Time 0 through 24 hours (TOpA24) This is a basic measurement of counting in total the number of morphine tablets (15 mg) patients had to use within a 24-hour period (typically called "rescue" to help manage pain. Zero (0) is the "lowest" score. The lower the number of tablets the better outcome. | Posted | Median | 95% Confidence Interval | morphine equivalents | Time 0 through 24 hours |
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| Secondary | TOpA48 | Total use of opioid analgesia (TOpA) from Time 0 through 48 hours (TOpA48) This is a basic measurement of counting in total the number of morphine tablets (15 mg) patients had use within a 48-hour period (typically called "rescue" to help manage pain. Zero (0) is the "lowest" score. The lower the number of tablets the better outcome. | mITT Population) | Posted | Median | 95% Confidence Interval | morphine equivalent | Time 0 through 48 hours |
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| Secondary | TOpA72 | Total use of opioid analgesia (TOpA) from Time 0 through 72 hours (TOpA72) This is a basic measurement of counting in total the number of morphine tablets (15 mg) patients had use within a 72-hour period (typically called "rescue" to help manage pain. Zero (0) is the "lowest" score. The lower the number of tablets the better outcome. | Posted | Median | 95% Confidence Interval | morphine tablets | Time 0 through 72 hours |
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| Secondary | SPI48 | Time-weighted sum of pain intensity from Time 0 through 48 hours (SPI48). Lower score has a better outcome. Pain Intensity was assessed by the subject using the 11-point NRS, where 0 indicated "no pain" and 10 indicated "worst pain possible". Minimum value would be "0" and Maximum value would be 480. Time-weighted SPI is calculated as the sum of the pain intensities between successive time points (i.e., if SPI48 = ∑[PI x (time t - time t-1)], where "t" represents a given time point,"t-1" represents the previous time point, and time is expressed in hours). This represents the AUC (Area Under the Curve) of the pain intensities when calculated with the trapezoidal rule. | (mITT Population) | Posted | Median | 95% Confidence Interval | units on a scale | 0 to 48 hours |
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| Secondary | SPI72 | Time-weighted sum of pain intensity from Time 0 through 72 hours (SPI72) A lower score is a better outcome. Pain Intensity was assessed by the subject using the 11-point NRS, where 0 indicated "no pain" and 10 indicated "worst pain possible" Minimum value would be "0" and Maximum value would be 720. Time-weighted SPI is calculated as the sum of the pain intensities between successive time points (i.e., if SPI72 = ∑[PI x (time t - time t-1)], where "t" represents a given time point,"t-1" represents the previous time point, and time is expressed in hours). This represents the AUC (Area Under the Curve) of the pain intensities when calculated with the trapezoidal rule. | mITT Population | Posted | Median | 95% Confidence Interval | units on a scale | 0 to 72 hours |
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30 days
Subject 628-018 was randomized to the INL-001 group but received placebo; the subject was included in the INL-001 group for efficacy analyses (ie, ITT and mITT populations) and was included in the placebo group for safety analyses (ie, safety population). The ITT population consisted of all randomized subjects who may or may not have received any dose of INL-001 or placebo
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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 | XaraColl | 3 XaraColl Bupivacaine Implants each containing 100 mg of bupivacaine hydrochloride, for a 300 mg total dose XaraColl: Surgical implantation of 3 bupivacaine collagen implants | 0 | 208 | 3 | 208 | 118 | 208 |
| EG001 | Placebo | 3 placebo implants Placebo: Plain collagen implant (vehicle) | 1 | 107 | 3 | 107 | 76 | 107 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Acute myocardial infarction | Cardiac disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Atrial fibrillation | Cardiac disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Abdominal pain | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Appendicitis | Infections and infestations | MedDRA (Unspecified) | Systematic Assessment |
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| Groin pain | Musculoskeletal and connective tissue disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Constipation | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Incision site complication | Injury, poisoning and procedural complications | MedDRA (Unspecified) | Systematic Assessment |
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| Incision site pain | Injury, poisoning and procedural complications | MedDRA (Unspecified) | Systematic Assessment |
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| Incision site swelling | Injury, poisoning and procedural complications | MedDRA (Unspecified) | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Dysgeusia | Nervous system disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Somnolence | Nervous system disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Anxiety | Psychiatric disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Restlessness | Psychiatric disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Charlene A. Tucker, MS Executive Director, Medical Writing and Document Management | Innocoll | 484-406-5211 | ctucker@innocoll.com |
| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
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| ID | Term |
|---|---|
| D003094 | Collagen |
| ID | Term |
|---|---|
| D001704 | Biopolymers |
| D011108 | Polymers |
| D046911 | Macromolecular Substances |
| D016326 | Extracellular Matrix Proteins |
| D012596 | Scleroproteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
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| Male |
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