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The study schedule is comprised of a 14-day Screening Period, a treatment period and an observation period. All eligible subjects will be randomized into one of 3 treatment groups (1 of 2 dose levels or matched placebo). Study drug CR845 will be administered intravenously prior to surgery, and at specific time intervals post surgery. Additional rescue pain and anti-nausea medication will be made available. Post surgical changes in pain intensity, nausea and vomiting will be assessed.
Patients will be admitted to the surgical center on the day of their abdominal surgery (Day 1, unless admission the night before is required). All patients will be seen by the study staff to confirm eligibility, review study procedures, and conduct all pre-surgical assessments required for randomization.
Qualified patients will be randomized into 1 of 3 treatment groups, corresponding to 1 of 2 dose levels of intravenous (IV) CR845 (0.5 or 1 mcg/kg) or matched placebo, respectively.
Study drug will be administered every 6 hours during the 24-hour post-operative treatment period following these initial 2 drug administrations:
Subsequent dosing will be administered at 6, 12 and 18 hours.
During the Treatment and Observation Period, pain intensity scores will be obtained at specified time points and episodes of nausea or vomiting will be recorded. Upon request, patients may be provided with analgesic or anti-nausea rescue medication (restricted to morphine (if tolerated), and ondansetron, respectively) at any time after the Baseline dose of study drug is administered.
Blood sampling and safety assessments will be conducted during this period as well.
Patients will remain in the hospital until Day 3 (48-hours after surgery) at which point they will be evaluated for discharge. A follow-up medical evaluation will be scheduled within 7 - 10 days post-surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| CR845 IV 1 mcg/kg | Active Comparator | CR845 IV solution will be supplied in 2 mL glass vials.Study drug will be administered as an IV bolus into an infusion line, the volume is dependent upon the patient's body weight. |
|
| CR845 IV 0.5 mcg/kg | Active Comparator | CR845 solution will be supplied in 2 mL glass vials. Study drug will be administered as an IV bolus into an infusion line, the volume is dependent upon the patient's body weight. |
|
| Placebo IV | Placebo Comparator | Placebo will be supplied in matched vials containing the same volume of buffer but with no active drug. It will be administered as an IV bolus into an infusion line, the volume is dependent upon the patient's body weight. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| CR845 IV 1 mcg/kg | Drug | CR845 IV 1 mcg/kg will be administered as an IV bolus 2x loading dose one hour prior to anesthetic induction for surgery, then a dose within 30 minutes of the patient being considered stable in the post operative recovery room. Subsequent dosing will be administered at 6, 12 and 18 hours. Antinausea rescue medication (ondansetron 4 mg IV) may be requested, as well as analgesic rescue medication (morphine 5mg IV), post surgery, as needed. Saline infusion (IV 0.45%) for fluid replenishment will be provided. |
| Measure | Description | Time Frame |
|---|---|---|
| A comparison of the change in Pain Intensity over time using the Numeric Rating Scale | Using the Numeric Rating Scale (NRS) to quantify the difference between CR845-treated patients and placebo-treated patients. | 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| A study of the comparison of Post Surgical Nausea and Vomiting (PONV) scores | Incidence of vomiting will be analyzed against placebo | 6 hours |
| A comparison of the number of rescue medication doses administered |
| Measure | Description | Time Frame |
|---|---|---|
| Ongoing safety evaluation of CR845 assessed by physical examination, adverse events, vital signs, and laboratory evaluations | The safety of CR845 in this patient population will be assessed by physical examination, monitoring of adverse events, vital signs, fluid balance, and laboratory evaluations at specified times. Participants with clinically significant lab values or abnormal exam findings, as well as those with adverse events found to be related to the study drug will be compared to those receiving placebo. Safety data will be reviewed on an ongoing basis by the sponsor and an Independent Data Monitoring Committee (IDMC). |
Inclusion Criteria:
- A patient will be eligible for study participation if the subject meets the following criteria:
Voluntarily provide written informed consent to participate in the study prior to any study procedures.
Able to speak, read, and communicate clearly in English or Spanish; able to read and understand the study procedures.
Male or female between 21 and older at the time of Screening.
Scheduled for abdominal surgery (hysterectomy; prostatectomy; hemi-colectomy (including partial bowel resections) or ventral hernia repair) with no collateral procedures.
Patient is categorized as American Society of Anesthesiologists (ASA) risk class of I, II or III.
Has a body mass index (BMI) within 18.0-40.0 kg/m2 and weight between 50 kg and 112 kg, inclusive.
For women of childbearing potential- has a negative result on serum pregnancy testing at Screening and urine pregnancy test at Admission and does not currently breast feed, or is planning to do so within 30 days of receiving the last dose of study drug.
If female, the patient must be:
If male, the patient must be surgically or biologically sterile. If not sterile, the patient must agree to use an acceptable form of birth control with heterosexual partner (as described in inclusion criteria #8a) or abstain from sexual relations for 3 days following the last dose of study drug.
Is free of other physical, mental, or medical conditions, which, in the opinion of the Investigator, would make study participation inadvisable.
Following surgery, the patient will be eligible for the second dose of study drug.
Exclusion Criteria:
A patient will be excluded from the study if any of the following criteria are met:
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| Name | Affiliation | Role |
|---|---|---|
| Joseph Stauffer, DO, MBA | Cara Therapeutics | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cara Therapeutics Study Site | Sheffield | Alabama | United States | |||
| Cara Therapeutics Study Site |
| Type | Date | Date Unknown |
|---|---|---|
| Release | Mar 27, 2021 | |
| Reset | Apr 23, 2021 | |
| Release | Dec 13, 2021 |
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|
| CR845 IV 0.5 mcg/kg | Drug | CR845 IV 0.5 mcg/kg will be administered as an IV bolus 2x loading dose one hour prior to anesthetic induction for surgery, then a dose within 30 minutes of the patient being considered stable in the post operative recovery room. Subsequent dosing will be administered at 6, 12 and 18 hours. Antinausea rescue medication (ondansetron 4 mg IV) may be requested, as well as analgesic rescue medication (morphine 5mg IV), post surgery, as needed. Saline infusion (IV 0.45%) for fluid replenishment will be provided. |
|
| Placebo IV | Drug | Placebo IV will be administered as an IV bolus 2x loading dose one hour prior to anesthetic induction for surgery, then a dose within 30 minutes of the patient being considered stable in the post operative recovery room. Subsequent dosing will be administered at 6, 12 and 18 hours. Antinausea rescue medication (ondansetron 4 mg IV) may be requested, as well as analgesic rescue medication (morphine 5mg IV), post surgery, as needed. Saline infusion (IV 0.45%) for fluid replenishment will be provided. |
|
Count the number of rescue medication doses administered following surgery for the CR845 IV patients vs Placebo-treated patients
| 24 hours |
| Patient Global Assessment of study drug | Patients will complete a PGA (Patient Global Assessment) of the study drug. | 24 hours (or early termination) |
| 10 Days |
| New Haven |
| Connecticut |
| United States |
| Cara Therapeutics Study Site | Bradenton | Florida | 34209 | United States |
| Cara Therapeutics Study Site | Gainesville | Florida | United States |
| Cara Therapeutics Study Site | Maitland | Florida | United States |
| Cara Therapeutics Study Site | Miami Gardens | Florida | United States |
| Cara Therapeutics Study Site | Pensacola | Florida | 32503 | United States |
| Cara Therapeutics Study Site | St. Petersburg | Florida | 33713 | United States |
| Cara Therapeutics Study Site | Chicago | Illinois | United States |
| Cara Therapeutics Study Site | Boston | Massachusetts | United States |
| Cara Therapeutics Study Site | Camden | New Jersey | 08103 | United States |
| Cara Therapeutics Study Site | Neptune City | New Jersey | United States |
| Cara Therapeutics Study Site | Durham | North Carolina | 27710 | United States |
| Cara Therapeutics Study Site | Cleveland | Ohio | United States |
| Cara Therapeutics Study Site | Columbus | Ohio | United States |
| Cara Therapeutics Study Site | Pittsburgh | Pennsylvania | United States |
| Cara Therapeutics Study Site | Chattanooga | Tennessee | United States |
| Cara Therapeutics Study Site | Bellaire | Texas | United States |
| Cara Therapeutics Study Site | Fort Worth | Texas | United States |
| Cara Therapeutics Study Site | Houston | Texas | United States |
| Cara Therapeutics Study Site | Plano | Texas | United States |
| Cara Therapeutics Study Site | San Antonio | Texas | United States |
| Cara Therapeutics Study Site | Salt Lake City | Utah | 84124 | United States |
| Reset | Jan 10, 2022 |
| Release | Mar 29, 2022 |
| Reset | Apr 25, 2022 |
| Release | Sep 6, 2022 |
| Reset | Oct 3, 2022 |
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| Release Date | Unrelease Date | Unrelease Date Unknown | Reset Date | MCP Release Number |
|---|---|---|---|---|
| Mar 27, 2021 | Apr 23, 2021 | |||
| Dec 13, 2021 | Jan 10, 2022 | |||
| Mar 29, 2022 | Apr 25, 2022 | |||
| Sep 6, 2022 | Oct 3, 2022 |