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This study will evaluate the safety and tolerability based on the incidence of adverse experiences of buprenorphine sublingual spray (0.5 milligrams [mg] three times daily [TID]) compared with standard post-operative narcotic therapy in participants with postoperative pain. Standard post-operative narcotic therapy is defined as morphine intravenous (IV) injection (4 mg TID) followed by oxycodone hydrochloride tablet (10 mg TID).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Buprenorphine Sublingual Spray 0.5 mg | Experimental | Buprenorphine Sublingual Spray 0.5 milligrams (mg) three times a day (TID) for 7 days. |
|
| Standard of Care Narcotic Therapy | Active Comparator | Morphine intravenous (IV), 4 mg TID for 24 hours, followed by oxycodone hydrochloride tablet, 10 mg TID for 6 days. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Buprenorphine Sublingual Spray | Drug | 0.5 mg Sublingual Spray |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Number of Participants With Treatment Emergent Adverse Events (TEAEs) | An adverse event (AE) is defined as any untoward medical occurrence in a participant administered a pharmaceutical product during the course of a clinical investigation. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of an investigational product, whether or not thought to be related to the investigational product. A TEAE is an AE with onset that occurs after receiving study drug. | Days 1 to 8 |
| Measure | Description | Time Frame |
|---|---|---|
| Percentage of Participants Provided Rescue Medication for Nausea | Zofran was used at the clinician's discretion as rescue medication for nausea. | Days 1 to7 |
| Time to First Use of Rescue Medication for Nausea Following Each Dose of the Investigational Product (IP) |
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Inclusion criteria:
Is able to speak and understand the language in which the study is being conducted, is able to understand and comply with the procedures and study requirements, and has voluntarily signed and dated an informed consent form approved by an Institutional Review Board before the conduct of any study procedure.
Is a male or female ≥18 and ≤65 years of age.
Scheduled for elective bunionectomy, breast augmentation (in women only), or abdominoplasty.
Is classified using the American Society of Anesthesiologists Physical Status Classification System as P1 to P2.
If female, is either not of childbearing potential (defined as postmenopausal for at least 1 year or surgically sterile [bilateral tubal ligation, bilateral oophorectomy, or hysterectomy]) or practicing one of the following medically acceptable methods of birth control:
Has a body weight ≥45 kilograms (kg) and a body mass index (BMI) ≤40 kg/m^2.
Is willing and able to comply with study requirements (including diet, alcohol, and smoking restrictions), complete evaluations and diary, remain at the study site for ≥72 hours, and return for follow up Day 8 + 2 days after surgery.
Exclusion criteria:
Post-surgical eligibility requirements:
The participant will be assessed for the following postoperative eligibility criteria
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| Name | Affiliation | Role |
|---|---|---|
| Giovanni DeCastro | INSYS Therapeutics Inc | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lotus Clinical Research, LLC | Pasadena | California | 91105 | United States | ||
| Epic Medical Research |
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| ID | Title | Description |
|---|---|---|
| FG000 | Standard of Care Narcotic Therapy | Morphine intravenous (IV), 4 mg TID for 24 hours, followed by oxycodone hydrochloride tablet, 10 mg TID for 6 days. Morphine: Morphine Oxycodone Hydrochloride: Oxycodone Hydrochloride 10 mg tablet |
| FG001 | Buprenorphine Sublingual Spray 0.5 mg |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Aug 2, 2017 | Sep 25, 2018 |
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| Morphine |
| Drug |
4 mg Intravenous Injection |
|
| Oxycodone Hydrochloride | Drug | 10 mg tablet |
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| Zofran | Drug | 4 mg oral disintegrating tablet (ODT) or IV injection given at the investigator's discretion for nausea |
|
Zofran was used at the clinician's discretion as rescue medication for nausea. Time "0" is defined as the time of the administration of study drug. |
| Days 1 to 7 |
| Total Use of Rescue Medication for Nausea Over 0 to 24 Hours, Over 0 to 48 Hours, Over 0-72 Hours and 0-7 Days | Zofran was used at the clinician's discretion as rescue medication for nausea. The total use of rescue medication was calculated for the following 4 time-frames: 0 to 24 hours, 0 to 48 hours, 0 to 72 hours and 0 to 7 days. | 0 to 24 hours, 0 to 48 hours, 0 to 72 hours and 0 to 7 days |
| Pulse Oximetry Levels at 90 Minutes,12, 24, 48 and 72 Hours | Pulse oximetry is a non-invasive method to measure a person's oxygen saturation. | 90 Minutes,12, 24, 48 and 72 Hours |
| Number of Participants With Abnormal Electrocardiograms (ECGs) Findings at 90 Minutes,12, 24, 48 and 72 Hours | A standard 12-lead ECG will be performed after the participant is in the supine (lying face up) position for 5 minutes. | Pre-dose and 90 minutes, 12, 24, 48 and 72 hours after first dose |
| Number of Participants With Abnormal Oral Cavity Examinations | Study staff will perform a sublingual (under the tongue) assessment, noting the color of mucosa and whether inflammation is present. | Pre-dose and 90 minutes, 12, 24, 48 and 72 hours after first dose on Days 1 to 4 and End of Study Day 8 |
| Murray |
| Utah |
| 84123 |
| United States |
Buprenorphine Sublingual Spray 0.5 milligrams (mg) three times a day (TID) for 7 days. Buprenorphine Sublingual Spray: Buprenorphine Sublingual Spray 0.5 mg |
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Standard of Care Narcotic Therapy | Morphine intravenous (IV), 4 mg TID for 24 hours, followed by oxycodone hydrochloride tablet, 10 mg TID for 6 days. Morphine: Morphine Oxycodone Hydrochloride: Oxycodone Hydrochloride 10 mg tablet |
| BG001 | Buprenorphine Sublingual Spray 0.5 mg | Buprenorphine Sublingual Spray 0.5 milligrams (mg) three times a day (TID) for 7 days. Buprenorphine Sublingual Spray: Buprenorphine Sublingual Spray 0.5 mg |
| 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 |
| ||||||||||||||||
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
| ||||||||||||||||
| Race (NIH/OMB) | Count of Participants | Participants |
|
| 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 | Number of Participants With Treatment Emergent Adverse Events (TEAEs) | An adverse event (AE) is defined as any untoward medical occurrence in a participant administered a pharmaceutical product during the course of a clinical investigation. An AE can therefore be any unfavorable and unintended sign, symptom, or disease temporally associated with the use of an investigational product, whether or not thought to be related to the investigational product. A TEAE is an AE with onset that occurs after receiving study drug. | Safety population, all participants who received study drug. | Posted | Count of Participants | Participants | Days 1 to 8 |
|
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| |||||||||||||||||||||||||||||
| Secondary | Percentage of Participants Provided Rescue Medication for Nausea | Zofran was used at the clinician's discretion as rescue medication for nausea. | Safety population, all participants who received study drug. | Posted | Number | percentage of participants | Days 1 to7 |
|
| ||||||||||||||||||||||||||||||
| Secondary | Time to First Use of Rescue Medication for Nausea Following Each Dose of the Investigational Product (IP) | Zofran was used at the clinician's discretion as rescue medication for nausea. Time "0" is defined as the time of the administration of study drug. | Safety population, all participants who received study drug. | Posted | Median | 95% Confidence Interval | hours | Days 1 to 7 |
|
| |||||||||||||||||||||||||||||
| Secondary | Total Use of Rescue Medication for Nausea Over 0 to 24 Hours, Over 0 to 48 Hours, Over 0-72 Hours and 0-7 Days | Zofran was used at the clinician's discretion as rescue medication for nausea. The total use of rescue medication was calculated for the following 4 time-frames: 0 to 24 hours, 0 to 48 hours, 0 to 72 hours and 0 to 7 days. | Safety population, all participants who received study drug. | Posted | Number | cumulative number of rescue doses | 0 to 24 hours, 0 to 48 hours, 0 to 72 hours and 0 to 7 days |
|
| ||||||||||||||||||||||||||||||
| Secondary | Pulse Oximetry Levels at 90 Minutes,12, 24, 48 and 72 Hours | Pulse oximetry is a non-invasive method to measure a person's oxygen saturation. | Safety population, all participants who received study drug. | Posted | Mean | Standard Deviation | percentage of oxygen saturation | 90 Minutes,12, 24, 48 and 72 Hours |
|
| |||||||||||||||||||||||||||||
| Secondary | Number of Participants With Abnormal Electrocardiograms (ECGs) Findings at 90 Minutes,12, 24, 48 and 72 Hours | A standard 12-lead ECG will be performed after the participant is in the supine (lying face up) position for 5 minutes. | Safety population, all participants who received study drug. | Posted | Count of Participants | Participants | Pre-dose and 90 minutes, 12, 24, 48 and 72 hours after first dose |
|
| ||||||||||||||||||||||||||||||
| Secondary | Number of Participants With Abnormal Oral Cavity Examinations | Study staff will perform a sublingual (under the tongue) assessment, noting the color of mucosa and whether inflammation is present. | Safety population, all participants who received study drug. | Posted | Count of Participants | Participants | Pre-dose and 90 minutes, 12, 24, 48 and 72 hours after first dose on Days 1 to 4 and End of Study Day 8 |
|
|
Screening to Day 8
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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 | Standard of Care Narcotic Therapy | Morphine intravenous (IV), 4 mg TID for 24 hours, followed by oxycodone hydrochloride tablet, 10 mg TID for 6 days. Morphine: Morphine Oxycodone Hydrochloride: Oxycodone Hydrochloride 10 mg tablet | 0 | 50 | 0 | 50 | 33 | 50 |
| EG001 | Buprenorphine Sublingual Spray 0.5 mg | Buprenorphine Sublingual Spray 0.5 milligrams (mg) three times a day (TID) for 7 days. Buprenorphine Sublingual Spray: Buprenorphine Sublingual Spray 0.5 mg | 0 | 50 | 1 | 50 | 47 | 50 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Hematoma | General disorders | MedDRA 19.0 | Systematic Assessment |
|
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea | Gastrointestinal disorders | MedDRA 19.0 | Systematic Assessment |
| |
| Vomiting | Gastrointestinal disorders | MedDRA 19.0 | Systematic Assessment |
| |
| Constipation | Gastrointestinal disorders | MedDRA 19.0 | Systematic Assessment |
| |
| Dizziness | Nervous system disorders | MedDRA 19.0 | Systematic Assessment |
| |
| Headache | Nervous system disorders | MedDRA 19.0 | Systematic Assessment |
| |
| Somnolence | Nervous system disorders | MedDRA 19.0 | Systematic Assessment |
| |
| Hypoxia | Respiratory, thoracic and mediastinal disorders | MedDRA 19.0 | Systematic Assessment |
| |
| Dyspnea | Respiratory, thoracic and mediastinal disorders | MedDRA 19.0 | Systematic Assessment |
| |
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA 19.0 | Systematic Assessment |
|
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Director, Clinical Development | Insys Therapeutics, Inc. | 4805003105 | gdecastro@insysrx.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Sep 8, 2017 | Sep 25, 2018 | SAP_001.pdf |
| 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 |
|---|---|
| D009020 | Morphine |
| D010098 | Oxycodone |
| D017294 | Ondansetron |
| ID | Term |
|---|---|
| D009022 | Morphine Derivatives |
| 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 |
| D003061 | Codeine |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D002227 | Carbazoles |
| D007211 | Indoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D006575 | Heterocyclic Compounds, 3-Ring |
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| Male |
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| Not Hispanic or Latino |
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| Unknown or Not Reported |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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