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| Name | Class |
|---|---|
| Long Island University | OTHER |
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The study to be performed will utilize already FDA-approved marketed products in healthy adults for the purpose to generate data for establishing rate of drug delivery of Lidoderm® topical patch (manufactured by Endo Pharmaceuticals) and the lidocaine 5% patch (manufactured by Mylan Pharmaceuticals) in healthy adults, and to ensure the safety of individuals utilizing these types of products.
Topical drug delivery systems in the form of patches are convenient, attractive, and easy to use. Lidocaine is a very popular patch available on the United States market today. Accurate determination of the rate and extent of drug release and absorption is crucial to ensure the safety of individuals using these and other types of patches. The drug delivery rate can be determined early in the development process by using in vitro skin flux permeation studies, and later in humans by accurately quantifying residual drug from patches post-wear and in pharmacokinetic studies. In this study the investigators will employ two types of evaluation to determine the rate and extent of drug release and absorption from lidocaine patches, namely residual drug analysis post-wear and pharmacokinetic analysis in healthy adult volunteers. In addition, the investigators will compare the serum drug concentrations following patch and intravenous administration in order to determine the absolute bioavailability of these patches. Positive outcomes of this project will identify appropriate methods to determine the rate and extent of drug release and absorption from topical patches, and will help regulatory agencies in the development of Guidances for Industry regarding the characterization of drug release and absorption kinetics to ensure the safety of individuals utilizing these types of products.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Lidocaine 5% patch | Active Comparator | Each subject will wear three generic Lidocaine 5% topical patches for 12 hours. |
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| Lidoderm® 5% patch | Active Comparator | Each subject will wear three Lidoderm® topical patches for 12 hours. |
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| Intravenous lidocaine | Active Comparator | A single intravenous dose of 0.5 mg/kg lidocaine hydrochloride will be administered to each subject. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lidocaine 5% patch | Drug | Each subject will wear three generic Lidocaine 5% topical patches for 12 hours. |
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| Measure | Description | Time Frame |
|---|---|---|
| Measurement of Maximum Serum Concentration of Lidocaine (Cmax) | Cmax is the highest lidocaine concentration measured in the serum. | For both patch arms measured at time points: 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 27, 30, 33, 36, 39, 48 hours. For intravenous lidocaine hydrochloride arm measured at time points: 2, 5, 10, 20, 30, 45 minutes, 1, 2, 3, 4, 6, 8, 10 hours. |
| Measure | Description | Time Frame |
|---|---|---|
| Measurement of Volume of Lidocaine Distribution (V) | Volume of distribution is a mathematical concept that relates the amount of lidocaine in the body to the concentration of lidocaine measured in the serum. | For both patch arms measured at time points: 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 27, 30, 33, 36, 39, 48 hours. For intravenous lidocaine hydrochloride arm measured at time points: 2, 5, 10, 20, 30, 45 minutes, 1, 2, 3, 4, 6, 8, 10 hours. |
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Inclusion Criteria:
Exclusion Criteria:
Women who are pregnant or lactating or have a positive serum pregnancy test at enrollment or positive urine pregnancy test at any time during the study.
Smokers. A "smoker", for the purposes of the study, will be defined as an individual who has regularly and habitually used nicotine-containing substances, including tobacco products (e.g., cigarettes, cigars, chewing tobacco, gum, patch or electronic cigarettes) over the past 12 months. Occasional recreational use (less than once monthly) will not warrant exclusion unless the individual has used nicotine-containing substances in the previous 30 days before study enrollment.
Participation in any ongoing investigational drug trial or clinical drug trial period unless the study is in the follow-up phase and it has been ≥ one month since the subject received any experimental agents or treatments.
Abnormal vital signs, defined as:
Temperature >38.0ºC (100.4ºF) or symptoms of an acute self-limited illness such as an upper respiratory infection or gastroenteritis within seven days of administration of a study product.
History of chronic obstructive pulmonary disease.
Positive urine drug screening test.
Use of any prescription medication during the period 0 to 30 days or over-the counter medication during the period 0 to 3 days before entry to the study (vitamins, herbal supplements and birth control medications will be allowed).
Use of medications or treatments that would significantly influence or exaggerate responses to the test product or that would alter inflammatory or immune response to the product. This includes antihistamines (within 72 hours prior to dosing), systemic or topical corticosteroids within four weeks prior to dosing, use of monoamine oxidase inhibitors 21 days prior to study, cyclosporine, tacrolimus, cytotoxic drugs, immune globulin, Bacillus Calmette-Guerin [BCG], monoclonal antibodies, or radiation therapy.
Donation or loss of greater than one pint of blood within 60 days of entry to the study.
Any prior serious adverse reaction or hypersensitivity to lidocaine administered by any route.
Current diagnosis of any major psychiatric illness.
Received an experimental agent (vaccine, drug, biologic, device, blood product or medication) within 30 days before enrollment in this study or expects to receive an experimental agent during the study.
Medical history of a serious chronic condition, including (but not limited to): allergic conditions such as anaphylaxis to food or drugs; asthma; generalized drug reactions; any seizure disorder; any central nervous system disorder; glaucoma (open or closed angle); history of pyloric or urinary bladder neck obstruction; intestinal obstruction; difficulty swallowing; stomach or bowel problems (e.g, blockage, muscle weakness, ulcerative colitis, Crohn's disease); bleeding disorders; acid reflux disease; myasthenia gravis; allergy to belladonna alkaloids; impaired hepatic or renal function.
Any condition that would, in the opinion of the Principal Investigator (PI) or MAI, place the subject at an unacceptable risk of injury or render the subject unable to meet the requirements of the protocol.
Inability to communicate or cooperate with the investigators.
Medical history of significant dermatologic diseases or conditions, such as atopy, psoriasis, vitiligo or conditions known to alter skin appearance or physiologic response (e.g. diabetes, porphyria).
History of significant dermatologic cancers (e.g. melanoma, squamous cell carcinoma), except basal cell carcinomas that were superficial and did not involve the investigative site.
History of consumption of alcohol within 24 hours prior to dose administration.
Subject has an obvious difference in skin color at patch sites (compared to neighboring skin), or the presence of a skin condition, excessive hair at the application site, sunburn, raised moles and scars, open sores at application site, scar tissue, tattoo, or coloration that would interfere with placement of test articles, or the assessment of the skin and/or reactions to drug.
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| Name | Affiliation | Role |
|---|---|---|
| Nicole K Brogden, PharmD, PhD | University of Iowa | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Iowa | Iowa City | Iowa | 52242 | United States |
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Recruitment was conducted at the University of Iowa by advertisements in the "Noon News", a UIHC newsletter, and by a mass email that was sent to all staff/faculty/and students. Recruitment began in March 2018 and continued until the enrollment goal was reached in October 2019.
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| ID | Title | Description |
|---|---|---|
| FG000 | Group 1: Generic Lidocaine Patches First, IV Lidocaine Second, the Lidoderm(R) Topical Patches Last | Each subject in this group received study interventions in the following order: Each subject first wore three generic 5% (Mylan Pharmaceuticals, 140mg) lidocaine patches for 12 hours, followed by a minimum washout period of 24 hours. Each subject then received a single intravenous dose of 0.5 mg/kg lidocaine hydrochloride, followed by a minimum washout period of 24 hours. Each subject then wore three lidoderm(R) 5% (Endo Pharmaceuticals, 700mg) lidocaine patches for 12 hours. |
| FG001 | Group 2: Lidoderm(R) Topical Patches First, IV Lidocaine Second, Then Generic Lidocaine Patches Last | Each subject in this group received study interventions in the following order: Each subject first wore three lidoderm(R) 5% (Endo Pharmaceuticals, 700mg) lidocaine patches for 12 hours, followed by a minimum washout period of 24 hours. Each subject then received a single intravenous dose of 0.5 mg/kg lidocaine hydrochloride, followed by a minimum washout period of 24 hours. Each subject then wore three generic 5% (Mylan Pharmaceuticals, 140mg) lidocaine patches for 12 hours. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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Measure Description: Analysis of all study participants that received all three interventions as well as the 1 subject who withdrew consent prior to completing all study procedures.
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| ID | Title | Description |
|---|---|---|
| BG000 | All Study Participants | All study participants received IV lidocaine, generic lidocaine patches, and Lidoderm patches. |
| 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, Categorical | Count of 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 | Measurement of Maximum Serum Concentration of Lidocaine (Cmax) | Cmax is the highest lidocaine concentration measured in the serum. | Posted | Mean | Standard Deviation | ng/ml | For both patch arms measured at time points: 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 27, 30, 33, 36, 39, 48 hours. For intravenous lidocaine hydrochloride arm measured at time points: 2, 5, 10, 20, 30, 45 minutes, 1, 2, 3, 4, 6, 8, 10 hours. |
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Adverse Events were recorded from the date of consent, during study intervention and washout (12 days), and for 2 days of follow-up after study procedures were completed (14 days total).
Adverse Events were collected based on subject reporting of events. While not all 23 participants were included in the data assessment, Adverse events were recorded for all 23 study participants. While all participants completed all three arms of the study, 1 participant withdrew after completing the Intravenous Lidocaine and Lidoderm Topical Patch Arm, leaving only 22 participants to be analyzed in the lidocaine patch arm.
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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 | Lidocaine Patch | Each subject will wear three generic lidocaine patches for 12 hours. |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Headache | General disorders | Non-systematic Assessment | Participant reported |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Nicole Brogden, Associate Professor | University of Iowa | 319-335-8752 | nicole-brogden@uiowa.ed |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Sep 6, 2017 | Jul 6, 2021 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D008012 | Lidocaine |
| D057968 | Transdermal Patch |
| C511998 | Lidoderm |
| ID | Term |
|---|---|
| D000083 | Acetanilides |
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 |
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| Lidocaine hydrochloride | Drug | Each subject will receive a dose of 0.5 mg/kg intravenously over a period of 5 minutes. |
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| Lidoderm 5% patch | Drug | Each subject will wear three Lidoderm® topical patches for 12 hours. |
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| Measurement of Time of Maximum Serum Lidocaine Concentration (Tmax). | Tmax is the time point at which the maximum drug concentration in serum is measured. | For both patch arms measured at time points: 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 27, 30, 33, 36, 39, 48 hours. For intravenous lidocaine hydrochloride arm measured at time points: 2, 5, 10, 20, 30, 45 minutes, 1, 2, 3, 4, 6, 8, 10 hours. |
| Measurement of Elimination Rate Constant of Lidocaine (Kel) | The elimination rate constant is a mathematical value describing the rate at which lidocaine is removed from the body. | For both patch arms measured at time points: 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 27, 30, 33, 36, 39, 48 hours. For intravenous lidocaine hydrochloride arm measured at time points: 2, 5, 10, 20, 30, 45 minutes, 1, 2, 3, 4, 6, 8, 10 hours. |
| Determination of Area Under the Serum-concentration-time Curve (AUC) | Area under the serum-concentration-time curve is a mathematical measure of total systemic exposure to lidocaine in the body. | For both patch arms measured at time points: 1, 2, 3, 4, 5, 6, 8, 10, 12 hours. For intravenous lidocaine hydrochloride arm measured at time points: 2, 5, 10, 20, 30, 45 minutes, 1, 2, 3, 4, 6, 8, 10 hours. |
| Residual Drug Analysis in Worn TDDS and Patches | The amount of drug remaining in the patches is measured after the patches have been worn and removed. This outcome is only reported for the patch arms of the study and is not applicable to the intravenous arm. | Measured after patches are removed from subjects following 12 hours of patch wear. |
| Participants |
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| Age, Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Race/Ethnicity, Customized | Count of Participants | Participants |
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| Body mass index | Mean | Standard Deviation | kg/m^2 |
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| Units | Counts |
|---|---|
| Participants |
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| Secondary | Measurement of Volume of Lidocaine Distribution (V) | Volume of distribution is a mathematical concept that relates the amount of lidocaine in the body to the concentration of lidocaine measured in the serum. | Posted | Mean | Standard Deviation | L/kg | For both patch arms measured at time points: 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 27, 30, 33, 36, 39, 48 hours. For intravenous lidocaine hydrochloride arm measured at time points: 2, 5, 10, 20, 30, 45 minutes, 1, 2, 3, 4, 6, 8, 10 hours. |
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| Secondary | Measurement of Time of Maximum Serum Lidocaine Concentration (Tmax). | Tmax is the time point at which the maximum drug concentration in serum is measured. | Posted | Mean | Standard Deviation | hours | For both patch arms measured at time points: 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 27, 30, 33, 36, 39, 48 hours. For intravenous lidocaine hydrochloride arm measured at time points: 2, 5, 10, 20, 30, 45 minutes, 1, 2, 3, 4, 6, 8, 10 hours. |
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| Secondary | Measurement of Elimination Rate Constant of Lidocaine (Kel) | The elimination rate constant is a mathematical value describing the rate at which lidocaine is removed from the body. | Posted | Mean | Standard Deviation | 1/hr | For both patch arms measured at time points: 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 24, 27, 30, 33, 36, 39, 48 hours. For intravenous lidocaine hydrochloride arm measured at time points: 2, 5, 10, 20, 30, 45 minutes, 1, 2, 3, 4, 6, 8, 10 hours. |
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| Secondary | Determination of Area Under the Serum-concentration-time Curve (AUC) | Area under the serum-concentration-time curve is a mathematical measure of total systemic exposure to lidocaine in the body. | Posted | Mean | Standard Deviation | ng*h/ml | For both patch arms measured at time points: 1, 2, 3, 4, 5, 6, 8, 10, 12 hours. For intravenous lidocaine hydrochloride arm measured at time points: 2, 5, 10, 20, 30, 45 minutes, 1, 2, 3, 4, 6, 8, 10 hours. |
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| Secondary | Residual Drug Analysis in Worn TDDS and Patches | The amount of drug remaining in the patches is measured after the patches have been worn and removed. This outcome is only reported for the patch arms of the study and is not applicable to the intravenous arm. | Posted | Mean | Standard Deviation | mg | Measured after patches are removed from subjects following 12 hours of patch wear. |
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| 0 |
| 22 |
| 0 |
| 22 |
| 19 |
| 22 |
| EG001 | Lidoderm ® Topical Patch | Each subject will wear three Lidoderm® topical patches for 12 hours. | 0 | 23 | 0 | 23 | 19 | 23 |
| EG002 | Intravenous Lidocaine | A single intravenous dose of 0.5 mg/kg lidocaine hydrochloride will be administered to each subject. | 0 | 23 | 0 | 23 | 17 | 23 |
| Increased Respiratory Rate | Respiratory, thoracic and mediastinal disorders | Systematic Assessment | Respiratory Rate Normal Range: 12 - 17 breaths per minutes. Measured by nursing staff. |
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| Increased Heart Rate | Respiratory, thoracic and mediastinal disorders | Systematic Assessment | Heart Rate Normal Range: 55 - 100 beats per minutes. Measured by nursing staff |
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| Decreased Heart Rate | Respiratory, thoracic and mediastinal disorders | Systematic Assessment | Heart Rate Normal Range: 55 - 100 beats per minute. Measured by nursing staff |
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| Itchy lower back after patch removal | General disorders | Non-systematic Assessment | Participant reported |
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| Decreased Blood Pressure | Respiratory, thoracic and mediastinal disorders | Systematic Assessment | Blood Pressure Normal Range: systolic (90-139 mmHg) diastolic (60-89 mmHg). Blood Pressure was recorded as decreased if either the systolic or diastolic was below normal range defined. Measured by nursing staff. |
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| Increased Blood Pressure | Respiratory, thoracic and mediastinal disorders | Systematic Assessment | Blood Pressure Normal Range: systolic (90-139 mmHg) diastolic (60-89 mmHg). Blood Pressure was recorded as elevated if either the systolic or diastolic was above normal range defined. Measured by nursing staff |
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| Lightheadedness | General disorders | Non-systematic Assessment | Participant reported |
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| Abnormal Hearing | Ear and labyrinth disorders | Non-systematic Assessment | Any hearing changes reported by subjects (which were temporary and resolved prior to study end). For example, muffled hearing, ringing in the ears |
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| Drowsiness/Sleepiness | General disorders | Non-systematic Assessment | Patient reported |
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| Nausea | Gastrointestinal disorders | Non-systematic Assessment | Patient reported |
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| Heartburn | Gastrointestinal disorders | Non-systematic Assessment | Participant reported |
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| Contact erythema from IV placement | Skin and subcutaneous tissue disorders | Non-systematic Assessment | Participant reported |
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| Aniline Compounds |
| D000588 | Amines |
| D004864 | Equipment and Supplies |
| Title | Measurements |
|---|---|
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| Title | Measurements |
|---|---|
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| Title | Measurements |
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| Title | Measurements |
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