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This is a Phase 2, open-label, multi-cohort study to evaluate the analgesic efficacy, safety, and pharmacokinetics (PK) of a single, individualized dose of HTX-011 administered into the surgical site as a monotherapy or with other medications to enhance analgesia in subjects undergoing unilateral simple bunionectomy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment Group 1: HTX-011 | Experimental | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation. |
|
| Treatment Group 2: HTX-011 + Aprepitant | Experimental | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation; Aprepitant, three single doses of aprepitant will be administered orally. |
|
| Treatment Group 3: HTX-011 + Non-Opioid MMA Regimen | Experimental | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation and a scheduled multimodal analgesic (MMA) regimen. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| HTX-011 | Drug | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Mean Area Under the Curve (AUC) of the NRS-A (Windowed Worst Observation Carried Forward) Pain Intensity Scores | Pain intensity scores are assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable". NRS scores are recorded with activity (NRS-A), sitting with the plantar surface of the ball of the surgically attended foot touching the floor (no weight-bearing). | 72 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Mean Total Postoperative Opioid Consumption (in Morphine Equivalents) Through 72 Hours | 72 hours | |
| Percentage of Subjects Receiving no Opioid Rescue | 72 hours | |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Endeavor Clinical Trials, LLC | San Antonio | Texas | 78229 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Treatment Group 1: HTX-011 | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation. |
| FG001 | Treatment Group 2: HTX-011 + Aprepitant | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation; Aprepitant, three single doses of aprepitant will be administered orally. |
| FG002 | Treatment Group 3: HTX-011 + Non-Opioid MMA Regimen | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation and a scheduled multimodal analgesic (MMA) regimen. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Treatment Group 1: HTX-011 | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation. |
| BG001 | Treatment Group 2: HTX-011 + Aprepitant | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation; Aprepitant, three single doses of aprepitant will be administered orally. |
| Units | Counts |
|---|---|
| Participants |
|
| 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 | Mean Area Under the Curve (AUC) of the NRS-A (Windowed Worst Observation Carried Forward) Pain Intensity Scores | Pain intensity scores are assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable". NRS scores are recorded with activity (NRS-A), sitting with the plantar surface of the ball of the surgically attended foot touching the floor (no weight-bearing). | Safety Population | Posted | Mean | Standard Deviation | pain intensity score*hr | 72 hours |
|
42 Days.
For each PT, subjects are included only once, even if they experienced multiple events in that PT.
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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 | Treatment Group 1: HTX-011 | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation. |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Cellulitis | Infections and infestations | MedDRA Version 19.1 | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Localised infection | Infections and infestations | MedDRA Version 19.1 | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Tricia Mulford | Heron Therapeutics, Inc. | 760-622-3709 | tmulford@herontx.com |
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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 | Jan 14, 2019 | Jun 11, 2021 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Jan 4, 2019 | Jun 11, 2021 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D010149 | Pain, Postoperative |
| D000071378 | Bunion |
| ID | Term |
|---|---|
| D011183 | Postoperative Complications |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010146 | Pain |
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| ID | Term |
|---|---|
| D000077608 | Aprepitant |
| ID | Term |
|---|---|
| D009025 | Morpholines |
| D010078 | Oxazines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
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| Luer Lock applicator | Device | Applicator for instillation. |
|
| Vial access device | Device | Device for withdrawal of drug product. |
|
| aprepitant | Drug | Aprepitant, three single doses of aprepitant will be administered orally. |
|
| Percentage of Subjects Receiving no Opioid Rescue |
Only subjects in Cohort 3 received a scheduled, non-opioid MMA regimen following surgery. |
| Day 7 and Day 28 |
| Mean Area Under the Curve (AUC) of the NRS-R (Windowed Worst Observation Carried Forward) Pain Intensity Scores | Pain intensity scores are assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable". NRS scores are measured at rest. | 72 hours |
| BG002 | Treatment Group 3: HTX-011 + Non-Opioid MMA Regimen | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation and a scheduled multimodal analgesic (MMA) regimen. |
| BG003 | Total | Total of all reporting groups |
| Participants |
|
| 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 |
|
| Region of Enrollment | Number | participants |
|
HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation; Aprepitant, three single doses of aprepitant will be administered orally. |
| OG002 | Treatment Group 3: HTX-011 + Non-Opioid MMA Regimen | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation and a scheduled multimodal analgesic (MMA) regimen. |
|
|
| Secondary | Mean Total Postoperative Opioid Consumption (in Morphine Equivalents) Through 72 Hours | Safety Population | Posted | Mean | Standard Deviation | MME, morphine milligram equivalents | 72 hours |
|
|
|
| Secondary | Percentage of Subjects Receiving no Opioid Rescue | Safety Population | Posted | Count of Participants | Participants | 72 hours |
|
|
|
| Secondary | Percentage of Subjects Receiving no Opioid Rescue | Only subjects in Cohort 3 received a scheduled, non-opioid MMA regimen following surgery. | Safety Population, Cohort 3 only | Posted | Count of Participants | Participants | Day 7 and Day 28 |
|
|
|
| Secondary | Mean Area Under the Curve (AUC) of the NRS-R (Windowed Worst Observation Carried Forward) Pain Intensity Scores | Pain intensity scores are assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable". NRS scores are measured at rest. | Safety Population | Posted | Mean | Standard Deviation | pain intensity score*hr | 72 hours |
|
|
|
| 0 |
| 30 |
| 0 |
| 30 |
| 13 |
| 30 |
| EG001 | Treatment Group 2: HTX-011 + Aprepitant | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation; Aprepitant, three single doses of aprepitant will be administered orally. | 0 | 17 | 1 | 17 | 13 | 17 |
| EG002 | Treatment Group 3: HTX-011 + Non-Opioid MMA Regimen | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation and a scheduled multimodal analgesic (MMA) regimen. | 0 | 31 | 0 | 31 | 16 | 31 |
| Postoperative abscess | Infections and infestations | MedDRA Version 19.1 | Systematic Assessment |
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| Tinea pedis | Infections and infestations | MedDRA Version 19.1 | Systematic Assessment |
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| Staphylococcal infection | Infections and infestations | MedDRA Version 19.1 | Systematic Assessment |
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| Decreased appetite | Metabolism and nutrition disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Hypokalaemia | Metabolism and nutrition disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Hyperlipidaemia | Metabolism and nutrition disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Hyponatraemia | Metabolism and nutrition disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Hypertension | Vascular disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Hypotension | Vascular disorders | MedDRA Version 19.1 | Systematic Assessment |
|
| Hiccups | Respiratory, thoracic and mediastinal disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Sinus congestion | Respiratory, thoracic and mediastinal disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Abdominal discomfort | Gastrointestinal disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Dyspepsia | Gastrointestinal disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Ileus | Gastrointestinal disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Toothache | Gastrointestinal disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Hyperhidrosis | Skin and subcutaneous tissue disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Pruritus | Skin and subcutaneous tissue disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Cold sweat | Skin and subcutaneous tissue disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Erythema | Skin and subcutaneous tissue disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Pain in extremity | Musculoskeletal and connective tissue disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Menstrual disorder | Reproductive system and breast disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Pruritus genital | Reproductive system and breast disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Pyrexia | General disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Chest discomfort | General disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Feeling hot | General disorders | MedDRA Version 19.1 | Systematic Assessment |
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| Post procedural haematoma | Injury, poisoning and procedural complications | MedDRA Version 19.1 | Systematic Assessment |
|
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| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D005531 | Foot Deformities, Acquired |
| D005530 | Foot Deformities |
| D009140 | Musculoskeletal Diseases |