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This is a pilot, open label, single center study in 40 subjects undergoing bunionectomy. The study will assess and collect information on pharmacokinetics, pharmacodynamics, safety and efficacy of EXPAREL administered as a sciatic nerve block (in popliteal fossa).
A total of 10 subjects will be enrolled in each of the 4 cohorts.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Cohort 1 - EXPAREL | Experimental | A total of 10 subjects will be enrolled. Subjects in this cohort will receive 266mg of EXPAREL admixed with bupivacaine. |
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| Cohort 2 - EXPAREL | Experimental | A total of 10 subjects will be enrolled. Subjects in this cohort will receive 133mg of EXPAREL admixed with bupivacaine. |
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| Cohort 3 - EXPAREL | Experimental | A total of 10 subjects will be enrolled. Subjects in this cohort will receive 266mg of EXPAREL only |
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| Cohort 4 - bupivacaine | Active Comparator | A total of 10 subjects will be enrolled. Subjects in this cohort will receive 100mg Bupivacaine only. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Exparel Injectable Product | Drug | bupivacaine liposome injectable suspension |
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| Measure | Description | Time Frame |
|---|---|---|
| Pharmacokinetic 1 (Area under the plasma concentration) | Area under the plasma concentration-versus-time curve (AUC). | predose (up to 15 min before block), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1), 60(±2), 72(±2), 84(±2), 96(±3), 120(±3), 144(±3), and 168(±3) hours following block |
| Pharmacokinetic 2 (Cmax) | Maximum plasma concentration (Cmax) | predose (up to 15 min before block), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1h), 60(±2h), 72(±2h), 84(±2h), 96(±3h), 120(±3h), 144(±3h), and 168(±3h) hours following block |
| Pharmacokinetic 3 (half-life ) | The apparent terminal elimination half-life (t1/2el). | predose (up to 15 min before block), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1h), 60(±2h), 72(±2h), 84(±2h), 96(±3h), 120(±3h), 144(±3h), and 168(±3h) hours following block |
| Pharmacokinetic 4 (Apparent clearance) | Apparent clearance (CL/F). | predose (up to 15 min before block), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1h), 60(±2h), 72(±2h), 84(±2h), 96(±3h), 120(±3h), 144(±3h), and 168(±3h) hours following block |
| Pharmacokinetic 5 (volume of distribution) | Apparent volume of distribution (Vd). | predose (up to 15 min before block), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1h), 60(±2h), 72(±2h), 84(±2h), 96(±3h), 120(±3h), 144(±3h), and 168(±3h) hours following block |
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Inclusion Criteria:
Exclusion Criteria:
Allergy, hypersensitivity, intolerance, or contraindication to any of the study medications for which an alternative is not named in the protocol (eg, amide-type local anesthetics, opioids, bupivacaine, NSAIDs)
Documented history of long-term diabetes or severe peripheral vascular disease
Renal (serum creatinine level >2mg/dL [176.8 μmol/L]) or hepatic dysfunction (serum alanine or aspartame transferase > 3 times the upper limit of normal).
Concurrent painful physical condition that may require analgesic treatment (such as long-term, consistent use of opioids) in the post dosing period for pain and which, in the investigator's opinion may confound the post dosing assessments
History of, suspected, or known addiction to or abuse of illicit drug(s), prescription medicine(s), or alcohol within the past 2 years
Administration of an investigational drug within 30 days or 5 elimination half-lives of such investigational drug, whichever is longer, prior to study drug administration, or planned administration of another investigational product or procedure during the subject's participation in this study
Previous participation in an EXPAREL study
Uncontrolled anxiety, schizophrenia, or other psychiatric disorder that, in the opinion of the investigator, could interfere with study assessments or compliance
Currently pregnant, nursing, or planning to become pregnant during the study
Clinically significant medical disease that, in the opinion of the investigator, would make participation in a clinical study inappropriate. This includes any psychiatric or other conditions that would constitute a contraindication to participation in the study
Currently on neuroleptic agent [e.g., gabapentin, pregabalin (Lyrica), duloxetine (Cymbalta) etc.]
Inadequate sensory function on the foot (monofilament test)
Chronic opioid use in the last 30 days (≥30 morphine equivalents/ day)
In addition, the subject may be withdrawn from the study if the subject meets the following criterion during or post-surgery:
Any clinically significant event or condition uncovered during the surgery (e.g., excessive bleeding, acute sepsis) that, in the opinion of the investigator, renders the subject medically unstable or complicates the subject's post-operative course
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| Name | Affiliation | Role |
|---|---|---|
| Nayana Nagaraj | Medical Director | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| First Surgical Hospital | Bellaire | Texas | 77401 | United States |
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| Bupivacaine | Drug | 1.3%, 13.3 mg/mL |
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| Pharmacokinetic 6 (Tmax) | Time of Cmax (Tmax) | predose (up to 15 min before block), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1h), 60(±2h), 72(±2h), 84(±2h), 96(±3h), 120(±3h), 144(±3h), and 168(±3h) hours following block |
| Pharmacodynamic 1 (duration of sensory and motor block) | Average duration of sensory block and motor block | up to 15 min before block, 15 min(±5 min), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1), 60(±2), 72(±2), 84(±2), 96(±3), 120(±3), 144(±3), and 168(±3) hours following block |
| Pharmacodynamic 2 (duration of sensory and motor block) | Average duration of sensory block and motor block | up to 15 min before block, 15 min(±5min), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1), 60(±2), 72(±2), 84(±2), 96(±3), 120(±3), 144(±3), and 168(±3) hours following block |
| ID | Term |
|---|---|
| D000071378 | Bunion |
| ID | Term |
|---|---|
| D005531 | Foot Deformities, Acquired |
| D005530 | Foot Deformities |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D002045 | Bupivacaine |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
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