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Terminated for strategic and administrative reasons
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Primary objective: To assess the safety and tolerability of EXPAREL® administered as a single intrathecal injection in healthy volunteers
Secondary objective: To characterize the pharmacokinetic (PK) and pharmacodynamic (PD) profile of EXPAREL® administered as a single intrathecal injection in healthy volunteers
This is a Phase-1, single center, randomized, double-blind, active and placebo-controlled study in approximately 40 healthy adult subjects.
On Day 1, eligible subjects will be randomized in blocks of 5, in a ratio of 3:1:1 to receive EXPAREL® or bupivacaine or placebo (saline) injection, respectively. Starting with treatment Cohort 1, healthy volunteers will be randomized to the 3 treatment arms within cohorts. Each cohort will consist of 10 subjects (6 EXPAREL®, 2 bupivacaine and 2 placebo). In each cohort, all 10 subjects in each cohort will receive cerebrospinal fluid (CSF) taps. Within the EXPAREL® arm, subjects will be randomized 2:1 with 4 subjects undergoing CSF tap and 2 subjects not undergoing CSF tap in each cohort. Subjects who are not undergoing CSF tap, will still be injected with needles without draw of CSF to prevent subject bias. Such a randomization will allow for characterization of the complete pharmacodynamics profile of the drug without risk of drug removal in the CSF. For those subjects randomized to the EXPAREL® arm - the dose of EXPAREL® will be determined by the cohort. Starting at 1 mL (13.3 mg) for Cohort 1, the volume of EXPAREL® will be increased by 1 mL in each subsequent cohort for a maximum of 4 mL (53.2 mg). The decision to proceed to the next cohort will be made following a full review of the safety, PK, and PD (sensory and motor) data from current completed cohort(s). All subjects will remain in the EPRU for 5 days after drug administration and will be discharged on Day 6. Subjects will be instructed to return for a follow up visit on Day 9. Adverse events (AEs) and serious adverse events (SAEs) will be recorded from the time of consent through 30 days after drug administration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EXPAREL® | Experimental | For those subjects randomized to EXPAREL® arm - the dose of EXPAREL® will be determined by the cohort. Starting at 1mL (13.3mg) for cohort 1, the volume of EXPAREL® will be increased by 1 mL in each subsequent cohort for a maximum of 4mL (53.2mg). |
|
| Bupivacaine | Active Comparator | In each cohort, subjects randomized to the bupivacaine arm will receive 15mg of plain bupivacaine HCL (the equivalent of 13.3mg bupivacaine base) providing a 1:1 reference to the starting dose level chosen for EXPAREL®. |
|
| Placebo | Active Comparator | Subjects in the placebo arm will receive normal saline intrathecal injection |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| EXPAREL | Drug | Injection into the Intrathecal space. |
| |
| Bupivacaine Hydrochloride |
| Measure | Description | Time Frame |
|---|---|---|
| Area under the plasma concentration-versus-time curve | Pharmacokinetic endpoint | 6-8 weeks |
| Maximum plasma concentration (Cmax) and time of Cmax (Tmax). | Pharmacokinetic endpoint | 6-8 weeks |
| The apparent terminal elimination half-life (t1/2el) | Pharmacokinetic endpoint | 6-8 weeks |
| Apparent clearance (CL/F) | Pharmacokinetic endpoint | 6-8 weeks |
| Apparent volume of distribution (Vd) | Pharmacokinetic endpoint | 6-8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of treatment-emergent AEs (TEAEs) through Day 9 | Safety endpoint | 6-8 weeks |
| Proportion of subjects who have any of neurological events | Safety endpoint |
| Measure | Description | Time Frame |
|---|---|---|
| Average time to onset of sensory block and motor block | Pharmacodynamic Endpoint | 6-8 weeks |
| Average duration of sensory block and motor block | Pharmacodynamic Endpoint |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Donald C Manning, MD, PhD | Pacira Pharmaceuticals, Inc | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Duke University | Durham | North Carolina | 27710 | United States |
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The decision to proceed to each next cohort will be made following a full review of the safety, PK, and PD data from the previous completed cohort(s).
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Each of the cohorts will be masked as to proceed to subsequent next dose escalation cohort.
| Drug |
Injection into the Intrathecal space. |
|
|
| Placebo | Other | Injection into the Intrathecal space. |
|
|
| 6-8 weeks |
| 6-8 weeks |
| ID | Term |
|---|---|
| D002045 | Bupivacaine |
| D012965 | Sodium Chloride |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
| D002712 | Chlorides |
| D006851 | Hydrochloric Acid |
| D017606 | Chlorine Compounds |
| D007287 | Inorganic Chemicals |
| D017670 | Sodium Compounds |
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