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| Name | Class |
|---|---|
| Vertex Pharmaceuticals Incorporated | INDUSTRY |
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This study is a prospective, single-arm interventional trial enrolling patients undergoing total knee arthroplasty (TKA) for knee arthritis. All participants will receive Suzetrigine (brand name Journavx by Vertex Pharma) as part of a standardized multimodal perioperative analgesic regimen in addition to standard of care.
The objective of the study is to determine the effect suzetrigine has on postoperative pain, opioid use, sleep quality, and patient satisfaction when it is used as part of a multimodal pain regimen prescribed to patients after total knee arthroplasty.
The study will enroll eligible participants who are scheduled to receive a total knee arthroplasty. Participants will first consent to participate in the research study. They will then be asked to complete certain baseline measurements and instructed to begin wearing a device on their wrist that will quantify their activity and sleep quality ("sleep tracker"). They will complete a baseline KOOS JR survey. There are no additional surveys or diaries to complete pre-operatively. They will receive a suzetrigine prescription (the intervention) on the day of their total knee arthroplasty after the procedure has been completed in addition to the standard of care pain control regimen after surgery. They will complete a diary for a set time after surgery, and subject will continue to wear the sleep tracker for up to 2 weeks post-surgery. They will complete a daily sleep diary for 14 days after surgery to document sleep duration, sleep quality, nighttime awakenings, and other related factors. They will also complete a diary for 14 days after surgery that asks them to report their pain level 3 times daily, their nausea level 3 times daily, and the number of narcotic pills taken daily, and continue to wear their activity and sleep tracker. They will be asked to complete a pill tracking chart to confirm they are taking Journavx as directed for 14 days after surgery. 1 week and 2 weeks after surgery, they will complete a survey that quantifies their sleep related impairment. Approximately 3 months after surgery, subjects will complete another survey. Participants will have interactions with the study team until approximately 3 months after surgery.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Suzetrigine Regimen Arm | Experimental | Suzetrigine (JOURNAVX®) administered orally consisting of a course that lasts up to a maximum of 14 days. The starting dose will be 100 mg orally taken as two 50 mg tablets on an empty stomach (at least 1 hour before or 2 hours after food). Maintenance dosing will begin 12 hours after the initial dose, at which point patients will take 50 mg orally every 12 hours. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Suzetrigine | Drug | Suzetrigine is an orally administered, selective NaV1.8 voltage-gated sodium channel inhibitor being investigated as a non-opioid analgesic for the treatment of pain through inhibition of pain signal transmission in peripheral sensory neurons. |
| Measure | Description | Time Frame |
|---|---|---|
| Mean pain intensity score on the Numeric Rating Scale (NRS) | Pain will be measured using a scale from 0 to 10, where 0 equals no pain and 10 equals the worst possible pain, using a Visual Analog Pain Scale (VAS-pain). Higher score correlates with worse outcome. | Day 0-14 postoperative |
| Average daily opioid consumption | Postoperative opioid consumption will be quantified in morphine milligram equivalents (MME) during postoperative days 0-14. | Day 0-14 postoperative |
| Cumulative opioid consumption | Postoperative opioid consumption will be quantified as cumulative MME at 3 weeks and 3 months. | 3 weeks and 3 months postoperative |
| Measure | Description | Time Frame |
|---|---|---|
| Nausea scores postoperative | A nausea assessment will be assessed using the Visual Analog Nausea Scale (VAS-nausea), which is ranked from 0 (no nausea) to 10 (highest amount of nausea). Patients will be asked to fill out the VAS-nausea each day until post-operative day 14. | Day 0-14 post-operative |
| Total sleep time |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Darrell Favors | Contact | 404-313-3276 | darrell.favors@emory.edu |
| Name | Affiliation | Role |
|---|---|---|
| Ajay Premkumar, MD | Emory University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Emory Clinic | Atlanta | Georgia | 30322 | United States | ||
| Emory Clinic at Executive Park |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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Total sleep time will be collected using actigraphy during postoperative days 0-14. |
| Day 0-14 post-operative |
| Sleep efficiency | Sleep efficiency will be measured by recording the ratio of time asleep to time in bed, using actigraphy during postoperative days 0-14. | Day 0-14 post-operative |
| Sleep latency | Sleep latency will be measured by recording the time from "lights out" to sleep onset, using actigraphy during postoperative days 0-14. | Day 0-14 post-operative |
| Wake after sleep onset (WASO) | Wake after sleep onset (WASO) will be assessed using actigraphy during postoperative days 0-14. | Day 0-14 post-operative |
| EQ5D Score | Health-related quality of life measure using the EQ-5D questionnaire, which assesses mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Responses are converted into a summary index score, where 1 represents full health and 0 represents death (higher values indicating better health status). | 3 months post-operative |
| KOOS Jr Score | Patient-reported knee function assessed using the Knee Injury and Osteoarthritis Outcome Score Junior (KOOS Jr). The KOOS Jr is a validated short-form instrument derived from the full KOOS, designed to evaluate knee health based on key items related to pain, symptoms, and physical function. Scores are transformed to a 0 to 100 scale, with higher scores indicating better knee function and fewer symptoms. | Baseline, 3 months post-operative |
| Atlanta |
| Georgia |
| 30329 |
| United States |
| Emory Orthopaedics and Spine Center | Atlanta | Georgia | 30329 | United States |
| D012216 |
| Rheumatic Diseases |