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Placebo-Controlled Evaluation of Intranasal Dexmedetomidine for Postoperative Analgesia Following Bunionectomy

Primary Purpose

Pain, Post-operative

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Intranasal Dexmedetomidine
Intranasal Placebo
Sponsored by
Baudax Bio
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pain, Post-operative focused on measuring Bunion, Bunionectomy, Pain, Analgesia, dexmedetomidine, intranasal

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Voluntarily provide written informed consent.
  • Male or female between 18 and 70 years of age, inclusive.
  • Be scheduled to undergo a primary unilateral first metatarsal bunionectomy repair
  • Be American Society of Anesthesiology (ASA) physical class 1 or 2.
  • Female subject are eligible only if all the following apply:

    • Not pregnant;
    • Not lactating;
    • Not planning to become pregnant during the study;
    • Be surgically sterile; or at least two year post menopausal; or have a monogamous partner who is surgically sterile; or is practicing double-barrier contraception; or practicing abstinence; or using an insertable, injectable, transdermal, or combination oral contraceptive.
  • Male subjects must be surgically sterile or commit to the use of a reliable method of birth control
  • Have a body mass index ≤35 kg/m2
  • Be able to understand the study procedures, comply with all study procedures, and agree to participate in the study program.

Exclusion Criteria:

  • Have a known allergy to dexmedetomidine or any excipient DEX-IN/placebo or to any peri- or postoperative medications used in this study.
  • Have a clinically significant abnormal clinical laboratory tests value.
  • Have history of or positive test results for HIV, or hepatitis B or C.
  • Have a history or clinical manifestations of significant renal, hepatic, cardiovascular, metabolic, neurologic, psychiatric, or other condition that would preclude participation in the study.
  • Have a history of migraine or frequent headaches, seizures, or are currently taking anticonvulsants.
  • Have another painful physical condition that may confound the assessments of post operative pain.
  • Have a history of syncope or other syncopal attacks.
  • Have evidence of a clinically significant 12 lead ECG abnormality.
  • Have a history of alcohol abuse (regularly drinks > 4 units of alcohol per day; 8 oz. beer, 3 oz. wine, 1 oz. spirits) or prescription/illicit drug abuse..
  • Have positive results on the urine drug screen or alcohol breath test indicative of illicit drug or alcohol abuse.
  • Have a history or evidence of orthostatic hypotension.
  • Have a resting heart rate of <50 beats per minutes or systolic blood pressure <100mmHg.
  • Have been receiving or have received chronic opioid therapy defined as greater than 15 morphine equivalents units per day for greater than 3 out of 7 days per week over a one-month period within 12 months.
  • Use concurrent therapy that could interfere with the evaluation of efficacy or safety, such as any drugs which in the investigator's opinion may exert significant analgesic properties or act synergistically with DEX-IN.
  • Unable to discontinue medications, that have not been at a stable dose for at least 14 days prior to the scheduled bunionectomy procedure, within 5 half lives of the specific prior medication (or, if half life is not known, within 48 hours) before dosing.
  • Have utilized any intranasal medications within the preceding 10 days.
  • Have signs or a history of significant rhinitis or rhinorrhea (constant or chronic), nasal polyps, mucosal lesions of the nostril, postnasal drip of any etiology (constant or chronic), nasal ulcers, septal perforation or deviation, any nasal surgery, anosmia, nasal piercings, or frequent nosebleeds or other nasal pathology, that is sufficient to interfere with IN drug delivery.
  • Have had an upper respiratory tract infection within 14 days of screening.
  • Have utilized corticosteroids, either systemically, inhalational either intranasally or oral, or by intra-articular injection, within 14 days prior to the study.
  • Have received any investigational product within 30 days before dosing with study medication.
  • Have previously received DEX-IN in clinical trials, or had bunionectomy in the last 3 months.

Sites / Locations

  • Trovare Clinical Research, Inc.
  • Lotus Clinical Research, LLC
  • Endeavor Clinical Trials, P.A.

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

DEX-IN 35mcg

DEX-IN 50mcg

IN Placebo

Arm Description

DEX-IN 35mcg every 6 hours for 48 hours. DEX-IN 35mcg PRN for up to 3 additional days.

DEX-IN 50mcg every 6 hours for 48 hours. DEX-IN 50mcg PRN for up to 3 additional days.

IN Placebo every 6 hours for 48 hours. IN Placebo PRN for up to 3 additional days.

Outcomes

Primary Outcome Measures

Summed Pain Intensity Difference Over the First 48 Hours (SPID48).
Pain intensity was recorded using a Numeric Rating Scale (Range 0-10) where 0 equates to no pain, and 10 equates to the worst pain imaginable. Pain intensity scores were to be recorded at the following time points: 0.25, 0.5, 0.75, 1, 2, 4, and 6 hours post Dose 1. Thereafter pain assessments were to be recorded every 2 hours until 48 hours. Pain intensity differences from baseline at each time point were calculated and a time weighted SPID was then calculated. Time weighted SPID calculations were computed by multiplying a weight factor to each score prior to summation. The weight factor at each time point was the time elapsed since the previous observation.

Secondary Outcome Measures

Full Information

First Posted
June 17, 2014
Last Updated
November 6, 2015
Sponsor
Baudax Bio
Collaborators
Lotus Clinical Research, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT02169336
Brief Title
Placebo-Controlled Evaluation of Intranasal Dexmedetomidine for Postoperative Analgesia Following Bunionectomy
Official Title
A Phase 2, Multicenter, Randomized, Double-Blind, Placebo-Controlled, Evaluation of the Efficacy, Safety, and Pharmacokinetics of Intranasal Dexmedetomidine for Postoperative Analgesia Following Bunionectomy
Study Type
Interventional

2. Study Status

Record Verification Date
November 2015
Overall Recruitment Status
Terminated
Why Stopped
Lack of observed efficacy
Study Start Date
June 2014 (undefined)
Primary Completion Date
September 2014 (Actual)
Study Completion Date
October 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Baudax Bio
Collaborators
Lotus Clinical Research, LLC

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The primary objective of this study is to evaluate the analgesic efficacy of two dose levels of DEX-IN compared with placebo, using the summed pain intensity difference over the first 48 hours (SPID48) in subjects with acute moderate to severe pain following unilateral bunionectomy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pain, Post-operative
Keywords
Bunion, Bunionectomy, Pain, Analgesia, dexmedetomidine, intranasal

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
95 (Actual)

8. Arms, Groups, and Interventions

Arm Title
DEX-IN 35mcg
Arm Type
Experimental
Arm Description
DEX-IN 35mcg every 6 hours for 48 hours. DEX-IN 35mcg PRN for up to 3 additional days.
Arm Title
DEX-IN 50mcg
Arm Type
Experimental
Arm Description
DEX-IN 50mcg every 6 hours for 48 hours. DEX-IN 50mcg PRN for up to 3 additional days.
Arm Title
IN Placebo
Arm Type
Placebo Comparator
Arm Description
IN Placebo every 6 hours for 48 hours. IN Placebo PRN for up to 3 additional days.
Intervention Type
Drug
Intervention Name(s)
Intranasal Dexmedetomidine
Intervention Type
Other
Intervention Name(s)
Intranasal Placebo
Primary Outcome Measure Information:
Title
Summed Pain Intensity Difference Over the First 48 Hours (SPID48).
Description
Pain intensity was recorded using a Numeric Rating Scale (Range 0-10) where 0 equates to no pain, and 10 equates to the worst pain imaginable. Pain intensity scores were to be recorded at the following time points: 0.25, 0.5, 0.75, 1, 2, 4, and 6 hours post Dose 1. Thereafter pain assessments were to be recorded every 2 hours until 48 hours. Pain intensity differences from baseline at each time point were calculated and a time weighted SPID was then calculated. Time weighted SPID calculations were computed by multiplying a weight factor to each score prior to summation. The weight factor at each time point was the time elapsed since the previous observation.
Time Frame
48 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Voluntarily provide written informed consent. Male or female between 18 and 70 years of age, inclusive. Be scheduled to undergo a primary unilateral first metatarsal bunionectomy repair Be American Society of Anesthesiology (ASA) physical class 1 or 2. Female subject are eligible only if all the following apply: Not pregnant; Not lactating; Not planning to become pregnant during the study; Be surgically sterile; or at least two year post menopausal; or have a monogamous partner who is surgically sterile; or is practicing double-barrier contraception; or practicing abstinence; or using an insertable, injectable, transdermal, or combination oral contraceptive. Male subjects must be surgically sterile or commit to the use of a reliable method of birth control Have a body mass index ≤35 kg/m2 Be able to understand the study procedures, comply with all study procedures, and agree to participate in the study program. Exclusion Criteria: Have a known allergy to dexmedetomidine or any excipient DEX-IN/placebo or to any peri- or postoperative medications used in this study. Have a clinically significant abnormal clinical laboratory tests value. Have history of or positive test results for HIV, or hepatitis B or C. Have a history or clinical manifestations of significant renal, hepatic, cardiovascular, metabolic, neurologic, psychiatric, or other condition that would preclude participation in the study. Have a history of migraine or frequent headaches, seizures, or are currently taking anticonvulsants. Have another painful physical condition that may confound the assessments of post operative pain. Have a history of syncope or other syncopal attacks. Have evidence of a clinically significant 12 lead ECG abnormality. Have a history of alcohol abuse (regularly drinks > 4 units of alcohol per day; 8 oz. beer, 3 oz. wine, 1 oz. spirits) or prescription/illicit drug abuse.. Have positive results on the urine drug screen or alcohol breath test indicative of illicit drug or alcohol abuse. Have a history or evidence of orthostatic hypotension. Have a resting heart rate of <50 beats per minutes or systolic blood pressure <100mmHg. Have been receiving or have received chronic opioid therapy defined as greater than 15 morphine equivalents units per day for greater than 3 out of 7 days per week over a one-month period within 12 months. Use concurrent therapy that could interfere with the evaluation of efficacy or safety, such as any drugs which in the investigator's opinion may exert significant analgesic properties or act synergistically with DEX-IN. Unable to discontinue medications, that have not been at a stable dose for at least 14 days prior to the scheduled bunionectomy procedure, within 5 half lives of the specific prior medication (or, if half life is not known, within 48 hours) before dosing. Have utilized any intranasal medications within the preceding 10 days. Have signs or a history of significant rhinitis or rhinorrhea (constant or chronic), nasal polyps, mucosal lesions of the nostril, postnasal drip of any etiology (constant or chronic), nasal ulcers, septal perforation or deviation, any nasal surgery, anosmia, nasal piercings, or frequent nosebleeds or other nasal pathology, that is sufficient to interfere with IN drug delivery. Have had an upper respiratory tract infection within 14 days of screening. Have utilized corticosteroids, either systemically, inhalational either intranasally or oral, or by intra-articular injection, within 14 days prior to the study. Have received any investigational product within 30 days before dosing with study medication. Have previously received DEX-IN in clinical trials, or had bunionectomy in the last 3 months.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Neil Singla, MD
Organizational Affiliation
Lotus Clinical Research, LLC
Official's Role
Principal Investigator
Facility Information:
Facility Name
Trovare Clinical Research, Inc.
City
Bakersfield
State/Province
California
Country
United States
Facility Name
Lotus Clinical Research, LLC
City
Pasadena
State/Province
California
Country
United States
Facility Name
Endeavor Clinical Trials, P.A.
City
San Antonio
State/Province
Texas
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Placebo-Controlled Evaluation of Intranasal Dexmedetomidine for Postoperative Analgesia Following Bunionectomy

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