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Multicenter Study to Compare Intravenous and Oral Acetaminophen for the Treatment of Acute Moderate to Severe Pain

Primary Purpose

Acute Pain, Postoperative

Status
Terminated
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
IV acetaminophen
Oral acetaminophen
Morphine
Sponsored by
Mallinckrodt
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Pain, Postoperative focused on measuring Elective total knee arthroplasty

Eligibility Criteria

50 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject must be adequately informed and understand the nature and risks of the study and must be able to provide a signature and date on the informed consent form.
  2. Subject must be male or females, between 50 and 90 years of age (inclusive) at Screening.
  3. Subject must have a weight range of 50 to 120 kg.
  4. Subject must be in a American Society of Anesthesiologists risk class of I, II, or III.
  5. Subject must have successfully completed an unilateral uncomplicated total knee replacement surgery, able to take oral medication, and report having moderate to severe acute pain as determined by a pain score ≥ 5 from the 11-point Numeric Pain Rating Scale (NPRS) scale during the period of 3 to 6 hours postsurgery.
  6. Female subjects of child-bearing potential must have a negative serum pregnancy test at the Screening and day-of-surgery.
  7. Subjects must be able to communicate effectively with study personnel.
  8. Subject must be able and willing to follow all protocol requirements, including operating a PCA device, and study restrictions.

Exclusion Criteria:

  1. Subject is from a vulnerable population, as defined by the Code of Federal Regulations Title 45, Part 46, 1. Section 46.111(b), including but not limited to employees (temporary, part-time, full time, etc.) or a family member of the research staff conducting the study, or of the sponsor, or of the clinical research organization, or of the Institutional Review Board.
  2. Subject has an oxygen saturation of less than 95% while awake on room air.
  3. Subject has a positive test result for human immunodeficiency virus, hepatitis B (surface antigen), or hepatitis C virus antibody at Screening.
  4. Subject has used an average of 30 mg oral morphine equivalents or greater, 1 to 2 weeks prior to the day of surgery. Subjects who, in the investigator's opinion are developing opioid tolerance will be excluded.
  5. Subject has a history of any drug allergy, hypersensitivity, or intolerance to acetaminophen or morphine or to any of the excipients in the IV or oral formulations used.
  6. Subject has intra- or postoperative complications, which in the view of the investigator, makes the subject unsuitable for the participation of the study.
  7. Subject has received neuraxial (spinal or epidural) opioid injected perioperatively.
  8. Subject has received a local anesthetic, regional, or wound injection or continuous infusion by any route.
  9. Subject has impaired liver function (eg, aspartate aminotransferase, alanine aminotransferase, or bilirubin greater than or equal to 3.0 times the upper limit of normal), active hepatic disease, evidence of clinically significant liver disease, or other condition (eg, alcoholism, cirrhosis, or hepatitis) that suggests the potential for an increased susceptibility to hepatic toxicity with study drug exposure.
  10. Subject has renal dysfunction or is at risk for renal failure due to volume depletion.
  11. Subject has donated or had significant loss of whole blood (480 mL or more) within 30 days, or plasma within 14 days prior to dosing.
  12. Subject has had any major surgery within 3 months prior to day-of-surgery.
  13. Subject has a history of acute illness within 14 days prior to day-of-surgery.
  14. Subject has participated in another clinical study within 30 days prior to day-of-surgery or plans to participate in another clinical study while concurrently enrolled in this study.
  15. Subject has a history of conditions which might be specifically contraindicated or require caution to be used during the administration of any drug in the study.
  16. Subject has any other medical, psychiatric and/or social reason for exclusion as determined by the investigator.
  17. Subject has a positive test result for drugs of abuse (amphetamines, barbiturates, benzodiazepines, cannabinoids [including medical use of marijuana], cocaine, methamphetamine, methadone, or methylenedioxy-methamphetamine) at Screening. Subjects with a positive test result for prescribed drugs may be included in the study at the discretion of the investigator. Subjects with a positive test result for cannabinoids with a prescription for medical marijuana will be excluded from the study, subjects with a prescription for dronabinol (∆-9-tetrahydrocannabinol) may be included at the discretion of the investigator.

Sites / Locations

  • Pensacola Research Consultants
  • The Ohio State University, Wexner Medical Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

IV acetaminophen/Morphine

Oral acetaminophen/Morphine

Arm Description

IV acetaminophen 1000 mg every 6 hours over 18 hours

Oral acetaminophen two 500 mg tablets every 6 hours over 18 hours

Outcomes

Primary Outcome Measures

Pain Intensity on a Numerical Pain Scale (NPS) for 18 Hours
Participants rate intensity of their pain on a Numerical Pain Scale (NPS) from 0-10, wherein 0=no pain (better) and 10=most intense pain (worse). The highest possible score is 10.

Secondary Outcome Measures

Full Information

First Posted
March 18, 2016
Last Updated
November 5, 2019
Sponsor
Mallinckrodt
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1. Study Identification

Unique Protocol Identification Number
NCT02746263
Brief Title
Multicenter Study to Compare Intravenous and Oral Acetaminophen for the Treatment of Acute Moderate to Severe Pain
Official Title
A Randomized, Double-Blind, Double-Dummy, Active-Controlled, Repeated Dose, Multicenter Study to Compare Intravenous and Oral Acetaminophen for the Treatment of Acute Moderate to Severe Pain in Combination With Patient-Controlled Analgesia With Morphine in Adults Following Elective Total Knee Arthroplasty
Study Type
Interventional

2. Study Status

Record Verification Date
November 2016
Overall Recruitment Status
Terminated
Why Stopped
Business decision because enrollment was slower than expected
Study Start Date
April 27, 2016 (Actual)
Primary Completion Date
May 5, 2016 (Actual)
Study Completion Date
May 5, 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mallinckrodt

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to compare intravenous (IV) and oral acetaminophen for the treatment of acute moderate to severe pain in combination with standard patient-controlled analgesia (PCA) in adult subjects following total knee replacement.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Pain, Postoperative
Keywords
Elective total knee arthroplasty

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
1 (Actual)

8. Arms, Groups, and Interventions

Arm Title
IV acetaminophen/Morphine
Arm Type
Experimental
Arm Description
IV acetaminophen 1000 mg every 6 hours over 18 hours
Arm Title
Oral acetaminophen/Morphine
Arm Type
Active Comparator
Arm Description
Oral acetaminophen two 500 mg tablets every 6 hours over 18 hours
Intervention Type
Drug
Intervention Name(s)
IV acetaminophen
Other Intervention Name(s)
Ofirmev
Intervention Type
Drug
Intervention Name(s)
Oral acetaminophen
Other Intervention Name(s)
Acetaminophen (APAP)
Intervention Type
Drug
Intervention Name(s)
Morphine
Intervention Description
Patient controlled analgesia
Primary Outcome Measure Information:
Title
Pain Intensity on a Numerical Pain Scale (NPS) for 18 Hours
Description
Participants rate intensity of their pain on a Numerical Pain Scale (NPS) from 0-10, wherein 0=no pain (better) and 10=most intense pain (worse). The highest possible score is 10.
Time Frame
18 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject must be adequately informed and understand the nature and risks of the study and must be able to provide a signature and date on the informed consent form. Subject must be male or females, between 50 and 90 years of age (inclusive) at Screening. Subject must have a weight range of 50 to 120 kg. Subject must be in a American Society of Anesthesiologists risk class of I, II, or III. Subject must have successfully completed an unilateral uncomplicated total knee replacement surgery, able to take oral medication, and report having moderate to severe acute pain as determined by a pain score ≥ 5 from the 11-point Numeric Pain Rating Scale (NPRS) scale during the period of 3 to 6 hours postsurgery. Female subjects of child-bearing potential must have a negative serum pregnancy test at the Screening and day-of-surgery. Subjects must be able to communicate effectively with study personnel. Subject must be able and willing to follow all protocol requirements, including operating a PCA device, and study restrictions. Exclusion Criteria: Subject is from a vulnerable population, as defined by the Code of Federal Regulations Title 45, Part 46, 1. Section 46.111(b), including but not limited to employees (temporary, part-time, full time, etc.) or a family member of the research staff conducting the study, or of the sponsor, or of the clinical research organization, or of the Institutional Review Board. Subject has an oxygen saturation of less than 95% while awake on room air. Subject has a positive test result for human immunodeficiency virus, hepatitis B (surface antigen), or hepatitis C virus antibody at Screening. Subject has used an average of 30 mg oral morphine equivalents or greater, 1 to 2 weeks prior to the day of surgery. Subjects who, in the investigator's opinion are developing opioid tolerance will be excluded. Subject has a history of any drug allergy, hypersensitivity, or intolerance to acetaminophen or morphine or to any of the excipients in the IV or oral formulations used. Subject has intra- or postoperative complications, which in the view of the investigator, makes the subject unsuitable for the participation of the study. Subject has received neuraxial (spinal or epidural) opioid injected perioperatively. Subject has received a local anesthetic, regional, or wound injection or continuous infusion by any route. Subject has impaired liver function (eg, aspartate aminotransferase, alanine aminotransferase, or bilirubin greater than or equal to 3.0 times the upper limit of normal), active hepatic disease, evidence of clinically significant liver disease, or other condition (eg, alcoholism, cirrhosis, or hepatitis) that suggests the potential for an increased susceptibility to hepatic toxicity with study drug exposure. Subject has renal dysfunction or is at risk for renal failure due to volume depletion. Subject has donated or had significant loss of whole blood (480 mL or more) within 30 days, or plasma within 14 days prior to dosing. Subject has had any major surgery within 3 months prior to day-of-surgery. Subject has a history of acute illness within 14 days prior to day-of-surgery. Subject has participated in another clinical study within 30 days prior to day-of-surgery or plans to participate in another clinical study while concurrently enrolled in this study. Subject has a history of conditions which might be specifically contraindicated or require caution to be used during the administration of any drug in the study. Subject has any other medical, psychiatric and/or social reason for exclusion as determined by the investigator. Subject has a positive test result for drugs of abuse (amphetamines, barbiturates, benzodiazepines, cannabinoids [including medical use of marijuana], cocaine, methamphetamine, methadone, or methylenedioxy-methamphetamine) at Screening. Subjects with a positive test result for prescribed drugs may be included in the study at the discretion of the investigator. Subjects with a positive test result for cannabinoids with a prescription for medical marijuana will be excluded from the study, subjects with a prescription for dronabinol (∆-9-tetrahydrocannabinol) may be included at the discretion of the investigator.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Medical Affairs
Organizational Affiliation
Mallinckrodt
Official's Role
Study Director
Facility Information:
Facility Name
Pensacola Research Consultants
City
Pensacola
State/Province
Florida
ZIP/Postal Code
32503
Country
United States
Facility Name
The Ohio State University, Wexner Medical Center
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Multicenter Study to Compare Intravenous and Oral Acetaminophen for the Treatment of Acute Moderate to Severe Pain

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