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Dexmedetomidine Transdermal System (DMTS) for Post-Operative Analgesia Following Bunionectomy (DMTS)

Primary Purpose

Pain, Postoperative

Status
Completed
Phase
Phase 2
Locations
Australia
Study Type
Interventional
Intervention
DMTS
Placebo
Sponsored by
Teikoku Pharma USA, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pain, Postoperative focused on measuring Pain, Bunionectomy, Dexmedetomidine, Transdermal, Patch, Postoperative, DMTS

Eligibility Criteria

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

Inclusion Criteria:

  1. Voluntarily provide written informed consent.
  2. Male or female, ≥ 18 years of age.
  3. Scheduled to undergo a primary unilateral first metatarsal bunionectomy repair.
  4. Have a physical status classification of 1 or 2 per the American Society of Anesthesiology.
  5. Non-smoker for at least 1 year prior to screening; non-smoking is defined by cessation of smoking and use of all other tobacco and nicotine products (including chewing tobacco, snuff, e-cigarettes, nicotine patches, etc.).
  6. Female subjects are eligible only if all the following apply:

    1. Not pregnant, not lactating, and not planning to become pregnant during the study
    2. Surgically sterile; or at least 2 years postmenopausal; or have a monogamous partner who is surgically sterile; or have a same gender sex partner; or is practicing double-barrier contraception; or practicing abstinence; or using an insertable, injectable, transdermal, or combination oral contraceptive
  7. Male subjects with female sex partners must be surgically sterile or commit to the use of a reliable method of birth control.
  8. Have a body weight > 50 kg, and body mass index of 22 to 38 kg/m2, inclusive.
  9. Able to understand the study procedures, comply with all study procedures, and agree to participate in the study program for its full duration.

Exclusion Criteria:

  1. Have a known sensitivity to dexmedetomidine or any excipient in the DMTS/placebo or to any peri- or postoperative medication whose use is required in this study.
  2. Have a skin abnormality (eg, scar, tattoo) or unhealthy skin condition (eg, burns, wounds) at the patch application site, according to examination by the investigator at screening or admission to the clinic prior to surgery.
  3. Have a clinically significant abnormal clinical laboratory test value.
  4. Have history of or positive test results for the human immunodeficiency virus (HIV), hepatitis B, or hepatitis C.
  5. Have a history or clinical manifestations of: a significant renal, hepatic, cardiovascular, metabolic, neurologic, or psychiatric condition; congestive heart failure, peptic ulcer, gastrointestinal bleeding, or other condition that would preclude participation in the study.
  6. Have a history of migraine or frequent headaches, seizures, or are currently taking anticonvulsants.
  7. Have another painful physical condition that may confound the assessments of postoperative pain.
  8. Have a history of syncope or other syncopal attacks.
  9. Have evidence of a clinically significant 12-lead ECG abnormality.
  10. Have a history of alcohol abuse or prescription/illicit drug abuse.
  11. Have positive results on the urine drug screen or alcohol breath test indicative of illicit drug or alcohol use at screening and/or clinic check-in.
  12. Have a history or evidence of clinically significant orthostatic hypotension.
  13. Have a resting heart rate of < 50 beats per minute or systolic blood pressure < 100 mmHg.
  14. Have been receiving or have received opioid therapy chronically for > 2 weeks within the month prior to dosing of the study drug.
  15. 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 dexmedetomidine.
  16. Have had an upper respiratory tract infection within 14 days prior to dosing of the study drug.
  17. Have utilized oral or injectable corticosteroids within 14 days prior to dosing of the study drug (intranasal and topical corticosteroid use during this time period is allowed).
  18. Have received any investigational product within 30 days prior to dosing of the study drug.
  19. Have previously received DMTS in a clinical trial.
  20. Sensitivity to opioids, nonsteroidal anti-inflammatory drugs, or antibiotics.
  21. In the opinion of the investigator or designee, is considered unsuitable for study entry and/or is unlikely to comply with the study protocol for any reason.

Sites / Locations

  • Nucleus Network LTD
  • Linear Clinical Research

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Placebo Comparator

Arm Label

DMTS

Placebo

Arm Description

DMTS applied to the upper arm

Placebo patches to match DMTS applied to the upper arm

Outcomes

Primary Outcome Measures

Time-interval weighted summed pain intensity (SPI), measured using the 11 point (0 to 10) numeric rating scale (NRS) at designated time points from 4 to 24 hours following surgery (NRSSPI).

Secondary Outcome Measures

Time-interval weighted summed pain intensity over various time intervals
The proportion of subjects using opioid rescue pain medication
The time to first use of rescue pain medication

Full Information

First Posted
November 1, 2016
Last Updated
October 5, 2017
Sponsor
Teikoku Pharma USA, Inc.
Collaborators
Premier Research Group plc
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1. Study Identification

Unique Protocol Identification Number
NCT02953054
Brief Title
Dexmedetomidine Transdermal System (DMTS) for Post-Operative Analgesia Following Bunionectomy
Acronym
DMTS
Official Title
A Double-Blind, Placebo-Controlled, Single-Dose Evaluation of the Dexmedetomidine Transdermal System for Post-Operative Analgesia Following Bunionectomy
Study Type
Interventional

2. Study Status

Record Verification Date
June 2017
Overall Recruitment Status
Completed
Study Start Date
January 22, 2017 (Actual)
Primary Completion Date
July 3, 2017 (Actual)
Study Completion Date
July 3, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Teikoku Pharma USA, Inc.
Collaborators
Premier Research Group plc

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate whether the DMTS, compared with a placebo patch, will provide adequate pain relief during the first 3 days following bunionectomy surgery.
Detailed Description
The primary objective of this study is to evaluate the analgesic efficacy of the DMTS, compared with placebo in subjects with acute moderate to severe pain following unilateral bunionectomy. The secondary objectives are: To assess the safety and tolerability of the DMTS, including assessment of skin irritation To assess adhesion of the DMTS To assess the sedation effect of the DMTS

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pain, Postoperative
Keywords
Pain, Bunionectomy, Dexmedetomidine, Transdermal, Patch, Postoperative, DMTS

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
DMTS
Arm Type
Active Comparator
Arm Description
DMTS applied to the upper arm
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo patches to match DMTS applied to the upper arm
Intervention Type
Drug
Intervention Name(s)
DMTS
Intervention Description
DMTS applied before surgery and worn for 72 hours
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching patches that have no active drug applied before surgery and worn for 72 hours.
Primary Outcome Measure Information:
Title
Time-interval weighted summed pain intensity (SPI), measured using the 11 point (0 to 10) numeric rating scale (NRS) at designated time points from 4 to 24 hours following surgery (NRSSPI).
Time Frame
From 4 to 24 hours following surgery
Secondary Outcome Measure Information:
Title
Time-interval weighted summed pain intensity over various time intervals
Time Frame
Up to 72 hours after surgery
Title
The proportion of subjects using opioid rescue pain medication
Time Frame
Up to 72 hours after surgery
Title
The time to first use of rescue pain medication
Time Frame
intraoperative

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Voluntarily provide written informed consent. Male or female, ≥ 18 years of age. Scheduled to undergo a primary unilateral first metatarsal bunionectomy repair. Have a physical status classification of 1 or 2 per the American Society of Anesthesiology. Non-smoker for at least 1 year prior to screening; non-smoking is defined by cessation of smoking and use of all other tobacco and nicotine products (including chewing tobacco, snuff, e-cigarettes, nicotine patches, etc.). Female subjects are eligible only if all the following apply: Not pregnant, not lactating, and not planning to become pregnant during the study Surgically sterile; or at least 2 years postmenopausal; or have a monogamous partner who is surgically sterile; or have a same gender sex partner; or is practicing double-barrier contraception; or practicing abstinence; or using an insertable, injectable, transdermal, or combination oral contraceptive Male subjects with female sex partners must be surgically sterile or commit to the use of a reliable method of birth control. Have a body weight > 50 kg, and body mass index of 22 to 38 kg/m2, inclusive. Able to understand the study procedures, comply with all study procedures, and agree to participate in the study program for its full duration. Exclusion Criteria: Have a known sensitivity to dexmedetomidine or any excipient in the DMTS/placebo or to any peri- or postoperative medication whose use is required in this study. Have a skin abnormality (eg, scar, tattoo) or unhealthy skin condition (eg, burns, wounds) at the patch application site, according to examination by the investigator at screening or admission to the clinic prior to surgery. Have a clinically significant abnormal clinical laboratory test value. Have history of or positive test results for the human immunodeficiency virus (HIV), hepatitis B, or hepatitis C. Have a history or clinical manifestations of: a significant renal, hepatic, cardiovascular, metabolic, neurologic, or psychiatric condition; congestive heart failure, peptic ulcer, gastrointestinal bleeding, 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 postoperative 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 or prescription/illicit drug abuse. Have positive results on the urine drug screen or alcohol breath test indicative of illicit drug or alcohol use at screening and/or clinic check-in. Have a history or evidence of clinically significant orthostatic hypotension. Have a resting heart rate of < 50 beats per minute or systolic blood pressure < 100 mmHg. Have been receiving or have received opioid therapy chronically for > 2 weeks within the month prior to dosing of the study drug. 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 dexmedetomidine. Have had an upper respiratory tract infection within 14 days prior to dosing of the study drug. Have utilized oral or injectable corticosteroids within 14 days prior to dosing of the study drug (intranasal and topical corticosteroid use during this time period is allowed). Have received any investigational product within 30 days prior to dosing of the study drug. Have previously received DMTS in a clinical trial. Sensitivity to opioids, nonsteroidal anti-inflammatory drugs, or antibiotics. In the opinion of the investigator or designee, is considered unsuitable for study entry and/or is unlikely to comply with the study protocol for any reason.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
James Song, MS, MBA
Organizational Affiliation
Teikoku Pharma USA, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Nucleus Network LTD
City
Melbourne
State/Province
Victoria
ZIP/Postal Code
3004
Country
Australia
Facility Name
Linear Clinical Research
City
Nedlands
State/Province
Western Australia
ZIP/Postal Code
6009
Country
Australia

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
16369581
Citation
Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: a novel sedative-analgesic agent. Proc (Bayl Univ Med Cent). 2001 Jan;14(1):13-21. doi: 10.1080/08998280.2001.11927725.
Results Reference
background
PubMed Identifier
7957520
Citation
Kivisto KT, Kallio A, Neuvonen PJ. Pharmacokinetics and pharmacodynamics of transdermal dexmedetomidine. Eur J Clin Pharmacol. 1994;46(4):345-9. doi: 10.1007/BF00194403.
Results Reference
background
PubMed Identifier
11867405
Citation
Nemethy M, Paroli L, Williams-Russo PG, Blanck TJ. Assessing sedation with regional anesthesia: inter-rater agreement on a modified Wilson sedation scale. Anesth Analg. 2002 Mar;94(3):723-8; table of contents. doi: 10.1097/00000539-200203000-00045.
Results Reference
background
PubMed Identifier
22227789
Citation
American Society of Anesthesiologists Task Force on Acute Pain Management. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on Acute Pain Management. Anesthesiology. 2012 Feb;116(2):248-73. doi: 10.1097/ALN.0b013e31823c1030. No abstract available.
Results Reference
background

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Dexmedetomidine Transdermal System (DMTS) for Post-Operative Analgesia Following Bunionectomy

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