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Phase 2B Upper Extremity Nerve Block Study

Primary Purpose

Postoperative Pain

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
HTX-011
Bupivacaine HCl without epinephrine
Saline Placebo
Sponsored by
Heron Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Postoperative Pain

Eligibility Criteria

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

Inclusion Criteria:

  • Is scheduled to undergo primary bilateral submuscular augmentation mammoplasty with saline or silicone smooth implants with a volume of 300 to 500 cc, inclusive. Note: textured implants are not allowed.
  • Has an American Society of Anesthesiologists Physical Status of I, II, or III.
  • Subjects are eligible only if not pregnant, not lactating, not planning to become pregnant during the study, sterile; or using acceptable contraceptives.

Exclusion Criteria:

  • Has a planned concurrent surgical procedure.
  • Has a planned reconstructive procedure status post breast cancer therapy.
  • Has a pre-existing concurrent acute or chronic painful physical/restrictive condition expected to require analgesic treatment in the postoperative period for pain.
  • Has a contraindication or a known or suspected history of hypersensitivity or clinically significant idiosyncratic reaction to required study medication.
  • Has known or suspected daily use of opioids for 7 or more consecutive days within the previous 6 months.
  • Has taken NSAIDs within 10 days prior to scheduled surgery.
  • Has been administered bupivacaine within 5 days prior to the scheduled surgery.
  • Has been administered any local anesthetic within 72 hours prior to the scheduled surgery other than to treat an AE that occurs after signing the ICF or for pretreatment prior to a needle placement.
  • Has initiated treatment with any of the following medications within 1 month prior to study drug administration or is taking any of these medications to control pain: selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), gabapentin, pregabalin, duloxetine, or cyclooxygenase-2 (COX-2) inhibitors. (Note: If a subject is taking one of these medications for a reason other than pain control, she must be on a stable scheduled dose [ie, not "as needed"] for at least 1 month prior to study drug administration.) Anxiolytics prior to surgery are permitted, if necessary.
  • Has a medical condition that, in the opinion of the Investigator, participating in the study would pose a health risk to the subject or confound the postoperative assessments.
  • Has a known history of Hepatitis B, Hepatitis C, or human immunodeficiency virus (HIV).
  • Has uncontrolled anxiety, psychiatric, or neurological disorder that might interfere with study assessments
  • Has any chronic neuromuscular deficit of either pectoral nerve function or arm/shoulder/truncal musculature.
  • Has any chronic condition or disease that would compromise neurological or vascular assessments.
  • Had a malignancy in the last year, with the exception of non-metastatic basal cell or squamous cell carcinoma of the skin or localized carcinoma in situ of the cervix.
  • Has a known or suspected history of drug abuse, a positive drug screen on the day of surgery, or a recent history of alcohol abuse. Note: Subjects with a positive drug screen who are taking an allowed, prescribed medication that is known to result in a positive drug test (eg, amphetamine and dextroamphetamine for attention-deficit/hyperactivity disorder, benzodiazepine for anxiety disorder) may be eligible for participation in the study. Subjects taking medical marijuana are not allowed to participate in the study.
  • Received an investigational product or device in a clinical trial within 30 days or within 5 elimination half lives.
  • Has undergone 3 or more surgeries in 12 months.
  • Has a body mass index (BMI) >35 kg/m2.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm Type

Experimental

Experimental

Experimental

Experimental

Experimental

Active Comparator

Placebo Comparator

Arm Label

Group 1: HTX-011

Group 2: HTX-011

Group 3: HTX-011

Group 4: HTX-011

Group 5: HTX-011

Group 6: Bupivacaine HCl

Group 7: Saline Placebo

Arm Description

HTX-011 (bupivacaine/meloxicam), 60 mg/1.8 mg via nerve block.

HTX-011(bupivacaine/meloxicam), 120 mg/3.6 mg via nerve block.

HTX-011(bupivacaine/meloxicam), 240 mg/7.2 mg via nerve block.

HTX-011 (bupivacaine/meloxicam), 400 mg/12 mg via nerve block.

HTX-011 (bupivacaine/meloxicam), 400 mg/ 12 mg via instillation.

Bupivacaine HCl without epinephrine, 50 mg via nerve block.

Saline placebo via nerve block.

Outcomes

Primary Outcome Measures

Mean Area Under the Curve (AUC) of the NRS-A (Windowed Worst Observation Carried Forward) Pain Intensity Scores
Pain intensity scores are assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable". NRS scores are recorded with activity (NRS-A), raising the hands above the head (with wrists above the crown of the head) for at least 5 seconds.

Secondary Outcome Measures

Mean Total Postoperative Opioid Consumption (in Morphine Equivalents)

Full Information

First Posted
January 3, 2017
Last Updated
October 1, 2021
Sponsor
Heron Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT03011333
Brief Title
Phase 2B Upper Extremity Nerve Block Study
Official Title
A Phase 2B, Randomized, Controlled Study of HTX-011 Administered Via Pectoral Nerve Block in Subjects Undergoing Upper Extremity Surgery for Augmentation Mammoplasty
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
January 14, 2017 (Actual)
Primary Completion Date
February 1, 2018 (Actual)
Study Completion Date
March 19, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Heron Therapeutics

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This is a Phase 2B, randomized, assessor-blind, active- and saline placebo-controlled, multicenter study in subjects undergoing augmentation mammoplasty to evaluate the analgesic efficacy, safety, and pharmacokinetics (PK) of HTX-011 when administered via ultrasound-guided lateral and medial pectoral nerve block before surgery.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Postoperative Pain

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
243 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1: HTX-011
Arm Type
Experimental
Arm Description
HTX-011 (bupivacaine/meloxicam), 60 mg/1.8 mg via nerve block.
Arm Title
Group 2: HTX-011
Arm Type
Experimental
Arm Description
HTX-011(bupivacaine/meloxicam), 120 mg/3.6 mg via nerve block.
Arm Title
Group 3: HTX-011
Arm Type
Experimental
Arm Description
HTX-011(bupivacaine/meloxicam), 240 mg/7.2 mg via nerve block.
Arm Title
Group 4: HTX-011
Arm Type
Experimental
Arm Description
HTX-011 (bupivacaine/meloxicam), 400 mg/12 mg via nerve block.
Arm Title
Group 5: HTX-011
Arm Type
Experimental
Arm Description
HTX-011 (bupivacaine/meloxicam), 400 mg/ 12 mg via instillation.
Arm Title
Group 6: Bupivacaine HCl
Arm Type
Active Comparator
Arm Description
Bupivacaine HCl without epinephrine, 50 mg via nerve block.
Arm Title
Group 7: Saline Placebo
Arm Type
Placebo Comparator
Arm Description
Saline placebo via nerve block.
Intervention Type
Drug
Intervention Name(s)
HTX-011
Intervention Description
HTX-011 (bupivacaine/meloxicam) via nerve block or instillation.
Intervention Type
Drug
Intervention Name(s)
Bupivacaine HCl without epinephrine
Intervention Description
Bupivacaine HCl without epinephrine, 50 mg via nerve block.
Intervention Type
Drug
Intervention Name(s)
Saline Placebo
Intervention Description
Saline placebo via nerve block.
Primary Outcome Measure Information:
Title
Mean Area Under the Curve (AUC) of the NRS-A (Windowed Worst Observation Carried Forward) Pain Intensity Scores
Description
Pain intensity scores are assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable". NRS scores are recorded with activity (NRS-A), raising the hands above the head (with wrists above the crown of the head) for at least 5 seconds.
Time Frame
24 hours
Secondary Outcome Measure Information:
Title
Mean Total Postoperative Opioid Consumption (in Morphine Equivalents)
Time Frame
72 Hours

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Is scheduled to undergo primary bilateral submuscular augmentation mammoplasty with saline or silicone smooth implants with a volume of 300 to 500 cc, inclusive. Note: textured implants are not allowed. Has an American Society of Anesthesiologists Physical Status of I, II, or III. Subjects are eligible only if not pregnant, not lactating, not planning to become pregnant during the study, sterile; or using acceptable contraceptives. Exclusion Criteria: Has a planned concurrent surgical procedure. Has a planned reconstructive procedure status post breast cancer therapy. Has a pre-existing concurrent acute or chronic painful physical/restrictive condition expected to require analgesic treatment in the postoperative period for pain. Has a contraindication or a known or suspected history of hypersensitivity or clinically significant idiosyncratic reaction to required study medication. Has known or suspected daily use of opioids for 7 or more consecutive days within the previous 6 months. Has taken NSAIDs within 10 days prior to scheduled surgery. Has been administered bupivacaine within 5 days prior to the scheduled surgery. Has been administered any local anesthetic within 72 hours prior to the scheduled surgery other than to treat an AE that occurs after signing the ICF or for pretreatment prior to a needle placement. Has initiated treatment with any of the following medications within 1 month prior to study drug administration or is taking any of these medications to control pain: selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), gabapentin, pregabalin, duloxetine, or cyclooxygenase-2 (COX-2) inhibitors. (Note: If a subject is taking one of these medications for a reason other than pain control, she must be on a stable scheduled dose [ie, not "as needed"] for at least 1 month prior to study drug administration.) Anxiolytics prior to surgery are permitted, if necessary. Has a medical condition that, in the opinion of the Investigator, participating in the study would pose a health risk to the subject or confound the postoperative assessments. Has a known history of Hepatitis B, Hepatitis C, or human immunodeficiency virus (HIV). Has uncontrolled anxiety, psychiatric, or neurological disorder that might interfere with study assessments Has any chronic neuromuscular deficit of either pectoral nerve function or arm/shoulder/truncal musculature. Has any chronic condition or disease that would compromise neurological or vascular assessments. Had a malignancy in the last year, with the exception of non-metastatic basal cell or squamous cell carcinoma of the skin or localized carcinoma in situ of the cervix. Has a known or suspected history of drug abuse, a positive drug screen on the day of surgery, or a recent history of alcohol abuse. Note: Subjects with a positive drug screen who are taking an allowed, prescribed medication that is known to result in a positive drug test (eg, amphetamine and dextroamphetamine for attention-deficit/hyperactivity disorder, benzodiazepine for anxiety disorder) may be eligible for participation in the study. Subjects taking medical marijuana are not allowed to participate in the study. Received an investigational product or device in a clinical trial within 30 days or within 5 elimination half lives. Has undergone 3 or more surgeries in 12 months. Has a body mass index (BMI) >35 kg/m2.
Facility Information:
City
Pasadena
State/Province
California
ZIP/Postal Code
91105
Country
United States
City
Houston
State/Province
Texas
ZIP/Postal Code
77027
Country
United States

12. IPD Sharing Statement

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Phase 2B Upper Extremity Nerve Block Study

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