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Tramadol Versus Placebo in the Management of Postoperative Pain Following Bunionectomy

Primary Purpose

Pain Management

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Tramadol
Placebo
Sponsored by
Avenue Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pain Management

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

  • The patient is male or female 18-75 years of age undergoing unilateral first metatarsal bunionectomy surgery
  • Willing to give consent and able to understand the study procedures
  • Female patients must be of non-childbearing potential or be practicing a highly effective contraception
  • The patient must be willing to be housed in a healthcare facility and able to receive parenteral analgesia for at least 72 hours after surgery.
  • The patient meets definition of American Society of Anesthesiologists (ASA) Physical Class 1, or 2.

Exclusion Criteria:

  • Patient is not expected to receive a continuous infusion nerve block as described in the Post-Op anesthetic procedures protocol
  • Patient is undergoing bilateral or revision bunionectomy surgery
  • The patient has allergy or hypersensitivity (or is intolerant) to opioids or tramadol The patient has known physical dependence on opioids
  • The patient has taken other prior/concurrent chronic medications that have not been at a stable dose for at least 2 weeks prior to screening
  • The patient is taking herbal or dietary supplements or medications that are moderate or strong inhibitors of CYP2D6 or CYP3A4 or inducers of CYP3A4
  • The patient has taken monoamine oxidase (MAO) inhibitors, trazodone, or cyclobenzaprine within 14 days prior to surgery
  • The patient cannot be withdrawn from medications (at least 7 days prior to surgery) that may lower the seizure threshold (e.g. anti-psychotic agents, MAOI inhibitors) or which increase serotonergic tone (e.g. selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, triptans).
  • The patient has a history of epilepsy, or is known to be susceptible to seizures
  • The patient has a history of Long QT Syndrome or a relative with this condition
  • The patient has expressed suicidal ideation or is considered to be at risk of suicide.
  • The patient is morbidly obese (body mass index [BMI] ≥ 40 kg/m2) or has documented sleep apnea requiring pharmacological or device intervention.
  • Clinically significant abnormalities in the judgement of the Investigator
  • The patient was administered an investigational product within 30 days prior to Screening.
  • The patient has previously participated in a clinical study with AVE-901.

Sites / Locations

  • Trovare Clinical Research
  • Lotus Clinical Research
  • Cheseapeake Research Group, LLC
  • H.D. Research Corporation
  • Endeavor Clinical Trials, PA

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Active Comparator

Placebo Comparator

Arm Label

AVE-901 50 mg

AVE-901 25 mg

Placebo

Arm Description

Outcomes

Primary Outcome Measures

The Sum of Pain Intensity Differences (SPID) Through 48 Hours Post First Dose
Pain intensity was recorded using the Numerical Pain Rating Scale (NPRS) from 0 to 10, where 0 was no pain and 10 was the worst pain imaginable at hrs: .5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30, 32, 34, 36, 38, 40, 42, 44, 46, 48. As higher pain scores indicate worse pain, a negative Pain Intensity Difference (PID) indicates less pain (improvement from baseline). Thus, SPID scores are expected to be negative if a patient's pain decreases over time, with the lower SPID values indicating greater reduction in pain intensity.

Secondary Outcome Measures

Full Information

First Posted
September 19, 2017
Last Updated
March 11, 2020
Sponsor
Avenue Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03290378
Brief Title
Tramadol Versus Placebo in the Management of Postoperative Pain Following Bunionectomy
Official Title
A Phase 3, Multicenter, Randomized, Double Blind, Three-Arm Study to Evaluate the Efficacy and Safety of Tramadol Infusion (AVE-901) Versus Placebo in the Management of Postoperative Pain Following Bunionectomy
Study Type
Interventional

2. Study Status

Record Verification Date
September 2019
Overall Recruitment Status
Completed
Study Start Date
September 19, 2017 (Actual)
Primary Completion Date
April 11, 2018 (Actual)
Study Completion Date
April 23, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Avenue Therapeutics, Inc.

4. Oversight

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

5. Study Description

Brief Summary
The study evaluates the effectiveness and safety of IV tramadol compared to placebo managing postoperative pain following a bunionectomy
Detailed Description
(Non-clinical summary) Tramadol is a centrally-acting synthetic analgesic of the aminocyclohexanol group with opioidlike effects. Tramadol is extensively metabolized following administration, which results in a number of enantiomeric metabolites that display different opioid-receptor binding properties, and monoaminergic reuptake inhibition.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
409 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AVE-901 50 mg
Arm Type
Active Comparator
Arm Title
AVE-901 25 mg
Arm Type
Active Comparator
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Tramadol
Intervention Description
IV; 25 mg or 50 mg, given at Hours 0, 2, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, and 44
Intervention Type
Other
Intervention Name(s)
Placebo
Intervention Description
IV; Placebo, given at Hours 0, 2, 4, 8, 12, 16, 20, 24, 28, 32, 36, 40, and 44
Primary Outcome Measure Information:
Title
The Sum of Pain Intensity Differences (SPID) Through 48 Hours Post First Dose
Description
Pain intensity was recorded using the Numerical Pain Rating Scale (NPRS) from 0 to 10, where 0 was no pain and 10 was the worst pain imaginable at hrs: .5, 1, 2, 3, 4, 5, 6, 8, 10, 12, 14, 16, 18, 20, 22, 24, 26, 28, 30, 32, 34, 36, 38, 40, 42, 44, 46, 48. As higher pain scores indicate worse pain, a negative Pain Intensity Difference (PID) indicates less pain (improvement from baseline). Thus, SPID scores are expected to be negative if a patient's pain decreases over time, with the lower SPID values indicating greater reduction in pain intensity.
Time Frame
48 hours post first dose

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: The patient is male or female 18-75 years of age undergoing unilateral first metatarsal bunionectomy surgery Willing to give consent and able to understand the study procedures Female patients must be of non-childbearing potential or be practicing a highly effective contraception The patient must be willing to be housed in a healthcare facility and able to receive parenteral analgesia for at least 72 hours after surgery. The patient meets definition of American Society of Anesthesiologists (ASA) Physical Class 1, or 2. Exclusion Criteria: Patient is not expected to receive a continuous infusion nerve block as described in the Post-Op anesthetic procedures protocol Patient is undergoing bilateral or revision bunionectomy surgery The patient has allergy or hypersensitivity (or is intolerant) to opioids or tramadol The patient has known physical dependence on opioids The patient has taken other prior/concurrent chronic medications that have not been at a stable dose for at least 2 weeks prior to screening The patient is taking herbal or dietary supplements or medications that are moderate or strong inhibitors of CYP2D6 or CYP3A4 or inducers of CYP3A4 The patient has taken monoamine oxidase (MAO) inhibitors, trazodone, or cyclobenzaprine within 14 days prior to surgery The patient cannot be withdrawn from medications (at least 7 days prior to surgery) that may lower the seizure threshold (e.g. anti-psychotic agents, MAOI inhibitors) or which increase serotonergic tone (e.g. selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, triptans). The patient has a history of epilepsy, or is known to be susceptible to seizures The patient has a history of Long QT Syndrome or a relative with this condition The patient has expressed suicidal ideation or is considered to be at risk of suicide. The patient is morbidly obese (body mass index [BMI] ≥ 40 kg/m2) or has documented sleep apnea requiring pharmacological or device intervention. Clinically significant abnormalities in the judgement of the Investigator The patient was administered an investigational product within 30 days prior to Screening. The patient has previously participated in a clinical study with AVE-901.
Facility Information:
Facility Name
Trovare Clinical Research
City
Bakersfield
State/Province
California
ZIP/Postal Code
93301
Country
United States
Facility Name
Lotus Clinical Research
City
Pasadena
State/Province
California
ZIP/Postal Code
91105
Country
United States
Facility Name
Cheseapeake Research Group, LLC
City
Pasadena
State/Province
Maryland
ZIP/Postal Code
21122
Country
United States
Facility Name
H.D. Research Corporation
City
Houston
State/Province
Texas
ZIP/Postal Code
77004
Country
United States
Facility Name
Endeavor Clinical Trials, PA
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
32683644
Citation
Singla NK, Pollak R, Gottlieb I, Leiman D, Minkowitz H, Zimmerman J, Harnett M, Ryan M, Lu L, Reines S. Efficacy and Safety of Intravenously Administered Tramadol in Patients with Moderate to Severe Pain Following Bunionectomy: A Randomized, Double-Blind, Placebo-Controlled, Dose-Finding Study. Pain Ther. 2020 Dec;9(2):545-562. doi: 10.1007/s40122-020-00184-2. Epub 2020 Jul 18.
Results Reference
derived

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Tramadol Versus Placebo in the Management of Postoperative Pain Following Bunionectomy

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