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Study in Adult Subjects Undergoing Posterolateral Thoracotomy

Primary Purpose

Postoperative Pain Management

Status
Terminated
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
EXPAREL
Sponsored by
Pacira Pharmaceuticals, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Postoperative Pain Management

Eligibility Criteria

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

Inclusion Criteria:

  1. Males or females ≥18 years of age.
  2. American Society of Anesthesiologists (ASA) physical status 1, 2, or 3.
  3. Scheduled to undergo chest surgery using either minimally invasive (VATS or robotic-assisted surgery) or open techniques (posterolateral, lateral, or anterior thoracotomy or requiring insertion of an inter-rib spreader/retractor) for a primary thoracic non-infectious indication under general anesthesia.
  4. Able to provide informed consent, adhere to the study schedule, and complete all study assessments.

Exclusion Criteria:

  1. Currently pregnant, nursing, or planning to become pregnant during the study or within 1 month after study drug administration. Female subjects must be surgically sterile, at least 2 years menopausal, or using an acceptable method of birth control. If of childbearing potential, the subject must have a documented negative pregnancy test within 24 hours before surgery.
  2. Prior ipsilateral thoracotomy (the likely presence of adhesions will limit ability to perform a precise block guided by thoracoscopy). Note: previous VATS or robotic surgery is permissible.
  3. Any planned pleurodesis as part of the surgical procedure.
  4. Redo ipsilateral thoracotomy
  5. Received bupivacaine or any other local anesthetic within 7 days of screening.
  6. Body weight < 50 kilograms (110 pounds) or a body mass index ≥ 35 kg/m2.
  7. History of hypersensitivity or idiosyncratic reactions to amide-type local anesthetics or opioids.
  8. Previous participation in a liposome bupivacaine study.
  9. History of, suspected, or known addiction to or abuse of illicit drug(s), prescription medicine(s), or alcohol within the past 2 years.
  10. Uncontrolled anxiety, schizophrenia, or other psychiatric disorder that, in the opinion of the investigator, could interfere with study assessments or compliance.
  11. Significant medical conditions (including widely disseminated metastatic disease) or laboratory results that, in the opinion of the investigator, indicate an increased vulnerability to study drugs and procedures.
  12. History of coronary or vascular stent placed within the past 3 months (may be extended to 1 year if medically indicated per physician discretion).
  13. Have been treated for a deep vein thrombosis, pulmonary embolism, myocardial infarction, or ischemic stroke within the past 6 months (may be extended to 1 year if medically indicated per physician discretion).
  14. Severely impaired renal or hepatic function (eg, serum creatinine level > 2 mg/dL [176.8 μmol/L], blood urea nitrogen level >50 mg/dL [17.9 mmol/L], serum aspartate aminotransferase [AST] level >3 times the upper limit of normal [ULN], or serum alanine aminotransferase [ALT] level > 3 times ULN).

Sites / Locations

  • MD Anderson Cancer Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

EXPAREL 20 + 20

EXPAREL 20 + 10

Arm Description

20 mL EXPAREL with 20 mL normal saline

20 mL EXPAREL with 10 mL normal saline

Outcomes

Primary Outcome Measures

AUC of EXPAREL concentration
Area under the concentration curve for EXPAREL

Secondary Outcome Measures

Incidence of treatment-emergent adverse events
Incidence to treatment-emergent adverse events through 14 days

Full Information

First Posted
February 5, 2018
Last Updated
February 4, 2019
Sponsor
Pacira Pharmaceuticals, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT03428984
Brief Title
Study in Adult Subjects Undergoing Posterolateral Thoracotomy
Official Title
A Phase 1, Open-Label Study to Evaluate the Safety and Pharmacokinetics of EXPAREL When Administered for Postsurgical Analgesia in Subjects Undergoing Posterolateral Thoracotomy
Study Type
Interventional

2. Study Status

Record Verification Date
February 2019
Overall Recruitment Status
Terminated
Why Stopped
Slow study enrollment
Study Start Date
May 3, 2018 (Actual)
Primary Completion Date
September 28, 2018 (Actual)
Study Completion Date
September 28, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Pacira Pharmaceuticals, Inc

4. Oversight

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

5. Study Description

Brief Summary
Primary Objective: To characterize the pharmacokinetic (PK) profile of EXPAREL when administered as a posterior intercostal nerve block. Secondary Objective: To assess the safety and tolerability of EXPAREL in this surgical model.
Detailed Description
This is a Phase 1, single-center, open-label study designed to evaluate the safety and PK profile of EXPAREL when administered as a posterior intercostal nerve block. Twenty-four adult subjects undergoing thoracotomy are planned for enrollment. Subjects will be screened within 30 days prior to study drug administration. During the screening visit, which must take place at least 1 day prior to surgery, subjects will be assessed for past or present neurologic, cardiac, and general medical conditions that, in the opinion of the investigator, would preclude them from study participation. Subjects will undergo their pre-planned thoracotomy procedure per the institution's standard of care. Prior to wound closure, subjects will be given either 40 mL of study drug (20 mL EXPAREL expanded with 20 mL normal saline) or 30 mL of study drug (20 mL EXPAREL expanded with 10 mL normal saline). Subjects will remain in the hospital for a minimum of 48 hours for pharmacokinetic testing and evaluation of safety. On Day 14, the subject will complete the study via phone call in order to collect safety data.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
5 (Actual)

8. Arms, Groups, and Interventions

Arm Title
EXPAREL 20 + 20
Arm Type
Experimental
Arm Description
20 mL EXPAREL with 20 mL normal saline
Arm Title
EXPAREL 20 + 10
Arm Type
Experimental
Arm Description
20 mL EXPAREL with 10 mL normal saline
Intervention Type
Drug
Intervention Name(s)
EXPAREL
Intervention Description
EXAPREL 266 mg in 20 mL
Primary Outcome Measure Information:
Title
AUC of EXPAREL concentration
Description
Area under the concentration curve for EXPAREL
Time Frame
0-72 hours
Secondary Outcome Measure Information:
Title
Incidence of treatment-emergent adverse events
Description
Incidence to treatment-emergent adverse events through 14 days
Time Frame
0-14 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Males or females ≥18 years of age. American Society of Anesthesiologists (ASA) physical status 1, 2, or 3. Scheduled to undergo chest surgery using either minimally invasive (VATS or robotic-assisted surgery) or open techniques (posterolateral, lateral, or anterior thoracotomy or requiring insertion of an inter-rib spreader/retractor) for a primary thoracic non-infectious indication under general anesthesia. Able to provide informed consent, adhere to the study schedule, and complete all study assessments. Exclusion Criteria: Currently pregnant, nursing, or planning to become pregnant during the study or within 1 month after study drug administration. Female subjects must be surgically sterile, at least 2 years menopausal, or using an acceptable method of birth control. If of childbearing potential, the subject must have a documented negative pregnancy test within 24 hours before surgery. Prior ipsilateral thoracotomy (the likely presence of adhesions will limit ability to perform a precise block guided by thoracoscopy). Note: previous VATS or robotic surgery is permissible. Any planned pleurodesis as part of the surgical procedure. Redo ipsilateral thoracotomy Received bupivacaine or any other local anesthetic within 7 days of screening. Body weight < 50 kilograms (110 pounds) or a body mass index ≥ 35 kg/m2. History of hypersensitivity or idiosyncratic reactions to amide-type local anesthetics or opioids. Previous participation in a liposome bupivacaine study. History of, suspected, or known addiction to or abuse of illicit drug(s), prescription medicine(s), or alcohol within the past 2 years. Uncontrolled anxiety, schizophrenia, or other psychiatric disorder that, in the opinion of the investigator, could interfere with study assessments or compliance. Significant medical conditions (including widely disseminated metastatic disease) or laboratory results that, in the opinion of the investigator, indicate an increased vulnerability to study drugs and procedures. History of coronary or vascular stent placed within the past 3 months (may be extended to 1 year if medically indicated per physician discretion). Have been treated for a deep vein thrombosis, pulmonary embolism, myocardial infarction, or ischemic stroke within the past 6 months (may be extended to 1 year if medically indicated per physician discretion). Severely impaired renal or hepatic function (eg, serum creatinine level > 2 mg/dL [176.8 μmol/L], blood urea nitrogen level >50 mg/dL [17.9 mmol/L], serum aspartate aminotransferase [AST] level >3 times the upper limit of normal [ULN], or serum alanine aminotransferase [ALT] level > 3 times ULN).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
David Rice, MD
Organizational Affiliation
MD Anderson
Official's Role
Principal Investigator
Facility Information:
Facility Name
MD Anderson Cancer Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

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Study in Adult Subjects Undergoing Posterolateral Thoracotomy

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