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A Controlled Study to Determine the Efficacy and Safety of CL-108 5 mg for Acute Pain and the Prevention of OINV

Primary Purpose

Pain, Nausea, Vomiting

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
CL-108 5 mg
Norco
Placebo
Sponsored by
Charleston Laboratories, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Pain focused on measuring Pain, Nausea, Vomiting

Eligibility Criteria

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

Inclusion Criteria:

  • Informed consent: Signed informed consent form obtained at screening prior to any procedures being performed.
  • Gender: Male or non-pregnant and non-lactating female.
  • Age: 18 years or older at time of consent.
  • Foot condition: Primary unilateral first metatarsal bunionectomy (osteotomy and internal fixation) with no additional collateral procedures.
  • Pain Severity: Presence of moderate or severe pain on a categorical pain intensity scale at Baseline
  • Pain Confirmation: On the 0-10 numerical pain intensity scale at Baseline.
  • Diary Completion: Be willing and able to record safety and efficacy ratings in the Diaries.
  • Safe Transportation Home: Patient must have arrangements for transportation home from the research center accompanied by a responsible adult.

Exclusion Criteria:

  • Medical condition: Presence of a serious medical condition, intolerance to NSAIDs, or any other medical condition which, in the opinion of the Investigator, makes the patient unsuitable for participation.
  • Infection: Acute infection of the surgical site at the time of surgery that could confound post-surgical evaluation.
  • Drug Allergy: History of hypersensitivity to an opioid drug (such as hydrocodone), promethazine, acetaminophen, NSAID (such as ibuprofen or aspirin), midazolam, propofol, mepivacaine, ropivacaine or ketorolac.
  • Confounding and Contraindicated Drugs: Other than protocol-permitted medications administered pre-operatively or during surgery: use within 14 days before or during the surgical procedure of any systemic corticosteroid or use within 24 hours or during the surgical procedure of any confounding prescription or non-prescription drug or any drug contraindicated with hydrocodone, acetaminophen, or promethazine. [Note: Antibiotic for endocarditis prophylaxis (except if known to cause nausea) and aspirin (ASA) ≤ 325 mg for cardiovascular prophylaxis are permitted during the study.] History of consuming more than 2 alcoholic drinks per day every day for the last month or a positive urine test for opiates, benzodiazepines, barbiturates, tetrahydrocannabinol, methamphetamines, cocaine, oxycodone, cotinine at screening or the morning of surgery will exclude the patient from the trial.
  • Investigational Drug Use: Use of an investigational drug within the past 30 days.
  • Participated in Study: Previous participation in this study.
  • Pregnancy, Lactation: Women who are pregnant or lactating.
  • Compliance: Inability to swallow capsules whole.
  • Participant relationship: Employee at the research center, employee of the Principal Investigator, Sub-Investigators, or sponsor or relative of the Investigator, Sub-Investigators or research staff who is involved in this study.

Sites / Locations

  • Arizona Research Center
  • Chesapeake
  • Optimal Research
  • Endeavor Clinical Research
  • Jean Brown Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Placebo Comparator

Arm Label

CL-108 5 mg

Norco

Placebo

Arm Description

Hydrocodone 5 mg/APAP 325 mg/promethazine 12.5 mg (CL-108 5 mg) bi-layered tablet

hydrocodone 5 mg/APAP 325 mg

Placebo 0 mg matching CL-108

Outcomes

Primary Outcome Measures

Percentage of Participants With OINV Over 48 Hours
Number and Percentage of participants With opioid-induced nausea and vomiting (OINV) who experienced any Vomiting / use of Anti-Emetic Medication Over 48 Hours
The Sum of Pain Intensity Differences (on PI-NRS) Over 48 Hours (SPID48)
The SPID48 endpoint is calculated from the PI-NRS values at baseline, every 30 minutes until hour 12, then every hour (when awake) until hour 48 as follows: Each subsequent PI-NRS value is subtracted from the baseline PI-NRS value. Each difference is weighted by the elapsed time from the previous PI-NRS value to the current one. The weighed differences are summed to yield the SPID48. Summed pain intensity differences over 48 hours (SPID48) will be compared for patients treated with CL-108 5 mg and those treated with placebo. Pain intensity will be measured on a 0-10 Pain Intensity Numerical Rating Scale (PI-NRS), where 0 is "no pain" and 10 is "severe pain".

Secondary Outcome Measures

Percentage of Patients With Complete Absence of OINV (no Nausea, no Vomiting, and no Use of Anti-emetic Medication) Over 48 Hours
Percentage of patients with complete absence of OINV (no nausea, no vomiting, and no use of anti-emetic medication) over 48 hours comparing CL-108 5 mg to hydrocodone 5 mg/APAP 325 mg)
Percentage of Patients With Any Vomiting Over 48 Hours
Percentage of patients with any vomiting over 48 hours, comparing CL-108 5 mg to hydrocodone 5 mg/APAP 325 mg
Percentage of Patients With Any Nausea Over 48 Hours
Percentage of patients with any nausea over 48 hours, comparing CL-108 5 mg to hydrocodone 5 mg/APAP 325 mg
Percentage of Patients With Any Nausea or Vomiting Over 48 Hours
Percentage of patients with any nausea or vomiting over 48 hours, comparing CL-108 5 mg to hydrocodone 5 mg/APAP 325 mg
Percentage of Patients With Any Post-discharge Nausea and Vomiting (PDNV)
Percentage of patients with any Post-discharge Nausea and Vomiting (PDNV) over Days 3 to 7
Number of Doses of Study Medication Taken Over Days 3to7
Number of doses of study medication taken over Days 3 to 7
Number of Doses of Study Medication Taken Per Day Over Days 3to7
Number of doses of study medication taken per day over Days 3 to 7

Full Information

First Posted
December 5, 2017
Last Updated
February 24, 2023
Sponsor
Charleston Laboratories, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT03657810
Brief Title
A Controlled Study to Determine the Efficacy and Safety of CL-108 5 mg for Acute Pain and the Prevention of OINV
Official Title
A Randomized, Double-Blind, Placebo- and Active-Controlled Study to Determine the Efficacy and Safety of CL-108 5 mg (Hydrocodone 5 mg/Acetaminophen 325 mg/Promethazine 12.5 mg) as a Treatment for Moderate-to-Severe Acute Pain and the Prevention of Opioid-Induced Nausea and Vomiting (OINV) Following Orthopedic Surgery
Study Type
Interventional

2. Study Status

Record Verification Date
February 2023
Overall Recruitment Status
Completed
Study Start Date
August 2, 2017 (Actual)
Primary Completion Date
April 16, 2018 (Actual)
Study Completion Date
November 30, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Charleston Laboratories, 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
To determine the analgesic efficacy of CL-108 5 mg by comparison with placebo and the anti-emetic efficacy of CL-108 5 mg by comparison with hydrocodone 5 mg/acetaminophen 325 mg.
Detailed Description
Adult patients with moderate or severe pain after bunionectomy will be randomized to CL-108 5 mg (hydrocodone 5 mg/acetaminophen 325 mg/ promethazine 12.5 mg), hydrocodone 5 mg/ acetaminophen 325 mg, or placebo under double-blind conditions. Over 48 hours they will use the assigned study medication and assess pain intensity, nausea, and vomiting. Uses of supplementary analgesic and antiemetic medications will be documented. Patient responses and adverse effects will also be documented during the 5-day outpatient period, too.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pain, Nausea, Vomiting
Keywords
Pain, Nausea, Vomiting

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
349 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CL-108 5 mg
Arm Type
Experimental
Arm Description
Hydrocodone 5 mg/APAP 325 mg/promethazine 12.5 mg (CL-108 5 mg) bi-layered tablet
Arm Title
Norco
Arm Type
Active Comparator
Arm Description
hydrocodone 5 mg/APAP 325 mg
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo 0 mg matching CL-108
Intervention Type
Drug
Intervention Name(s)
CL-108 5 mg
Other Intervention Name(s)
hydrocodone bitartrate/ acetaminophen/ promethazine hydrochloride
Intervention Description
hydrocodone 5 mg/APAP 325 mg/promethazine 12.5 mg
Intervention Type
Drug
Intervention Name(s)
Norco
Other Intervention Name(s)
hydrocodone bitartrate/ acetaminophen
Intervention Description
hydrocodone 5 mg/APAP 325 mg
Intervention Type
Drug
Intervention Name(s)
Placebo
Other Intervention Name(s)
Matching Placebo
Intervention Description
Placebo matching CL-108
Primary Outcome Measure Information:
Title
Percentage of Participants With OINV Over 48 Hours
Description
Number and Percentage of participants With opioid-induced nausea and vomiting (OINV) who experienced any Vomiting / use of Anti-Emetic Medication Over 48 Hours
Time Frame
Up to 48 hours
Title
The Sum of Pain Intensity Differences (on PI-NRS) Over 48 Hours (SPID48)
Description
The SPID48 endpoint is calculated from the PI-NRS values at baseline, every 30 minutes until hour 12, then every hour (when awake) until hour 48 as follows: Each subsequent PI-NRS value is subtracted from the baseline PI-NRS value. Each difference is weighted by the elapsed time from the previous PI-NRS value to the current one. The weighed differences are summed to yield the SPID48. Summed pain intensity differences over 48 hours (SPID48) will be compared for patients treated with CL-108 5 mg and those treated with placebo. Pain intensity will be measured on a 0-10 Pain Intensity Numerical Rating Scale (PI-NRS), where 0 is "no pain" and 10 is "severe pain".
Time Frame
Up to 48 hours
Secondary Outcome Measure Information:
Title
Percentage of Patients With Complete Absence of OINV (no Nausea, no Vomiting, and no Use of Anti-emetic Medication) Over 48 Hours
Description
Percentage of patients with complete absence of OINV (no nausea, no vomiting, and no use of anti-emetic medication) over 48 hours comparing CL-108 5 mg to hydrocodone 5 mg/APAP 325 mg)
Time Frame
Up to 48 hours
Title
Percentage of Patients With Any Vomiting Over 48 Hours
Description
Percentage of patients with any vomiting over 48 hours, comparing CL-108 5 mg to hydrocodone 5 mg/APAP 325 mg
Time Frame
Up to 48 hours
Title
Percentage of Patients With Any Nausea Over 48 Hours
Description
Percentage of patients with any nausea over 48 hours, comparing CL-108 5 mg to hydrocodone 5 mg/APAP 325 mg
Time Frame
Up to 48 hours
Title
Percentage of Patients With Any Nausea or Vomiting Over 48 Hours
Description
Percentage of patients with any nausea or vomiting over 48 hours, comparing CL-108 5 mg to hydrocodone 5 mg/APAP 325 mg
Time Frame
Up to 48 hours
Title
Percentage of Patients With Any Post-discharge Nausea and Vomiting (PDNV)
Description
Percentage of patients with any Post-discharge Nausea and Vomiting (PDNV) over Days 3 to 7
Time Frame
Day 3 to 7
Title
Number of Doses of Study Medication Taken Over Days 3to7
Description
Number of doses of study medication taken over Days 3 to 7
Time Frame
Day3 to Day7
Title
Number of Doses of Study Medication Taken Per Day Over Days 3to7
Description
Number of doses of study medication taken per day over Days 3 to 7
Time Frame
Day3 to Day7

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Informed consent: Signed informed consent form obtained at screening prior to any procedures being performed. Gender: Male or non-pregnant and non-lactating female. Age: 18 years or older at time of consent. Foot condition: Primary unilateral first metatarsal bunionectomy (osteotomy and internal fixation) with no additional collateral procedures. Pain Severity: Presence of moderate or severe pain on a categorical pain intensity scale at Baseline Pain Confirmation: On the 0-10 numerical pain intensity scale at Baseline. Diary Completion: Be willing and able to record safety and efficacy ratings in the Diaries. Safe Transportation Home: Patient must have arrangements for transportation home from the research center accompanied by a responsible adult. Exclusion Criteria: Medical condition: Presence of a serious medical condition, intolerance to NSAIDs, or any other medical condition which, in the opinion of the Investigator, makes the patient unsuitable for participation. Infection: Acute infection of the surgical site at the time of surgery that could confound post-surgical evaluation. Drug Allergy: History of hypersensitivity to an opioid drug (such as hydrocodone), promethazine, acetaminophen, NSAID (such as ibuprofen or aspirin), midazolam, propofol, mepivacaine, ropivacaine or ketorolac. Confounding and Contraindicated Drugs: Other than protocol-permitted medications administered pre-operatively or during surgery: use within 14 days before or during the surgical procedure of any systemic corticosteroid or use within 24 hours or during the surgical procedure of any confounding prescription or non-prescription drug or any drug contraindicated with hydrocodone, acetaminophen, or promethazine. [Note: Antibiotic for endocarditis prophylaxis (except if known to cause nausea) and aspirin (ASA) ≤ 325 mg for cardiovascular prophylaxis are permitted during the study.] History of consuming more than 2 alcoholic drinks per day every day for the last month or a positive urine test for opiates, benzodiazepines, barbiturates, tetrahydrocannabinol, methamphetamines, cocaine, oxycodone, cotinine at screening or the morning of surgery will exclude the patient from the trial. Investigational Drug Use: Use of an investigational drug within the past 30 days. Participated in Study: Previous participation in this study. Pregnancy, Lactation: Women who are pregnant or lactating. Compliance: Inability to swallow capsules whole. Participant relationship: Employee at the research center, employee of the Principal Investigator, Sub-Investigators, or sponsor or relative of the Investigator, Sub-Investigators or research staff who is involved in this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Bernard Schachtel, MD
Organizational Affiliation
Charleston Laboratories, Inc
Official's Role
Study Director
Facility Information:
Facility Name
Arizona Research Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85023
Country
United States
Facility Name
Chesapeake
City
Pasadena
State/Province
Maryland
ZIP/Postal Code
21122
Country
United States
Facility Name
Optimal Research
City
Austin
State/Province
Texas
ZIP/Postal Code
78705
Country
United States
Facility Name
Endeavor Clinical Research
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78240
Country
United States
Facility Name
Jean Brown Research
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84124
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Links:
URL
http://www.charlestonlabs.com
Description
Charleston Website

Learn more about this trial

A Controlled Study to Determine the Efficacy and Safety of CL-108 5 mg for Acute Pain and the Prevention of OINV

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