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Phase 2 Herniorrhaphy Study for Opioid Elimination

Primary Purpose

Postoperative Pain

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
HTX-011
Luer lock applicator
Vial access device
Ibuprofen
Acetaminophen
Ketorolac
Sponsored by
Heron Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional prevention trial for Postoperative Pain focused on measuring inguinal hernia, hernia, hernia surgery, postoperative pain, herniorrhaphy

Eligibility Criteria

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

Inclusion Criteria:

  • Is scheduled to undergo a unilateral open inguinal herniorrhaphy with mesh under general anesthesia.
  • Has an American Society of Anesthesiologists Physical Status of I, II, or III.
  • Female subjects are eligible only if not pregnant, not lactating, not planning to become pregnant during the study, sterile; or using acceptable contraceptives.

Exclusion Criteria:

  • Had any prior inguinal hernia repair except as a child (less than 6 years of age).
  • Has a planned concurrent surgical procedure (eg, bilateral herniorrhaphy).
  • 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 medications.
  • Has known or suspected daily use of opioids for 7 or more consecutive days within the previous 6 months.
  • Has taken any NSAIDs within least 10 days prior to the scheduled surgery.
  • Has taken long-acting opioids within 3 days prior to the scheduled surgery.
  • Has taken any opioids within 24 hours prior to the 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.
  • Has initiated treatment with study medications within 1 month prior to study drug administration that can impact pain control.
  • Has been administered systemic steroids within 5 half-lives or 10 days prior to administration of study drug.
  • Has a medical condition such that, in the opinion of the Investigator, participating in the study would pose a health risk to the subject or confound the postoperative assessments.
  • As per subject history and/or medical records, has active infection or is currently undergoing treatment for Hepatitis B, Hepatitis C, or human immunodeficiency virus (HIV).
  • Has uncontrolled anxiety, psychiatric, or neurological disorder.
  • Had a malignancy in the last year, with the exception of nonmetastatic 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 at the discretion of the Sponsor. Subjects taking any marijuana (medical or recreational) are not allowed to participate in the study.
  • Previously participated in an HTX-011 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 within 12 months.
  • Has a body mass index (BMI) >39 kg/m2.

Sites / Locations

  • Anaheim Clinical Trials, LLC
  • Lotus Clinical Research, LLC
  • JBR Clinical Research
  • JBR Clinical Research
  • JBR Clinical Research

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Cohort 1: HTX-011 + MMA Regimen

Cohort 2: HTX-011 + MMA Regimen + Ketorolac

Arm Description

HTX-011 (bupivacaine/meloxicam), 300 mg/9 mg via instillation; non-opioid multimodal analgesic (MMA) regimen.

HTX-011 (bupivacaine/meloxicam), 300 mg/9 mg via instillation; non-opioid multimodal analgesic (MMA) regimen and IV ketorolac.

Outcomes

Primary Outcome Measures

Percentage of Subjects Receiving no Opioid Rescue

Secondary Outcome Measures

Total Postoperative Opioid Consumption (in IV Morphine Milligram Equivalents [IV MME])
Percentge of Subjects Receiving no Opioid Rescue
Percentge of Subjects Receiving no Opioid Rescue
Percentge of Subjects in Severe Pain With Numeric Rating Scale (NRS-R; Windowed Worst Observation Carried Forward) of Pain Intensity Scores >7 on a Scale of 0-10 at Any Point. NRS-R for Pain Where 0 Equals no Pain and 10 Equals Worst Pain Imaginable.

Full Information

First Posted
October 1, 2018
Last Updated
October 1, 2021
Sponsor
Heron Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT03695367
Brief Title
Phase 2 Herniorrhaphy Study for Opioid Elimination
Official Title
A Phase 2, Open-Label Study of HTX 011 in a Multimodal Analgesic Regimen for Decreased Opioid Use Following Unilateral Open Inguinal Herniorrhaphy
Study Type
Interventional

2. Study Status

Record Verification Date
October 2021
Overall Recruitment Status
Completed
Study Start Date
October 1, 2018 (Actual)
Primary Completion Date
November 20, 2018 (Actual)
Study Completion Date
December 15, 2018 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
Yes

5. Study Description

Brief Summary
This is a Phase 2, open-label study in subjects undergoing unilateral open inguinal herniorrhaphy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Postoperative Pain
Keywords
inguinal hernia, hernia, hernia surgery, postoperative pain, herniorrhaphy

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 2
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
63 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1: HTX-011 + MMA Regimen
Arm Type
Experimental
Arm Description
HTX-011 (bupivacaine/meloxicam), 300 mg/9 mg via instillation; non-opioid multimodal analgesic (MMA) regimen.
Arm Title
Cohort 2: HTX-011 + MMA Regimen + Ketorolac
Arm Type
Experimental
Arm Description
HTX-011 (bupivacaine/meloxicam), 300 mg/9 mg via instillation; non-opioid multimodal analgesic (MMA) regimen and IV ketorolac.
Intervention Type
Drug
Intervention Name(s)
HTX-011
Intervention Description
HTX-011 (bupivacaine/meloxicam), 300 mg/ 9 mg via instillation.
Intervention Type
Device
Intervention Name(s)
Luer lock applicator
Intervention Description
Applicator for instillation.
Intervention Type
Device
Intervention Name(s)
Vial access device
Intervention Description
Device for withdrawal of drug product.
Intervention Type
Drug
Intervention Name(s)
Ibuprofen
Intervention Description
Ibuprofen, 600 mg.
Intervention Type
Drug
Intervention Name(s)
Acetaminophen
Intervention Description
Acetaminophen, 1 g.
Intervention Type
Drug
Intervention Name(s)
Ketorolac
Intervention Description
Intraoperative IV ketorolac.
Primary Outcome Measure Information:
Title
Percentage of Subjects Receiving no Opioid Rescue
Time Frame
72 hours
Secondary Outcome Measure Information:
Title
Total Postoperative Opioid Consumption (in IV Morphine Milligram Equivalents [IV MME])
Time Frame
72 hours
Title
Percentge of Subjects Receiving no Opioid Rescue
Time Frame
0-24 hours, 24-48 hours, 24-72 hours, 48-72 hours
Title
Percentge of Subjects Receiving no Opioid Rescue
Time Frame
Day 28
Title
Percentge of Subjects in Severe Pain With Numeric Rating Scale (NRS-R; Windowed Worst Observation Carried Forward) of Pain Intensity Scores >7 on a Scale of 0-10 at Any Point. NRS-R for Pain Where 0 Equals no Pain and 10 Equals Worst Pain Imaginable.
Time Frame
72 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Is scheduled to undergo a unilateral open inguinal herniorrhaphy with mesh under general anesthesia. Has an American Society of Anesthesiologists Physical Status of I, II, or III. Female subjects are eligible only if not pregnant, not lactating, not planning to become pregnant during the study, sterile; or using acceptable contraceptives. Exclusion Criteria: Had any prior inguinal hernia repair except as a child (less than 6 years of age). Has a planned concurrent surgical procedure (eg, bilateral herniorrhaphy). 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 medications. Has known or suspected daily use of opioids for 7 or more consecutive days within the previous 6 months. Has taken any NSAIDs within least 10 days prior to the scheduled surgery. Has taken long-acting opioids within 3 days prior to the scheduled surgery. Has taken any opioids within 24 hours prior to the 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. Has initiated treatment with study medications within 1 month prior to study drug administration that can impact pain control. Has been administered systemic steroids within 5 half-lives or 10 days prior to administration of study drug. Has a medical condition such that, in the opinion of the Investigator, participating in the study would pose a health risk to the subject or confound the postoperative assessments. As per subject history and/or medical records, has active infection or is currently undergoing treatment for Hepatitis B, Hepatitis C, or human immunodeficiency virus (HIV). Has uncontrolled anxiety, psychiatric, or neurological disorder. Had a malignancy in the last year, with the exception of nonmetastatic 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 at the discretion of the Sponsor. Subjects taking any marijuana (medical or recreational) are not allowed to participate in the study. Previously participated in an HTX-011 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 within 12 months. Has a body mass index (BMI) >39 kg/m2.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Neil Singla, MD
Organizational Affiliation
Lotus Clinical Research, LLC
Official's Role
Study Chair
Facility Information:
Facility Name
Anaheim Clinical Trials, LLC
City
Anaheim
State/Province
California
ZIP/Postal Code
92801
Country
United States
Facility Name
Lotus Clinical Research, LLC
City
Pasadena
State/Province
California
ZIP/Postal Code
91105
Country
United States
Facility Name
JBR Clinical Research
City
Draper
State/Province
Utah
ZIP/Postal Code
84020
Country
United States
Facility Name
JBR Clinical Research
City
Murray
State/Province
Utah
ZIP/Postal Code
84107
Country
United States
Facility Name
JBR Clinical Research
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84124
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Phase 2 Herniorrhaphy Study for Opioid Elimination

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