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A Study to Evaluate Safety, PK, Efficacy of TLC590 for Postsurgical Pain Management Following Bunionectomy

Primary Purpose

Hallux Valgus

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
TLC590
Naropin®
Normal Saline
Bupivacaine
Sponsored by
Taiwan Liposome Company
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Hallux Valgus

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Able and willing to provide a written informed consent.
  2. Male or female between 18 and 65 years of age.
  3. Body mass index ≤ 35 kg/m2.
  4. Mild to moderate hallux valgus deformity.
  5. Scheduled to undergo a primary, unilateral first metatarsal bunionectomy repair under local anesthesia.
  6. American Society of Anesthesiology Physical Status Classification of 1 or 2 at screening.
  7. Female subjects are eligible only if all of the following apply:

    • Not pregnant;
    • Not lactating;
    • Not planning to become pregnant during the study;
    • Commits to the use of an acceptable form of birth control for the duration of the study and for 42 days from administration of study drug.
  8. Male subjects must be surgically sterile (biologically or surgically) or commit to the use of a reliable method of birth control, for the duration of the study until at least 1 week after the administration of study medication.

Exclusion Criteria:

  1. Clinically significant abnormal clinical laboratory test value.
  2. Evidence of a clinically significant 12-lead ECG abnormality.
  3. History or evidence of orthostatic hypotension, syncope or other syncopal attacks.
  4. History or clinical manifestations of significant renal, hepatic, gastrointestinal, cardiovascular, metabolic, neurologic, psychiatric, or other condition that would preclude participation in the study.
  5. A history of seizure disorder or currently taking anticonvulsants.
  6. History of hypersensitivity to ropivacaine, any other amide-type local anesthetic, propofol, lidocaine, midazolam, acetaminophen, naproxen, morphine or oxycodone (or other opioids).
  7. Concurrent painful physical condition that may confound post-operative pain assessments.
  8. Persistent or recurrent nausea and/or vomiting due to other etiologies.
  9. History of severe or refractory post-operative nausea or vomiting (PONV) deemed clinically significant.
  10. History of alcohol abuse or prescription/illicit drug abuse within 2 years.
  11. Current evidence of alcohol abuse within 6 months.
  12. Received opioid therapy for longer than 4 days per week within 2 months or opioid use within 2 weeks.
  13. Use of concurrent therapy that could interfere with the evaluation of efficacy or safety.
  14. Unable to discontinue medications that have not been at a stable dose for at least 14 days prior to the study surgical procedure, within 5 half-lives of the specific prior medication.
  15. Use of any of the following medications within 5 half-lives or as specified prior to the study surgical procedure:

    • Low-dose aspirin therapy for cardiovascular protection
    • Class III antiarrhythmic drugs
    • Strong CYP1A2 inhibitors
    • CYP1A2 substrates
    • Strong CYP3A4 inhibitors
    • Corticosteroids, either systemically, inhaled either intranasally or orally, or by intra-articular injection, or NSAIDs within 14 days
    • Any investigational product within 30 days.
  16. Positive results on the urine drug screen or alcohol breath test indicative of illicit drug or alcohol abuse.
  17. History or positive test results for HIV; active Hepatitis B or C.
  18. Contralateral foot bunionectomy in the last 3 months or have collateral procedures.
  19. Malignancy in the last 2 years, with the exception of non-metastatic basal cell or squamous cell carcinoma of the skin or localized carcinoma in situ of the cervix.
  20. History of rheumatoid disease, Type 1 or Type 2 diabetes or peripheral circulatory disorders.
  21. Documented sleep apnea or are on home continuous positive airway pressure.

Sites / Locations

  • Arizona Research Center
  • Anaheim Clinical Trials, LLC
  • Chesapeake Research Group
  • Endeavor Clinical Trials
  • JBR clinical research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm Type

Experimental

Experimental

Experimental

Active Comparator

Placebo Comparator

Active Comparator

Arm Label

TLC590 dose 1 (152 mg)

TLC590 dose 2 (190 mg)

TLC590 dose 3 (228 mg)

Naropin®

Placebo

Bupivacaine

Arm Description

TLC590 (Ropivacaine Liposome Injectable Suspension) is a sustained-release liposome formulation of ropivacaine, white aqueous suspension with ropivacaine concentration at approximately 19 mg/mL.

TLC590 (Ropivacaine Liposome Injectable Suspension) is a sustained-release liposome formulation of ropivacaine, white aqueous suspension with ropivacaine concentration at approximately 19 mg/mL.

TLC590 (Ropivacaine Liposome Injectable Suspension) is a sustained-release liposome formulation of ropivacaine, white aqueous suspension with ropivacaine concentration at approximately 19 mg/mL.

Naronpin injection contains ropivacaine HCl 50 mg (0.5%, 10 mL)

Normal Saline (0.9% sodium chloride, 10 mL)

Bupivacaine HCl 50 mg (0.5%, 10 mL)

Outcomes

Primary Outcome Measures

AUC of numerical pain rating scale
AUC of numerical pain rating scale (NPRS-R) following bunionectomy surgery

Secondary Outcome Measures

PK Cmax
Maximum blood concentration (Cmax)
PK Tmax
Time to reach maximum blood concentration (Tmax)
PK t½
Terminal elimination half-life (t½)
PK AUC
Area under the blood concentration-time curve (AUC)
Number of treatment emergent adverse event (TEAE)
Number of treatment emergent adverse event (TEAE) occurred in the study
Electrocardiogram (RR interval, QRS duration, QT duration, PR duration, QTcF interval)
The 12-lead electrocardiogram (ECG) result will be assessed including RR interval, QRS duration, QT duration, PR duration, and QTcF interval
Wound assessment by Numerical Pain Rating Scale (NPRS)
The surgical site will be examined by the investigator using a 5-point numerical pain rating scale as follows: Normal healing Bruising, erythema, edema Clear or hemoserous drainage Evidence of cellulitis such as heat, spreading erythema, purulent discharge Tissue breakdown, wound dehiscence, hematoma requiring aspiration
AUC of NPRS-R (0-10)
AUC of NPRS-R (0-10)
Proportion of pain-free (NPRS-R of 0 or 1) subjects
Proportion of pain-free (NPRS-R of 0 or 1) subjects
Proportion of subjects who used no rescue opioid analgesic
Proportion of subjects who used no rescue opioid analgesic
Time to the first postoperative use of rescue opioid analgesics
Time to the first postoperative use of rescue opioid analgesics
Total postoperative consumption of rescue opioid analgesics used
Total postoperative consumption of rescue opioid analgesics used

Full Information

First Posted
February 11, 2019
Last Updated
April 6, 2020
Sponsor
Taiwan Liposome Company
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1. Study Identification

Unique Protocol Identification Number
NCT03838133
Brief Title
A Study to Evaluate Safety, PK, Efficacy of TLC590 for Postsurgical Pain Management Following Bunionectomy
Official Title
A Phase 2, Randomized, Double-blind, Comparator- and Placebo-controlled Study to Evaluate the Safety, Pharmacokinetics, and Efficacy of TLC590 for Postsurgical Pain Management Following Bunionectomy
Study Type
Interventional

2. Study Status

Record Verification Date
April 2020
Overall Recruitment Status
Completed
Study Start Date
March 5, 2019 (Actual)
Primary Completion Date
March 31, 2020 (Actual)
Study Completion Date
March 31, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Taiwan Liposome Company

4. Oversight

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

5. Study Description

Brief Summary
This is a Phase 2, randomized, double-blind, 2-part comparator- and placebo-controlled study to evaluate the safety, PK, and efficacy of TLC590 via a single infiltrative local administration in adult subjects following bunionectomy.
Detailed Description
This is a Phase 2, randomized, double-blind, 2-part comparator- and placebo-controlled study to evaluate the safety, PK, and efficacy of TLC590 via a single infiltrative local administration in adult subjects following bunionectomy. The primary objective of this study is to evaluate the analgesic efficacy of TLC590 for post-surgical pain management in subjects following bunionectomy. The secondary objectives of this study are: To evaluate the pharmacokinetic (PK) profile and dose-exposure relationship of TLC590, as well as the bioavailability as compared with Naropin®. To evaluate the safety and tolerability of TLC590 for post-surgical pain management in subjects following bunionectomy. To evaluate the exposure-response relationship between PK parameters and pain intensity. The study will be divided into two parts: Part 1: Blinded Pharmacokinetics of TLC590 and Naropin®. Approximately 48 subjects will be randomized to treatments. Part 2: Efficacy and Safety of TLC590 versus bupivacaine and Placebo. Part 2 of the study will randomize approximately 150 evaluable subjects who meet all entry criteria.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hallux Valgus

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
150 (Actual)

8. Arms, Groups, and Interventions

Arm Title
TLC590 dose 1 (152 mg)
Arm Type
Experimental
Arm Description
TLC590 (Ropivacaine Liposome Injectable Suspension) is a sustained-release liposome formulation of ropivacaine, white aqueous suspension with ropivacaine concentration at approximately 19 mg/mL.
Arm Title
TLC590 dose 2 (190 mg)
Arm Type
Experimental
Arm Description
TLC590 (Ropivacaine Liposome Injectable Suspension) is a sustained-release liposome formulation of ropivacaine, white aqueous suspension with ropivacaine concentration at approximately 19 mg/mL.
Arm Title
TLC590 dose 3 (228 mg)
Arm Type
Experimental
Arm Description
TLC590 (Ropivacaine Liposome Injectable Suspension) is a sustained-release liposome formulation of ropivacaine, white aqueous suspension with ropivacaine concentration at approximately 19 mg/mL.
Arm Title
Naropin®
Arm Type
Active Comparator
Arm Description
Naronpin injection contains ropivacaine HCl 50 mg (0.5%, 10 mL)
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Normal Saline (0.9% sodium chloride, 10 mL)
Arm Title
Bupivacaine
Arm Type
Active Comparator
Arm Description
Bupivacaine HCl 50 mg (0.5%, 10 mL)
Intervention Type
Drug
Intervention Name(s)
TLC590
Other Intervention Name(s)
TLC590 (Ropivacaine Liposome Injectable Suspension)
Intervention Description
TLC590, a sustained-release formulation of the local anesthetics with lipid-based excipients
Intervention Type
Drug
Intervention Name(s)
Naropin®
Other Intervention Name(s)
Naropin, 0.5% Injectable Solution
Intervention Description
Local infiltration of Naropin to produce anesthesia for surgery and analgesia in postoperative pain management. 50 mg (0.5%, 10 mL)
Intervention Type
Drug
Intervention Name(s)
Normal Saline
Other Intervention Name(s)
Saline
Intervention Description
Normal Saline (0.9% sodium chloride, 10ml)
Intervention Type
Drug
Intervention Name(s)
Bupivacaine
Intervention Description
Bupivacaine 50 mg (0.5%, 10 mL)
Primary Outcome Measure Information:
Title
AUC of numerical pain rating scale
Description
AUC of numerical pain rating scale (NPRS-R) following bunionectomy surgery
Time Frame
0-24 hours, 0-72 hours
Secondary Outcome Measure Information:
Title
PK Cmax
Description
Maximum blood concentration (Cmax)
Time Frame
0-168 hours
Title
PK Tmax
Description
Time to reach maximum blood concentration (Tmax)
Time Frame
0-168 hours
Title
PK t½
Description
Terminal elimination half-life (t½)
Time Frame
0-168 hours
Title
PK AUC
Description
Area under the blood concentration-time curve (AUC)
Time Frame
0-24, 0-48 , 0-72, 0-96 hours
Title
Number of treatment emergent adverse event (TEAE)
Description
Number of treatment emergent adverse event (TEAE) occurred in the study
Time Frame
Screening through Day 43
Title
Electrocardiogram (RR interval, QRS duration, QT duration, PR duration, QTcF interval)
Description
The 12-lead electrocardiogram (ECG) result will be assessed including RR interval, QRS duration, QT duration, PR duration, and QTcF interval
Time Frame
Screening through Day 43
Title
Wound assessment by Numerical Pain Rating Scale (NPRS)
Description
The surgical site will be examined by the investigator using a 5-point numerical pain rating scale as follows: Normal healing Bruising, erythema, edema Clear or hemoserous drainage Evidence of cellulitis such as heat, spreading erythema, purulent discharge Tissue breakdown, wound dehiscence, hematoma requiring aspiration
Time Frame
Day 1 through Day 43
Title
AUC of NPRS-R (0-10)
Description
AUC of NPRS-R (0-10)
Time Frame
0-36, 0-48, 0-72, 0-96, 0-120,24-48, 48-72, 72-96, 96-120, and 120-168 hours
Title
Proportion of pain-free (NPRS-R of 0 or 1) subjects
Description
Proportion of pain-free (NPRS-R of 0 or 1) subjects
Time Frame
at 12, 24, 36, 48, 72, 96, 120, and 168 hours
Title
Proportion of subjects who used no rescue opioid analgesic
Description
Proportion of subjects who used no rescue opioid analgesic
Time Frame
through 12, 24, 36, 48, 72, 96, 120, and 168 hours
Title
Time to the first postoperative use of rescue opioid analgesics
Description
Time to the first postoperative use of rescue opioid analgesics
Time Frame
Day 1 to Day 43
Title
Total postoperative consumption of rescue opioid analgesics used
Description
Total postoperative consumption of rescue opioid analgesics used
Time Frame
through 24, 36, 48, 60, 72, 96, 120, and 168 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Able and willing to provide a written informed consent. Male or female between 18 and 65 years of age. Body mass index ≤ 35 kg/m2. Mild to moderate hallux valgus deformity. Scheduled to undergo a primary, unilateral first metatarsal bunionectomy repair under local anesthesia. American Society of Anesthesiology Physical Status Classification of 1 or 2 at screening. Female subjects are eligible only if all of the following apply: Not pregnant; Not lactating; Not planning to become pregnant during the study; Commits to the use of an acceptable form of birth control for the duration of the study and for 42 days from administration of study drug. Male subjects must be surgically sterile (biologically or surgically) or commit to the use of a reliable method of birth control, for the duration of the study until at least 1 week after the administration of study medication. Exclusion Criteria: Clinically significant abnormal clinical laboratory test value. Evidence of a clinically significant 12-lead ECG abnormality. History or evidence of orthostatic hypotension, syncope or other syncopal attacks. History or clinical manifestations of significant renal, hepatic, gastrointestinal, cardiovascular, metabolic, neurologic, psychiatric, or other condition that would preclude participation in the study. A history of seizure disorder or currently taking anticonvulsants. History of hypersensitivity to ropivacaine, any other amide-type local anesthetic, propofol, lidocaine, midazolam, acetaminophen, naproxen, morphine or oxycodone (or other opioids). Concurrent painful physical condition that may confound post-operative pain assessments. Persistent or recurrent nausea and/or vomiting due to other etiologies. History of severe or refractory post-operative nausea or vomiting (PONV) deemed clinically significant. History of alcohol abuse or prescription/illicit drug abuse within 2 years. Current evidence of alcohol abuse within 6 months. Received opioid therapy for longer than 4 days per week within 2 months or opioid use within 2 weeks. Use of concurrent therapy that could interfere with the evaluation of efficacy or safety. Unable to discontinue medications that have not been at a stable dose for at least 14 days prior to the study surgical procedure, within 5 half-lives of the specific prior medication. Use of any of the following medications within 5 half-lives or as specified prior to the study surgical procedure: Low-dose aspirin therapy for cardiovascular protection Class III antiarrhythmic drugs Strong CYP1A2 inhibitors CYP1A2 substrates Strong CYP3A4 inhibitors Corticosteroids, either systemically, inhaled either intranasally or orally, or by intra-articular injection, or NSAIDs within 14 days Any investigational product within 30 days. Positive results on the urine drug screen or alcohol breath test indicative of illicit drug or alcohol abuse. History or positive test results for HIV; active Hepatitis B or C. Contralateral foot bunionectomy in the last 3 months or have collateral procedures. Malignancy in the last 2 years, with the exception of non-metastatic basal cell or squamous cell carcinoma of the skin or localized carcinoma in situ of the cervix. History of rheumatoid disease, Type 1 or Type 2 diabetes or peripheral circulatory disorders. Documented sleep apnea or are on home continuous positive airway pressure.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Carl Brown, PhD
Organizational Affiliation
Taiwan Liposome Company
Official's Role
Study Director
Facility Information:
Facility Name
Arizona Research Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85053
Country
United States
Facility Name
Anaheim Clinical Trials, LLC
City
Anaheim
State/Province
California
ZIP/Postal Code
92801
Country
United States
Facility Name
Chesapeake Research Group
City
Pasadena
State/Province
Maryland
ZIP/Postal Code
21122-1020
Country
United States
Facility Name
Endeavor Clinical Trials
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
JBR clinical research
City
Draper
State/Province
Utah
ZIP/Postal Code
84020
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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A Study to Evaluate Safety, PK, Efficacy of TLC590 for Postsurgical Pain Management Following Bunionectomy

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