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Pediatric Postoperative Analgesia Herniorrhaphy Study

Primary Purpose

Analgesia

Status
Withdrawn
Phase
Phase 2
Locations
Study Type
Interventional
Intervention
HTX-011
Bupivacaine HCl
HTX-011
HTX-011
HTX-011
Luer Lock Applicator
Sponsored by
Heron Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Analgesia focused on measuring inguinal hernia, postoperative pain, herniorrhaphy, pediatric, local anesthetic

Eligibility Criteria

3 Years - 16 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Is scheduled to undergo a unilateral open inguinal herniorrhaphy with or without 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:

  • 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.
  • Has a planned concurrent surgical procedure (eg, bilateral herniorrhaphy).
  • Has a contraindication or a known or suspected history of hypersensitivity or clinically significant idiosyncratic reaction to required study medications.
  • Has taken meloxicam within least 10 days 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 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 a body mass index (BMI) >35 kg/m2.

In addition to the preceding exclusion criteria 1 through 14, subjects to be enrolled in Cohort 1 Part B, Cohort 2 Part B, or Cohort 3 who meet any of the following criteria prior to randomization will be excluded from the study:

  • Has had a prior ipsilateral inguinal 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 known or suspected daily use of opioids for 7 or more consecutive days within the previous 6 months.
  • Has taken long-acting opioids within 3 days prior to the scheduled surgery.
  • Has taken any opioids within 48 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 undergone 3 or more surgeries within 12 months.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm 3

    Arm 4

    Arm 5

    Arm 6

    Arm 7

    Arm 8

    Arm 9

    Arm 10

    Arm Type

    Experimental

    Active Comparator

    Experimental

    Active Comparator

    Experimental

    Active Comparator

    Experimental

    Active Comparator

    Experimental

    Active Comparator

    Arm Label

    Cohort 1 Part A: HTX-011

    Cohort 1 Part A: bupivacaine HCl

    Cohort 1 Part B: HTX-011

    Cohort 1 Part B: bupivacaine HCl

    Cohort 2 Part A: HTX-011

    Cohort 2 Part A: bupivacaine HCl

    Cohort 2 Part B: HTX-011

    Cohort 2 Part B: bupivacaine HCl

    Cohort 3: HTX-011

    Cohort 3: bupivacaine HCl

    Arm Description

    Adolescents ≥12 to <17 years of age. A single dose of HTX-011 via instillation into the surgical site.

    Adolescents ≥12 to <17 years of age. A single dose of bupivacaine HCl 0.25% (without epinephrine) via injection into the surgical site.

    Adolescents ≥12 to <17 years of age. Dose to be determined from Cohort 1 Part A.

    Adolescents ≥12 to <17 years of age. A single dose of bupivacaine HCl 0.25% (without epinephrine) via injection into the surgical site

    Children ≥6 to <12 years of age. Dose to be determined from Cohort 1.

    Children ≥6 to <12 years of age. A single dose of bupivacaine HCl 0.25% (without epinephrine) via injection into the surgical site

    Children ≥6 to <12 years of age. Dose to be determined from Cohort 1.

    Children ≥6 to <12 years of age. A single dose of bupivacaine HCl 0.25% (without epinephrine) via injection into the surgical site

    Children ≥3 to <6 years of age. Dose to be determined from Cohorts 1 and 2.

    Children ≥3 to <6 years of age. A single dose of bupivacaine HCl 0.25% (without epinephrine) via injection into the surgical site

    Outcomes

    Primary Outcome Measures

    Area under the concentration-time curve (AUC) from Time 0 extrapolated to infinity (AUCinf)
    Maximum concentration (Cmax)
    Time of occurrence of maximum concentration (Tmax)

    Secondary Outcome Measures

    Adolescents ≥12 to <17 years of age (Cohort 1): area under the curve (AUC) of the Numeric Rating Scale of pain intensity scores with activity (NRS-A)
    Children ≥6 to <12 years of age (Cohort 2): AUC of the Faces-Pain-Scale (FPS)-Revised pain intensity scores
    Children ≥3 to <6 years of age (Cohort 3): AUC of the Faces, Legs, Activity, Cry, Consolability (FLACC) scale pain intensity scores
    Total postoperative opioid consumption (in IV morphine milligram equivalents)
    Proportion of subjects who are opioid-free
    AUC of the Numeric Rating Scale pain intensity scores at rest (NRS-R)
    Proportion of subjects who do not receive an opioid prescription at discharge.

    Full Information

    First Posted
    April 17, 2019
    Last Updated
    June 1, 2023
    Sponsor
    Heron Therapeutics
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    1. Study Identification

    Unique Protocol Identification Number
    NCT03922048
    Brief Title
    Pediatric Postoperative Analgesia Herniorrhaphy Study
    Official Title
    A Phase 2, 2-Part, Open-Label, Dose-Finding and Double-Blind Study to Assess the Pharmacokinetics, Pharmacodynamics, and Safety of HTX-011 for Postoperative Analgesia in Adolescents and Children (≥3 to <17 Years of Age) Undergoing Unilateral Open Inguinal Herniorrhaphy
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    June 2023
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Withdrawn due to lack of enrollment.
    Study Start Date
    July 2023 (Anticipated)
    Primary Completion Date
    November 2025 (Anticipated)
    Study Completion Date
    December 2025 (Anticipated)

    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 study in pediatric subjects undergoing inguinal herniorrhaphy.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Analgesia
    Keywords
    inguinal hernia, postoperative pain, herniorrhaphy, pediatric, local anesthetic

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 2
    Interventional Study Model
    Sequential Assignment
    Masking
    ParticipantInvestigatorOutcomes Assessor
    Allocation
    Randomized
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Cohort 1 Part A: HTX-011
    Arm Type
    Experimental
    Arm Description
    Adolescents ≥12 to <17 years of age. A single dose of HTX-011 via instillation into the surgical site.
    Arm Title
    Cohort 1 Part A: bupivacaine HCl
    Arm Type
    Active Comparator
    Arm Description
    Adolescents ≥12 to <17 years of age. A single dose of bupivacaine HCl 0.25% (without epinephrine) via injection into the surgical site.
    Arm Title
    Cohort 1 Part B: HTX-011
    Arm Type
    Experimental
    Arm Description
    Adolescents ≥12 to <17 years of age. Dose to be determined from Cohort 1 Part A.
    Arm Title
    Cohort 1 Part B: bupivacaine HCl
    Arm Type
    Active Comparator
    Arm Description
    Adolescents ≥12 to <17 years of age. A single dose of bupivacaine HCl 0.25% (without epinephrine) via injection into the surgical site
    Arm Title
    Cohort 2 Part A: HTX-011
    Arm Type
    Experimental
    Arm Description
    Children ≥6 to <12 years of age. Dose to be determined from Cohort 1.
    Arm Title
    Cohort 2 Part A: bupivacaine HCl
    Arm Type
    Active Comparator
    Arm Description
    Children ≥6 to <12 years of age. A single dose of bupivacaine HCl 0.25% (without epinephrine) via injection into the surgical site
    Arm Title
    Cohort 2 Part B: HTX-011
    Arm Type
    Experimental
    Arm Description
    Children ≥6 to <12 years of age. Dose to be determined from Cohort 1.
    Arm Title
    Cohort 2 Part B: bupivacaine HCl
    Arm Type
    Active Comparator
    Arm Description
    Children ≥6 to <12 years of age. A single dose of bupivacaine HCl 0.25% (without epinephrine) via injection into the surgical site
    Arm Title
    Cohort 3: HTX-011
    Arm Type
    Experimental
    Arm Description
    Children ≥3 to <6 years of age. Dose to be determined from Cohorts 1 and 2.
    Arm Title
    Cohort 3: bupivacaine HCl
    Arm Type
    Active Comparator
    Arm Description
    Children ≥3 to <6 years of age. A single dose of bupivacaine HCl 0.25% (without epinephrine) via injection into the surgical site
    Intervention Type
    Drug
    Intervention Name(s)
    HTX-011
    Intervention Description
    Single-dose instillation of approximately 0.17 mL/kg (total dose does not exceed 10.5 mL) of HTX-011.
    Intervention Type
    Drug
    Intervention Name(s)
    Bupivacaine HCl
    Intervention Description
    Bupivacaine HCl 0.25% (without epinephrine) (total dose not to exceed 75 mg).
    Intervention Type
    Drug
    Intervention Name(s)
    HTX-011
    Intervention Description
    Dose to be determined from Cohort 1.
    Intervention Type
    Drug
    Intervention Name(s)
    HTX-011
    Intervention Description
    Dose to be determined from Cohorts 1 and 2.
    Intervention Type
    Drug
    Intervention Name(s)
    HTX-011
    Intervention Description
    Dose to be determined from Cohort 1 Part A.
    Intervention Type
    Device
    Intervention Name(s)
    Luer Lock Applicator
    Intervention Description
    Applicator for instillation.
    Primary Outcome Measure Information:
    Title
    Area under the concentration-time curve (AUC) from Time 0 extrapolated to infinity (AUCinf)
    Time Frame
    72 hours
    Title
    Maximum concentration (Cmax)
    Time Frame
    72 hours
    Title
    Time of occurrence of maximum concentration (Tmax)
    Time Frame
    72 hours
    Secondary Outcome Measure Information:
    Title
    Adolescents ≥12 to <17 years of age (Cohort 1): area under the curve (AUC) of the Numeric Rating Scale of pain intensity scores with activity (NRS-A)
    Time Frame
    72 hours
    Title
    Children ≥6 to <12 years of age (Cohort 2): AUC of the Faces-Pain-Scale (FPS)-Revised pain intensity scores
    Time Frame
    72 hours
    Title
    Children ≥3 to <6 years of age (Cohort 3): AUC of the Faces, Legs, Activity, Cry, Consolability (FLACC) scale pain intensity scores
    Time Frame
    72 hours
    Title
    Total postoperative opioid consumption (in IV morphine milligram equivalents)
    Time Frame
    72 hours
    Title
    Proportion of subjects who are opioid-free
    Time Frame
    72 hours
    Title
    AUC of the Numeric Rating Scale pain intensity scores at rest (NRS-R)
    Time Frame
    72 hours
    Title
    Proportion of subjects who do not receive an opioid prescription at discharge.
    Time Frame
    72 hours

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    3 Years
    Maximum Age & Unit of Time
    16 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Is scheduled to undergo a unilateral open inguinal herniorrhaphy with or without 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: 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. Has a planned concurrent surgical procedure (eg, bilateral herniorrhaphy). Has a contraindication or a known or suspected history of hypersensitivity or clinically significant idiosyncratic reaction to required study medications. Has taken meloxicam within least 10 days 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 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 a body mass index (BMI) >35 kg/m2. In addition to the preceding exclusion criteria 1 through 14, subjects to be enrolled in Cohort 1 Part B, Cohort 2 Part B, or Cohort 3 who meet any of the following criteria prior to randomization will be excluded from the study: Has had a prior ipsilateral inguinal 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 known or suspected daily use of opioids for 7 or more consecutive days within the previous 6 months. Has taken long-acting opioids within 3 days prior to the scheduled surgery. Has taken any opioids within 48 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 undergone 3 or more surgeries within 12 months.

    12. IPD Sharing Statement

    Plan to Share IPD
    Undecided

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    Pediatric Postoperative Analgesia Herniorrhaphy Study

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