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EXPAREL Facia Iliaca Compartment Block for Intertrochanteric Hip Fracture (RESTORE)

Primary Purpose

Hip Fractures, Intertrochanteric Fractures

Status
Withdrawn
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
EXPAREL
Ropivacaine
Bupivacaine Hydrochloride
Sponsored by
Pacira Pharmaceuticals, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hip Fractures focused on measuring EXPAREL, FICB, Fascia Iliaca Compartment Block, Ropivacaine

Eligibility Criteria

65 Years - 85 Years (Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Individuals between 65 and 85 years of age (inclusive of) at screening.
  2. Intertrochanteric femoral fractures with American Society of Anesthesiology physical status 1, 2, or 3.
  3. Able to provide informed consent, adhere to the study visit schedule, and complete all study assessments.

Exclusion Criteria:

  1. Hip fracture that requires total arthroplasty.
  2. Patients transferred from other hospitals.
  3. Patients that have other acute fractures.
  4. Pre-existing dementia (Mini-Mental State examination score <20) or delirium (Mini-Mental State examination score <24).
  5. Allergy, hypersensitivity, intolerance, or contraindication to any of the study medications for which an alternative is not named in the protocol (e.g., amide-type local anesthetics, opioids, bupivacaine, ropivacaine, acetaminophen, NSAIDs).
  6. Serious systemic comorbidities that cause a contraindication for EXPAREL/bupivacaine (severe hepatic or renal impairment) or ropivacaine.
  7. Use of anticoagulants (including aspirin, except low dose aspirin).
  8. Chronic opioid use of ≥ 20 morphine milligram equivalent (MME)/day for more than 7 days in the last 30 days.
  9. Body Mass Index (BMI) <17 kg/m2 or >45 kg/m2.
  10. Known history of renal or hepatic dysfunction, coagulation or bleeding disorder.
  11. Concurrent painful physical condition that may require analgesic treatment (such as long-term, consistent use of opioids) in the post-operative period for pain that is not strictly related to the surgery and which may confound the post-operative assessments based on the physician's discretion.
  12. Clinically significant medical disease that, in the opinion of the investigator, would make participation in a clinical study inappropriate. This includes any psychiatric or other conditions that would constitute a contraindication to participation in the study.
  13. History of suspected or known addiction to or abuse of illicit drug(s), prescription medicine(s), or alcohol within the past 2 years.
  14. Administration of an investigational drug within 30 days or 5 elimination half-lives of such investigational drug, whichever is longer, prior to study drug administration, or planned administration of another investigational product or procedure during the subject's participation in this study.
  15. Previous participation in an EXPAREL study.
  16. Resident of a skilled nursing facility (SNF), long-term acute care (LTAC) facility, inpatient rehabilitation facility (IRF), or nursing home. Participants from assisted living facilities will be eligible for the study.

    In addition, the subject may be withdrawn from the study if the subject meets the following criteria during the hospital stay:

  17. Any clinically significant event or condition uncovered during the surgery (e.g., excessive bleeding, acute sepsis) that might render the subject medically unstable or complicate the subject's post-operative course.
  18. Subjects who undergo hip fracture surgery more than 30 hours after admission to the Emergency Department.

Sites / Locations

  • Cleveland Clinic

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

FICB with EXPAREL

FICB with Standard of Care: ropivacaine

Arm Description

Group 1: Suprainguinal Fascia Iliaca Compartment Block (FICB) with EXPAREL and bupivacaine HCl

Suprainguinal FICB with continuous infusion of local anesthetic (ropivacaine) via catheter placed in the FIC.

Outcomes

Primary Outcome Measures

Primary objective (total opioid consumption in morphine equivalents)
to compare total opioid consumption in morphine equivalents following FICB with EXPAREL +bupivacaine HCl to that following continuous infusion of ropivacaine via catheter, from end of FICB placement through 72 hours post-FICB, in subjects undergoing repair of intertrochanteric hip fracture To be measured as date, time, and dosage of all medication administered from the time ICF is signed to 72-hours post-surgery.

Secondary Outcome Measures

Full Information

First Posted
May 14, 2019
Last Updated
February 25, 2020
Sponsor
Pacira Pharmaceuticals, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT03955458
Brief Title
EXPAREL Facia Iliaca Compartment Block for Intertrochanteric Hip Fracture
Acronym
RESTORE
Official Title
A Phase-4, Multicenter, Randomized, Active-Controlled Study to Evaluate the Efficacy and Safety of EXPAREL When Administered Via Fascia Iliaca Compartment Block Versus Fascia Iliaca Compartment Block With Continuous Infusion of Ropivacaine Per Standard of Care Through a Catheter in Intertrochanteric Hip Fracture Patients
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Withdrawn
Why Stopped
Recruitment difficulties
Study Start Date
August 26, 2019 (Actual)
Primary Completion Date
May 2020 (Anticipated)
Study Completion Date
May 2020 (Anticipated)

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
No

5. Study Description

Brief Summary
This study evaluates the effect of EXPAREL on total opioid consumption through 72 hours following fascia iliaca compartment block (FICB) in subjects undergoing repair of intertrochanteric hip fracture.
Detailed Description
The current standard of care treatment for pain relief in patients with intertrochanteric hip fracture is a FICB with continuous infusion of ropivacaine given via catheter. In this study, some people will receive a single injection FICB with EXPAREL + bupivacaine HCl. The groups will be evaluated to determine the amount of pain medication they took from the FICB to 72 hours after.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hip Fractures, Intertrochanteric Fractures
Keywords
EXPAREL, FICB, Fascia Iliaca Compartment Block, Ropivacaine

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
FICB with EXPAREL
Arm Type
Experimental
Arm Description
Group 1: Suprainguinal Fascia Iliaca Compartment Block (FICB) with EXPAREL and bupivacaine HCl
Arm Title
FICB with Standard of Care: ropivacaine
Arm Type
Active Comparator
Arm Description
Suprainguinal FICB with continuous infusion of local anesthetic (ropivacaine) via catheter placed in the FIC.
Intervention Type
Drug
Intervention Name(s)
EXPAREL
Intervention Description
FICB with EXPAREL + Bupivacaine HCL (single dose)
Intervention Type
Drug
Intervention Name(s)
Ropivacaine
Intervention Description
FICB with continuous infusion of ropivacaine
Intervention Type
Drug
Intervention Name(s)
Bupivacaine Hydrochloride
Intervention Description
FICB with EXPAREL + Bupivacaine HCL (Single dose)
Primary Outcome Measure Information:
Title
Primary objective (total opioid consumption in morphine equivalents)
Description
to compare total opioid consumption in morphine equivalents following FICB with EXPAREL +bupivacaine HCl to that following continuous infusion of ropivacaine via catheter, from end of FICB placement through 72 hours post-FICB, in subjects undergoing repair of intertrochanteric hip fracture To be measured as date, time, and dosage of all medication administered from the time ICF is signed to 72-hours post-surgery.
Time Frame
Through 72 hours post-FICB

10. Eligibility

Sex
All
Minimum Age & Unit of Time
65 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Individuals between 65 and 85 years of age (inclusive of) at screening. Intertrochanteric femoral fractures with American Society of Anesthesiology physical status 1, 2, or 3. Able to provide informed consent, adhere to the study visit schedule, and complete all study assessments. Exclusion Criteria: Hip fracture that requires total arthroplasty. Patients transferred from other hospitals. Patients that have other acute fractures. Pre-existing dementia (Mini-Mental State examination score <20) or delirium (Mini-Mental State examination score <24). Allergy, hypersensitivity, intolerance, or contraindication to any of the study medications for which an alternative is not named in the protocol (e.g., amide-type local anesthetics, opioids, bupivacaine, ropivacaine, acetaminophen, NSAIDs). Serious systemic comorbidities that cause a contraindication for EXPAREL/bupivacaine (severe hepatic or renal impairment) or ropivacaine. Use of anticoagulants (including aspirin, except low dose aspirin). Chronic opioid use of ≥ 20 morphine milligram equivalent (MME)/day for more than 7 days in the last 30 days. Body Mass Index (BMI) <17 kg/m2 or >45 kg/m2. Known history of renal or hepatic dysfunction, coagulation or bleeding disorder. Concurrent painful physical condition that may require analgesic treatment (such as long-term, consistent use of opioids) in the post-operative period for pain that is not strictly related to the surgery and which may confound the post-operative assessments based on the physician's discretion. Clinically significant medical disease that, in the opinion of the investigator, would make participation in a clinical study inappropriate. This includes any psychiatric or other conditions that would constitute a contraindication to participation in the study. History of suspected or known addiction to or abuse of illicit drug(s), prescription medicine(s), or alcohol within the past 2 years. Administration of an investigational drug within 30 days or 5 elimination half-lives of such investigational drug, whichever is longer, prior to study drug administration, or planned administration of another investigational product or procedure during the subject's participation in this study. Previous participation in an EXPAREL study. Resident of a skilled nursing facility (SNF), long-term acute care (LTAC) facility, inpatient rehabilitation facility (IRF), or nursing home. Participants from assisted living facilities will be eligible for the study. In addition, the subject may be withdrawn from the study if the subject meets the following criteria during the hospital stay: Any clinically significant event or condition uncovered during the surgery (e.g., excessive bleeding, acute sepsis) that might render the subject medically unstable or complicate the subject's post-operative course. Subjects who undergo hip fracture surgery more than 30 hours after admission to the Emergency Department.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nayana Nagaraj, MD, PhD, MPH
Organizational Affiliation
Pacira BioSciences, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

EXPAREL Facia Iliaca Compartment Block for Intertrochanteric Hip Fracture

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