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Study to Evaluate the Pharmacokinetics, Pharmacodynamics and Safety, of EXPAREL Administered as Sciatic Nerve Block (In Popliteal Fossa), for Postsurgical Analgesia in Subjects Undergoing Bunionectomy

Primary Purpose

Bunion

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Exparel Injectable Product
Bupivacaine
Sponsored by
Pacira Pharmaceuticals, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Bunion

Eligibility Criteria

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

Inclusion Criteria:

  1. Healthy adult male or female volunteers ages 18 or older
  2. American Society of Anesthesiologists (ASA) physical status 1, 2, or 3
  3. Able to provide informed consent, adhere to the study schedule, and complete all study assessments.
  4. Body Mass Index ≥18 and ≤40 kg/m2

Exclusion Criteria:

  1. Allergy, hypersensitivity, intolerance, or contraindication to any of the study medications for which an alternative is not named in the protocol (eg, amide-type local anesthetics, opioids, bupivacaine, NSAIDs)
  2. Documented history of long-term diabetes or severe peripheral vascular disease
  3. Renal (serum creatinine level >2mg/dL [176.8 μmol/L]) or hepatic dysfunction (serum alanine or aspartame transferase > 3 times the upper limit of normal).
  4. Concurrent painful physical condition that may require analgesic treatment (such as long-term, consistent use of opioids) in the post dosing period for pain and which, in the investigator's opinion may confound the post dosing assessments
  5. History of, suspected, or known addiction to or abuse of illicit drug(s), prescription medicine(s), or alcohol within the past 2 years
  6. 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
  7. Previous participation in an EXPAREL study
  8. Uncontrolled anxiety, schizophrenia, or other psychiatric disorder that, in the opinion of the investigator, could interfere with study assessments or compliance
  9. Currently pregnant, nursing, or planning to become pregnant during the study
  10. 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
  11. Currently on neuroleptic agent [e.g., gabapentin, pregabalin (Lyrica), duloxetine (Cymbalta) etc.]
  12. Inadequate sensory function on the foot (monofilament test)
  13. Chronic opioid use in the last 30 days (≥30 morphine equivalents/ day)

    In addition, the subject may be withdrawn from the study if the subject meets the following criterion during or post-surgery:

  14. Any clinically significant event or condition uncovered during the surgery (e.g., excessive bleeding, acute sepsis) that, in the opinion of the investigator, renders the subject medically unstable or complicates the subject's post-operative course

Sites / Locations

  • First Surgical Hospital

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Active Comparator

Arm Label

Cohort 1 - EXPAREL

Cohort 2 - EXPAREL

Cohort 3 - EXPAREL

Cohort 4 - bupivacaine

Arm Description

A total of 10 subjects will be enrolled. Subjects in this cohort will receive 266mg of EXPAREL admixed with bupivacaine.

A total of 10 subjects will be enrolled. Subjects in this cohort will receive 133mg of EXPAREL admixed with bupivacaine.

A total of 10 subjects will be enrolled. Subjects in this cohort will receive 266mg of EXPAREL only

A total of 10 subjects will be enrolled. Subjects in this cohort will receive 100mg Bupivacaine only.

Outcomes

Primary Outcome Measures

Pharmacokinetic 1 (Area under the plasma concentration)
Area under the plasma concentration-versus-time curve (AUC).
Pharmacokinetic 2 (Cmax)
Maximum plasma concentration (Cmax)
Pharmacokinetic 3 (half-life )
The apparent terminal elimination half-life (t1/2el).
Pharmacokinetic 4 (Apparent clearance)
Apparent clearance (CL/F).
Pharmacokinetic 5 (volume of distribution)
Apparent volume of distribution (Vd).
Pharmacokinetic 6 (Tmax)
Time of Cmax (Tmax)
Pharmacodynamic 1 (duration of sensory and motor block)
Average duration of sensory block and motor block
Pharmacodynamic 2 (duration of sensory and motor block)
Average duration of sensory block and motor block

Secondary Outcome Measures

Full Information

First Posted
June 25, 2019
Last Updated
January 7, 2021
Sponsor
Pacira Pharmaceuticals, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT04002089
Brief Title
Study to Evaluate the Pharmacokinetics, Pharmacodynamics and Safety, of EXPAREL Administered as Sciatic Nerve Block (In Popliteal Fossa), for Postsurgical Analgesia in Subjects Undergoing Bunionectomy
Official Title
A Phase 1, Pilot, Open Label, Dose Escalation Study to Evaluate the Pharmacokinetics, Pharmacodynamics and Safety, of EXPAREL Administered as Sciatic Nerve Block (In Popliteal Fossa), for Postsurgical Analgesia in Subjects Undergoing Bunionectomy
Study Type
Interventional

2. Study Status

Record Verification Date
January 2021
Overall Recruitment Status
Completed
Study Start Date
July 26, 2019 (Actual)
Primary Completion Date
December 2, 2019 (Actual)
Study Completion Date
December 2, 2019 (Actual)

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

5. Study Description

Brief Summary
This is a pilot, open label, single center study in 40 subjects undergoing bunionectomy. The study will assess and collect information on pharmacokinetics, pharmacodynamics, safety and efficacy of EXPAREL administered as a sciatic nerve block (in popliteal fossa). A total of 10 subjects will be enrolled in each of the 4 cohorts.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
45 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1 - EXPAREL
Arm Type
Experimental
Arm Description
A total of 10 subjects will be enrolled. Subjects in this cohort will receive 266mg of EXPAREL admixed with bupivacaine.
Arm Title
Cohort 2 - EXPAREL
Arm Type
Experimental
Arm Description
A total of 10 subjects will be enrolled. Subjects in this cohort will receive 133mg of EXPAREL admixed with bupivacaine.
Arm Title
Cohort 3 - EXPAREL
Arm Type
Experimental
Arm Description
A total of 10 subjects will be enrolled. Subjects in this cohort will receive 266mg of EXPAREL only
Arm Title
Cohort 4 - bupivacaine
Arm Type
Active Comparator
Arm Description
A total of 10 subjects will be enrolled. Subjects in this cohort will receive 100mg Bupivacaine only.
Intervention Type
Drug
Intervention Name(s)
Exparel Injectable Product
Intervention Description
bupivacaine liposome injectable suspension
Intervention Type
Drug
Intervention Name(s)
Bupivacaine
Intervention Description
1.3%, 13.3 mg/mL
Primary Outcome Measure Information:
Title
Pharmacokinetic 1 (Area under the plasma concentration)
Description
Area under the plasma concentration-versus-time curve (AUC).
Time Frame
predose (up to 15 min before block), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1), 60(±2), 72(±2), 84(±2), 96(±3), 120(±3), 144(±3), and 168(±3) hours following block
Title
Pharmacokinetic 2 (Cmax)
Description
Maximum plasma concentration (Cmax)
Time Frame
predose (up to 15 min before block), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1h), 60(±2h), 72(±2h), 84(±2h), 96(±3h), 120(±3h), 144(±3h), and 168(±3h) hours following block
Title
Pharmacokinetic 3 (half-life )
Description
The apparent terminal elimination half-life (t1/2el).
Time Frame
predose (up to 15 min before block), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1h), 60(±2h), 72(±2h), 84(±2h), 96(±3h), 120(±3h), 144(±3h), and 168(±3h) hours following block
Title
Pharmacokinetic 4 (Apparent clearance)
Description
Apparent clearance (CL/F).
Time Frame
predose (up to 15 min before block), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1h), 60(±2h), 72(±2h), 84(±2h), 96(±3h), 120(±3h), 144(±3h), and 168(±3h) hours following block
Title
Pharmacokinetic 5 (volume of distribution)
Description
Apparent volume of distribution (Vd).
Time Frame
predose (up to 15 min before block), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1h), 60(±2h), 72(±2h), 84(±2h), 96(±3h), 120(±3h), 144(±3h), and 168(±3h) hours following block
Title
Pharmacokinetic 6 (Tmax)
Description
Time of Cmax (Tmax)
Time Frame
predose (up to 15 min before block), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1h), 60(±2h), 72(±2h), 84(±2h), 96(±3h), 120(±3h), 144(±3h), and 168(±3h) hours following block
Title
Pharmacodynamic 1 (duration of sensory and motor block)
Description
Average duration of sensory block and motor block
Time Frame
up to 15 min before block, 15 min(±5 min), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1), 60(±2), 72(±2), 84(±2), 96(±3), 120(±3), 144(±3), and 168(±3) hours following block
Title
Pharmacodynamic 2 (duration of sensory and motor block)
Description
Average duration of sensory block and motor block
Time Frame
up to 15 min before block, 15 min(±5min), 30 min(±5min), 45 min(±5min), and 60 min (±15min) and 30 min(±5min), 45 min(±5min), 1(±15min), 2(±30min), 12(±30min), 24(±1), 60(±2), 72(±2), 84(±2), 96(±3), 120(±3), 144(±3), and 168(±3) hours following block

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Healthy adult male or female volunteers ages 18 or older American Society of Anesthesiologists (ASA) physical status 1, 2, or 3 Able to provide informed consent, adhere to the study schedule, and complete all study assessments. Body Mass Index ≥18 and ≤40 kg/m2 Exclusion Criteria: Allergy, hypersensitivity, intolerance, or contraindication to any of the study medications for which an alternative is not named in the protocol (eg, amide-type local anesthetics, opioids, bupivacaine, NSAIDs) Documented history of long-term diabetes or severe peripheral vascular disease Renal (serum creatinine level >2mg/dL [176.8 μmol/L]) or hepatic dysfunction (serum alanine or aspartame transferase > 3 times the upper limit of normal). Concurrent painful physical condition that may require analgesic treatment (such as long-term, consistent use of opioids) in the post dosing period for pain and which, in the investigator's opinion may confound the post dosing assessments 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 Uncontrolled anxiety, schizophrenia, or other psychiatric disorder that, in the opinion of the investigator, could interfere with study assessments or compliance Currently pregnant, nursing, or planning to become pregnant during the study 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 Currently on neuroleptic agent [e.g., gabapentin, pregabalin (Lyrica), duloxetine (Cymbalta) etc.] Inadequate sensory function on the foot (monofilament test) Chronic opioid use in the last 30 days (≥30 morphine equivalents/ day) In addition, the subject may be withdrawn from the study if the subject meets the following criterion during or post-surgery: Any clinically significant event or condition uncovered during the surgery (e.g., excessive bleeding, acute sepsis) that, in the opinion of the investigator, renders the subject medically unstable or complicates the subject's post-operative course
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nayana Nagaraj
Organizational Affiliation
Medical Director
Official's Role
Study Director
Facility Information:
Facility Name
First Surgical Hospital
City
Bellaire
State/Province
Texas
ZIP/Postal Code
77401
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Study to Evaluate the Pharmacokinetics, Pharmacodynamics and Safety, of EXPAREL Administered as Sciatic Nerve Block (In Popliteal Fossa), for Postsurgical Analgesia in Subjects Undergoing Bunionectomy

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