search
Back to results

Bunionectomy Study for Postoperative Analgesia (EPOCH 1)

Primary Purpose

Postoperative Pain

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
HTX-011
Saline Placebo
Bupivacaine HCl
Luer-lock applicator
Vial access device
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 bunion, bunionectomy, bunion surgery, postoperative pain

Eligibility Criteria

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

Inclusion Criteria:

  • Is scheduled to undergo a primary unilateral, distal, first metatarsal bunionectomy with osteotomy and internal fixation under regional 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 had a contralateral foot bunionectomy in the past 3 months.
  • Has a planned concurrent surgical procedure (eg, bilateral bunionectomy or collateral procedures on the surgical foot).
  • Has other 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 at least 10 days prior to the scheduled surgery.
  • Has taken opioids within 24 hours prior to the scheduled surgery (3 days for long-acting).
  • Has been administered bupivacaine within 5 days prior to the scheduled surgery.
  • Has initiated treatment with 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. Subjects taking medical marijuana are not allowed to participate in the 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

  • Springhill Medical Center
  • Orthopaedic Specialists of North America, PLLC
  • Arizona Research Center
  • Anaheim Clinical Trials, LLC
  • Trovare Clinical Research, Inc.
  • Alliance Research Centers
  • Chesapeake Research Group, LLC
  • Optimal Research , LLC
  • Hermann Drive Surgical Hospital
  • Westside Surgical Hospital
  • Futuro Clinical Trials, LLC
  • Plano Surgical Hospital
  • Endeavor Clinical Trials
  • EPIC Medical Research, LLC
  • Jean Brown Research

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Placebo Comparator

Active Comparator

Arm Label

Treatment Group 1: HTX-011

Treatment Group 2: Saline Placebo

Treatment Group 3: Bupivacaine HCI

Arm Description

HTX 011 (bupivacaine/meloxicam)

Saline placebo

Bupivacaine HCl

Outcomes

Primary Outcome Measures

Mean Area Under the Curve (AUC) of the Numeric Rating Scale of Pain Intensity Scores With Activity (NRS-A; Windowed Worst Observation Carried Forward) for HTX-011 Compared With Saline Placebo.
Pain intensity scores are assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable". NRS scores are recorded with activity (NRS-A), seated with the plantar surface of the ball of the surgically attended foot touching the floor (no weight-bearing).

Secondary Outcome Measures

Mean AUC of the NRS-A Pain Intensity Scores (Windowed Worst Observation Carried Forward) for HTX 011 Compared With Bupivacaine HCl.
Pain intensity scores are assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable". NRS scores are recorded with activity (NRS-A) seated with the plantar surface of the ball of the surgically attended foot touching the floor (no weight-bearing).
Mean Total Postoperative Opioid Consumption (in Morphine Equivalents) for HTX 011 Compared With Saline Placebo.
Percentage of Subjects Who Are Opioid-free for HTX-011 Compared With Bupivacaine HCl.
Mean Total Postoperative Opioid Consumption (in Morphine Equivalents) for HTX 011 Compared With Bupivacaine HCl.

Full Information

First Posted
September 25, 2017
Last Updated
September 29, 2021
Sponsor
Heron Therapeutics
search

1. Study Identification

Unique Protocol Identification Number
NCT03295721
Brief Title
Bunionectomy Study for Postoperative Analgesia (EPOCH 1)
Official Title
A Phase 3, Randomized, Double Blind, Saline Placebo and Active Controlled, Multicenter Study of HTX 011 Via Local Administration for Postoperative Analgesia and Decreased Opioid Use Following Unilateral Simple Bunionectomy
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
October 24, 2017 (Actual)
Primary Completion Date
January 8, 2018 (Actual)
Study Completion Date
March 13, 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
Product Manufactured in and Exported from the U.S.
Yes

5. Study Description

Brief Summary
This is a Phase 3, randomized, double-blind, saline placebo- and active-controlled, multicenter study to evaluate the analgesic efficacy and safety of HTX 011 administered via local administration into the surgical site in subjects undergoing bunionectomy.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Postoperative Pain
Keywords
bunion, bunionectomy, bunion surgery, postoperative pain

7. Study Design

Primary Purpose
Prevention
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
412 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Treatment Group 1: HTX-011
Arm Type
Experimental
Arm Description
HTX 011 (bupivacaine/meloxicam)
Arm Title
Treatment Group 2: Saline Placebo
Arm Type
Placebo Comparator
Arm Description
Saline placebo
Arm Title
Treatment Group 3: Bupivacaine HCI
Arm Type
Active Comparator
Arm Description
Bupivacaine HCl
Intervention Type
Drug
Intervention Name(s)
HTX-011
Intervention Description
HTX 011 (bupivacaine/meloxicam), 60 mg/1.8 mg by instillation
Intervention Type
Drug
Intervention Name(s)
Saline Placebo
Intervention Description
Saline placebo by instillation
Intervention Type
Drug
Intervention Name(s)
Bupivacaine HCl
Intervention Description
Bupivacaine HCl without epinephrine, 50 mg by injection
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
Primary Outcome Measure Information:
Title
Mean Area Under the Curve (AUC) of the Numeric Rating Scale of Pain Intensity Scores With Activity (NRS-A; Windowed Worst Observation Carried Forward) for HTX-011 Compared With Saline Placebo.
Description
Pain intensity scores are assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable". NRS scores are recorded with activity (NRS-A), seated with the plantar surface of the ball of the surgically attended foot touching the floor (no weight-bearing).
Time Frame
72 hours
Secondary Outcome Measure Information:
Title
Mean AUC of the NRS-A Pain Intensity Scores (Windowed Worst Observation Carried Forward) for HTX 011 Compared With Bupivacaine HCl.
Description
Pain intensity scores are assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable". NRS scores are recorded with activity (NRS-A) seated with the plantar surface of the ball of the surgically attended foot touching the floor (no weight-bearing).
Time Frame
72 hours
Title
Mean Total Postoperative Opioid Consumption (in Morphine Equivalents) for HTX 011 Compared With Saline Placebo.
Time Frame
72 hours
Title
Percentage of Subjects Who Are Opioid-free for HTX-011 Compared With Bupivacaine HCl.
Time Frame
72 hours
Title
Mean Total Postoperative Opioid Consumption (in Morphine Equivalents) for HTX 011 Compared With Bupivacaine HCl.
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 primary unilateral, distal, first metatarsal bunionectomy with osteotomy and internal fixation under regional 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 had a contralateral foot bunionectomy in the past 3 months. Has a planned concurrent surgical procedure (eg, bilateral bunionectomy or collateral procedures on the surgical foot). Has other 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 at least 10 days prior to the scheduled surgery. Has taken opioids within 24 hours prior to the scheduled surgery (3 days for long-acting). Has been administered bupivacaine within 5 days prior to the scheduled surgery. Has initiated treatment with 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. Subjects taking medical marijuana are not allowed to participate in the 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.
Facility Information:
Facility Name
Springhill Medical Center
City
Mobile
State/Province
Alabama
ZIP/Postal Code
36608
Country
United States
Facility Name
Orthopaedic Specialists of North America, PLLC
City
Mesa
State/Province
Arizona
ZIP/Postal Code
85206
Country
United States
Facility Name
Arizona Research Center
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85059
Country
United States
Facility Name
Anaheim Clinical Trials, LLC
City
Anaheim
State/Province
California
ZIP/Postal Code
92801
Country
United States
Facility Name
Trovare Clinical Research, Inc.
City
Bakersfield
State/Province
California
ZIP/Postal Code
93301
Country
United States
Facility Name
Alliance Research Centers
City
Laguna Hills
State/Province
California
ZIP/Postal Code
92653
Country
United States
Facility Name
Chesapeake Research Group, LLC
City
Pasadena
State/Province
Maryland
ZIP/Postal Code
21122
Country
United States
Facility Name
Optimal Research , LLC
City
Austin
State/Province
Texas
ZIP/Postal Code
78705
Country
United States
Facility Name
Hermann Drive Surgical Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77004
Country
United States
Facility Name
Westside Surgical Hospital
City
Houston
State/Province
Texas
ZIP/Postal Code
77027
Country
United States
Facility Name
Futuro Clinical Trials, LLC
City
McAllen
State/Province
Texas
ZIP/Postal Code
78501
Country
United States
Facility Name
Plano Surgical Hospital
City
Plano
State/Province
Texas
ZIP/Postal Code
75093
Country
United States
Facility Name
Endeavor Clinical Trials
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
EPIC Medical Research, LLC
City
Murray
State/Province
Utah
ZIP/Postal Code
84123
Country
United States
Facility Name
Jean Brown Research
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84124
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
34284613
Citation
Yip T, Hu J, Hawn PS, Yamamoto A, Oderda G. HTX-011 effectively reduces postoperative pain intensity and opioid use in the elderly. Pain Manag. 2022 Jan;12(1):45-57. doi: 10.2217/pmt-2021-0043. Epub 2021 Jul 21.
Results Reference
derived
PubMed Identifier
31113830
Citation
Viscusi E, Gimbel JS, Pollack RA, Hu J, Lee GC. HTX-011 reduced pain intensity and opioid consumption versus bupivacaine HCl in bunionectomy: phase III results from the randomized EPOCH 1 study. Reg Anesth Pain Med. 2019 May 21:rapm-2019-100531. doi: 10.1136/rapm-2019-100531. Online ahead of print.
Results Reference
derived

Learn more about this trial

Bunionectomy Study for Postoperative Analgesia (EPOCH 1)

We'll reach out to this number within 24 hrs