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Multicenter Study for Pediatric Subjects Evaluating Pharmacokinetics and Safety of EXPAREL (PLAY)

Primary Purpose

Postoperative Pain Management

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Exparel
0.5% Bupivacaine HCl
Sponsored by
Pacira Pharmaceuticals, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Postoperative Pain Management focused on measuring Pediatric

Eligibility Criteria

6 Years - 17 Years (Child)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subjects whose parent(s) or guardian(s) has/have signed and dated the ICF for the subject to participate in the study, and subjects who have provided written assent to participate in the study (if capable).
  2. American Society of Anesthesiologists (ASA) Class 1-3.
  3. Male or female subjects 6 to less than 17 years of age on the day of surgery.
  4. Body mass index (BMI) at screening within the 5th to 95th percentile for age and sex (see Appendix 5).
  5. A negative pregnancy test for female subjects of childbearing potential must be available prior to the start of surgery. The pregnancy test must be conducted in the preoperative holding area according to the study site's standard of care.
  6. Subjects and their parent(s)/guardian(s) must be able to speak, read, and understand the language of the ICF and any instruments used for collecting subject-reported outcomes to enable accurate and appropriate responses to study assessments, and provide informed consent/assent.
  7. Subjects must be able to adhere to the study visit schedule and complete all study assessments.

Exclusion Criteria:

  1. Currently pregnant, breastfeeding, or planning to become pregnant during the study or within 1 month after study drug administration.
  2. History of hypersensitivity or idiosyncratic reactions to amide-type local anesthetics or to opioid medication.
  3. Contraindication to bupivacaine HCl or other amide-type local anesthetics or to opioid medication.
  4. Administration of EXPAREL or bupivacaine HCl within 30 days prior to study drug administration.
  5. Subjects with coagulopathies or immunodeficiency disorders.
  6. History of, suspected, or known addiction to or abuse of drugs or alcohol within the past 2 years.
  7. Clinically significant medical or psychiatric disease that, in the opinion of the investigator, indicates an increased vulnerability to study drugs and/or procedures.
  8. 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.

    In addition, the subject will be ineligible to receive study drug if he or she meets the following criterion during surgery:

  9. 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 postsurgical course.

Sites / Locations

  • Loma Linda University
  • Shriners Hospitals for Children, Northern California
  • Stanford University
  • Children's Hospital Colorado
  • Nemours / Alfred I. DuPont Hospital for Children
  • Nicklaus Children's Hospital
  • Shriners Hospitals for Children-Chicago
  • Riley Hospital for Children at Indiana University Health
  • University of Minnesota Masonic Children's Hospital
  • Duke University Medical Center
  • Wake Forest Baptist Health
  • Cleveland Clinic
  • University of Oklahoma Health Sciences Center
  • Children's Hospital of Philadelphia
  • McGovern Medical School at UTHealth
  • Southwest Scoliosis Institute
  • Children's Hospital of Wisconsin

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Active Comparator

Experimental

Experimental

Arm Label

Group 1: 12 to less than 17 years, undergoing spine surgery, EXPAREL

Group 1: 12 to less than 17 years, undergoing spine surgery, bupivacine

Group 2: 6 to less than 12 years, undergoing spine surgery, EXPAREL

Group 2: 6 to less than 12 years, undergoing cardiac surgery, EXPAREL

Arm Description

Single dose of EXPAREL 4 mg/kg (not to exceed a maximum total dose of 266 mg) via local infiltration at the end of spine surgery.

Single dose of bupivacaine hydrochloride (HCl) 2 mg/kg (not to exceed a maximum total dose of 175 mg) via local infiltration at the end of spine surgery.

Single dose of EXPAREL 4 mg/kg (not to exceed a maximum total dose of 266 mg) via local infiltration at the end of spine surgery.

Single dose of EXPAREL 4 mg/kg (not to exceed a maximum total dose of 266 mg) via local infiltration at the end of cardiac surgery.

Outcomes

Primary Outcome Measures

Area Under the Plasma Concentration-versus-time Curve (AUC) 0 to Infinity
Maximum Plasma Concentration (Cmax)
The Apparent Terminal Elimination Half-life (t1/2el)
Apparent Clearance (CL/F)
Apparent Volume of Distribution (Vd/F)
Area Under the Plasma Concentration-versus-time Curve (AUC) 0 to Tlast

Secondary Outcome Measures

Full Information

First Posted
September 20, 2018
Last Updated
December 10, 2020
Sponsor
Pacira Pharmaceuticals, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT03682302
Brief Title
Multicenter Study for Pediatric Subjects Evaluating Pharmacokinetics and Safety of EXPAREL
Acronym
PLAY
Official Title
A Multicenter Study to Evaluate the Pharmacokinetics and Safety of EXPAREL for Postsurgical Analgesia in Pediatric Subjects Aged 6 to Less Than 17 Years
Study Type
Interventional

2. Study Status

Record Verification Date
December 2020
Overall Recruitment Status
Completed
Study Start Date
April 2, 2019 (Actual)
Primary Completion Date
August 30, 2019 (Actual)
Study Completion Date
September 24, 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
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Primary Objective: To evaluate the pharmacokinetics (PK) of EXPAREL in pediatric subjects aged 6 to less than 17 years undergoing various types of surgeries. Secondary Objective: To evaluate the safety of EXPAREL in pediatric subjects aged 6 to less than 17 years undergoing various types of surgeries.
Detailed Description
This is a Phase 3, two-part, multi-center, open-label study designed to evaluate the PK and safety profile of EXPAREL in pediatric subjects aged 6 to less than 17 years when administered intraoperatively at the end of surgery via local infiltration. 90 pediatric subjects undergoing spine and/or cardiac surgeries are planned for enrollment. Part 1 is a multicenter, randomized, open-label study in subjects aged 6 to less than 17 years undergoing spine or cardiac surgeries. There will be 2 treatment groups: Group 1 will include subjects aged 12 to less than 17 years, while Group 2 will include subjects aged 6 to less than 12 years Part 2 is a multicenter, randomized, open-label, safety study in subjects aged 6 to less than 17 years undergoing spine or cardiac surgeries. There will be 2 treatment groups: Group 1 will include subjects aged 12 to less than 17 years, while Group 2 will include subjects aged 6 to less than 12 years. Subjects will be screened within 30 days prior to study drug administration. During the screening visit, subjects will be assessed for past or present neurologic, cardiac, and general medical conditions that, in the opinion of the investigator, would preclude them from study participation. Subjects will undergo their pre-planned spinal or cardiac surgeries per the institution's standard of care. On Day 1, eligible subjects will receive the study drug intraoperatively at the end of surgery via local infiltration into the surgical site. Dosing of EXPAREL will be based on body weight, with a starting dose of 4 mg/kg (maximum 266 mg). There is no required length of stay in the hospital; subjects may be discharged based on the medical judgment of the treating physician. A follow-up phone call will be scheduled for all subjects on Day 7. A final follow-up visit will be made on Day 30 to all subjects who would have received the study drug.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Postoperative Pain Management
Keywords
Pediatric

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Sequential Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
98 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1: 12 to less than 17 years, undergoing spine surgery, EXPAREL
Arm Type
Experimental
Arm Description
Single dose of EXPAREL 4 mg/kg (not to exceed a maximum total dose of 266 mg) via local infiltration at the end of spine surgery.
Arm Title
Group 1: 12 to less than 17 years, undergoing spine surgery, bupivacine
Arm Type
Active Comparator
Arm Description
Single dose of bupivacaine hydrochloride (HCl) 2 mg/kg (not to exceed a maximum total dose of 175 mg) via local infiltration at the end of spine surgery.
Arm Title
Group 2: 6 to less than 12 years, undergoing spine surgery, EXPAREL
Arm Type
Experimental
Arm Description
Single dose of EXPAREL 4 mg/kg (not to exceed a maximum total dose of 266 mg) via local infiltration at the end of spine surgery.
Arm Title
Group 2: 6 to less than 12 years, undergoing cardiac surgery, EXPAREL
Arm Type
Experimental
Arm Description
Single dose of EXPAREL 4 mg/kg (not to exceed a maximum total dose of 266 mg) via local infiltration at the end of cardiac surgery.
Intervention Type
Drug
Intervention Name(s)
Exparel
Other Intervention Name(s)
Liposomal bupivacaine
Intervention Description
EXPAREL 4mg/kg (maximum 266 mg)
Intervention Type
Drug
Intervention Name(s)
0.5% Bupivacaine HCl
Other Intervention Name(s)
Bupivacaine
Intervention Description
Bupivacaine HCl 2mg/kg
Primary Outcome Measure Information:
Title
Area Under the Plasma Concentration-versus-time Curve (AUC) 0 to Infinity
Time Frame
15, 30, 45 min, 1-1.25h, 2-4h, 10-18h, 24-36h, 42-60h (spine surgery) or 15, 30, 45 min, 1-1.25, 15-25, 20-40, 45-55, 64-72h (cardiac surgery)
Title
Maximum Plasma Concentration (Cmax)
Time Frame
15, 30, 45 min, 1-1.25h, 2-4h, 10-18h, 24-36h, 42-60h (spine surgery) or 15, 30, 45 min, 1-1.25, 15-25, 20-40, 45-55, 64-72h (cardiac surgery)
Title
The Apparent Terminal Elimination Half-life (t1/2el)
Time Frame
15, 30, 45 min, 1-1.25h, 2-4h, 10-18h, 24-36h, 42-60h (spine surgery) or 15, 30, 45 min, 1-1.25, 15-25, 20-40, 45-55, 64-72h (cardiac surgery)
Title
Apparent Clearance (CL/F)
Time Frame
15, 30, 45 min, 1-1.25h, 2-4h, 10-18h, 24-36h, 42-60h (spine surgery) or 15, 30, 45 min, 1-1.25, 15-25, 20-40, 45-55, 64-72h (cardiac surgery)
Title
Apparent Volume of Distribution (Vd/F)
Time Frame
15, 30, 45 min, 1-1.25h, 2-4h, 10-18h, 24-36h, 42-60h (spine surgery) or 15, 30, 45 min, 1-1.25, 15-25, 20-40, 45-55, 64-72h (cardiac surgery)
Title
Area Under the Plasma Concentration-versus-time Curve (AUC) 0 to Tlast
Time Frame
15, 30, 45 min, 1-1.25h, 2-4h, 10-18h, 24-36h, 42-60h (spine surgery) or 15, 30, 45 min, 1-1.25, 15-25, 20-40, 45-55, 64-72h (cardiac surgery)

10. Eligibility

Sex
All
Minimum Age & Unit of Time
6 Years
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects whose parent(s) or guardian(s) has/have signed and dated the ICF for the subject to participate in the study, and subjects who have provided written assent to participate in the study (if capable). American Society of Anesthesiologists (ASA) Class 1-3. Male or female subjects 6 to less than 17 years of age on the day of surgery. Body mass index (BMI) at screening within the 5th to 95th percentile for age and sex (see Appendix 5). A negative pregnancy test for female subjects of childbearing potential must be available prior to the start of surgery. The pregnancy test must be conducted in the preoperative holding area according to the study site's standard of care. Subjects and their parent(s)/guardian(s) must be able to speak, read, and understand the language of the ICF and any instruments used for collecting subject-reported outcomes to enable accurate and appropriate responses to study assessments, and provide informed consent/assent. Subjects must be able to adhere to the study visit schedule and complete all study assessments. Exclusion Criteria: Currently pregnant, breastfeeding, or planning to become pregnant during the study or within 1 month after study drug administration. History of hypersensitivity or idiosyncratic reactions to amide-type local anesthetics or to opioid medication. Contraindication to bupivacaine HCl or other amide-type local anesthetics or to opioid medication. Administration of EXPAREL or bupivacaine HCl within 30 days prior to study drug administration. Subjects with coagulopathies or immunodeficiency disorders. History of, suspected, or known addiction to or abuse of drugs or alcohol within the past 2 years. Clinically significant medical or psychiatric disease that, in the opinion of the investigator, indicates an increased vulnerability to study drugs and/or procedures. 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. In addition, the subject will be ineligible to receive study drug if he or she meets the following criterion during surgery: 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 postsurgical course.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Igor Grachev, MD, PhD
Organizational Affiliation
Pacira Pharmaceuticals, Inc
Official's Role
Study Director
Facility Information:
Facility Name
Loma Linda University
City
Loma Linda
State/Province
California
ZIP/Postal Code
92354
Country
United States
Facility Name
Shriners Hospitals for Children, Northern California
City
Sacramento
State/Province
California
ZIP/Postal Code
95817
Country
United States
Facility Name
Stanford University
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
Facility Name
Children's Hospital Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Nemours / Alfred I. DuPont Hospital for Children
City
Wilmington
State/Province
Delaware
ZIP/Postal Code
19803
Country
United States
Facility Name
Nicklaus Children's Hospital
City
Miami
State/Province
Florida
ZIP/Postal Code
33155
Country
United States
Facility Name
Shriners Hospitals for Children-Chicago
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60707
Country
United States
Facility Name
Riley Hospital for Children at Indiana University Health
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46204
Country
United States
Facility Name
University of Minnesota Masonic Children's Hospital
City
Minneapolis
State/Province
Minnesota
ZIP/Postal Code
55454
Country
United States
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Wake Forest Baptist Health
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
University of Oklahoma Health Sciences Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73110
Country
United States
Facility Name
Children's Hospital of Philadelphia
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
McGovern Medical School at UTHealth
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Southwest Scoliosis Institute
City
Plano
State/Province
Texas
ZIP/Postal Code
75075
Country
United States
Facility Name
Children's Hospital of Wisconsin
City
Milwaukee
State/Province
Wisconsin
ZIP/Postal Code
53226
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
34534923
Citation
Tirotta CF, de Armendi AJ, Horn ND, Hammer GB, Szczodry M, Matuszczak M, Wang NQ, Scranton R, Ballock RT. A multicenter study to evaluate the pharmacokinetics and safety of liposomal bupivacaine for postsurgical analgesia in pediatric patients aged 6 to less than 17 years (PLAY). J Clin Anesth. 2021 Dec;75:110503. doi: 10.1016/j.jclinane.2021.110503. Epub 2021 Sep 14.
Results Reference
derived

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Multicenter Study for Pediatric Subjects Evaluating Pharmacokinetics and Safety of EXPAREL

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