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Safety, Tolerability, PK, and Analgesic Effect of INL-001 in Children Following Open Inguinal Hernia Repair

Primary Purpose

Inguinal Hernia, Postoperative Pain

Status
Recruiting
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Bupivacaine HCl collagen-matrix implant
Bupivacaine HCl infiltration
Sponsored by
Innocoll
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Inguinal Hernia focused on measuring INL-001, Bupivacaine, Collagen, Children, Pediatric, Inguinal hernia

Eligibility Criteria

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

Inclusion Criteria:

  • Be a male or female 2 to <17 years of age.
  • Be eligible for an elective open inguinal hernia repair that will be performed according to standard surgical technique under general anesthesia.
  • Be premenarche or have a serum confirmed negative pregnancy test at screening and a negative urine pregnancy test before surgery on day 1, if an adolescent female of childbearing potential.
  • Be willing and able to cooperate with all the requirements of the study.
  • Be able to speak and understand English or Spanish.
  • Have a legally authorized representative (eg, parent, guardian) who is able to read, speak, and understand English or Spanish and who will voluntarily sign and date a parental permission/informed consent form that is approved by the Institutional Review Board/Independent Ethics Committee/Human Research Ethics Committee (IRB/IEC/HREC).
  • Be willing to sign an assent (if appropriate dependent upon the child's age, understanding, and IRB requirements), before the conduct of any study procedure.

Exclusion Criteria:

  • Has a known hypersensitivity to amide local anesthetics, bovine products, or to inactive ingredients of the study drugs.
  • Requires any additional surgical procedures, either related or unrelated to the scheduled surgery (ie, open inguinal hernia surgery), during the same hospitalization.
  • Requires epidural or spinal blockade perioperatively.
  • Is required to receive neuraxial (spinal or epidural) opioid analgesics during the study.
  • Has undergone major surgery within 3 months of the scheduled surgery or plans to undergo another surgical procedure within the 30-day postoperative period.
  • Has known or suspected history of drug abuse or misuse or evidence of tolerance or physical dependency on opioid analgesics or sedative-hypnotic medications.
  • Has participated in a clinical trial (investigational or marketed product) within 30 days before surgery.
  • Has any clinically significant medical history or condition (eg, unstable cardiac, neurological, immunological, renal, hepatic, or hematological disease or any other condition) that in the opinion of the investigator, substantially increases the risk associated with the subject's participation in the protocol or compromises the scientific objectives of the study.

Sites / Locations

  • Alliance Research CentersRecruiting
  • Cornerstone Research InstituteRecruiting
  • Medical Research Center
  • Elion & Volhard Pharmaceutical Research (E&V PR)
  • Children's Hospital of Pittsburgh of UPMC (CHP-UPMC)Recruiting
  • Driscoll Children's HospitalRecruiting
  • El Paso Children's HospitalRecruiting
  • Memorial Hermann Memorial City Medical CenterRecruiting
  • The Woman's Hospital of Texas
  • Plano Surgical HospitalRecruiting
  • Jean Brown Research

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

INL-001

Infiltration

Arm Description

Bupivacaine HCl collagen-matrix implant

Bupivacaine HCl infiltration

Outcomes

Primary Outcome Measures

Adverse events
Possibly related to bupivacaine toxicity
Blood pressure (systolic/diastolic)
Signs/symptoms of bupivacaine toxicity
Heart rate
Signs/symptoms of bupivacaine toxicity
Respiratory rate
Signs/symptoms of bupivacaine toxicity
Body temperature
Signs/symptoms of bupivacaine toxicity
12-lead ECG
Screening only
3-lead ECG
Signs/symptoms of bupivacaine toxicity
Oxygen saturation levels
Pulse oximetry
Clinical laboratory testing
Collection of blood and urine samples
Wound healing assessments
Inspection of surgical wound site for signs of wound infection and dehiscence.
Nausea
Measured using a categorical scoring system (none = 0, mild = 1, moderate = 2, and severe = 3). Nausea scores will also be recorded immediately before the use of rescue antiemetics
Sedation
Sedation scores: awake and alert = 0, quietly awake = 1, asleep but easily roused = 2, and deep sleep = 3.

Secondary Outcome Measures

Cmax
Maximum observed plasma concentration
AUC0-last
Area under the plasma concentration time curve from Time zero to last quantifiable plasma concentration
AUC0-∞
Area under the plasma concentration time curve from Time zero to extrapolated through infinity
Tmax
Time to maximum obserbved plasma concentration
t1/2
Apparent first-order terminal elimination half-life
Pain intensity
Assessed using an 11-point NRS (for children 12 to <17 years of age), a FACES pain severity scale (children 4 through <12 years of age), or FLACC (children 2 and 3 years of age) immediately before the child receives any parenteral or oral rescue medication for breakthrough pain

Full Information

First Posted
August 21, 2017
Last Updated
July 23, 2021
Sponsor
Innocoll
Collaborators
Premier Research Group plc
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1. Study Identification

Unique Protocol Identification Number
NCT03262688
Brief Title
Safety, Tolerability, PK, and Analgesic Effect of INL-001 in Children Following Open Inguinal Hernia Repair
Official Title
A Multicenter, Randomized, Controlled Study to Evaluate the Safety, Tolerability, Pharmacokinetics, and Analgesic Effect of the INL-001 Bupivacaine Hydrochloride (HCl) Collagen-Matrix Implant in Children 2 to <17 Years of Age Following Open Inguinal Hernia Repair
Study Type
Interventional

2. Study Status

Record Verification Date
July 2021
Overall Recruitment Status
Recruiting
Study Start Date
June 16, 2017 (Actual)
Primary Completion Date
January 31, 2024 (Anticipated)
Study Completion Date
January 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Innocoll
Collaborators
Premier Research Group plc

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
A multicenter, single-dose study in children 12 to <17 years of age, 6 to <12 years of age, and 2 to <6 years of age who are scheduled for elective open inguinal hernia repair. Enrollment in this study will start with the oldest age group (12 to <17 years) and will continue in a stepwise fashion until appropriate doses are established for all 3 pediatric age groups (12 to <17 years, 6 to <12 years, 2 to <6 years).
Detailed Description
This is a multicenter, single-dose study in children 12 to <17 years of age, 6 to <12 years of age, and 2 to <6 years of age who are scheduled for elective open inguinal hernia repair. Within 21 days of surgery, eligible subjects will be screened and have routine clinical laboratory testing and an electrocardiogram performed. Subjects will then undergo an open inguinal hernia repair under general anesthesia according to the investigator's standard surgical practice on day 1. Enrollment in this study will start with the oldest age group (12 to <17 years) and will continue in a stepwise fashion until appropriate doses are established for all 3 pediatric age groups. Within each age group, the study will be conducted in 3 parts. Children in each age group who are randomized to INL-001 will receive approximately less than or equal to 2.5 mg/kg of INL-001. Study drug will be administered prior to wound closure. The INL-001 implant will be cut before placement into the surgical site using sterile technique. Children randomized to 0.25% bupivacaine HCl injection will receive 2.5 mg/kg according to standard practice. After completion of the surgical procedure, all subjects will remain in the post-anesthesia care unit for at least 3 hours and will be continuously monitored for safety. At the discretion of the investigator, subjects may receive rescue medication (opioid or nonopioid) upon request for the management of breakthrough pain and may receive an antiemetic for the management of nausea or vomiting. After the initial 3-hour period, subjects who are deemed stable may be discharged to the hospital ward. Subjects will remain housed in the hospital ward for at least 48 hours. Blood samples will be collected for pharmacokinetic analysis from a subset of 8 children in each age group after INL-001 is implanted.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Inguinal Hernia, Postoperative Pain
Keywords
INL-001, Bupivacaine, Collagen, Children, Pediatric, Inguinal hernia

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Model Description
Randomized, controlled
Masking
ParticipantOutcomes Assessor
Masking Description
Participant, legal guardian and study personnel involved in the assessment of efficacy and safety are blinded to treatment.
Allocation
Randomized
Enrollment
159 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
INL-001
Arm Type
Experimental
Arm Description
Bupivacaine HCl collagen-matrix implant
Arm Title
Infiltration
Arm Type
Active Comparator
Arm Description
Bupivacaine HCl infiltration
Intervention Type
Drug
Intervention Name(s)
Bupivacaine HCl collagen-matrix implant
Other Intervention Name(s)
Xaracoll
Intervention Description
Placement of the bupivacaine collagen-matrix in the surgical site
Intervention Type
Drug
Intervention Name(s)
Bupivacaine HCl infiltration
Other Intervention Name(s)
Marcaine
Intervention Description
Infiltration of the surgical site
Primary Outcome Measure Information:
Title
Adverse events
Description
Possibly related to bupivacaine toxicity
Time Frame
30 days
Title
Blood pressure (systolic/diastolic)
Description
Signs/symptoms of bupivacaine toxicity
Time Frame
Starting at Time 0 and continuing for 3 hours and then 5, 8, 12, 24, 36, and 48 hours after Time 0
Title
Heart rate
Description
Signs/symptoms of bupivacaine toxicity
Time Frame
Continuously from Time 0 through 3 hours, and then 5, 8, 12, 24, 36, and 48 hours after Time 0
Title
Respiratory rate
Description
Signs/symptoms of bupivacaine toxicity
Time Frame
Continuously from Time 0 through 3 hours, and then 5, 8, 12, 24, 36, and 48 hours after Time 0
Title
Body temperature
Description
Signs/symptoms of bupivacaine toxicity
Time Frame
Through Day 30
Title
12-lead ECG
Description
Screening only
Time Frame
1 day at screening
Title
3-lead ECG
Description
Signs/symptoms of bupivacaine toxicity
Time Frame
Starting at Time 0 and continuing for at least 3 hours
Title
Oxygen saturation levels
Description
Pulse oximetry
Time Frame
Starting at Time 0 and continuing for at least 3 hours
Title
Clinical laboratory testing
Description
Collection of blood and urine samples
Time Frame
1 day at screening
Title
Wound healing assessments
Description
Inspection of surgical wound site for signs of wound infection and dehiscence.
Time Frame
Assessment on Day 1 through Day 3; follow-up evaluations on Days 7, 15 and 30
Title
Nausea
Description
Measured using a categorical scoring system (none = 0, mild = 1, moderate = 2, and severe = 3). Nausea scores will also be recorded immediately before the use of rescue antiemetics
Time Frame
1, 2, 4, 6, 12, 24, 36, and 48 hours after Time 0
Title
Sedation
Description
Sedation scores: awake and alert = 0, quietly awake = 1, asleep but easily roused = 2, and deep sleep = 3.
Time Frame
1, 2, 4, 6, 12, 24, 36, and 48 hours after Time 0
Secondary Outcome Measure Information:
Title
Cmax
Description
Maximum observed plasma concentration
Time Frame
0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 36, and 48 hour time points after Time 0.
Title
AUC0-last
Description
Area under the plasma concentration time curve from Time zero to last quantifiable plasma concentration
Time Frame
0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 36, and 48 hour time points after Time 0
Title
AUC0-∞
Description
Area under the plasma concentration time curve from Time zero to extrapolated through infinity
Time Frame
0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 36, and 48 hour time points after Time 0
Title
Tmax
Description
Time to maximum obserbved plasma concentration
Time Frame
0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 36, and 48 hour time points after Time 0
Title
t1/2
Description
Apparent first-order terminal elimination half-life
Time Frame
0.5, 1, 1.5, 2, 3, 4, 5, 6, 8, 10, 12, 18, 24, 36, and 48 hour time points after Time 0
Title
Pain intensity
Description
Assessed using an 11-point NRS (for children 12 to <17 years of age), a FACES pain severity scale (children 4 through <12 years of age), or FLACC (children 2 and 3 years of age) immediately before the child receives any parenteral or oral rescue medication for breakthrough pain
Time Frame
1, 2, 4, 6, 12, 24, 36, and 48 hours after Time 0

10. Eligibility

Sex
All
Minimum Age & Unit of Time
2 Years
Maximum Age & Unit of Time
16 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Be a male or female 2 to <17 years of age. Be eligible for an elective open inguinal hernia repair that will be performed according to standard surgical technique under general anesthesia. Be premenarche or have a serum confirmed negative pregnancy test at screening and a negative urine pregnancy test before surgery on day 1, if an adolescent female of childbearing potential. Be willing and able to cooperate with all the requirements of the study. Be able to speak and understand English or Spanish. Have a legally authorized representative (eg, parent, guardian) who is able to read, speak, and understand English or Spanish and who will voluntarily sign and date a parental permission/informed consent form that is approved by the Institutional Review Board/Independent Ethics Committee/Human Research Ethics Committee (IRB/IEC/HREC). Be willing to sign an assent (if appropriate dependent upon the child's age, understanding, and IRB requirements), before the conduct of any study procedure. Exclusion Criteria: Has a known hypersensitivity to amide local anesthetics, bovine products, or to inactive ingredients of the study drugs. Requires any additional surgical procedures, either related or unrelated to the scheduled surgery (ie, open inguinal hernia surgery), during the same hospitalization. Requires epidural or spinal blockade perioperatively. Is required to receive neuraxial (spinal or epidural) opioid analgesics during the study. Has undergone major surgery within 3 months of the scheduled surgery or plans to undergo another surgical procedure within the 30-day postoperative period. Has known or suspected history of drug abuse or misuse or evidence of tolerance or physical dependency on opioid analgesics or sedative-hypnotic medications. Has participated in a clinical trial (investigational or marketed product) within 30 days before surgery. Has any clinically significant medical history or condition (eg, unstable cardiac, neurological, immunological, renal, hepatic, or hematological disease or any other condition) that in the opinion of the investigator, substantially increases the risk associated with the subject's participation in the protocol or compromises the scientific objectives of the study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Nina Head of Clinical Operations
Phone
484-406-5214
Email
rsmall@innocoll.com
First Name & Middle Initial & Last Name or Official Title & Degree
Nina Head of Clinical Research, MD
Phone
484-406-5205
Email
nskuban@innocoll.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gwendolyn Niebler, DO
Organizational Affiliation
Innocoll
Official's Role
Study Director
Facility Information:
Facility Name
Alliance Research Centers
City
Laguna Hills
State/Province
California
ZIP/Postal Code
92653
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Tracy Bessette
Phone
949-680-3490
Email
tbessette@researchalliance.com
Facility Name
Cornerstone Research Institute
City
Altamonte Springs
State/Province
Florida
ZIP/Postal Code
32701
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Derrica Robinson
Phone
407-729-1236
Email
drobinson@cornerstonestudy.com
Facility Name
Medical Research Center
City
Miami
State/Province
Florida
ZIP/Postal Code
33144
Country
United States
Individual Site Status
Withdrawn
Facility Name
Elion & Volhard Pharmaceutical Research (E&V PR)
City
Miami
State/Province
Florida
ZIP/Postal Code
33165
Country
United States
Individual Site Status
Withdrawn
Facility Name
Children's Hospital of Pittsburgh of UPMC (CHP-UPMC)
City
Pittsburgh
State/Province
Pennsylvania
ZIP/Postal Code
15224
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Denise McCarthy
Phone
412-692-5585
Email
mccarthydj@anes.upmc.edu
Facility Name
Driscoll Children's Hospital
City
Corpus Christi
State/Province
Texas
ZIP/Postal Code
78411
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Debhanhi Gaylan
Phone
540-314-1838
Email
debhanhi@researchhd.com
Facility Name
El Paso Children's Hospital
City
El Paso
State/Province
Texas
ZIP/Postal Code
79905
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Isaac Martinez
Phone
915-244-0751
Email
isaac@researchhd.com
Facility Name
Memorial Hermann Memorial City Medical Center
City
Houston
State/Province
Texas
ZIP/Postal Code
77024
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jayme Carr
Phone
832-524-7177
Email
jayme@researchHD.com
Facility Name
The Woman's Hospital of Texas
City
Houston
State/Province
Texas
ZIP/Postal Code
77054
Country
United States
Individual Site Status
Withdrawn
Facility Name
Plano Surgical Hospital
City
Plano
State/Province
Texas
ZIP/Postal Code
75093
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Laura Kade
Phone
410-614-5775
Email
laura@researchhd.com
Facility Name
Jean Brown Research
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84124
Country
United States
Individual Site Status
Active, not recruiting

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Safety, Tolerability, PK, and Analgesic Effect of INL-001 in Children Following Open Inguinal Hernia Repair

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