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Study in Subjects Undergoing Complete Abdominoplasty

Primary Purpose

Postsurgical Pain

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
CA-008 5 mg
Placebo
Bupivacaine Hydrochloride
Hydromorphone
Fentanyl
Acetaminophen
Oxycodone
CA-008 10 mg
CA-008 15 mg
Sponsored by
Concentric Analgesics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Postsurgical Pain

Eligibility Criteria

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

Key Inclusion Criteria:

  • Plan to undergo an elective complete abdominoplasty (C-ABD), without collateral procedure or additional surgeries.
  • In the medical judgment of the investigator, be a reasonably healthy adult aged 18 - 65 years old, inclusive, and American Society of Anesthesiology (ASA) physical Class 1 or 2 at the time of randomization.
  • Unless the subject has a same sex partner, he or she must either be sterile (surgically or biologically) or commit to an acceptable method of birth control while participating in the study.
  • Have a body mass index ≤ 35 kg/m².
  • Be willing and able to sign the informed consent form (ICF) approved by an Institutional Review Board (IRB).

Key Exclusion Criteria:

  • In the opinion of the Investigator, have a concurrent painful condition that may require analgesic treatment during the study period or may confound post-surgical pain assessments.
  • Have a known allergy to chili peppers, capsaicin or the components of CA-008, acetaminophen, bupivacaine, fentanyl hydromorphone or oxycodone.
  • As determined by the investigator have a history or clinical manifestation of significant medical, neuropsychiatric or other condition, including a clinically significant existing arrhythmia, left bundle branch block or abnormal ECG, myocardial infarction or coronary arterial bypass graft surgery within the prior 12 months, significant abnormal clinical laboratory test value, or known bleeding abnormality that could preclude or impair study participation or interfere with study assessments.
  • The following are considered disallowed medications:

    1. Be tolerant to opioids defined as those who have been receiving or have received chronic opioid therapy greater than 15 mg of oral morphine equivalents per day for greater than 3 out of 7 days per week over a one-month period within 6 months of screening.
    2. Within 1 day prior to surgery and throughout the inpatient period, be taking any capsaicin-containing products, such as dietary supplements or over-the-counter (OTC) preparations, including topical formulations, and prescription medications.
    3. Within the 7 days prior to surgery, be taking any central nervous system (CNS) active agent as an analgesic adjunct medication, such as anticonvulsants, antidepressants, benzodiazepines, sedative- hypnotics, clonidine and other central alpha-2 agents, ketamine or muscle relaxants.

    i. These drugs are permitted if prescribed for non-pain indications and the dose has been stable for at least 30 days prior to surgery.

ii. The use of benzodiazepines and the non-benzodiazepines are permitted to treat insomnia during the postoperative period.

Sites / Locations

  • Lotus Clinical Research, LLC

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm Type

Active Comparator

Placebo Comparator

Active Comparator

Active Comparator

Placebo Comparator

Arm Label

CA-008 5 mg (0.05 mg/mL) Cohort 1

Placebo for Cohort 1

CA-008 10 mg (0.1 mg/mL)

CA-008 15 mg (0.15 mg/mL)

Placebo for Cohorts 2 and 3

Arm Description

Cohort 1 (CA-008 5 mg): the surgery for each subject is to be performed under general anesthesia supplemented by a transverse abdominis plane (TAP) block and local surgical site infiltration. Prior to the surgery, perform the TAP block as a single injection of 0.25% bupivacaine hydrochloride (HCl) 60 mL (150 mg).

Cohort 1: Placebo comparator is identical in appearance to the investigational product, containing the same excipients as the active comparator. The surgery for each subject is to be performed under general anesthesia supplemented by a transverse abdominis plane (TAP) block and local surgical site infiltration. Prior to the surgery, perform the TAP block as a single injection of 0.25% bupivacaine hydrochloride (HCl) 60 mL (150 mg).

Cohort 2 (CA-008 10 mg): the surgery is to be performed under general anesthesia supplemented by a transverse abdominis plane (TAP) block and local surgical site infiltration. Prior to the surgery, perform the TAP block as a single injection of 0.25% bupivacaine hydrochloride (HCl) 60 mL (150 mg).

Cohort 3 (CA-008 15 mg): the surgery is to be performed under general anesthesia supplemented by a transverse abdominis plane (TAP) block and local surgical site infiltration. Prior to the surgery, perform the TAP block as a single injection of 0.25% bupivacaine hydrochloride (HCl) 60 mL (150 mg).

Cohorts 2 & 3: Placebo comparator in each cohort is identical in appearance to the investigational product, containing the same excipients as the active comparator. The surgery for each subject is to be performed under general anesthesia supplemented by a transverse abdominis plane (TAP) block and local surgical site infiltration. Prior to the surgery, perform the TAP block as a single injection of 0.25% bupivacaine hydrochloride (HCl) 60 mL (150 mg).

Outcomes

Primary Outcome Measures

Pain Intensity Scores at 96 Hours at Rest Using Numerical Rating Scale (NRS)
Numeric Rating Scale (NRS) of pain intensity from 0-10 where 0 is no pain and 10 is the worst pain imaginable at 96 hours

Secondary Outcome Measures

Weighted Sum of Pain Intensity (SPI) Assessments = AUC of NRS Scores
Pain intensity scores (using a Numeric Rating Scale of pain intensity from 0-10 where 0 is no pain and 10 is the worst pain imaginable) from 0 to T96 hours
Time to Opioid Cessation or Freedom
Time to the last use of opioid
Percent of Opioid Free Subjects
Percent of subjects who were opioid free at 0-96 hours
Total Opioid Consumption
The sum of daily opioid consumption (in morphine equivalents)

Full Information

First Posted
December 2, 2018
Last Updated
January 4, 2022
Sponsor
Concentric Analgesics
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1. Study Identification

Unique Protocol Identification Number
NCT03789318
Brief Title
Study in Subjects Undergoing Complete Abdominoplasty
Official Title
A Phase 2, Randomized, Double-blind, Placebo-Controlled Efficacy, Pharmacokinetics and Safety Study of CA-008 in Subjects Undergoing Complete Abdominoplasty
Study Type
Interventional

2. Study Status

Record Verification Date
January 2022
Overall Recruitment Status
Completed
Study Start Date
December 3, 2018 (Actual)
Primary Completion Date
May 16, 2019 (Actual)
Study Completion Date
June 12, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Concentric Analgesics

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
Phase 2, single center, randomized, double-blind, placebo-controlled, parallel design study of CA-008 vs. placebo in subjects undergoing an elective C-ABD under general anesthesia supplemented with a bupivacaine hydrochloride (HCl)transverse abdominis plane (TAP) block.
Detailed Description
This is a Phase 2, single-center, randomized, double-blind, placebo-controlled, parallel design study evaluating up to 4 ascending dose level cohorts, each evaluating a single dose of CA-008 vs. placebo injected/instilled during an elective C-ABD. Up to 72 subjects may be randomized in 4 cohorts. For each subject, postsurgical assessments will be conducted in two parts: Inpatient period: starts with completion of study treatment injection (T0) and continues through 96 hours (T96h). Outpatient period: begins on discharge from the inpatient unit through various follow up visits to day 29 (D29)/week 4 (W4) after surgery. Note that additional follow up visits may occur at any time or even after D29/W4 to follow adverse events (AEs) to resolution or establishment of a new baseline.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
54 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CA-008 5 mg (0.05 mg/mL) Cohort 1
Arm Type
Active Comparator
Arm Description
Cohort 1 (CA-008 5 mg): the surgery for each subject is to be performed under general anesthesia supplemented by a transverse abdominis plane (TAP) block and local surgical site infiltration. Prior to the surgery, perform the TAP block as a single injection of 0.25% bupivacaine hydrochloride (HCl) 60 mL (150 mg).
Arm Title
Placebo for Cohort 1
Arm Type
Placebo Comparator
Arm Description
Cohort 1: Placebo comparator is identical in appearance to the investigational product, containing the same excipients as the active comparator. The surgery for each subject is to be performed under general anesthesia supplemented by a transverse abdominis plane (TAP) block and local surgical site infiltration. Prior to the surgery, perform the TAP block as a single injection of 0.25% bupivacaine hydrochloride (HCl) 60 mL (150 mg).
Arm Title
CA-008 10 mg (0.1 mg/mL)
Arm Type
Active Comparator
Arm Description
Cohort 2 (CA-008 10 mg): the surgery is to be performed under general anesthesia supplemented by a transverse abdominis plane (TAP) block and local surgical site infiltration. Prior to the surgery, perform the TAP block as a single injection of 0.25% bupivacaine hydrochloride (HCl) 60 mL (150 mg).
Arm Title
CA-008 15 mg (0.15 mg/mL)
Arm Type
Active Comparator
Arm Description
Cohort 3 (CA-008 15 mg): the surgery is to be performed under general anesthesia supplemented by a transverse abdominis plane (TAP) block and local surgical site infiltration. Prior to the surgery, perform the TAP block as a single injection of 0.25% bupivacaine hydrochloride (HCl) 60 mL (150 mg).
Arm Title
Placebo for Cohorts 2 and 3
Arm Type
Placebo Comparator
Arm Description
Cohorts 2 & 3: Placebo comparator in each cohort is identical in appearance to the investigational product, containing the same excipients as the active comparator. The surgery for each subject is to be performed under general anesthesia supplemented by a transverse abdominis plane (TAP) block and local surgical site infiltration. Prior to the surgery, perform the TAP block as a single injection of 0.25% bupivacaine hydrochloride (HCl) 60 mL (150 mg).
Intervention Type
Drug
Intervention Name(s)
CA-008 5 mg
Other Intervention Name(s)
Vocacapsaicin
Intervention Description
5 mg CA-008 reconstituted in saline.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Each cohort will use placebo reconstituted in saline.
Intervention Type
Drug
Intervention Name(s)
Bupivacaine Hydrochloride
Intervention Description
0.25% administered pre-surgery
Intervention Type
Drug
Intervention Name(s)
Hydromorphone
Intervention Description
0.02 mg/kg IV administered intraoperatively
Intervention Type
Drug
Intervention Name(s)
Fentanyl
Intervention Description
100 mcg IV administered intraoperatively
Intervention Type
Drug
Intervention Name(s)
Acetaminophen
Intervention Description
1000 mg IV administered intraoperatively
Intervention Type
Drug
Intervention Name(s)
Oxycodone
Intervention Description
5-10 mg PO administered post-surgery
Intervention Type
Drug
Intervention Name(s)
CA-008 10 mg
Other Intervention Name(s)
Vocacapsaicin
Intervention Description
10 mg CA-008 reconstituted in saline.
Intervention Type
Drug
Intervention Name(s)
CA-008 15 mg
Other Intervention Name(s)
Vocacapsaicin
Intervention Description
15 mg CA-008 reconstituted in saline.
Primary Outcome Measure Information:
Title
Pain Intensity Scores at 96 Hours at Rest Using Numerical Rating Scale (NRS)
Description
Numeric Rating Scale (NRS) of pain intensity from 0-10 where 0 is no pain and 10 is the worst pain imaginable at 96 hours
Time Frame
96 hours
Secondary Outcome Measure Information:
Title
Weighted Sum of Pain Intensity (SPI) Assessments = AUC of NRS Scores
Description
Pain intensity scores (using a Numeric Rating Scale of pain intensity from 0-10 where 0 is no pain and 10 is the worst pain imaginable) from 0 to T96 hours
Time Frame
0 to 96 hours
Title
Time to Opioid Cessation or Freedom
Description
Time to the last use of opioid
Time Frame
From Surgery to Day 17
Title
Percent of Opioid Free Subjects
Description
Percent of subjects who were opioid free at 0-96 hours
Time Frame
0 to 96 hours
Title
Total Opioid Consumption
Description
The sum of daily opioid consumption (in morphine equivalents)
Time Frame
0 to 96 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Plan to undergo an elective complete abdominoplasty (C-ABD), without collateral procedure or additional surgeries. In the medical judgment of the investigator, be a reasonably healthy adult aged 18 - 65 years old, inclusive, and American Society of Anesthesiology (ASA) physical Class 1 or 2 at the time of randomization. Unless the subject has a same sex partner, he or she must either be sterile (surgically or biologically) or commit to an acceptable method of birth control while participating in the study. Have a body mass index ≤ 35 kg/m². Be willing and able to sign the informed consent form (ICF) approved by an Institutional Review Board (IRB). Key Exclusion Criteria: In the opinion of the Investigator, have a concurrent painful condition that may require analgesic treatment during the study period or may confound post-surgical pain assessments. Have a known allergy to chili peppers, capsaicin or the components of CA-008, acetaminophen, bupivacaine, fentanyl hydromorphone or oxycodone. As determined by the investigator have a history or clinical manifestation of significant medical, neuropsychiatric or other condition, including a clinically significant existing arrhythmia, left bundle branch block or abnormal ECG, myocardial infarction or coronary arterial bypass graft surgery within the prior 12 months, significant abnormal clinical laboratory test value, or known bleeding abnormality that could preclude or impair study participation or interfere with study assessments. The following are considered disallowed medications: Be tolerant to opioids defined as those who have been receiving or have received chronic opioid therapy greater than 15 mg of oral morphine equivalents per day for greater than 3 out of 7 days per week over a one-month period within 6 months of screening. Within 1 day prior to surgery and throughout the inpatient period, be taking any capsaicin-containing products, such as dietary supplements or over-the-counter (OTC) preparations, including topical formulations, and prescription medications. Within the 7 days prior to surgery, be taking any central nervous system (CNS) active agent as an analgesic adjunct medication, such as anticonvulsants, antidepressants, benzodiazepines, sedative- hypnotics, clonidine and other central alpha-2 agents, ketamine or muscle relaxants. i. These drugs are permitted if prescribed for non-pain indications and the dose has been stable for at least 30 days prior to surgery. ii. The use of benzodiazepines and the non-benzodiazepines are permitted to treat insomnia during the postoperative period.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alina Beaton, MD
Organizational Affiliation
Lotus Clinical Research, LLC
Official's Role
Principal Investigator
Facility Information:
Facility Name
Lotus Clinical Research, LLC
City
Pasadena
State/Province
California
ZIP/Postal Code
91105
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Study in Subjects Undergoing Complete Abdominoplasty

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