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Total Knee Arthroplasty Infiltration Study for Postoperative Analgesia

Primary Purpose

Postoperative Pain

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
HTX-011
Saline Placebo
Bupivicaine HCl
Ropivacaine
Sponsored by
Heron Therapeutics
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Postoperative Pain focused on measuring knee, knee replacement, arthroplasty, joint replacement, knee pain

Eligibility Criteria

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

Inclusion Criteria:

  • Is scheduled to undergo primary unilateral TKA under general anesthesia.
  • Has not previously undergone TKA in either knee.
  • Has an American Society of Anesthesiologists Physical Status of I, II, or III.
  • Is able to demonstrate motor function by performing a timed 20-meter walk unassisted, but with the optional use of a 4-legged walker for balance.
  • 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 a planned concurrent surgical procedure (eg, bilateral TKA).
  • Has a pre-existing concurrent acute or chronic painful/restrictive physical condition that may require analgesic treatment in the postoperative period for pain.
  • Has a contraindication or a known or suspected history of hypersensitivity or 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 NSAIDs within 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.
  • Has a known history of Hepatitis B, human immunodeficiency virus (HIV), or active Hepatitis C.
  • Has uncontrolled anxiety, psychiatric, or neurological disorder that might interfere with study assessments.
  • Has any chronic neuromuscular deficit of either femoral nerve function or thigh musculature. Has any chronic condition or disease that would compromise neurological or vascular assessments.
  • Had a malignancy in the last year, with the exception of non-metastatic 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.
  • 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) >38 kg/m2.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm 5

Arm 6

Arm 7

Arm 8

Arm Type

Experimental

Experimental

Placebo Comparator

Active Comparator

Experimental

Experimental

Placebo Comparator

Active Comparator

Arm Label

Cohort 1, Group 1: HTX-011

Cohort 1, Group 2: HTX-011

Cohort 1, Group 3: Saline Placebo

Cohort 1, Group 4: Bupivacaine HCI

Cohort 2, Group 1: HTX-011

Cohort 2, Group 2: HTX-011 + Ropivacaine

Cohort 2, Group 3: Saline Placebo

Cohort 2, Group 4: Bupivacaine HCI

Arm Description

HTX-011 (bupivacaine/meloxicam), 200 mg/6 mg via instillation

HTX-011 (bupivacaine/meloxicam), 200 mg/6 mg via injection and instillation (combination)

Saline placebo via injection

Bupivacaine HCl without epinephrine, 125 mg via injection

HTX-011 (bupivacaine/meloxicam), 400 mg/12 mg via instillation

HTX-011 (bupivacaine/meloxicam), 400 mg/12 mg via instillation; Ropivacaine, 50 mg via injection

Saline placebo via injection

Bupivacaine HCl without epinephrine, 125 mg via injection

Outcomes

Primary Outcome Measures

Mean Area Under the Curve (AUC) of the NRS-R (Windowed Worst Observation Carried Forward) Pain Intensity Scores
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 at rest (NRS-R).

Secondary Outcome Measures

Mean Area Under the Curve (AUC) of the NRS-R (Windowed Worst Observation Carried Forward) Pain Intensity Scores
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 at rest (NRS-R).
Mean Total Postoperative Opioid Consumption (in Morphine Equivalents)

Full Information

First Posted
January 6, 2017
Last Updated
September 29, 2021
Sponsor
Heron Therapeutics
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1. Study Identification

Unique Protocol Identification Number
NCT03015532
Brief Title
Total Knee Arthroplasty Infiltration Study for Postoperative Analgesia
Official Title
A Phase 2b, Randomized, Double-Blind, Saline Placebo- and Active-Controlled, Multicenter Study of HTX-011 Via Infiltration for Postoperative Analgesia in Subjects Undergoing Total Knee Arthroplasty
Study Type
Interventional

2. Study Status

Record Verification Date
September 2021
Overall Recruitment Status
Completed
Study Start Date
January 13, 2017 (Actual)
Primary Completion Date
April 20, 2018 (Actual)
Study Completion Date
May 16, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Heron Therapeutics

4. Oversight

5. Study Description

Brief Summary
This is a Phase 2b, randomized, double-blind, saline placebo- and active-controlled, multicenter study in subjects undergoing primary unilateral total knee arthroplasty (TKA) to evaluate the analgesic efficacy, safety, and pharmacokinetics (PK) of HTX-011 administered via infiltration to the surgical site.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Postoperative Pain
Keywords
knee, knee replacement, arthroplasty, joint replacement, knee pain

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
285 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Cohort 1, Group 1: HTX-011
Arm Type
Experimental
Arm Description
HTX-011 (bupivacaine/meloxicam), 200 mg/6 mg via instillation
Arm Title
Cohort 1, Group 2: HTX-011
Arm Type
Experimental
Arm Description
HTX-011 (bupivacaine/meloxicam), 200 mg/6 mg via injection and instillation (combination)
Arm Title
Cohort 1, Group 3: Saline Placebo
Arm Type
Placebo Comparator
Arm Description
Saline placebo via injection
Arm Title
Cohort 1, Group 4: Bupivacaine HCI
Arm Type
Active Comparator
Arm Description
Bupivacaine HCl without epinephrine, 125 mg via injection
Arm Title
Cohort 2, Group 1: HTX-011
Arm Type
Experimental
Arm Description
HTX-011 (bupivacaine/meloxicam), 400 mg/12 mg via instillation
Arm Title
Cohort 2, Group 2: HTX-011 + Ropivacaine
Arm Type
Experimental
Arm Description
HTX-011 (bupivacaine/meloxicam), 400 mg/12 mg via instillation; Ropivacaine, 50 mg via injection
Arm Title
Cohort 2, Group 3: Saline Placebo
Arm Type
Placebo Comparator
Arm Description
Saline placebo via injection
Arm Title
Cohort 2, Group 4: Bupivacaine HCI
Arm Type
Active Comparator
Arm Description
Bupivacaine HCl without epinephrine, 125 mg via injection
Intervention Type
Drug
Intervention Name(s)
HTX-011
Intervention Description
HTX-011 (bupivacaine/meloxicam), via instillation
Intervention Type
Drug
Intervention Name(s)
Saline Placebo
Intervention Description
Saline placebo via injection
Intervention Type
Drug
Intervention Name(s)
Bupivicaine HCl
Intervention Description
Bupivacaine HCl without epinephrine
Intervention Type
Drug
Intervention Name(s)
Ropivacaine
Intervention Description
Ropivacaine, via injection
Primary Outcome Measure Information:
Title
Mean Area Under the Curve (AUC) of the NRS-R (Windowed Worst Observation Carried Forward) Pain Intensity Scores
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 at rest (NRS-R).
Time Frame
48 hours
Secondary Outcome Measure Information:
Title
Mean Area Under the Curve (AUC) of the NRS-R (Windowed Worst Observation Carried Forward) Pain Intensity Scores
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 at rest (NRS-R).
Time Frame
72 hours
Title
Mean Total Postoperative Opioid Consumption (in Morphine Equivalents)
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 primary unilateral TKA under general anesthesia. Has not previously undergone TKA in either knee. Has an American Society of Anesthesiologists Physical Status of I, II, or III. Is able to demonstrate motor function by performing a timed 20-meter walk unassisted, but with the optional use of a 4-legged walker for balance. 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 a planned concurrent surgical procedure (eg, bilateral TKA). Has a pre-existing concurrent acute or chronic painful/restrictive physical condition that may require analgesic treatment in the postoperative period for pain. Has a contraindication or a known or suspected history of hypersensitivity or 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 NSAIDs within 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. Has a known history of Hepatitis B, human immunodeficiency virus (HIV), or active Hepatitis C. Has uncontrolled anxiety, psychiatric, or neurological disorder that might interfere with study assessments. Has any chronic neuromuscular deficit of either femoral nerve function or thigh musculature. Has any chronic condition or disease that would compromise neurological or vascular assessments. Had a malignancy in the last year, with the exception of non-metastatic 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. 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) >38 kg/m2.
Facility Information:
City
Mobile
State/Province
Alabama
ZIP/Postal Code
36608
Country
United States
City
Sheffield
State/Province
Alabama
ZIP/Postal Code
35660
Country
United States
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85015
Country
United States
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85023
Country
United States
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
City
Riverside
State/Province
California
ZIP/Postal Code
92503
Country
United States
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States
City
Miami
State/Province
Florida
ZIP/Postal Code
33143
Country
United States
City
Miami
State/Province
Florida
ZIP/Postal Code
33155
Country
United States
City
Tamarac
State/Province
Florida
ZIP/Postal Code
33321
Country
United States
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89109
Country
United States
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43203
Country
United States
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
City
Dayton
State/Province
Ohio
ZIP/Postal Code
45417
Country
United States
City
Bellaire
State/Province
Texas
ZIP/Postal Code
77401
Country
United States
City
Houston
State/Province
Texas
ZIP/Postal Code
77004
Country
United States
City
Houston
State/Province
Texas
ZIP/Postal Code
77027
Country
United States
City
Houston
State/Province
Texas
ZIP/Postal Code
77043
Country
United States
City
Plano
State/Province
Texas
ZIP/Postal Code
75093
Country
United States
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78209
Country
United States
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78240
Country
United States
City
Webster
State/Province
Texas
ZIP/Postal Code
77598
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
32561266
Citation
Lachiewicz PF, Lee GC, Pollak RA, Leiman DG, Hu J, Sah AP. HTX-011 Reduced Pain and Opioid Use After Primary Total Knee Arthroplasty: Results of a Randomized Phase 2b Trial. J Arthroplasty. 2020 Oct;35(10):2843-2851. doi: 10.1016/j.arth.2020.05.044. Epub 2020 May 27.
Results Reference
derived

Learn more about this trial

Total Knee Arthroplasty Infiltration Study for Postoperative Analgesia

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