Phase 2 Herniorrhaphy Study for Opioid Elimination

Heron Therapeutics

Status and phase: Completed; Phase 2

Conditions: Postoperative Pain

Treatments: Drug: Ibuprofen; Drug: HTX-011; Device: Luer lock applicator; Device: Vial access device; Drug: Acetaminophen; Drug: Ketorolac

Study type: Interventional

Funder types: Industry

Identifiers

NCT03695367

HTX-011-215

Details and patient eligibility

About

This is a Phase 2, open-label study in subjects undergoing unilateral open inguinal herniorrhaphy.

Enrollment: 63 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Is scheduled to undergo a unilateral open inguinal herniorrhaphy with mesh under general 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

• Had any prior inguinal hernia repair except as a child (less than 6 years of age).
• Has a planned concurrent surgical procedure (eg, bilateral herniorrhaphy).
• Has a 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 least 10 days prior to the scheduled surgery.
• Has taken long-acting opioids within 3 days prior to the scheduled surgery.
• Has taken any opioids within 24 hours prior to the scheduled surgery.
• Has been administered bupivacaine within 5 days prior to the scheduled surgery.
• Has been administered any local anesthetic within 72 hours prior to the scheduled surgery.
• Has initiated treatment with study 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 at the discretion of the Sponsor. Subjects taking any marijuana (medical or recreational) are not allowed to participate in the study.
• Previously participated in an HTX-011 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.

Trial design

Primary purpose: Prevention

Allocation: Non-Randomized

Interventional model: Sequential Assignment

Masking: None (Open label)

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63 participants in 2 patient groups

Cohort 1: HTX-011 + MMA Regimen

Experimental group

Description:

HTX-011 (bupivacaine/meloxicam), 300 mg/9 mg via instillation; non-opioid multimodal analgesic (MMA) regimen.

Treatment:

Device: Luer lock applicator

Device: Vial access device

Drug: Acetaminophen

Drug: HTX-011

Drug: Ibuprofen

Cohort 2: HTX-011 + MMA Regimen + Ketorolac

Experimental group

Description:

HTX-011 (bupivacaine/meloxicam), 300 mg/9 mg via instillation; non-opioid multimodal analgesic (MMA) regimen and IV ketorolac.

Treatment:

Device: Luer lock applicator

Device: Vial access device

Drug: Acetaminophen

Drug: HTX-011

Drug: Ketorolac

Drug: Ibuprofen