Efficacy and Safety Study of Buprenorphine HCl Buccal Film in Subjects With Low Back Pain
- Registration Number
- NCT01256450
- Lead Sponsor
- BioDelivery Sciences International
- Brief Summary
The purpose of this study is to determine whether buprenorphine hydrochloride (HCl) buccal film is effective and safe in the treatment of chronic low back pain (CLBP).
- Detailed Description
This is an enriched enrollment, randomized withdrawal study with an open label, dose-titration period followed by a randomized, double-blind, placebo-controlled treatment period of 12 weeks. During the double-blind treatment period, this study will evaluate the effectiveness of buprenorphine HCl buccal film versus placebo buccal film in treating CLBP in subjects.
Buprenorphine HCl buccal film is an oral transmucosal form of the opioid analgesic, buprenorphine hydrochloride, intended for application to the buccal mucosa. Buprenorphine is a synthetic opioid that is classified as a partial µ-receptor agonist and a Schedule III controlled substance in the United States.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 334
- Male or non-pregnant and non-nursing female aged 18 or older
- History of moderate to severe chronic low back pain for ≥3 months with a pain intensity ≥5 [11 point numerical rating scale] reported at the open-label titration period Day 0/1 visit following a washout period (opioids, nonsteroidal anti-inflammatory drugs [NSAIDs], and muscle relaxants) of approximately 12 to 24 hours
- Currently taking ≤60 mg oral morphine/day or equianalgesic dose of another opioid (including opioid naïve) for 1 week or longer
- Stable health, as determined by the Investigator, on the basis of medical history, physical examination, and screening laboratory results so as to comply with all study procedures
- Female subjects of childbearing potential must be using a recognized effective method of birth control
- Written informed consent obtained at Screening, prior to any procedure being performed
- Reflex sympathetic dystrophy or causalgia (complex regional pain syndrome), acute spinal cord compression, cauda equina compression, acute nerve root compression, meningitis, and discitis
- Surgical procedure for back pain within 2 months prior to screening or nerve/plexus block within 4 weeks of screening
- Hypokalemia or clinically unstable cardiac disease, including: unstable atrial fibrillation, symptomatic bradycardia, unstable congestive heart failure, or active myocardial ischemia
- Corrected QT (QTc) interval of >450 milliseconds on the 12-lead electrocardiogram (ECG)
- History of long QT syndrome, or an immediate family member with this condition
- Diagnosis of moderate to severe hepatic impairment.
- History of severe emesis with opioids
- Clinically significant sleep apnea
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description BEMA Placebo Placebo placebo buccal soluble film BEMA Buprenorphine Buprenorphine buprenorphine buccal soluble film
- Primary Outcome Measures
Name Time Method Change in Pain Intensity From Baseline to Week 12 Baseline, Week 12 Change in pain intensity = average of daily pain scores from the last 7 days prior to week 12 visit - average of daily pain scores for the last 7 days prior to randomization. Average pain intensity over the last 24 hours was rated on an 11-point numeric rating scale (NRS) ranging from 0 (no pain) to 10 (worst pain imaginable).
- Secondary Outcome Measures
Name Time Method Subject Impression of Change in Pain Intensity From Baseline to Week 12 Using PGIC Scale Baseline, Week 12 Subjects assessed changes in activity, limitations, symptoms, and overall quality of life related to their painful condition since beginning treatment using the Patient Global Impression of Change (PGIC), a balanced 7-point scale from 1 (no change or condition got worse) to 7 (a great deal better and considerable improvement that has made all the difference).
Change From Baseline to Week 12 in Roland Morris Disability Questionnaire Baseline, Week 12 Subjects assess disability due to back pain using the Roland Morris Disability Questionnaire (RMDQ) consisting of 24 statements of disability. The score of the RMDQ is the total number of items checked, ranging from 0 to 24 with higher scores indicating greater disability.
Use of Rescue Medication Day 7, 14, 28, 42, 56, 70, 84, and 91 within double-blind treatment phase Calculated from the use of rescue medication recorded in subject diary as the sum of all rescue medication tablets used in the last 7 days previous to the derived visit, divided by the number of days in this duration where the amount was reported.
Change From Baseline in Pain Intensity Over Time Using NRS Scale Baseline; Day 14, Day 28, Day 42, Day 56, Day 70, and Day 84 Change in pain intensity = average of daily pain scores from the last 7 days prior to each visit - average of daily pain scores for the last 7 days prior to randomization. Average pain intensity over the last 24 hours was rated on an 11-point numeric rating scale (NRS) ranging from 0 (no pain) to 10 (worst pain imaginable).
Number of Participants With Response to Treatment as Assessed by an NRS Scale Week 12 Responses are defined as the relative improvement in pain score at week 12 from baseline, calculated from ratings of average pain intensity over the last 24 hours on an 11-point numeric rating scale (NRS) ranging from 0 (no pain) to 10 (worst pain imaginable).
Percentage of Participants With Treatment Failure in the Double-blind Treatment Phase (up to 12 Weeks) Baseline to treatment failure or end of double-blind treatment phase (up to 12 weeks) Treatment failure is defined as study discontinuation due to lack of efficacy or due to adverse event in the double-blind treatment phase.
Change From Baseline to Week 12 in Treatment Satisfaction Using TSQM Baseline, Week 12 The Treatment Satisfaction Questionnaire for Medication (TSQM) is a 14-item instrument used to assess the subject's satisfaction with the ability of the study medication to prevent or treat the condition of chronic low back pain (CLBP) for effectiveness, side effects, convenience, and global satisfaction. Scores range from 0 to 100, where a higher score indicates less dissatisfaction (ie, greater satisfaction).
Change From Baseline to Week 12 in Subject's Overall Satisfaction With Study Drug Baseline, Week 12 Subjects were asked to rate their overall satisfaction with their study drug on a 5-point scale ranging from 1 (poor) to 5 (excellent).
Change From Baseline to Week 12 in Investigator's Overall Satisfaction With Study Drug Baseline, Week 12 Investigators rated their overall satisfaction with the study drug administered to a given subject on a 5-point scale ranging from 1 (poor) to 5 (excellent).
Trial Locations
- Locations (24)
Coastal Clinical Research, Inc.
🇺🇸Mobile, Alabama, United States
Alabama Orthopaedic Center - Research
🇺🇸Birmingham, Alabama, United States
Neuro-Pain Medical Center
🇺🇸Fresno, California, United States
University of California, San Diego Medical Center, UCSD Center for Pain Medicine
🇺🇸La Jolla, California, United States
Collaborative Neuroscience Network, Inc.
🇺🇸Long Beach, California, United States
Gold Coast Research, LLC
🇺🇸Plantation, Florida, United States
Avail Clinical Research, LLC
🇺🇸DeLand, Florida, United States
Health Awareness, Inc.
🇺🇸Jupiter, Florida, United States
Accord Clinical Research, LLC
🇺🇸Port Orange, Florida, United States
Taylor Research, LLC
🇺🇸Marietta, Georgia, United States
Millennium Pain Center
🇺🇸Bloomington, Illinois, United States
MediSphere Medical Research Center, LLC
🇺🇸Evansville, Indiana, United States
International Clinical Research Institute
🇺🇸Leawood, Kansas, United States
MedVadis Research Corporation
🇺🇸Watertown, Massachusetts, United States
The Center for Clinical Research, LLC
🇺🇸Winston-Salem, North Carolina, United States
Research Across American
🇺🇸New York, New York, United States
Wake Research Associates, LLC
🇺🇸Raleigh, North Carolina, United States
Allegheny Pain Management
🇺🇸Altoona, Pennsylvania, United States
FutureSearch Trials of Neurology
🇺🇸Austin, Texas, United States
Southwest Urgent Care Center
🇺🇸El Paso, Texas, United States
Advanced Clinical Research
🇺🇸West Jordan, Utah, United States
Arizona Research Center
🇺🇸Phoenix, Arizona, United States
Lifetree Clinical Research
🇺🇸Salt Lake City, Utah, United States
Office of Stephen H. Miller, MD
🇺🇸Las Vegas, Nevada, United States