The Safety and Efficacy of the Buprenorphine Transdermal System (BTDS) in Subjects With Chronic Back Pain.
- Conditions
- Back Pain
- Interventions
- Drug: OXY/APAPDrug: Placebo oxycodone/acetaminophen tabletsDrug: Placebo transdermal patch (TDS)
- Registration Number
- NCT00315445
- Lead Sponsor
- Purdue Pharma LP
- Brief Summary
The objective of this study is to assess the safety of the buprenorphine transdermal system (5, 10, and 20) in comparison to placebo transdermal system and immediate release oxycodone/ acetaminophen in subjects with chronic back pain. The double-blind treatment intervention duration is 84 days during which time supplemental analgesic medication (non-steroidal anti-inflammatory drugs) will be allowed for all subjects in addition to study drug.
- Detailed Description
Buprenorphine is a synthetic opioid analgesic with over twenty-five years of international clinical experience indicating it to be safe and effective in a variety of therapeutic situations for the relief of moderate to severe pain.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 134
- clinical evidence of stable, chronic (>2 months) back pain related to intervertebral disc disease, nerve root entrapment, spondylolithesis, and osteoarthritis or other, similar nonmalignant conditions.
- unacceptable pain control despite currently taking a nonsteroidal anti-inflammatory drug considered at a therapeutic and/or tolerated dose or, subjects currently taking </=2 short-acting opioid doses per day, or subjects taking 3-12 short-acting opioid doses per day.
- receiving opioids at an average daily dose of >90 mg of oral morphine equivalents or receiving more than 12 tablets per day of short-acting opioid-containing products.
- scheduled to have surgery (including dental) involving the use of preoperative or postoperative analgesics or anesthetics during the study period.
Other protocol-specific exclusion/inclusion criteria may apply.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Placebo Placebo transdermal patch (TDS) Placebo oxycodone (OXY)/acetaminophen (APAP) tablets and placebo transdermal patch (TDS) 5, 10, or 20 OXY/APAP OXY/APAP 5 mg oxycodone/325 mg acetaminophen tablets BTDS Buprenorphine transdermal patch Buprenorphine transdermal patch 5, 10, or 20 mcg/hour Placebo Placebo oxycodone/acetaminophen tablets Placebo oxycodone (OXY)/acetaminophen (APAP) tablets and placebo transdermal patch (TDS) 5, 10, or 20
- Primary Outcome Measures
Name Time Method Pain on the Average, Mean Change From Baseline Days 21-84 (Last Observation Carried Forward [LOCF]) On baseline day 1 and days 21, 30, 45, 60, 75, and 84, and, if applicable, at early termination. Subjects were asked, "Please rate your pain by circling the one number (0-10) that best describes your pain on the average since your last visit." 0 = no pain and 10 = pain as bad as you can imagine it.
Pain Right Now, Mean Change From Baseline, Days 21-84 (LOCF) Assessed at baseline day 1 and days 21, 30, 45, 60, 75, and 84, and, if applicable, at early termination. Subjects were asked, "Please rate your pain by circling the one number (0-10) that tells how much pain you have right now." Subjects rated their answers on a 0-10 ordinal scale from 0 = "No pain" to 10 = "Pain as bad as you can imagine it." Pain right now is presented as the LSmean \[change from baseline\] (SE).
- Secondary Outcome Measures
Name Time Method "Bodily Pain" (MOS SF-36): Mean Percent at Day 84 (LOCF) Day 84 The MOS Short-Form Health Survey assesses 8 categories of functionality through 36 individual questions. "Bodily Pain" is 1 of the 8 categories. Its transformed score, scaled from 0% to 100%, is used. A higher score represents a better subject condition. The survey was completed by the subject at the clinic. The mean scores were analyzed.
"Physical Functioning" Scale of the Medical Outcomes Survey (MOS) 36 Item Short-Form Health Survey (SF-36): Mean Percent ± Standard Error of the Mean (SEM) at Day 84 (LOCF) Day 84, or, if applicable, at early termination The Medical Outcomes Survey (MOS) Short-Form-36 Health Survey (SF-36) assesses 8 categories of functionality through 36 individual questions. "Physical Functioning" is 1 of the 8 categories. Its transformed score, scaled from 0% to 100%, is used. A higher score represents a better subject condition. The survey was completed by the subject at the clinic. The mean scores were analyzed.
"Physical Role" Scale (MOS SF-36): Mean Percent ± SEM at Day 84(LOCF) Day 84 The Medical Outcomes Survey Short-Form-36 health survey assesses 8 categories of functionality through 36 individual questions. "Physical Role" is 1 of the 8 categories. Its transformed score, scaled from 0% to 100%, is used. A higher score represents a better subject condition. The survey was completed by the subject at the clinic. The mean scores were analyzed.
"General Health" (MOS SF-36): Mean Percent ± SEM at Day 84 (LOCF) Day 84 The MOS Short-Form Health Survey assesses 8 categories of functionality through 36 individual questions. "General Health" is 1 of the 8 categories. Its transformed score, scaled from 0% to 100%, is used. A higher score represents a better subject condition. The survey was completed by the subject at clinic. The mean scores were analyzed.
"Vitality" (MOS SF-36): Mean Percent ± SEM at Day 84 (LOCF) Day 84 The MOS Short-Form Health Survey assesses 8 categories of functionality through 36 individual questions. "Vitality" is 1 of the 8 categories. Its transformed score, scaled from 0% to 100%, is used. A higher score represents a better subject condition. The survey was completed by the subject at the clinic. The mean scores were analyzed.
"Social Functioning" (MOS SF-36): Mean Percent ± SEM at Day 84 (LOCF) Day 84 The MOS Short-Form Health Survey assesses 8 categories of functionality through 36 individual questions. "Social Functioning" is 1 of the 8 categories. Its transformed score, scaled from 0% to 100%, is used. A higher score represents a better subject condition. The survey was completed by the subject at the clinic.
"Emotional Role" (MOS SF-36): Mean Percent ± SEM at Day 84 (LOCF) Day 84 The MOS Short-Form Health Survey assesses 8 categories of functionality through 36 individual questions. "Emotional Role" is 1 of the 8 categories. Its transformed score, scaled from 0% to 100%, is used. A higher score represents a better subject condition. The survey was completed by the subject at the clinic.
"Mental Health" (MOS SF-36):Mean Percent ± SEM at Day 84 (LOCF) Day 84 The MOS Short-Form Health Survey assesses 8 categories of functionality through 36 individual questions. "Mental Health" is 1 of the 8 categories. Its transformed score, scaled from 0% to 100%, is used. A higher score represents a better subject condition. The survey was completed by the subject at the clinic.
Therapeutic Response - Investigator: Mean ± SEM (Day 84)(LOCF) Day 84 The therapeutic response was rated by the investigator. The assessment was completed by the investigator using a 0-3 ordinal scale from 0 = "No response" to 3 = "Marked response."
Therapeutic Response - Subject: Mean ± SEM (Day 84) (LOCF) Day 84 The therapeutic response was rated by the subject. The assessment was completed by the subject using a 0-3 ordinal scale from 0 = "No response" to 3 = "Marked response."
Subject Comparison to Prestudy Analgesic: Mean ± SEM (Day 84)(LOCF) Day 84 The subject compared study drug treatment to prestudy analgesic. The assessment was completed by the subject using a 0-2 ordinal scale from 0 = "Worse than prestudy medicine" to 2 = "Better than prestudy medicine."
Subject Satisfaction: Mean ± SEM (Day 84)(LOCF) Day 84 The subject assessed satisfaction with study drug. The assessment was completed by the subject using a 0-3 ordinal scale from 0 = "No response" to 3 = "Marked response."
Time to Stable Pain Management Start of study to day 21. For each subject, "time to stable pain management" is defined as the first (post-baseline) time during the titration period when his/her "diary pain" was 4 or less (or at least 2 points lower than baseline) for 3 consecutive daily records or the "pain on the average" (at the day 7 or day 21 visit) was 4 or less (or at least 2 points lower than baseline).
The Time to Discontinuation Due to Lack of Efficacy Time after dosing to dropout due to lack of efficacy Dropouts due to various reasons were summarized by counts and percentage. Cox proportional hazards regression was used to assess the treatment differences in time to dropout due to lack of efficacy. Clinically important covariates (including gender, age, race, weight, baseline pain, and previous opioid use) were incorporated into the model when statistically significant at P\< .10, using a backward elimination procedure.
Trial Locations
- Locations (12)
Atlanta Research Center
🇺🇸Decatur, Georgia, United States
Phoenix Orthopedic Center, Ltd.
🇺🇸Phoenix, Arizona, United States
Phoenix Center for Clinical Research
🇺🇸Phoenix, Arizona, United States
SeaView Research
🇺🇸Miami, Florida, United States
Park Place Therapeutic Center
🇺🇸Plantation, Florida, United States
New Jersey Research Foundation
🇺🇸Linwood, New Jersey, United States
The Center for Pharmaceutical Research, P.C.
🇺🇸Kansas City, Missouri, United States
Rheumatology Associates of North Alabama
🇺🇸Huntsville, Alabama, United States
North Carolina Clinical Research, Inc.
🇺🇸Raleigh, North Carolina, United States
Research Across America
🇺🇸Dallas, Texas, United States
Gainesville Clinical Research Center
🇺🇸Gainesville, Florida, United States
Metroplex Clinical Research Center
🇺🇸Dallas, Texas, United States