Phase 3 Herniorrhaphy Study for Postoperative Analgesia (EPOCH 2)

Phase 3

Completed

• Conditions: Postoperative Pain
• Interventions: Drug: HTX-011; Drug: Saline placebo; Drug: Bupivacaine HCl; Device: Luer-lock applicator; Device: Vial access device

• Registration Number: NCT03237481
• Lead Sponsor: Heron Therapeutics

Brief Summary

This is a Phase 3, randomized, double-blind, saline placebo- and active-controlled, multicenter study to evaluate the analgesic efficacy and safety of HTX 011 administered via local administration into the surgical site in subjects undergoing unilateral open inguinal herniorrhaphy.

Detailed Description

Not available

Study Timeline

• Study Start: 2017-07-31
• Study First Submitted: 2017-07-31
• Study First Submitted QC: 2017-07-31
• Study First Posted: 2017-08-02
• Primary Completion: 2017-12-22
• Study Completion: 2018-01-16
• Disposition First Submitted: 2018-06-08
• Results First Submitted: 2021-06-11
• Results First Submitted QC: 2021-09-29
• Disposition First Submitted QC: 2021-09-29
• Results First Posted: 2021-10-27
• Disposition First Posted: 2021-10-27
• Status Verified: 2025-02
• Last Update Submitted: 2025-02-26
• Last Update Posted: 2025-03-07

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 418

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.
• Has a planned concurrent surgical procedure.
• Has other 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 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, in the opinion of the Investigator, might interfere with study assessments.
• 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) may be eligible for participation in the study. Subjects taking medical marijuana are not allowed to participate in the 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.

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Treatment Group 1: HTX-011	HTX-011	HTX 011 (bupivacaine/meloxicam)
Treatment Group 1: HTX-011	Luer-lock applicator	HTX 011 (bupivacaine/meloxicam)
Treatment Group 1: HTX-011	Vial access device	HTX 011 (bupivacaine/meloxicam)
Treatment Group 3: Saline Placebo	Saline placebo	Saline placebo
Treatment Group 3: Saline Placebo	Luer-lock applicator	Saline placebo
Treatment Group 2: Bupivacaine HCI	Bupivacaine HCl	Bupivacaine HCl

Primary Outcome Measures

Name	Time	Method
Mean Area Under the Curve (AUC) of the Numeric Rating Scale (NRS) Pain Intensity Scores With Activity (NRS-A) Through 72 Hours Postsurgery (AUC0-72), Compared With Saline Placebo.	72 hours	Pain intensity is assessed using an 11-point NRS (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable" (using windowed worst observation carried forward to adjust for opioid rescue medication use). The theoretical range of AUC0-72 is 0-720. The prescribed activity for NRS-A is sitting up from a resting position.

Secondary Outcome Measures

Name	Time	Method
Mean Area Under the Curve (AUC) of the Numeric Rating Scale (NRS) Pain Intensity Scores With Activity (NRS-A) Through 72 Hours Postsurgery (AUC0-72), Compared With Bupivacaine HCl.	72 hours	Pain intensity is assessed using an 11-point NRS (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable" (using windowed worst observation carried forward to adjust for opioid rescue medication use). The theoretical range of AUC0-72 is 0-720. The prescribed activity for NRS-A is sitting up from a resting position.
Mean Total Postoperative Opioid Consumption (in Morphine Equivalents) for HTX 011 Compared With Saline Placebo.	72 hours
Percetange of Subjects Who Are Opioid-free for HTX-011 Compared With Bupivacaine HCl.	72 hours
Mean Total Postoperative Opioid Consumption (in Morphine Equivalents) for HTX 011 Compared With Bupivacaine HCl.	72 hours

Trial Locations

Locations (24)

Trovare Clinical Research, Inc.; 🇺🇸 Bakersfield, California, United States

Alliance Research Centers; 🇺🇸 Laguna Hills, California, United States

Westside Surgical Hospital; 🇺🇸 Houston, Texas, United States

Park Place Surgery Center; 🇺🇸 Maitland, Florida, United States

Hermann Drive Surgical Hospital; 🇺🇸 Houston, Texas, United States

Plano Surgical Hospital; 🇺🇸 Plano, Texas, United States

Cornerstone Research Institute, LLC; 🇺🇸 Longwood, Florida, United States

HD Research Corp; 🇺🇸 Riverside, California, United States

Yale University School of Medicine; 🇺🇸 New Haven, Connecticut, United States

St. Louis Clinical Trials; 🇺🇸 Saint Louis, Missouri, United States

Ziekenhuis Oost Limburg; 🇧🇪 Genk, Belgium

Jessa Ziekenhuis; 🇧🇪 Hasselt, Limburg, Belgium

Jean Brown Research; 🇺🇸 Salt Lake City, Utah, United States

Eliza Coffee Memorial Hospital; 🇺🇸 Florence, Alabama, United States

Anaheim Clinical Trials, LLC; 🇺🇸 Anaheim, California, United States

Shoals Medical Trials, Inc.; 🇺🇸 Sheffield, Alabama, United States

Arizona Research Center; 🇺🇸 Phoenix, Arizona, United States

Lotus Clinical Research, LLC; 🇺🇸 Pasadena, California, United States

University of Miami; 🇺🇸 Miami, Florida, United States

American Institute of Research; 🇺🇸 Whittier, California, United States

EPIC Medical Research, LLC; 🇺🇸 Murray, Utah, United States

Midwest Clinical Research; 🇺🇸 Dayton, Ohio, United States

eStudySite; 🇺🇸 Las Vegas, Nevada, United States

Endeavor Clinical Trials, P.A.; 🇺🇸 San Antonio, Texas, United States