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Phase 3 N=116 Treatment

Total Knee Arthroplasty (TKA) Study of HTX-011 in an Multimodal Analgesic Regimen (MMA) Regimen

Analgesia

Enrolled (actual)
116
Serious AEs
3.5%
Results posted
Aug 2023
Primary outcome: Primary: Mean Area Under the Curve (AUC) of the Visual Analogue Scale (VAS). — 155.57; 185.27; 161.36; 126.59 pain intensity score*hr

Study Design & Population

Study type
Interventional
Phase
Phase 3
Interventions
HTX-011 (Drug); Ibuprofen (Drug); Acetaminophen (Drug); Celecoxib (Drug); +/- Bupivacaine HCl (Drug); Luer Lock Applicator (Device)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
Heron Therapeutics
Primary completion
Dec 2020

Outcome Measures

OutcomeResultp-value
PRIMARY
Mean Area Under the Curve (AUC) of the Visual Analogue Scale (VAS).
155.57; 185.27; 161.36; 126.59
SECONDARY
Mean AUC of VAS Scores.
277.03; 319.81; 276.87; 216.18
SECONDARY
Mean AUC of the NRS of Pain Intensity at Rest (NRS-R).
309.89; 355.20; 311.00; 245.00
SECONDARY
Percentage of Subjects With Severe Pain.
26; 4; 5; 6; 29; 5
SECONDARY
Mean Total Postoperative Opioid Consumption (in IV Morphine Milligram Equivalents [MME]).
26.40; 31.50; 23.40; 17.62
SECONDARY
Percentage of Subjects Who Are Opioid-free
25; 4; 3; 10
SECONDARY
Percentage of Subjects Who Are Opioid-free Through 72 Hours Who Remain Opioid-free Through Day 11.
9; 1; 0; 5
SECONDARY
Median Time to First Opioid Rescue Medication.
6.12; 5.63; 9.96; 12.76
SECONDARY
Percentage of Subjects Who do Not Receive an Opioid Prescription at Discharge.
41; 8; 12; 13
SECONDARY
Percentage of Subjects Who do Not Receive an Opioid Prescription Between Discharge and the Day 11 Visit.
44; 8; 8; 17
SECONDARY
Percentage of Subjects Achieving a Score of "Good" or Better (>1) Pain Control Based on Patient Global Assessment (PGA).
60; 10; 14; 16; 61; 11
SECONDARY
Median Time to First Ambulation Postsurgery.
20.66; 23.20; 26.72; 20.58
SECONDARY
Percentage of Subjects Unable to Participate in Each Rehabilitation Session Because of Pain.
23; 1; 2; 3
SECONDARY
Percentage of Subjects Who First Achieve an MPADSS Score ≥9.
15; 2; 2; 0; 16; 3
SECONDARY
Percentage of Subjects Who Are Discharged Home vs to a Skilled Nursing Facility.
61; 10; 16; 20
SECONDARY
Mean Overall Benefit of Analgesia Score (OBAS).
6.5; 7.4; 7.6; 5.9; 5.7; 4.9
SECONDARY
Mean Total TSQM-9 Score
86.9; 77.0; 89.3; 86.8; 86.4; 80.2
SECONDARY
Maximum Concentration (Cmax)
566; 534; 742; 851; 238; 247
SECONDARY
Time of Occurrence of Maximum Concentration (Tmax)
21.05; 20.54; 20.14; 22.48; 47.13; 58.58

Summary

Phase 3b, open-label single-arm study in which all subjects receive HTX-011 as part of a scheduled non-opioid MMA regimen.

Eligibility Criteria

Inclusion Criteria

  • Is scheduled to undergo primary unilateral TKA under spinal anesthesia.
  • Has not previously undergone TKA in either knee.
  • Has an American Society of Anesthesiologists (ASA) Physical Status of I, II, or III.
  • Is able to walk at least 20 feet with 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 is at least 2 years post-menopausal; or is in a monogamous relationship with a partner who is surgically sterile; or using acceptable contraceptives.

Exclusion Criteria

  • 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.
  • Using or expected to use Factor IX Complex or anti-inhibitor coagulant concentrates during the study.
  • 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 with the exception of subjects on low-dose (≤100 mg) daily acetylsalicylic acid for cardioprotection.
  • 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 been administered any local anesthetic within 72 hours 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.
  • Received an investigational product or device in a clinical trial within 30 days or within 5 elimination half lives.
  • 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.
  • 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.
  • Is currently undergoing treatment for hepatitis B, hepatitis C, or HIV.
  • Has uncontrolled anxiety, psychiatric, or neurological disorder that, in the opinion of the Investigator, might interfere with study assessments.
  • Has acquired defective color vision or acute gastrointestinal ulcers, either of which could interfere with scheduled study medications.
  • 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 nonmetastatic basal cell or squamous cell carcinoma of the skin or localized carcinoma in situ of the cervix.
  • Has undergone 3 or more surgeries within 12 months.
  • Has a body mass index (BMI) >39 kg/m2.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT03974932). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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