Opioid Use Disorder, Opioid-related Disorders
Conditions
Brief summary
Study is to provide ongoing treatment with RBP-6000 and safety monitoring for subjects who complete the RB-US-13-0003 study (NCT02510014) and for whom a new treatment venue has not been identified or arranged.
Detailed description
This is a multi-center, open-label, RBP-6000 treatment extension study in which subjects who have completed the End of Study (EOS) procedures for study RB-US-13-0003 are eligible. EOS assessments completed at the RB-US-13-0003 EOS visit serve as part of the screening visit for this study. In addition, subjects were requested to complete a Columbia Suicide Severity Rating Scale (C-SSRS) baseline/screening survey and a medical history and height was obtained. The informed consent may be shared with subjects up to 2 months prior to the RB-US-13-0003 EOS visit, however should not be signed until all assessments for the EOS visit have been completed. On Day 1, eligible subjects receive a subcutaneous (SC) injection of RBP-6000 at a low or high dose based on the medical judgment of the investigator. After the injection, vital signs and the injection site were assessed. Prior to departing the site, subjects were also assessed for adverse events (AEs) and use of concomitant medications (ConMeds). Subjects return to the site for monthly injection visits every 28 days (-2 / +7 days) for a total of up to 6 injections (participants were not required to complete all 6 injections). At each subsequent visit (Injections 2 through 6) the following procedures / assessments were performed : urine pregnancy test performed for all female subjects who are of childbearing potential before each injection; previous injection site assessed for potential reaction and evidence of attempts to remove the depot; vital signs collected pre and post each injection; RBP-6000 injection, urine drug screen (UDS); C-SSRS since last visit assessment, counseling (manual-guided behavioral therapy); use of ConMeds; local injection site grading, subject self-assessment of injection site pain (Injection Site Pain Visual Analog Scale \[VAS\]), assessment for adverse events (AEs). Laboratory tests (hematology, chemistry and urinalysis) may be requested by the Investigator on an ad-hoc basis in order to assess for AEs. A subject's alternative treatment options were assessed at least two months before EOS at each visit. At EOS or early termination (ET), the following assessments were performed: urine pregnancy test performed for all female subjects who are of childbearing potential; vital signs; previous injection site assessed for potential reaction and evidence of attempts to remove the depot; UDS; C-SSRS since last visit assessment, counseling (manual-guided behavioral therapy); use of ConMeds; assessment for AEs; a brief physical exam; height and body weight were measured and a subject's body mass index (BMI) and waist-to-hip ratio calculated; laboratory tests (hematology, chemistry, urinalysis). Subjects were to be contacted by telephone approximately 4 weeks after EOS/ET for a safety follow-up assessment of AEs and use of ConMeds.
Interventions
Monthly injections subcutaneously on alternate sides of participant's abdomen. Dose could be adjusted from 100 mg to 300 mg (or the reverse) based on the medical judgment of the investigator.
Sponsors
Study design
Eligibility
Inclusion criteria
1. Provide written consent to participate in this study. 2. Completed the End of Study Visit for the RB-US-13-0003 study (NCT02510014). 3. Be considered eligible in the medical judgment of the Investigator. 4. Females: Women of childbearing potential (defined as all women who are not surgically sterile or postmenopausal for at least 1 year prior to informed consent form (ICF)) must have a negative pregnancy test prior to enrollment and must agree to use a medically acceptable means of contraception from screening through at least 6 months after the last dose of investigational medicinal product (IMP). Males: Subjects with female partners of child-bearing potential must agree to use medically acceptable contraception after signing the ICF through at least 6 months after the last dose of IMP. Male subjects must also agree not to donate sperm during the study and for 6 months after receiving the last dose of IMP. 5. Subjects must agree not to take any buprenorphine products other than those administered during the current study throughout participation in the study. 6. Subjects must be willing to adhere to study procedures.
Exclusion criteria
1. Subject compliance issues during participation in the RB-US-13-0003 study which, in the opinion of the Investigator, could potentially compromise subject safety. 2. Women of childbearing potential who have a positive pregnancy test at RB-US-13-0003 at the end-of-study (EOS) visit, who are pregnant or breastfeeding, seeking pregnancy, or failing to use adequate contraceptive methods during the study. 3. History of suicidal ideation within 28 days prior to signing the ICF as evidenced by answering yes' to questions 4 or 5 on the suicidal ideation portion of the Columbia-Suicide Severity Rating Scale (C-SSRS) since last visit assessment (completed in the EOS Visit for Study RB-US-13-0003), screening/baseline assessment for the current study), or history of a suicide attempt (per the C-SSRS) in the 6 months prior to signing the ICF. 4. Taking any cytochrome P450 3A4 and 2C8 inducers and inhibitors, self-reported additional buprenorphine, or over the counter (OTC) and/or herbal supplements with the potential to prolong QTc within 28 days of Day 1 unless prior written approval was obtained from the Medical Monitor.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Participants With Treatment-Emergent Adverse Events (TEAE) During the Treatment Period | Day 1 up to Week 29 | TEAE=any untoward medical occurrence that develops or worsens in severity after dispensation of the study drug and does not necessarily have a causal relationship to the study drug. Severity was rated by the investigator on a scale of mild, moderate and severe, with severe= a marked limitation in activity. Relation of AE to treatment was determined by the investigator. Serious AEs include death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, OR an important medical event that jeopardized the patient and required medical or surgical intervention to prevent one of the outcomes listed in this definition. |
| Percentage Change From Baseline to Week 25 in Vital Signs | Day 1, Week 25 | Vital signs include: * systolic blood pressure (mmHg) * diastolic blood pressure (mmHg) * respiratory rate (breaths/minute) * pulse oximetry (%) * pulse rate (beats/min) * temperature (C) |
| Participants With Treatment-emergent Adverse Events (TEAEs) Pertaining to Laboratory Test Values | Day 1 up to Week 25 | TEAE=any untoward medical occurrence that develops or worsens in severity after dispensation of the study drug and does not necessarily have a causal relationship to the study drug. The number of participants with TEAEs specific to laboratory tests are summarized. |
Countries
United States
Participant flow
Pre-assignment details
A total of 208 subjects were screened across 25 sites, and of those, all 208 subjects entered the treatment period and received at least 1 dose of RBP-6000.
Participants by arm
| Arm | Count |
|---|---|
| RBP-6000 (100/300 mg Flex) On Day 1 of the study all eligible subjects received a single subcutaneous (SC) injection of RBP-6000. Participants returned to the site for monthly injection visits every 28 days (-2/+7 days) for a total of up to 6 injections. Participants were not required to complete all 6 injections and could choose to terminate from the study at any time.
For each injection, participants could receive either a dose of 100 mg RBP-6000 or 300 mg RBP-6000, based on the medical judgement of the investigator. | 208 |
| Total | 208 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Adverse Event | 1 |
| Overall Study | Incarceration | 1 |
| Overall Study | Lost to Follow-up | 19 |
| Overall Study | Physician Decision | 2 |
| Overall Study | Pregnancy | 1 |
| Overall Study | Relocation | 1 |
| Overall Study | Site closing | 7 |
| Overall Study | Withdrawal by Subject | 10 |
Baseline characteristics
| Characteristic | RBP-6000 (100/300 mg Flex) |
|---|---|
| Age, Continuous | 42.1 years STANDARD_DEVIATION 11.47 |
| Age, Customized >=18 and <30 years | 32 Participants |
| Age, Customized >= 30 and < 45 years | 88 Participants |
| Age, Customized >=45 and < 60 years | 71 Participants |
| Age, Customized >= 60 years | 17 Participants |
| Body Mass Index | 26.12 kg/m^2 STANDARD_DEVIATION 5.031 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 10 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 198 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Females of Childbearing Potential | 40 Participants |
| Height | 173.26 cm STANDARD_DEVIATION 9.788 |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants |
| Race (NIH/OMB) Asian | 0 Participants |
| Race (NIH/OMB) Black or African American | 78 Participants |
| Race (NIH/OMB) More than one race | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants |
| Race (NIH/OMB) White | 129 Participants |
| Sex: Female, Male Female | 70 Participants |
| Sex: Female, Male Male | 138 Participants |
| Waist-to-Hip Ratio | 0.925 ratio STANDARD_DEVIATION 0.0878 |
| Weight | 78.41 kg STANDARD_DEVIATION 16.949 |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 208 |
| other Total, other adverse events | 0 / 208 |
| serious Total, serious adverse events | 5 / 208 |
Outcome results
Participants With Treatment-Emergent Adverse Events (TEAE) During the Treatment Period
TEAE=any untoward medical occurrence that develops or worsens in severity after dispensation of the study drug and does not necessarily have a causal relationship to the study drug. Severity was rated by the investigator on a scale of mild, moderate and severe, with severe= a marked limitation in activity. Relation of AE to treatment was determined by the investigator. Serious AEs include death, a life-threatening adverse event, inpatient hospitalization or prolongation of existing hospitalization, persistent or significant disability or incapacity, a congenital anomaly or birth defect, OR an important medical event that jeopardized the patient and required medical or surgical intervention to prevent one of the outcomes listed in this definition.
Time frame: Day 1 up to Week 29
Population: Safety analysis set
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-Emergent Adverse Events (TEAE) During the Treatment Period | >=1 TEAE | 71 Participants |
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-Emergent Adverse Events (TEAE) During the Treatment Period | >=1 TEAE related to study drug | 14 Participants |
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-Emergent Adverse Events (TEAE) During the Treatment Period | >=1 serious TEAE | 5 Participants |
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-Emergent Adverse Events (TEAE) During the Treatment Period | >=1 serious study treatment-related TEAE | 0 Participants |
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-Emergent Adverse Events (TEAE) During the Treatment Period | Death | 0 Participants |
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-Emergent Adverse Events (TEAE) During the Treatment Period | >=1 severe TEAE | 8 Participants |
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-Emergent Adverse Events (TEAE) During the Treatment Period | TEAE leading to study treatment discontinuation | 1 Participants |
Participants With Treatment-emergent Adverse Events (TEAEs) Pertaining to Laboratory Test Values
TEAE=any untoward medical occurrence that develops or worsens in severity after dispensation of the study drug and does not necessarily have a causal relationship to the study drug. The number of participants with TEAEs specific to laboratory tests are summarized.
Time frame: Day 1 up to Week 25
Population: Safety population
| Arm | Measure | Group | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-emergent Adverse Events (TEAEs) Pertaining to Laboratory Test Values | Aspartate aminotransferase increased | 1 Participants |
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-emergent Adverse Events (TEAEs) Pertaining to Laboratory Test Values | Alanine aminotransferase increased | 1 Participants |
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-emergent Adverse Events (TEAEs) Pertaining to Laboratory Test Values | Blood cholesterol increased | 1 Participants |
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-emergent Adverse Events (TEAEs) Pertaining to Laboratory Test Values | Diabetes mellitus | 1 Participants |
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-emergent Adverse Events (TEAEs) Pertaining to Laboratory Test Values | Hepatic enzyme increased | 1 Participants |
| RBP-6000 (100/300 mg Flex) | Participants With Treatment-emergent Adverse Events (TEAEs) Pertaining to Laboratory Test Values | Liver function test increased | 1 Participants |
Percentage Change From Baseline to Week 25 in Vital Signs
Vital signs include: * systolic blood pressure (mmHg) * diastolic blood pressure (mmHg) * respiratory rate (breaths/minute) * pulse oximetry (%) * pulse rate (beats/min) * temperature (C)
Time frame: Day 1, Week 25
Population: Safety analysis set. Participants with both baseline and Week 25 data are included.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| RBP-6000 (100/300 mg Flex) | Percentage Change From Baseline to Week 25 in Vital Signs | Systolic blood pressure | 1.93 percentage change from baseline | Standard Deviation 11.208 |
| RBP-6000 (100/300 mg Flex) | Percentage Change From Baseline to Week 25 in Vital Signs | Diastolic blood pressure | 2.61 percentage change from baseline | Standard Deviation 12.397 |
| RBP-6000 (100/300 mg Flex) | Percentage Change From Baseline to Week 25 in Vital Signs | Pulse oximetry | 0.13 percentage change from baseline | Standard Deviation 1.377 |
| RBP-6000 (100/300 mg Flex) | Percentage Change From Baseline to Week 25 in Vital Signs | Pulse rate | 6.04 percentage change from baseline | Standard Deviation 16.975 |
| RBP-6000 (100/300 mg Flex) | Percentage Change From Baseline to Week 25 in Vital Signs | Respiratory rate | 0.67 percentage change from baseline | Standard Deviation 8.36 |
| RBP-6000 (100/300 mg Flex) | Percentage Change From Baseline to Week 25 in Vital Signs | Temperature | 0.02 percentage change from baseline | Standard Deviation 1.003 |