Chronic Pain
Conditions
Brief summary
An open-label, single dose, randomized, cross-over study to confirm the bioequivalence (BE) of OTR tablet 40 mg and OXYCONTIN tablet 40 mg in a fed state in Chinese subjects with chronic pain.
Detailed description
The investigation is designed as an open-label, single dose, randomized, and cross-over study to determine the pharmacokinetics(PK) profile of oxycodone from OTR tablet 40 mg and OXYCONTIN tablet 40 mg in Chinese subjects with chronic pain in a fed stat. Subjects with histories of chronic pain are chosen as the target population. Inclusion/exclusion criteria are strictly defined to reduce the potential variation of the PK data.
Interventions
Orally taking Oxycodone Tamper Resistant 40mg in fed state
DRUGOxyContin®
Orally taking OXYCONTIN® 40mg in fed state
Sponsors
Mundipharma (China) Pharmaceutical Co. Ltd
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
OTHER
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 55 Years
Healthy volunteers
No
Inclusion criteria
1. Chinese male or female subjects with histories of chronic pain regardless of the aetiology, aged 18-55 years both inclusive 2. The average pain over the last 24 hours should be scored \< 4 assessed with Numeric Rating Scales (NRS), when not receiving analgesics. The pain condition has been kept stable at least in the past 7 days prior to entering into the screening and is expected to be stable during the study duration 3. Body weight ≥45 kg and a body mass index (BMI) ≥18 and ≤28 kg/m2 4. Karnofsky score of Performance Status ≥70 5. Willing to take all the food supplied while the subject is in the study unit 6. Be able to read, understand, and sign written Informed Consent Form (ICF) prior to study participation and be willing to follow the protocol requirements 7. Willing to use adequate and highly effective methods of contraception throughout the study. A highly effective method of birth control is defined as one which results in a low failure rate (i.e. less than 1% per year) when used consistently and correctly such as sterilisation, implants, injectables, some Intrauterine Device (IUD), sexual abstinence, or vasectomised partner 8. Female subjects, including those up to less than one year post-menopausal, must have a negative serum pregnancy test and be non-lactating
Exclusion criteria
1. Subjects who are currently taking opioids or have used opioids in the past 14 days prior to receiving the study drug 2. Have hypersensitivity history to any opioids, naltrexone, naloxone, or related compounds or any contraindications as detailed in the OTR and OXYCONTIN tablet Summary of Product Characteristics 3. Histories of or any current conditions that might interfere with drug absorption, distribution, metabolism, or excretion 4. Subjects who are likely to have paralytic ileus or acute abdomen or to require an operation on abdominal regions 5. Subjects with biliary tract diseases, pancreatitis, prostatic hypertrophy, or corticoadrenal insufficiency 6. Subjects with respiratory depression, corpulmonale, or chronic bronchial asthma 7. Any history of seizures or symptomatic head trauma 8. Subjects with abnormal liver function (values exceeding the upper limit of normal (ULN) for alanine aminotransferase (ALT), aspartate aminotransferase (AST), or total bilirubin during the Screening Phase) or abnormal renal function (values exceeding the ULN for serum creatinine during the Screening Phase). Note: if the values of ALT, AST or total bilirubin are between 1 to 1.2 times of ULN and confirmed not clinically significant by the Investigators, the subject may be recruited after getting the approval from Sponsor. 9. Any other significant illness other than the primary disease of chronic pain during the 4 weeks preceding the entry into this study 10. Subjects who are unable to stop taking monoamine oxidase inhibitors during this trial period or time lapses less than 2 weeks since drug withdrawal prior to the study drug administration 11. Subjects who are currently taking tricyclic antidepressants or have used tricyclic antidepressants within 4 weeks prior to the study drug administration 12. Subjects who have used any medicinal product which inhibits Cytochrome P450 3A4 (CYP3A4) (e.g. troleandomycin, ketoconazole, gestodene, etc.) or induces CYP3A4 (e.g. glucocorticoids, barbiturates, rifampicin, etc.) within 4 weeks prior to the study drug administration 13. Subjects who have used any medicinal product which inhibits Cytochrome P450 2D6 (CYP2D6) (e.g. fluoxetine, quinidine, ritonavir, etc.) or induces CYP2D6 (e.g. dexamethasone, rifampicin, glutethimide, etc.) within 4 weeks prior to the study drug administration 14. Histories of smoking (being a smoker or an occasional smoker) within 45 days prior to the study drug administration and refusal to abstain from smoking during the study. According to World Health Organization (WHO), a smoker is defined as having smoked at least 1 cigarette per day continuously for more than 6 months and an occasional smoker is defined as having smoked for more than 4 times per week and less than 1 cigarette per day continuously for more than 6 months. 15. Subjects with histories of alcoholism or drug abuse. Alcoholism is defined as regular alcohol consumption exceeding 14 drinks/week (1 drink = 150 mL of wine or 360 mL of beer or 45 mL of hard liquor) 16. Consumption of alcoholic beverages within 48 hours before study drug administration, and refusal to abstain from alcohol for at least 48 hours after study drug administration 17. Refusal to abstain from food for 10 hours preceding and 4 hours following administration of the study drug and to abstain from caffeine or xanthine entirely during each confinement 18. Positive Hepatitis B Surface Antigen (HBsAg), anti-Hepatitis C Virus (HCV), anti-Human Immunodeficiency Virus (HIV), or syphilis antibody test result 19. Urine screening before study is positive for opioids, barbiturates, amphetamines, cocaine metabolites, methadone, benzodiazepines, phencyclidine, methamphetamine, or cannabinoids. Or alcohol breath test is positive 20. Any history of frequent nausea or emesis regardless of aetiology 21. Blood or blood products donated within 30 days prior to administration of the study drugs or anytime during the study, except as required by this protocol 22. Subjects who participated in a clinical research study within 30 days of study entry
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Cmax of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg in a Fed State | up to 32 hours | The analysis was for PK parameters Cmax of analyte oxycodone. Analysis of Variance (ANOVA) with fixed effect terms for treatment, period, sequence, and subject within sequence for ratio of means (using log scale) were used to compare the test and the reference treatments. |
| AUCt of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg in a Fed State | up to 32 hours | The analysis was for PK parameters AUCt of analyte oxycodone. Analysis of Variance (ANOVA) with fixed effect terms for treatment, period, sequence, and subject within sequence for ratio of means (using log scale) were used to compare the test and the reference treatments. |
| AUCINF of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg in a Fed State | up to 32 hours | The analysis was for PK parameters AUCINF for analyte oxycodone. Analysis of Variance (ANOVA) with fixed effect terms for treatment, period, sequence, and subject within sequence for ratio of means (using log scale) was used to compare the test and the reference treatments. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Number of AEs Related to ECGs | up to 35 days | Summarized table of 12-lead ECG is presented. ECG was measured at Screening and 4 days after IMP dosing in Period 2. |
| Adverse Events of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg, When Given to Chinese Subjects With Chronic Pain in a Fed State | up to 35 days | An overall summary of the number and percentage of Adverse Events will be provided for each treatment groups to assess the safety of OTR tablet 40 mg and OXYCONTIN® tablet 40 mg. |
| Number of AEs Related to Physical Examination | up to 35 days | Physical examination were measured at Screening, 1 day before IMP dosing and 4 days after IMP dosing in each period. |
| Number of Lab Tests With Clinical Significance | up to 35 days | Clinical laboratory data to be summarised includes haematology, blood chemistry, and urinalysis.Each parameter will be assigned an LNH classification according to whether the value is lower than (L), within (N) or higher than (H) the reference range for that parameter. Results will be summarised using shift tables to evaluate categorical changes from baseline to end of study with respect to reference range values (lower than, within, and higher than). |
| Number of AEs Related to Vital Signs | up to 35 days | Vital sign parameters to be summarised include systolic blood pressure, diastolic blood pressure, pulse rate, respiration rate, and axillary temperature.Vital sign results for each parameter will be assigned an LNH classification according to whether the value is lower than (L), within (N), or higher than (H) the reference range for that parameter. Vital sign results will be summarised using shift tables to evaluate categorical changes from baseline to end of study with respect to reference range values (lower than, within, and higher than). |
Countries
China
Participant flow
Recruitment details
42, from Mar2017 to Sep2017, from patient database, medical clinic, advertisement recruitment and etc.
Participants by arm
| Arm | Count |
|---|---|
| OTR 40 Mg-OXYCONTIN 40 mg the treatment sequence is OTR 40 mg dose first and then OXYCONTIN 40 mg dose | 21 |
| OXYCONTIN 40 Mg-OTR 40 mg the treatment sequence is OXYCONTIN 40 mg dose first and then OTR 40 mg dose in fed | 21 |
| Total | 42 |
Baseline characteristics
| Characteristic | OTR 40 Mg-OXYCONTIN 40 mg | OXYCONTIN 40 Mg-OTR 40 mg | Total |
|---|---|---|---|
| Age, Continuous | 36.4 years STANDARD_DEVIATION 13.47 | 38.8 years STANDARD_DEVIATION 10.12 | 37.6 years STANDARD_DEVIATION 11.83 |
| BMI | 22.50 kg/m2 STANDARD_DEVIATION 2.195 | 23.95 kg/m2 STANDARD_DEVIATION 2.243 | 23.23 kg/m2 STANDARD_DEVIATION 2.31 |
| Height | 164.1 cm STANDARD_DEVIATION 8.25 | 162.4 cm STANDARD_DEVIATION 8.31 | 163.3 cm STANDARD_DEVIATION 8.22 |
| Race/Ethnicity, Customized HAN | 21 Participants | 21 Participants | 42 Participants |
| Sex: Female, Male Female | 10 Participants | 12 Participants | 22 Participants |
| Sex: Female, Male Male | 11 Participants | 9 Participants | 20 Participants |
| Weight | 60.80 kg STANDARD_DEVIATION 8.874 | 63.40 kg STANDARD_DEVIATION 9.211 | 62.10 kg STANDARD_DEVIATION 9.03 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 37 | 0 / 40 |
| other Total, other adverse events | 5 / 37 | 10 / 40 |
| serious Total, serious adverse events | 1 / 37 | 0 / 40 |
Outcome results
Primary
AUCINF of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg in a Fed State
The analysis was for PK parameters AUCINF for analyte oxycodone. Analysis of Variance (ANOVA) with fixed effect terms for treatment, period, sequence, and subject within sequence for ratio of means (using log scale) was used to compare the test and the reference treatments.
Time frame: up to 32 hours
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Cmax of OTR Tablet 40 mg | AUCINF of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg in a Fed State | 648.2546 ng*h/ml |
| Cmax of OXYCONTIN Tablet 40 mg | AUCINF of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg in a Fed State | 664.0493 ng*h/ml |
Primary
AUCt of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg in a Fed State
The analysis was for PK parameters AUCt of analyte oxycodone. Analysis of Variance (ANOVA) with fixed effect terms for treatment, period, sequence, and subject within sequence for ratio of means (using log scale) were used to compare the test and the reference treatments.
Time frame: up to 32 hours
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Cmax of OTR Tablet 40 mg | AUCt of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg in a Fed State | 641.3017 ng*h/ml |
| Cmax of OXYCONTIN Tablet 40 mg | AUCt of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg in a Fed State | 646.2133 ng*h/ml |
Primary
Cmax of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg in a Fed State
The analysis was for PK parameters Cmax of analyte oxycodone. Analysis of Variance (ANOVA) with fixed effect terms for treatment, period, sequence, and subject within sequence for ratio of means (using log scale) were used to compare the test and the reference treatments.
Time frame: up to 32 hours
| Arm | Measure | Value (MEAN) |
|---|---|---|
| Cmax of OTR Tablet 40 mg | Cmax of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg in a Fed State | 86.15 ng/ml |
| Cmax of OXYCONTIN Tablet 40 mg | Cmax of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg in a Fed State | 63.54 ng/ml |
Secondary
Adverse Events of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg, When Given to Chinese Subjects With Chronic Pain in a Fed State
An overall summary of the number and percentage of Adverse Events will be provided for each treatment groups to assess the safety of OTR tablet 40 mg and OXYCONTIN® tablet 40 mg.
Time frame: up to 35 days
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Cmax of OTR Tablet 40 mg | Adverse Events of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg, When Given to Chinese Subjects With Chronic Pain in a Fed State | Number of AEs (#) | 29 TEAEs |
| Cmax of OTR Tablet 40 mg | Adverse Events of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg, When Given to Chinese Subjects With Chronic Pain in a Fed State | Number of TEAEs (#) | 29 TEAEs |
| Cmax of OTR Tablet 40 mg | Adverse Events of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg, When Given to Chinese Subjects With Chronic Pain in a Fed State | Number of relateda TEAEs | 20 TEAEs |
| Cmax of OXYCONTIN Tablet 40 mg | Adverse Events of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg, When Given to Chinese Subjects With Chronic Pain in a Fed State | Number of AEs (#) | 37 TEAEs |
| Cmax of OXYCONTIN Tablet 40 mg | Adverse Events of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg, When Given to Chinese Subjects With Chronic Pain in a Fed State | Number of TEAEs (#) | 35 TEAEs |
| Cmax of OXYCONTIN Tablet 40 mg | Adverse Events of OTR Tablet 40 mg and OXYCONTIN Tablet 40 mg, When Given to Chinese Subjects With Chronic Pain in a Fed State | Number of relateda TEAEs | 30 TEAEs |
Secondary
Number of AEs Related to ECGs
Summarized table of 12-lead ECG is presented. ECG was measured at Screening and 4 days after IMP dosing in Period 2.
Time frame: up to 35 days
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cmax of OTR Tablet 40 mg | Number of AEs Related to ECGs | 0 AEs of ECG related |
| Cmax of OXYCONTIN Tablet 40 mg | Number of AEs Related to ECGs | 1 AEs of ECG related |
Secondary
Number of AEs Related to Physical Examination
Physical examination were measured at Screening, 1 day before IMP dosing and 4 days after IMP dosing in each period.
Time frame: up to 35 days
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cmax of OTR Tablet 40 mg | Number of AEs Related to Physical Examination | 1 AEs related to Physical examination |
| Cmax of OXYCONTIN Tablet 40 mg | Number of AEs Related to Physical Examination | 1 AEs related to Physical examination |
Secondary
Number of AEs Related to Vital Signs
Vital sign parameters to be summarised include systolic blood pressure, diastolic blood pressure, pulse rate, respiration rate, and axillary temperature.Vital sign results for each parameter will be assigned an LNH classification according to whether the value is lower than (L), within (N), or higher than (H) the reference range for that parameter. Vital sign results will be summarised using shift tables to evaluate categorical changes from baseline to end of study with respect to reference range values (lower than, within, and higher than).
Time frame: up to 35 days
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cmax of OTR Tablet 40 mg | Number of AEs Related to Vital Signs | 0 AEs of vital signs related |
| Cmax of OXYCONTIN Tablet 40 mg | Number of AEs Related to Vital Signs | 1 AEs of vital signs related |
Secondary
Number of Lab Tests With Clinical Significance
Clinical laboratory data to be summarised includes haematology, blood chemistry, and urinalysis.Each parameter will be assigned an LNH classification according to whether the value is lower than (L), within (N) or higher than (H) the reference range for that parameter. Results will be summarised using shift tables to evaluate categorical changes from baseline to end of study with respect to reference range values (lower than, within, and higher than).
Time frame: up to 35 days
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Cmax of OTR Tablet 40 mg | Number of Lab Tests With Clinical Significance | 5 Lab tests with clinical significance |
| Cmax of OXYCONTIN Tablet 40 mg | Number of Lab Tests With Clinical Significance | 11 Lab tests with clinical significance |