Postsurgical Pain Management
Conditions
Brief summary
A phase 2/3 randomized, double-blind, 2-part, comparator- and placebo-controlled study to assess the safety, pharmacokinetics and efficacy of postsurgical local infiltration in adult subjects following inguinal hernia repair surgery.
Detailed description
This is a phase 2/3 randomized, double-blind, 2-part, comparator- and placebo-controlled study to assess the safety, pharmacokinetics and efficacy of postsurgical local infiltration in adult subjects following inguinal hernia repair surgery. This study includes 2 parts. An unblinded interim analysis will be performed after completion of part 1 (phase 2, approximately 115 subjects to be randomized for 2 different doses of TLC590, bupivacaine, ropivacaine, or placebo), for selecting a TLC590 dose for part 2 (phase 3, approximately 300 subjects to be randomized for TLC590, bupivacaine, or placebo).In this study, 2 doses of TLC590 24.5 mg/mL in inguinal hernia repair will be assessed in an initial phase 2 part before proceeding to a phase 3 pivotal evaluation.
Interventions
TLC590 490mg or 588mg
Bupivacaine 75mg
Ropivacaine 150mg
Normal saline 20mL or 24mL
Sponsors
Study design
Eligibility
Inclusion criteria
* Male or female at least 18 years old * BMI 18-39 kg/m2 * Scheduled to undergo a primary, unilateral Lichtenstein inguinal hernia repair with mesh * ASA Physical Status Classification of 1, 2 or 3
Exclusion criteria
* Clinically significant abnormal clinical laboratory test value * Clinically significant 12-lead ECG * History of orthostatic hypotension or syncope * History of significant renal, hepatic, gastrointestinal, cardiovascular, metabolic, neurologic, psychiatric, or other condition * History of seizure or currently taking anticonvulsants * History of hypersensitivity to bupivacaine/ropivacaine, any other amide-type local anesthetic, propofol, oxycodone or morphine (or other opioids) * History of severe or refractory post-operative nausea or vomiting (PONV) * Abnormalities of laboratory parameters: HbA1c, platelet, hemoglobin, WBC, serun bilirubin/alanine aminotransferase/aspartate aminotrasferase, serum creatinine, PTT/INR * Concurrent acute, or chronic painful restrictive/physical condition * Received opioid therapy for longer than 4 days per week * Prohibited medication: aspirin and other anti-platelet medication, anticoagulants, class III antiarrhythmic drugs, strong CYP1A2 inhibitors,systemic corticosteroids, NSAID, opioid, bupivacaine or ropivacaine, any investigational product * History of drug abuse or alcohol abuse * Positive results on the urine drug screen or alcohol breath test * History of HIV; active HBV or HCV * An inguinal hernia repair in the last 3 months or has undergone 3 or more surgeries within 12 months * Malignancy in the last 2 years * Documented sleep apnea or on home continuous positive airway pressure treatment (CPAP) * Personal or family history of malignant hyperthermia.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Part 1 - AUC 0-24 of NPRS-M | 0-24 hours | AUC 0-24 of NPRS-M, evaluated comparing each dose of TLC590 with Placebo |
| Part 2 - AUC 0-72 of NPRS-M | 0-72 hours | AUC 0-72 of NPRS-M, evaluated comparing each dose of TLC590 with Placebo |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| AUC 0-72 of NPRS-M (active comparator) | 0-72 hours | AUC 0-72 of NPRS-M (TLC590 vs Bupivacaine) |
| Proportion of opioid-free subjects through 72 hours (placebo) | 0-72 hours | Proportion of opioid-free subjects through 72 hours (TLC590 vs. Placebo) |
| Proportion of opioid-free subjects through 72 hours (active comparator) | 0-72 hours | Proportion of opioid-free subjects through 72 hours (TLC590 vs. Bupivacaine) |