Safety and Pharmacokinetic Study of EMBEDA in Children Ages 7-17 With Pain
AN OPEN-LABEL STUDY TO EVALUATE THE SAFETY AND PHARMACOKINETICS OF PF-06412528 IN CHILDREN 7-17 YEARS FOR THE TREATMENT OF MODERATE-TO-SEVERE PAIN
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
California
-
Irvine, California, United States, 92697
- Gottschalk Medical Plaza
-
Los Angeles, California, United States, 90027
- Children's Hospital Los Angeles
-
Orange, California, United States, 92868
- The University of California, Irvine Health - Medical Specialties
-
Orange, California, United States, 92868
- UCI Medical Center- Outpatient Pharmacy
-
Orange, California, United States, 92868
- University of California, Irvine Health-Inpatient Pharmacy
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Orange, California, United States, 92868
- University of California, Irvine Health-Medical Specialties
-
-
Florida
-
Miami, Florida, United States, 33155
- Nicklaus Children's Hospital
-
Miami, Florida, United States, 33136
- University of Miami / Jackson Memorial Hospital
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Miami, Florida, United States, 33136
- Holtz Children Hospital/Jackson Memorial Hospital
-
Miami, Florida, United States, 33136
- Jackson Memorial Hospital - Pharmacy Department Basement West
-
Miami, Florida, United States, 33136
- Sylvester Comprehensive Cancer Center-Alex's Place
-
Miami Lakes, Florida, United States, 33014
- Veritas Research Corp.
-
-
Illinois
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Chicago, Illinois, United States, 60612
- University of Illinois Hospital and Health Sciences System
-
Chicago, Illinois, United States, 60612
- University of Illinois at Chicago Clinical Research Center
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Chicago, Illinois, United States, 60612
- University of Illinois at the Med Center, University of Illinois
-
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North Carolina
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Greenville, North Carolina, United States, 27834
- East Carolina University Brody School of Medicine(ECU)
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Greenville, North Carolina, United States, 27834
- Leo Jenkins Cancer Center Pharmacy Attn: Rebecca Turnage
-
-
Utah
-
Salt Lake City, Utah, United States, 84113
- Primary Children's Hospital
-
Salt Lake City, Utah, United States, 84113
- Primary Children's Hospital Outpatient Services
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Children 7-17 with moderate to severe pain requiring around the clock treatment with an opioid analgesic.
- Be an experienced opioid user, defined as any subject treated with opioid therapy, equivalent or equal to >20 mg per day of morphine, for a period of 3 consecutive days immediately prior to first day of dosing.
Exclusion Criteria:
- Columbia-Suicide Severity Rating Scale (C-SSRS) for suicidal ideation and behavior in past year.
- Hypersensitivity to morphine, naltrexone.
- A life expectancy (assessed by investigator) of less than 6 months or is no longer capable of taking medication orally.
- Undergone surgery within 3 days prior to the first day of dosing.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Embeda
One arm, open label, active
|
Oral/Capsule, once per day or twice per day dosing; Treatment duration consists of a 1 to 4 week Conversion/Titration Phase leading to a 2 to 6 week Maintenance Treatment duration.
Oral/Capsule, once per day or twice per day dosing; Treatment duration consists of a 1 to 4 week Conversion/Titration Phase leading to a 2 to 6 week Maintenance Treatment duration.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Treatment Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs): Week 1 to Week 4
Time Frame: Week 1 to Week 4
|
An AE was any untoward medical occurrence in a participant who received study treatment without regard to possibility of causal relationship.
SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death, initial or prolonged inpatient hospitalization, life-threatening experience (immediate risk of dying), persistent or significant disability or incapacity, congenital anomaly.
A treatment emergent AE was defined as an event that emerged during the treatment period that was absent before treatment, or worsened during the treatment period relative to the pretreatment state.
AEs included both serious and non-serious adverse events.
|
Week 1 to Week 4
|
|
Number of Participants With Treatment Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs): Week 5 to Week 10
Time Frame: Week 5 to Week 10
|
An AE was any untoward medical occurrence in a participant who received study treatment without regard to possibility of causal relationship.
SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death, initial or prolonged inpatient hospitalization, life-threatening experience (immediate risk of dying), persistent or significant disability or incapacity, congenital anomaly.
A treatment emergent AE was defined as an event that emerged during the treatment period that was absent before treatment, or worsened during the treatment period relative to the pretreatment state.
AEs included both serious and non-serious adverse events.
|
Week 5 to Week 10
|
|
Number of Participants With Treatment Emergent Adverse Events According to Severity: Week 1 to Week 4
Time Frame: Week 1 to Week 4
|
An adverse event was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship.
AE was assessed according to severity; mild (does not interfere with participant's usual function), moderate (interferes to some extent with participant's usual function) and severe (interferes significantly with participant's usual function).A treatment emergent AE was defined as an event that emerged during the treatment period that was absent before treatment, or worsened during the treatment period relative to the pretreatment state.
AEs included both serious and non-serious adverse events.
|
Week 1 to Week 4
|
|
Number of Participants With Treatment Emergent Adverse Events According to Severity: Week 5 to Week 10
Time Frame: Week 5 to Week 10
|
An adverse event was any untoward medical occurrence in a participant who received study drug without regard to possibility of causal relationship.
AE was assessed according to severity; mild (does not interfere with participant's usual function), moderate (interferes to some extent with participant's usual function) and severe (interferes significantly with participant's usual function).
A treatment emergent AE was defined as an event that emerged during the treatment period that was absent before treatment, or worsened during the treatment period relative to the pretreatment state.
AEs included both serious and non-serious adverse events.
|
Week 5 to Week 10
|
|
Number of Participants With Treatment Emergent Treatment Related Adverse Events: Week 1 to Week 4
Time Frame: Week 1 to Week 4
|
An AE was any untoward medical occurrence attributed to study drug in a participant who received study drug.
A treatment emergent AE was defined as an event that emerged during the treatment period that was absent before treatment, or worsened during the treatment period relative to the pretreatment state.
Relatedness to PF-06412528 was assessed by the investigator.
|
Week 1 to Week 4
|
|
Number of Participants With Treatment Emergent Treatment Related Adverse Events: Week 5 to Week 10
Time Frame: Week 5 to Week 10
|
An AE was any untoward medical occurrence attributed to study drug in a participant who received study drug.
A treatment emergent AE was defined as an event that emerged during the treatment period that was absent before treatment, or worsened during the treatment period relative to the pretreatment state.
Relatedness to PF-06412528 was assessed by the investigator.
|
Week 5 to Week 10
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Screening Before Day 1
Time Frame: At Screening (2 weeks before Day 1 of study)
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
At Screening (2 weeks before Day 1 of study)
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Day 1
Time Frame: Day 1 (Pre-dose)
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
Day 1 (Pre-dose)
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Week 1
Time Frame: Week 1
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
Week 1
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Week 2
Time Frame: Week 2
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
Week 2
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Week 3
Time Frame: Week 3
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
Week 3
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Week 4
Time Frame: Week 4
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
Week 4
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Early Termination Before Week 4
Time Frame: Early Termination before Week 4 (anytime between Week 1 to Week 4)
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
Early Termination before Week 4 (anytime between Week 1 to Week 4)
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Screening on Week 5
Time Frame: Screening before treatment started at Week 5
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
Screening before treatment started at Week 5
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Day 1 of Week 5
Time Frame: Day 1 of Week 5
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
Day 1 of Week 5
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Week 6
Time Frame: Week 6
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
Week 6
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Week 8
Time Frame: Week 8
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
Week 8
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Week 10
Time Frame: Week 10
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
Week 10
|
|
Number of Participants With Clinical Opiate Withdrawal Scale (COWS) at Early Termination Before Week 10
Time Frame: Early Termination before Week 10 (anytime between Week 5 to Week 10)
|
COWS is a clinician-administered instrument, to assess participants' clinical opiate withdrawal level.
The scale ranges from 0 (none symptoms) to 48 (severe symptoms), higher score = more severe withdrawal.
Scores category: 0 to 4 = none to minimal, 5 to 12 = mild, 13 to 24 = moderate, 25 to 36 = moderately severe withdrawal and 37 to 48 = severe withdrawal.
Participants experiencing a COWS score greater than equal to (>=) 13 is treated for opiate withdrawal signs and symptoms according to the investigator's medical judgment.
In this outcome measure, participants as per COWS score categories are reported.
Only those COWS categories are presented which had at least 1 participant for any reporting arm.
|
Early Termination before Week 10 (anytime between Week 5 to Week 10)
|
|
Apparent Oral Clearance (CL/F) of PF-06412528
Time Frame: Anytime post-dose on Visit 4 (Week 4)
|
Clearance of a drug is a measure of the rate at which a drug is metabolized or eliminated by normal biological processes.
|
Anytime post-dose on Visit 4 (Week 4)
|
|
Average Concentration at Steady-state (Css, av) of PF-06412528
Time Frame: Anytime post-dose on Visit 4 (Week 4)
|
Css, av was defines as the average steady state concentration of a drug ("steady state" has been achieved when the rate of drug administration and the rate of drug elimination are equal).
|
Anytime post-dose on Visit 4 (Week 4)
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Number of Participants With Pre-defined Criteria of Vital Signs
Time Frame: Week 1 up to Week 10
|
Pre-defined criteria of vital signs included supine diastolic blood pressure (DBP) change from baseline greater than or equal to (>=) 20 millimeter of mercury (mmHg): increase and decrease; supine systolic blood pressure (SBP) change from baseline >=30 mmHg: increase and decrease.
|
Week 1 up to Week 10
|
|
Number of Participants With Laboratory Test Abnormalities
Time Frame: Week 1 up to Week 10
|
Laboratory parameters included: hematology (hemoglobin: <0.8*LLN, hematocrit: <0.8*LLN, red blood cell: <0.8* LLN, platelet <0.5*LLN; >1.75*ULN and white blood cell count <0.6*LLN, neutrophils <0.8* LLN, eosinophils >1.2*ULN, monocytes >1.2*ULN, basophils >1.2*ULN and lymphocytes <0.8* LLN), chemistry (blood urea nitrogen >1.3*ULN, creatinine>1.3*ULN,
sodium <0.95*LLN, potassium <0.9*LLN, >1.1*ULN, aspartate aminotransferase >3.0*ULN, alanine aminotransferase >3.0*ULN, total bilirubin >1.5*ULN, alkaline phosphatase >3.0*ULN, albumin <0.8*LLN, total protein<0.8*LLN,
>1.2*ULN, Albumin <0.8*LLN, Blood Urea Nitrogen >1.3*ULN, Creatinine >1.3*ULN, HDL Cholesterol <0.8*LLN, Chloride <0.9*LLN, Phosphate <0.8*LLN, Bicarbonate <0.9*LLN, Glucose <0.6*LLN, Creatine Kinase >2.0*ULN, Urobilinogen >=1) and urinalysis (specific gravity <1.003, pH <4.5 urine glucose >=1, ketones >=1 urine protein >=1, urine bilirubin >=1, nitrite >=1, urine leukocytes >=20).
|
Week 1 up to Week 10
|
|
Apparent Volume of Distribution (Vz/F) of PF-06412528
Time Frame: Anytime post-dose on Visit 4 (Week 4)
|
Volume of distribution is defined as the theoretical volume in which the total amount of drug would need to be uniformly distributed to produce the desired plasma concentration of a drug.
Apparent volume of distribution after oral dose (Vz/F) is influenced by the fraction absorbed.
|
Anytime post-dose on Visit 4 (Week 4)
|
|
Dose-Exposure Relationship of Metabolites of Morphine, Naltrexone and 6-β-Naltrexol
Time Frame: Anytime post-dose on Visit 4 (Week 4)
|
Anytime post-dose on Visit 4 (Week 4)
|
Collaborators and Investigators
Sponsor
Sponsor
Publications and helpful links
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Other Study ID Numbers
Other Study ID Numbers
- B4541006
- EMBEDA (Other Identifier: Alias Study Number)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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