Pharmacokinetics and Safety of ORF Tablets in Pediatric Patients

An Open-label Study to Characterize the Pharmacokinetics and Safety of Oxycodone Hydrochloride q12h Controlled-Release (ORF) Tablets in Pediatric Patients Aged 6 to 16 Years Inclusive, Who Require Opioid Analgesia

The purpose of this study is to characterize the pharmacokinetics (PK) of single-dose ORF tablets in pediatric patients aged 6 to 16 years, inclusive.

Study Overview

• Status: Completed
• Conditions: Opioid Analgesia
• Intervention / Treatment: Drug: Oxycodone hydrochloride controlled-release (ORF) tablets

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Phase 1

Contacts and Locations

Study Locations

• Australia
  • Parkville, Australia, 3052
    • The Royal Children's Hospital
• Finland
  • Helsinki, Finland, 00290
    • Helsinki University Central Hospital/Children and Adolescent Hospital
  • Kuopio, Finland, 70211
    • Kuopio University Hospital/Operative Services and Intensive Care
• New Zealand
  • Hamilton, New Zealand, 3214
    • Waikato Clinical Research (2008) Ltd
• United States
  • Arizona
    • Phoenix, Arizona, United States, 85008
      • Maricopa Medical Center
  • Arkansas
    • Little Rock, Arkansas, United States, 72202-3591
      • Arkansas Childrens Hospital
  • California
    • Palo Alto, California, United States, 94304
      • LS Packard Children's Hospital
  • Colorado
    • Aurora, Colorado, United States, 80045
      • The Children's Hospital Association
  • Florida
    • Miami, Florida, United States, 33136
      • Research Facility
  • Michigan
    • Ann Arbor, Michigan, United States, 48109
      • F3900 C.S. Mott Children's Hospital
  • Ohio
    • Akron, Ohio, United States, 44308
      • Akron Children's Hospital
  • Oklahoma
    • Oklahoma City, Oklahoma, United States, 73104-5070
      • The Children's Hospital at OUMC
  • Pennsylvania
    • Pittsburgh, Pennsylvania, United States, 15224
      • Children's Hospital of Pittsburgh
  • Texas
    • Dallas, Texas, United States, 75235
      • Children's Med Center of Dallas
    • Temple, Texas, United States, 76508
      • Scott & White Memorial Hospital & Clinic
  • Washington
    • Seattle, Washington, United States, 98104-2420
      • University of Washington School of Medicine - Harborview Medical Center
  • Wisconsin
    • Milwaukee, Wisconsin, United States, 53226
      • Children's Hospital of Wisconsin

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 years to 16 years (Child)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Written informed consent provided by the parent or legal guardian and patient assent, when appropriate.
• Children of either gender, aged 6 to 16 years, inclusive.
• Have or are expected to have moderate to severe pain for an extended period of time requiring inpatient opioid analgesic treatment for at least 12 hours as this is the minimum duration of study period treatment.
• In order to receive the first oral dose, patients must have respiratory stability, including a sustained SpO2 of at least 92% with or without supplemental oxygen during the 15 minute period just prior to dosing.
• Must be inpatient for the treatment period of the study.
• The patient's anticipated opioid analgesic requirement over the first 12 hours that will follow administration of ORF must be equivalent to at least 10 mg of intravenous (IV) morphine.
• Have adequate pain control during the 6 hours prior to study drug administration, based on appropriate clinical assessment.
• Must be sufficiently alert to communicate and complete the faces pain scales-revised (FPS-R) or 100-mm visual analogue scale (VAS).
• Females who are of child bearing potential must be using an adequate and reliable method of contraception (e.g., barrier with additional spermicidal foam or jelly, intra-uterine device, hormonal contraception) or be abstinent.
• If female, must have a negative pregnancy test and be non-lactating.
• Must be able to swallow tablets whole.
• Must have stable vital signs.
• Must have vascular access to facilitate blood draws.
• Must be willing and able to participate in all aspects of this study involving use of oral medications, patient evaluation, and phlebotomy, as evidenced by written informed consent from the parent or legal guardian and written patient assent when required by the local IRB/EC.
• Must be willing to have up to 10 milliliters (mL) of blood collected for blood analysis (7 mL for primary PK and 3 mL for secondary PK analysis); and up to 10 mL of blood for pre-specified safety laboratory tests, without safety concerns.
• Must be treated with an opioid for a minimum of 96 hours prior to first dose of ORF.

Exclusion Criteria:

• Any history of hypersensitivity or medical contraindication for the use of oxycodone (this does not exclude patients with a history of expected opioid-related adverse events (AEs), such as light-headedness, dizziness, sedation, nausea, or vomiting).
• Any current history of medical or surgical conditions that might significantly interfere with the gastrointestinal absorption, distribution, metabolism, or excretion of oxycodone (this includes any history of serious disease+ of the gastrointestinal tract, liver, kidneys, and/or blood-forming organs).
• Received oxycodone in the 24 hours prior to study drug administration. .
• Received epidural (or regional) anesthesia < 12 hours prior to the first oral dose of ORF.
• A current history of malabsorption syndrome.
• A current diagnosis of sleep apnea within the last year.
• Reduced renal function (serum creatinine > 1.8 X the upper limit of normal for age).
• Hepatic impairment as evidenced by serum alanine amino transferase (ALT) or serum aspartate amino transferase (AST) > 5 times the upper limit of normal (ULN) for age.
• Currently taking any medications which are CYP3A4 inhibitors.
• Impaired respiratory reserve including severe acute or chronic lung disease, or patients receiving mechanical respiratory support, including mechanical ventilation, BIPAP, or CPAP 6 hours prior to the first oral dose and during the entire oral treatment period.
• Impaired cardiovascular stability (e.g., the day of surgery for cardiac surgery patients).
• Participated in a clinical drug study within 30 days preceding the initial dose in this study.
• Patients who have had surgery within 96 hours prior to the day of the first dose of study drug.
• Deemed to be unsuitable by the investigator for reason(s) not specifically stated in the exclusion criteria.

Study Plan

How is the study designed?

Design Details

• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: ORF Tablets	Drug: Oxycodone hydrochloride controlled-release (ORF) tablets; Oxycodone hydrochloride controlled-release (ORF) tablets (10 mg, 15 mg or 20 mg) taken every 12 hours

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Single-dose PK Metric: Area Under the Plasma Concentration-time Curve From Hour 0 to the Last Measurable Plasma Concentration [AUCt]		Up to 24 hours
Single-dose PK Metric: Area Under the Plasma Concentration-time Curve Extrapolated to Infinity (AUCinf)	Due to insufficient sampling, AUCinf was not estimated.	Up to 24 hours
Single-dose PK Metric: Maximum Observed Plasma Concentration (Cmax)		Up to 24 hours
Single-dose PK Metric: Time to Maximum Plasma Concentration (Tmax)		Up to 24 hours
Single-dose PK Metric: Apparent Terminal Phase Rate Constant (Lamda z)	Due to insufficient sampling, Lamda z was not estimated.	Up to 24 hours
Single-dose PK Metric: Apparent Plasma Terminal Phase Half/Life (t1/2z)	Due to insufficient sampling, t1/2z was not estimated.	Up to 24 hours
Single-dose PK Metric: Lag Time Was Estimated as the Time Point Immediately Prior to the First Measurable Plasma Concentration Value (Tlag)	Due to insufficient sampling, tlag was not estimated.	Up to 24 hours
Single- and Multiple-dose PK Metric: Mean Area Under the Plasma Concentration During Each Dosing Interval-time Curve From Hour 0 to 12 Hours of the First Dose of ORF (AUC 0-12)		Up to 12 hours
Single- and Multiple-dose PK Metric: Maximum Observed Plasma Concentration From Hour 0 to 12 Hours of the First Dose of ORF (Cmax 0-12)		Up to 12 hours
Single- and Multiple-dose PK Metric: Time to Maximum Plasma Concentration From Hour 0 to 12 Hours of the First Dose of ORF (Tmax 0-12)		Up to 12 hours
Single- and Multiple-dose PK Metric: Lag Time Estimated as the Time Point Immediately Prior to the First Measurable Plasma Concentration Value From Hour 0 to 12 Hours of the First Dose of ORF (Tlag 0-12)	Due to insufficient sampling, tlag 0-12 was not estimated.	Up to 12 hours
The Number of Patients With Adverse Events as a Measure of Safety		Adverse events (AEs) & serious adverse events (SAEs) were reported from start of study participation through the period beyond study completion (AEs) & through 30 days following last study drug dose, or until last study visit, whichever was later (SAEs).

Secondary Outcome Measures

Outcome Measure	Time Frame
Multiple-dose PK Metric: Minimum Observed Plasma Concentration Just Prior to the Next Dose (Cmin)	Up to 72 hours if all 5 doses were administered

Collaborators and Investigators

• Sponsor: Purdue Pharma LP

Publications and helpful links

Helpful Links

• Label Information

Study record dates

Study Major Dates

• Study Start: July 1, 2010
• Primary Completion (Actual): August 1, 2011
• Study Completion (Actual): August 1, 2011

Study Registration Dates

• First Submitted: July 8, 2010
• First Submitted That Met QC Criteria: July 8, 2010
• First Posted (Estimate): July 12, 2010

Study Record Updates

• Last Update Posted (Estimate): October 15, 2012
• Last Update Submitted That Met QC Criteria: October 11, 2012
• Last Verified: October 1, 2012

More Information

Terms related to this study

• Keywords: patients; Pediatric; Opioid; Post-operative; Nonsurgical
• Additional Relevant MeSH Terms: Physiological Effects of Drugs; Central Nervous System Depressants; Peripheral Nervous System Agents; Analgesics; Sensory System Agents; Analgesics, Opioid; Narcotics; Oxycodone
• Other Study ID Numbers: OTR1020; 2010-020510-29 (EudraCT Number)