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Clinical Trial Results:
Open-label Investigation of the Pharmacokinetic (PK) Profile, Safety, Tolerability, and Efficacy of Multiple Administrations of Tapentadol Oral Solution Used for Treatment of Acute Pain in Children Aged 2 Years to Less Than 7 Years.

Summary
EudraCT number
2019-000205-77
Trial protocol
PL  
Global end of trial date
06 Aug 2020

Results information
Results version number
v1(current)
This version publication date
08 Jan 2021
First version publication date
08 Jan 2021
Other versions

Trial information

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Trial identification
Sponsor protocol code
KF5503-75
Additional study identifiers
ISRCTN number
-
US NCT number
-
WHO universal trial number (UTN)
U1111-1225-7869
Sponsors
Sponsor organisation name
Grünenthal GmbH
Sponsor organisation address
Zieglerstr. 6, Aachen, Germany, 52099
Public contact
Grünenthal Trial Information Desk, Grünenthal GmbH, 49 2415693223, Clinical-Trials@grunenthal.com
Scientific contact
Grünenthal Trial Information Desk, Grünenthal GmbH, 49 2415693223, Clinical-Trials@grunenthal.com
Paediatric regulatory details
Is trial part of an agreed paediatric investigation plan (PIP)
No
Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
No
Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
Yes
Results analysis stage
Analysis stage
Final
Date of interim/final analysis
26 Aug 2020
Is this the analysis of the primary completion data?
No
Global end of trial reached?
Yes
Global end of trial date
06 Aug 2020
Was the trial ended prematurely?
No
General information about the trial
Main objective of the trial
To investigate the Pharmacokinetic (PK) profile of tapentadol after the administration of multiple doses of tapentadol oral solution to children aged 2 years to less than 7 years after a painful event that routinely produces acute pain requiring treatment with a strong analgesic medication (e.g., opioids or metamizole).
Protection of trial subjects
The trial was conducted according to Good Clinical Practice guidelines, the applicable local laws, and in accordance with the ethical principles that have their origins in the Declaration of Helsinki. The competent authority approved the trial as required by national regulations. The regulatory authority was notified of the trial and amendments as required by national regulations. Tapentadol oral solution was administered to pediatric subjects in accordance with the approved SmPC for the pediatric population. Assessments/interventions have been limited as far as possible to those that would be performed according to the standard of care. Subjects were hospitalised during the entire treatment and evaluation phase to ensure the medical status of each subject was regularly and carefully monitored by qualified medical professionals. Vital signs (respiratory rate, blood pressure, and heart rate) and oxygen saturation (by pulse oximetry) were monitored as per local standard of care from before the administration of Dose 1 until the end of Visit 3. Vital signs and oxygen saturation values were recorded at specified time points before each investigational medicinal product administration and PK blood sampling.
Background therapy
-
Evidence for comparator
-
Actual start date of recruitment
09 Sep 2019
Long term follow-up planned
No
Independent data monitoring committee (IDMC) involvement?
No
Population of trial subjects
Number of subjects enrolled per country
Country: Number of subjects enrolled
Poland: 10
Worldwide total number of subjects
10
EEA total number of subjects
10
Number of subjects enrolled per age group
In utero
0
Preterm newborn - gestational age
0
Newborns (0-27 days)
0
Infants and toddlers (28 days-23 months)
0
Children (2-11 years)
10
Adolescents (12-17 years)
0
Adults (18-64 years)
0
From 65 to 84 years
0
85 years and over
0

Subject disposition

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Recruitment
Recruitment details
The study was conducted at 3 sites in Poland between 9 September 2019 and 06 August 2020.

Pre-assignment
Screening details
A total of 10 subjects were enrolled and treated in the study.

Period 1
Period 1 title
Overall Study (overall period)
Is this the baseline period?
Yes
Allocation method
Not applicable
Blinding used
Not blinded

Arms
Arm title
Tapentadol Oral Solution
Arm description
Subjects received a target dose of 1.25 milligram (mg) tapentadol per kilogram (kg) body weight every 4 hours (± 15 minutes), in 1 of 2 available concentrations. Subjects with body weight less than or equal to (<=) 16 kg received tapentadol oral solution 4 milligram per milliliter (mg/mL); whereas subjects with body weight greater than (>)16 kg received tapentadol oral solution 20 mg/mL.
Arm type
Experimental

Investigational medicinal product name
Tapentadol
Investigational medicinal product code
Other name
Pharmaceutical forms
Oral solution
Routes of administration
Oral use
Dosage and administration details
Subjects with body weight <=16 kg received tapentadol oral solution 4 mg/mL; whereas subjects with body weight >16 kg received tapentadol oral solution 20 mg/mL.

Number of subjects in period 1
Tapentadol Oral Solution
Started
10
Completed
10

Baseline characteristics

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Baseline characteristics reporting groups
Reporting group title
Overall Study
Reporting group description
Subjects received a target dose of 1.25 mg tapentadol per kg body weight every 4 hours (± 15 minutes), in 1 of 2 available concentrations. Subjects with body weight <= 16 kg received tapentadol oral solution 4 mg/mL; whereas subjects with body weight >16 kg received tapentadol oral solution 20 mg/mL.

Reporting group values
Overall Study Total
Number of subjects
10 10
Age categorical
Units: Subjects
Age continuous
Units: years
    arithmetic mean (standard deviation)
3.8 ± 1.8 -
Gender categorical
Units: Subjects
    Female
1 1
    Male
9 9
Race
Units: Subjects
    White
10 10
    American Indian Or Alaska Native
0 0
    Asian
0 0
    Black Or African American
0 0
    Native Hawaiian Or Other Pacific Islander
0 0
    Not Reported
0 0
    Other
0 0

End points

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End points reporting groups
Reporting group title
Tapentadol Oral Solution
Reporting group description
Subjects received a target dose of 1.25 milligram (mg) tapentadol per kilogram (kg) body weight every 4 hours (± 15 minutes), in 1 of 2 available concentrations. Subjects with body weight less than or equal to (<=) 16 kg received tapentadol oral solution 4 milligram per milliliter (mg/mL); whereas subjects with body weight greater than (>)16 kg received tapentadol oral solution 20 mg/mL.

Primary: Area Under the Concentration-Time Curve at Steady State for the Dosing Interval (AUCtau,SS) for Tapentadol

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End point title
Area Under the Concentration-Time Curve at Steady State for the Dosing Interval (AUCtau,SS) for Tapentadol [1]
End point description
AUCtau,SS was defined as area under the concentration-time curve at steady state for the dosing interval. The endpoint of this trial was estimated based on a population PK (popPK) model and the observed concentration-time data. The concentration data of all subjects who had a quantifiable serum concentration of tapentadol were analysed. The descriptive statistics presented for the endpoint include all evaluable subjects as per trial protocol.
End point type
Primary
End point timeframe
Four-hour dosing interval at steady-state
Notes
[1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
Justification: Nonlinear mixed effects modeling approach using the first-order method with conditional estimation and interaction was applied to develop a popPK model based on the observed concentration-time data. The model was used to provide estimates of population and individual PK parameters and to simulate full multiple-dose concentration-time profiles for each subject based on the Empirical Bayes Estimates.The AUCtau,SS was calculated from the individual full profiles using the linear trapezoidal method.
End point values
Tapentadol Oral Solution
Number of subjects analysed
8
Units: hour*nanogram per milliliter (h*ng/ml)
    arithmetic mean (standard deviation)
234.96 ± 51.45
No statistical analyses for this end point

Secondary: Area Under the Concentration-Time Curve at Steady State for the Dosing Interval (AUCtau,SS) for Tapentadol-O-Glucuronide

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End point title
Area Under the Concentration-Time Curve at Steady State for the Dosing Interval (AUCtau,SS) for Tapentadol-O-Glucuronide
End point description
Tapentadol-O-Glucuronide was the metabolite of Tapentadol. AUCtau,SS was defined as area under the concentration-time curve at steady state for the dosing interval. The endpoint of this trial was estimated based on a popPK model and the observed concentration-time data. The concentration data of all subjects who had a quantifiable serum concentration of tapentadol-O-glucuronide were analysed. The descriptive statistics presented for the endpoint include all evaluable subjects as per trial protocol.
End point type
Secondary
End point timeframe
Four-hour dosing interval at steady-state
End point values
Tapentadol Oral Solution
Number of subjects analysed
8
Units: h*ng/ml
    arithmetic mean (standard deviation)
5829.38 ± 1000.07
No statistical analyses for this end point

Secondary: Area Under the Concentration-Time Curve at Steady State for the Dosing Interval (AUCtau,SS) for Tapentadol-O-Sulphate

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End point title
Area Under the Concentration-Time Curve at Steady State for the Dosing Interval (AUCtau,SS) for Tapentadol-O-Sulphate
End point description
Tapentadol-O-Sulphate was the metabolite of Tapentadol. AUCtau,SS was defined as area under the concentration-time curve at steady state for the dosing interval. The endpoint of this trial was estimated based on a popPK model and the observed concentration-time data. The concentration data of all subjects who had a quantifiable serum concentration of tapentadol-O-sulphate were analysed. The descriptive statistics presented for the endpoint include all evaluable subjects as per trial protocol.
End point type
Secondary
End point timeframe
Four-hour dosing interval at steady-state
End point values
Tapentadol Oral Solution
Number of subjects analysed
8
Units: h*ng/ml
    arithmetic mean (standard deviation)
334.51 ± 138.33
No statistical analyses for this end point

Adverse events

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Adverse events information
Timeframe for reporting adverse events
Any adverse event (AE) that occurred between Dose 1 (included) until final dose + 48 hours (included), i.e. treatment emergent AE.
Adverse event reporting additional description
Reported AE were treatment emergent AEs i.e. any AE that occurred between Dose 1 until final dose + 48 hour (included). Analysis was performed on safety analysis set that included all subjects with at least 1 investigational medicinal product administration.
Assessment type
Systematic
Dictionary used for adverse event reporting
Dictionary name
MedDRA
Dictionary version
23.0
Reporting groups
Reporting group title
Tapentadol Oral Solution
Reporting group description
Subjects received a target dose of 1.25 mg tapentadol per kg body weight every 4 hours (± 15 minutes), in 1 of 2 available concentrations. Subjects with body weight <= 16 kg received tapentadol oral solution 4 mg/mL; whereas subjects with body weight >16 kg received tapentadol oral solution 20 mg/mL.

Serious adverse events
Tapentadol Oral Solution
Total subjects affected by serious adverse events
     subjects affected / exposed
0 / 10 (0.00%)
     number of deaths (all causes)
0
     number of deaths resulting from adverse events
Frequency threshold for reporting non-serious adverse events: 0%
Non-serious adverse events
Tapentadol Oral Solution
Total subjects affected by non serious adverse events
     subjects affected / exposed
5 / 10 (50.00%)
Gastrointestinal disorders
Constipation
     subjects affected / exposed
1 / 10 (10.00%)
     occurrences all number
1
Nausea
     subjects affected / exposed
2 / 10 (20.00%)
     occurrences all number
2
Regurgitation
     subjects affected / exposed
1 / 10 (10.00%)
     occurrences all number
2
Vomiting
     subjects affected / exposed
1 / 10 (10.00%)
     occurrences all number
1
Skin and subcutaneous tissue disorders
Hyperhidrosis
     subjects affected / exposed
1 / 10 (10.00%)
     occurrences all number
1

More information

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Substantial protocol amendments (globally)

Were there any global substantial amendments to the protocol? No

Interruptions (globally)

Were there any global interruptions to the trial? No

Limitations and caveats

Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
None reported
3
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