Pain, PostoperativePhase 2NCT00749749
Efficacy and Safety of the CollaRx Bupivacaine Implant Compared to the ON-Q Painbuster Following Abdominal Hysterectomy
A Phase 2 study testing Bupivacaine Collagen Sponge (CollaRx Bupivacaine Implant) and ON-Q PainBuster Post-op Pain relief System in people with Pain, Postoperative, run by Innocoll at 1 site in United States.
Trial summary
The purpose of this study is to determine whether the CollaRx Bupivacaine Implant is safe and effective in reducing the amount of narcotic pain medication needed to control pain during the first 96 hours after abdominal hysterectomy when compared to the ON-Q PainBuster Post-op Pain Relief System. Read more about this study
- Who is it for?
- Ages 18 to 75 years, women only
- Conditions the study is for
- Pain, Postoperative
- What is being tested?
- Bupivacaine Collagen Sponge (CollaRx Bupivacaine Implant) and ON-Q PainBuster Post-op Pain relief System
- Type of treatment
- Injection or infusion
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 27 participants
- Where
- 1 siteUnited States
- Study dates
- 10 Sep 2008to 22 Dec 2008
- Phase
- Phase 2
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 75 years
- Women only
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Must be a woman who is ≥ 18 and ≤ 75 years of age.
- Has a body mass index (BMI) > 19 and < 40 kg/m2.
- Has planned an elective total abdominal hysterectomy for reasons other than malignancies (such as uterine adenocarcinoma, cervical cancer or leiomyosarcoma) to be performed according to standard surgical technique using a standard incision and under general anesthesia with the following caveats:
- Laparoscopic procedures or supraumbilical or Maylard incisions will not be allowed.
- A nonlaparoscopic incision for benign nonhysterectomy gynecological procedures (such as myomectomy or adnexal surgery) is acceptable if the surgical indication is not to treat pelvic pain.
- No concomitant vaginal procedures such as anterior and posterior colporrhaphy (A\&P repairs) are allowed. An abdominal urethropexy and an incidental appendectomy will be allowed.
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- Has a risk classification of I, II or III according to the American Society of Anesthesiologists (ASA).
- Is nonpregnant (negative pregnancy test at Screening and Day 0 before surgery) and nonlactating.
- Is free of other physical or mental conditions that, in the opinion of the Investigator, may confound quantification of postoperative pain resulting from the abdominal hysterectomy.
- Has the ability to read, understand and comply with the study procedures and the use of the pain scales; is deemed capable of operating a patient controlled analgesia (PCA) device; and is able to communicate meaningfully with the study staff.
- Must voluntarily sign and date an informed consent form (ICF), approved by an Institutional Review Board (IRB), prior to the conduct of any study specific procedures.
- Must be able to fluently speak and understand English and be able to provide meaningful written informed consent for the study.
Who cannot join
- Has known hypersensitivity to amide local anesthetics, opioids, bovine products or to inactive ingredients of the test article or reference product.
- Has cardiac arrhythmias or atrioventricular (AV) conduction disorders.
- Concomitantly uses other amide local anesthetics.
- Concomitantly uses antiarrhythmics (eg, amiodarone), propranolol or strong/moderate cytochrome P450 (CYP) 3A4 inhibitors or inducers (eg, macrolide antibiotics and grapefruit juice).
- Has used long acting analgesics within 24 hours of surgery. Short acting analgesics such as acetaminophen may be used on the day of surgery but are subject to preoperative restrictions for oral intake.
- Has used aspirin or aspirin containing products within 7 days of surgery. Aspirin at a dose of ≤ 325 mg is allowed for cardiovascular prophylaxis if the patient has been on a stable dose regimen for ≥ 30 days prior to Screening.
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- Has undergone major surgery within 3 months of the scheduled hysterectomy.
- Requires the use of Seprafilm® or other absorbable adhesion barriers for the scheduled hysterectomy.
- Requires any additional surgical procedures either related or unrelated to the abdominal hysterectomy during the same hospitalization (except for the specific allowed procedures noted in the Inclusion Criteria).
- Is required to receive neuraxial (spinal or epidural) opioid analgesics during the surgery.
- Has known or suspected history of alcohol or drug abuse or misuse within 3 years of Screening or evidence of tolerance or physical dependency on opioid analgesics or sedative hypnotic medications.
- Has used opioids or tramadol on an extended daily basis (> 7 days) prior to surgery. Patients who, in the Investigator's opinion, are developing opioid tolerance are to be excluded.
Trial locations and contacts
1 site in 1 country.
United States1 site
Visions Clinical Research
Boynton Beach, Florida, 33472
About this study
Official title: A Phase II, Randomized, Single-dose, Unblinded Study to Compare the Efficacy and Safety of the CollaRx Bupivacaine Implant With the ON-Q PainBuster Post-op Pain Relief System in Women Following Abdominal Hysterectomy
The purpose of this study is to determine whether the CollaRx Bupivacaine Implant is safe and effective in reducing the amount of narcotic pain medication needed to control pain during the first 96 hours after abdominal hysterectomy when compared to the ON-Q PainBuster Post-op Pain Relief System.
Read the detailed description
Hysterectomy is the second most common surgery among women in the United States (US). Abdominal hysterectomy surgery may be performed to treat benign tumors, such as fibroids, heavy periods, painful periods and chronic pelvic pain. The most common route for performing hysterectomy is through an incision in the abdominal wall; however, about 20% are performed vaginally.Laparoscopic assisted vaginal hysterectomy is performed when warranted.
Bupivacaine is a local anesthetic (pain medication) that has an established safety profile. Collagen is a protein that is found in all mammals. The CollaRx Bupivacaine implant is a thin flat sponge made out of collagen that comes from cattle tendons and contains bupivacaine. When inserted into a surgical site, the collagen breaks down and bupivacaine is released at the site but very little is absorbed into the blood stream. The high levels of bupivacaine at the surgical site may result in less pain for several days after surgery.
The ON Q system consists of 1 elastometric pump with a fill volume of 270 mL containing 0.25% bupivacaine; 1 soaker catheter measuring 12.5 cm in size; and a fill port, tubing, clamp, filter and flow restrictor. The pump provides positive pressure and is portable. It may be attached to the patient's dressing or placed in a carrying pouch. The catheter is inserted directly into the surgical wound providing a continuous flow of bupivacaine into the wound. A capillary flow restricting orifice located at the end of the tubing controls the flow rate.
This study will compare the total narcotic use in patients with the CollaRx Bupivacaine Implant with the total narcotic use in patients with the ON Q PainBuster Post op Pain Relief System after abdominal hysterectomy.
- Conditions
- Pain, Postoperative
- Being tested
- Bupivacaine Collagen Sponge (CollaRx Bupivacaine Implant), ON-Q PainBuster Post-op Pain relief System
- Keywords
- Abdominal Hysterectomy, Postoperative pain
- Medical subject headings
- Pain, Postoperative
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Bupivacaine Collagen Sponge (CollaRx Bupivacaine Implant)Drug
Also called CollRx Bupivacaine Implant
The bupivacaine collagen sponge contains 70mg Type I bovine collagen and 50mg bupivacaine hydrochloride
ON-Q PainBuster Post-op Pain relief SystemDrug
5 mL/hr per catheter of 0.25% bupivacaine (12.5 mg) for 72 hours(total dose 360 mL [900 mg])
| Study group | Role | What they receive |
|---|---|---|
| Bupivacaine collagen sponge | Experimental | Three Bupivacaine sponges placed at different levels within the surgical cavity; one deep within the vault, one at the incision line in the peritoneum and one at the dermal incision line. Receives: Drug: Bupivacaine Collagen Sponge (CollaRx Bupivacaine Implant) |
| ON-ON-Q PainBuster Post-op Pain relief SystemQ system | Active comparator | Insertion of the ON-Q system catheter into the deep subcutaneous space overlying the fascia. Receives: Drug: ON-Q PainBuster Post-op Pain relief System |
What is being measured
The primary outcome is the main question the study is designed to answer.
Total Amount of Opioid Rescue Analgesia Used
Higher value means worse outcome - Higher number reflects a need for more analgesia - For the first 24 hours after surgery, patients received IV morphine via a PCA pump as rescue analgesia. Patient demand for morphine was recorded. Measurement recorded in total Morphine Milligrams
Measured: 0 to 24 hours postoperatively
Secondary outcomes (6)
Total Amount of Opioid Rescue Analgesia Used
Higher score means worse outcome - Higher number means more Analgesia was needed. For the first 24 hours after surgery, patients received IV morphine via a PCA pump as rescue analgesia. Patient demand for morphine was recorded. After 24 hours, patients were offered hydrocodone/acetaminophen (maximum could not exceed 8 tablets per 24 hours of the 5/500 mg tablets [40 mg hydrocodone and 4000 mg acetaminophen]) or similar medication as determined by the Investigator for pain until discharge. If oral medication was insufficient for control of pain, IM or IV morphine could be administered.
Measured: 0 to 48 hours postoperatively
The Total Amount of Opioid Rescue Analgesia Used
Higher score means worse outcome. Higher number means more Analgesia was needed. For the first 24 hours after surgery, patients received IV morphine via a PCA pump as rescue analgesia. Patient demand for morphine was recorded. After 24 hours, patients were offered hydrocodone/acetaminophen (maximum could not exceed 8 tablets per 24 hours of the 5/500 mg tablets [40 mg hydrocodone and 4000 mg acetaminophen]) or similar medication as determined by the Investigator for pain until discharge. If oral medication was insufficient for control of pain, IM or IV morphine could be administered.
Measured: 0 to 96 hours postoperatively
Total Use of Opioid Rescue Analgesia (mg) Over 0 to 72 Hours
Higher score means worse outcome. Higher number means more Analgesia was needed. For the first 24 hours after surgery, patients received IV morphine via a PCA pump as rescue analgesia. Patient demand for morphine was recorded. After 24 hours, patients were offered hydrocodone/acetaminophen (maximum could not exceed 8 tablets per 24 hours of the 5/500 mg tablets [40 mg hydrocodone and 4000 mg acetaminophen]) or similar medication as determined by the Investigator for pain until discharge. If oral medication was insufficient for control of pain, IM or IV morphine could be administered.
Measured: 0 to 72 Hours
Time to First Use of Opioid Rescue Analgesia
Higher score has a better outcome
Measured: 0 to 72 hours
VAS Pain Intensity Scores Over Time AT REST
For the VAS assessment, patients measured their pain intensity at rest using a horizontal 100-mm VAS scale labeled as follows: No Pain (0 mm) as the left anchor and Worst Pain Imaginable (100 mm) as the right anchor.
Measured: Hour 1, 1.5, 2,3,6,9,12,18,24,36,48,72,96
VAS (mm) Pain Intensity Scores Over Time (After Cough)
For the VAS assessment, patients measured their pain intensity after aggravated movement (cough) using a horizontal 100-mm VAS scale labeled as follows: No Pain (0 mm) as the left anchor and Worst Pain Imaginable (100 mm) as the right anchor.
Measured: Hour 1, 1.5, 2,3,6,9,12,18,24,36,48,72,96
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Sep 2008 (estimated)
- Study start10 Sep 2008
- Primary completion22 Dec 2008
- Study completion22 Dec 2008
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Pain, PostoperativeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 27 participants (actual)
Sponsor and investigators
- Lead sponsor
- Innocoll
- Sponsor type
- Industry (pharma, biotech, devices)
- Collaborators
- Premier Research
- Responsible party
- Sponsor
- Investigators
- David Prior, Study director, Innocoll
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00749749
- Sponsor's protocol ID
- INN-CB-005
- Status last verified
- Nov 2020
- First submitted
- 8 Sep 2008
- Last updated
- 4 Nov 2020
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- No
- Individual data sharing
- No
Publications
Cusack SL, Minkowitz HS, Kuss M, Jaros M, Hemsen L. A randomized, multicenter, pilot study comparing the efficacy and safety of a bupivacaine-collagen implant (XaraColl((R))) with the ON-Q PainBuster((R)) Post-op Pain Relief System following open gynecological surgery. J Pain Res. 2012;5:453-61. doi: 10.2147/JPR.S37310. Epub 2012 Nov 2.
PubMed 23152696
Study at a glance
From the registry record, last updated by the sponsor on 4 Nov 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase II, Randomized, Single-dose, Unblinded Study to Compare the Efficacy and Safety of the CollaRx Bupivacaine Implant With the ON-Q PainBuster Post-op Pain Relief System in Women Following Abdominal Hysterectomy
- ClinicalTrials.gov ID
- NCT00749749
- Acronym / sponsor ID
- INN-CB-005
- Conditions
- Pain, Postoperative
- Keywords
- Abdominal Hysterectomy, Postoperative pain
- Phase
- Phase 2
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 27 participants (actual)
- Lead sponsor
- InnocollIndustry (pharma, biotech, devices)
- Collaborators
- Premier Research
- Study start
- 10 Sep 2008
- Primary completion
- 22 Dec 2008 (actual)
- Study completion
- 22 Dec 2008 (actual)
- First posted
- 9 Sep 2008 (estimated)
- Results
- Posted 4 Nov 2020
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study is to determine whether the CollaRx Bupivacaine Implant is safe and effective in reducing the amount of narcotic pain medication needed to control pain during the first 96 hours after abdominal hysterectomy when compared to the ON-Q PainBuster Post-op Pain Relief System.
Detailed description
Hysterectomy is the second most common surgery among women in the United States (US). Abdominal hysterectomy surgery may be performed to treat benign tumors, such as fibroids, heavy periods, painful periods and chronic pelvic pain. The most common route for performing hysterectomy is through an incision in the abdominal wall; however, about 20% are performed vaginally.Laparoscopic assisted vaginal hysterectomy is performed when warranted.
Bupivacaine is a local anesthetic (pain medication) that has an established safety profile. Collagen is a protein that is found in all mammals. The CollaRx Bupivacaine implant is a thin flat sponge made out of collagen that comes from cattle tendons and contains bupivacaine. When inserted into a surgical site, the collagen breaks down and bupivacaine is released at the site but very little is absorbed into the blood stream. The high levels of bupivacaine at the surgical site may result in less pain for several days after surgery.
The ON Q system consists of 1 elastometric pump with a fill volume of 270 mL containing 0.25% bupivacaine; 1 soaker catheter measuring 12.5 cm in size; and a fill port, tubing, clamp, filter and flow restrictor. The pump provides positive pressure and is portable. It may be attached to the patient's dressing or placed in a carrying pouch. The catheter is inserted directly into the surgical wound providing a continuous flow of bupivacaine into the wound. A capillary flow restricting orifice located at the end of the tubing controls the flow rate.
This study will compare the total narcotic use in patients with the CollaRx Bupivacaine Implant with the total narcotic use in patients with the ON Q PainBuster Post op Pain Relief System after abdominal hysterectomy.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Bupivacaine collagen sponge | Experimental | Drug: Bupivacaine Collagen Sponge (CollaRx Bupivacaine Implant)Three Bupivacaine sponges placed at different levels within the surgical cavity; one deep within the vault, one at the incision line in the peritoneum and one at the dermal incision line. |
| ON-ON-Q PainBuster Post-op Pain relief SystemQ system | Active comparator | Drug: ON-Q PainBuster Post-op Pain relief SystemInsertion of the ON-Q system catheter into the deep subcutaneous space overlying the fascia. |
Who may qualify
- Ages
- 18 to 75 years
- Sex
- Female only
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (12 listed)
- Must be a woman who is ≥ 18 and ≤ 75 years of age.
- Has a body mass index (BMI) > 19 and < 40 kg/m2.
- Has planned an elective total abdominal hysterectomy for reasons other than malignancies (such as uterine adenocarcinoma, cervical cancer or leiomyosarcoma) to be performed according to standard surgical technique using a standard incision and under general anesthesia with the following caveats:
- Has a risk classification of I, II or III according to the American Society of Anesthesiologists (ASA).
- Is nonpregnant (negative pregnancy test at Screening and Day 0 before surgery) and nonlactating.
Key exclusion criteria (12 listed)
- Has known hypersensitivity to amide local anesthetics, opioids, bovine products or to inactive ingredients of the test article or reference product.
- Has cardiac arrhythmias or atrioventricular (AV) conduction disorders.
- Concomitantly uses other amide local anesthetics.
- Concomitantly uses antiarrhythmics (eg, amiodarone), propranolol or strong/moderate cytochrome P450 (CYP) 3A4 inhibitors or inducers (eg, macrolide antibiotics and grapefruit juice).
- Has used long acting analgesics within 24 hours of surgery. Short acting analgesics such as acetaminophen may be used on the day of surgery but are subject to preoperative restrictions for oral intake.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Bupivacaine Collagen Sponge (CollaRx Bupivacaine Implant)Also: CollRx Bupivacaine ImplantThe bupivacaine collagen sponge contains 70mg Type I bovine collagen and 50mg bupivacaine hydrochloride | Drug | Bupivacaine collagen sponge |
| ON-Q PainBuster Post-op Pain relief System5 mL/hr per catheter of 0.25% bupivacaine (12.5 mg) for 72 hours(total dose 360 mL [900 mg]) | Drug | ON-ON-Q PainBuster Post-op Pain relief SystemQ system |
Primary outcome
Total Amount of Opioid Rescue Analgesia Used
Time frame: 0 to 24 hours postoperatively
Higher value means worse outcome - Higher number reflects a need for more analgesia - For the first 24 hours after surgery, patients received IV morphine via a PCA pump as rescue analgesia. Patient demand for morphine was recorded. Measurement recorded in total Morphine Milligrams
6 secondary outcomes
Total Amount of Opioid Rescue Analgesia Used
Time frame: 0 to 48 hours postoperatively
The Total Amount of Opioid Rescue Analgesia Used
Time frame: 0 to 96 hours postoperatively
Total Use of Opioid Rescue Analgesia (mg) Over 0 to 72 Hours
Time frame: 0 to 72 Hours
Time to First Use of Opioid Rescue Analgesia
Time frame: 0 to 72 hours
VAS Pain Intensity Scores Over Time AT REST
Time frame: Hour 1, 1.5, 2,3,6,9,12,18,24,36,48,72,96
VAS (mm) Pain Intensity Scores Over Time (After Cough)
Time frame: Hour 1, 1.5, 2,3,6,9,12,18,24,36,48,72,96
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Nov 2020.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 23152696Cusack SL, Minkowitz HS, Kuss M, Jaros M, Hemsen L. A randomized, multicenter, pilot study comparing the efficacy and safety of a bupivacaine-collagen implant (XaraColl((R))) with the ON-Q PainBuster((R)) Post-op Pain Relief System following open gynecological surgery. J Pain Res. 2012;5:453-61. doi: 10.2147/JPR.S37310. Epub 2012 Nov 2.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
David Prior study director
Innocoll
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2 study testing Bupivacaine Collagen Sponge (CollaRx Bupivacaine Implant) and ON-Q PainBuster Post-op Pain relief System in people with Pain, Postoperative, run by Innocoll at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 12 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Nov 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 4 Nov 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Total Amount of Opioid Rescue Analgesia Used (time frame: 0 to 24 hours postoperatively). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00749749, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Nov 2020.