Open-Label Study to Evaluate the Effect of Treatment With Fentanyl Buccal Tablets on Pain Anxiety Symptoms When Used for the Management of Breakthrough Pain

NCT ID: NCT00387010

Last Updated: 2012-10-22

Study Results

Results available

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Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

218 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-12-31

Study Completion Date

2007-10-31

Brief Summary

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The primary purpose of the study is to evaluate the impact of treatment with fentanyl buccal tablets on the anxiety symptoms commonly associated with chronic pain in patients with breakthrough pain (BTP). Other purposes are to assess the management of BTP, to evaluate patient functioning, and to determine any influences on the successful dose achieved.

Detailed Description

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Conditions

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Pain Chronic Pain Breakthrough Pain

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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fentanyl buccal tablets

Successful dose strength for each participant was determined during a titration period of no more than 10 days. Participants used the successful dose of 100, 200, 400, 600, or 800 mcg during the four week open-label treatment period.

Group Type EXPERIMENTAL

Fentanyl Buccal Tablets

Intervention Type DRUG

Fentanyl buccal tablets (FBT) placed in the buccal cavity above a rear molar until disintegrated, approximately 14-25 minutes.

Dose titration: Participants self-administered FBT, starting at 100, 200 or 400 mcg (depending on analgesic used pre-study) and titrated to 600 and 800 mcg as needed. For each breakthrough pain (BTP) episode, participants took a dose, and did not take further study drug if adequate pain relief was achieved. If pain was not controlled within 30 minutes, the same dose level was repeated. If pain relief was inadequate 30 minutes after the second dose, usual rescue medication was taken for that BTP episode. Doses were adjusted until pain relief was adequate and side effects were tolerated.

Open-label: Once the successful dose of FBT was identified (100, 200, 400, 600, or 800 mcg), participants were dispensed a 4-week supply at the successful dose. Participants were not to use FBT for more than 6 BTP episodes or take more than 8 FBT daily.

Interventions

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Fentanyl Buccal Tablets

Fentanyl buccal tablets (FBT) placed in the buccal cavity above a rear molar until disintegrated, approximately 14-25 minutes.

Dose titration: Participants self-administered FBT, starting at 100, 200 or 400 mcg (depending on analgesic used pre-study) and titrated to 600 and 800 mcg as needed. For each breakthrough pain (BTP) episode, participants took a dose, and did not take further study drug if adequate pain relief was achieved. If pain was not controlled within 30 minutes, the same dose level was repeated. If pain relief was inadequate 30 minutes after the second dose, usual rescue medication was taken for that BTP episode. Doses were adjusted until pain relief was adequate and side effects were tolerated.

Open-label: Once the successful dose of FBT was identified (100, 200, 400, 600, or 800 mcg), participants were dispensed a 4-week supply at the successful dose. Participants were not to use FBT for more than 6 BTP episodes or take more than 8 FBT daily.

Intervention Type DRUG

Other Intervention Names

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Fentora CEP-25608 Fentanyl citrate

Eligibility Criteria

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Inclusion Criteria

* The patient is willing to provide written informed consent to participate in this study.
* The patient is 18 through 80 years of age.
* Women must be surgically sterile, 2 years postmenopausal, or, if of childbearing potential, using a medically accepted method of birth control (i.e., barrier method with spermicide, steroidal contraceptive \[oral, transdermal, implanted, and injected contraceptives must be used in conjunction with the barrier method\], or intrauterine device \[IUD\]) and agree to continued use of this method for the duration of the study.
* The patient has chronic pain of at least 3 months duration associated with any of the following conditions: cancer, diabetic peripheral neuropathy, postherpetic neuralgia, traumatic injury, complex regional pain syndrome, back pain, neck pain, fibromyalgia (patient has met diagnostic criteria), chronic pancreatitis, or osteoarthritis. Other chronic painful conditions may be evaluated for entry upon discussion with and written approval from the Cephalon medical expert.
* The patient is currently using 1 of the following: at least 60 mg of oral morphine/day, or at least 25 mcg of transdermal fentanyl/hour, or at least 30 mg of oxycodone/day, or at least 8 mg of hydromorphone/day, or an equianalgesic dose of another opioid/day as a stable dose of around-the-clock (ATC) therapy for at least 7 days prior to enrollment in the study.
* The patient reports an average pain intensity score, over the prior 24 hours, of 6 or less (0=no pain through 10=worst pain) for the chronic pain.
* The patient experiences, on average, 1 to 4 BTP episodes per day while taking around-the-clock (ATC) opioid therapy, and on average, the duration of each breakthrough pain (BTP) episode is less than 3 hours.
* The patient currently uses opioid therapy for alleviation of BTP episodes occurring at the location of the chronic pain, and achieves at least partial relief.
* The patient must be willing and able to successfully self-administer the study drug, comply with study restrictions, and return to the clinic for scheduled study visits and a follow-up evaluation as specified in this protocol.

Exclusion Criteria

* The patient has uncontrolled or rapidly escalating pain as determined by the investigator (ie, the ATC therapy may be expected to change between the first and last treatments with study drug), or has pain uncontrolled by therapy that could adversely impact the safety of the patient or that could be compromised by treatment with study drug.
* The patient has known or suspected hypersensitivities, allergies, or other contraindications to any ingredient in the study drug.
* The patient has a recent history (within 5 years) or current evidence of alcohol or other substance abuse.
* The patient has cardiopulmonary disease that, in the opinion of the investigator, would significantly increase the risk of treatment with potent synthetic opioids.
* The patient has medical or psychiatric disease that, in the opinion of the investigator, would compromise collected data.
* The patient's primary painful condition is headache, including migraine.
* The patient is expected to have surgery during the study, and it is anticipated that the surgery will alleviate the patient's pain.
* The patient has had therapy before study drug treatment that, in the opinion of the investigator, could alter pain or response to pain medication.
* The patient is pregnant or lactating.
* The patient has participated in a previous study with fentanyl buccal tablets.
* The patient has participated in a study involving an investigational drug in the previous 30 days.
* The patient has received a monoamine oxidase inhibitor (MAOI) within 14 days before the first treatment with study drug.
* The patient has any other medical condition or is receiving concomitant medication/therapy (e.g., regional nerve block) that, in the opinion of the investigator, would compromise the patient's safety or compliance with the study protocol, or compromise collected data.
* The patient is involved in active litigation in regard to chronic pain currently being treated.
* The patient has a positive urine drug screen (UDS) for an illicit substance or a medication not legitimately prescribed to the patient.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Cephalon

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Birmingham Pain Center

Birmingham, Alabama, United States

Site Status

Arizona Research Center

Phoenix, Arizona, United States

Site Status

Orange County Clinical Trials

Anaheim, California, United States

Site Status

Vertex Clinical Research

Bakersfield, California, United States

Site Status

Lovelace Scientific Resources, Inc.

Beverly Hills, California, United States

Site Status

Synergy Clinical Research Center

National City, California, United States

Site Status

Pain Institute of Santa Monica

Santa Monica, California, United States

Site Status

Integrative Pain Manage Centers

Westminster, Colorado, United States

Site Status

Advanced Diagnostic Pain Treatment Center

New Haven, Connecticut, United States

Site Status

Alliance Medical Research Group

Clearwater, Florida, United States

Site Status

Innovative Research of West Florida

Largo, Florida, United States

Site Status

Lovelace Scientific Resources, Inc.

Sarasota, Florida, United States

Site Status

Stedman Clinical Trials

Tampa, Florida, United States

Site Status

Dawsonville Family Medicine

Dawsonville, Georgia, United States

Site Status

Millennium Pain Center

Bloomington, Illinois, United States

Site Status

Pain and Rehabilitation Clinic of Chicago

Chicago, Illinois, United States

Site Status

Elkhart Clinic, LLC

Elkhart, Indiana, United States

Site Status

Rehabilitation Associates of Indiana

Indianapolis, Indiana, United States

Site Status

Northwest Indiana Center for Clinical Research, PC

Valparaiso, Indiana, United States

Site Status

ICRI, Inc.

Overland Park, Kansas, United States

Site Status

Willis-Knighton Pain Management Center

Shreveport, Louisiana, United States

Site Status

Montana Cancer Specialists

Missoula, Montana, United States

Site Status

Lovelace Scientific Resources Center

Henderson, Nevada, United States

Site Status

Clinical Research Center of Nevada

Las Vegas, Nevada, United States

Site Status

SUNY - Stonybrook

Stony Brook, New York, United States

Site Status

Pain Consultants of Oregon

Eugene, Oregon, United States

Site Status

Allegheny Pain Management, PC

Altoona, Pennsylvania, United States

Site Status

Altoona Center for Clinical Research

Duncansville, Pennsylvania, United States

Site Status

DeGarmo Institute of Medical Research

Greer, South Carolina, United States

Site Status

Comprehensive Pain Specialists, PLLC

Hendersonville, Tennessee, United States

Site Status

KRK Medical Research

Richardson, Texas, United States

Site Status

BeXar Clinical Trials, LLC

Richardson, Texas, United States

Site Status

Lifetree Clinical Research

Salt Lake City, Utah, United States

Site Status

Countries

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United States

References

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Webster LR, Messina J, Xie F, Nalamachu S. Effect of fentanyl buccal tablet on pain-related anxiety: a 4-week open-label study among opioid-tolerant patients with chronic and breakthrough pain. J Opioid Manag. 2011 Jul-Aug;7(4):297-308.

Reference Type RESULT
PMID: 21957829 (View on PubMed)

Other Identifiers

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C25608/3054/BP/US

Identifier Type: -

Identifier Source: org_study_id