Trial Outcomes & Findings for Assessment of Long-term Safety in Patients With Non-cancer-related Pain and Opioid-induced Constipation (NCT NCT01336205)

NCT ID: NCT01336205

Last Updated: 2014-10-20

Results Overview

The incidence of patients experiencing at least one AE during the randomized treatment and follow-up periods was calculated.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

844 participants

Primary outcome timeframe

Baseline (Week 0) to end of the follow-up period

Results posted on

2014-10-20

Participant Flow

This multicenter study was conducted in the United States between 18 April 2011 and 03 December 2012.

The study duration was 54 to 58 weeks. New patients underwent an initial screening period lasting up to 2 weeks and a 2-week OIC confirmation period. New patients and patients enrolling from another study (also referred to as 'roll over patients') entered the 52-week treatment period, followed by a 2 week follow-up period.

Participant milestones

Participant milestones
Measure
NKTR-118 25 mg
NKTR-118 25 mg QD, oral treatment
Usual Care
Laxative treatment regimen for OIC determined by the investigator according to his/her best clinical judgment.
Overall Study
STARTED
563
281
Overall Study
COMPLETED
330
192
Overall Study
NOT COMPLETED
233
89

Reasons for withdrawal

Reasons for withdrawal
Measure
NKTR-118 25 mg
NKTR-118 25 mg QD, oral treatment
Usual Care
Laxative treatment regimen for OIC determined by the investigator according to his/her best clinical judgment.
Overall Study
Other
22
9
Overall Study
Lost to Follow-up
40
20
Overall Study
Study-Specific Withdrawal Criteria
16
7
Overall Study
Lack of Efficacy
4
0
Overall Study
Severe noncompliance with protocol
9
2
Overall Study
Adverse Event
56
6
Overall Study
Death
1
1
Overall Study
Eligibility Criteria Not Fulfilled
9
6
Overall Study
Withdrawal by Subject
72
38
Overall Study
Did not receive treatment
4
0

Baseline Characteristics

Assessment of Long-term Safety in Patients With Non-cancer-related Pain and Opioid-induced Constipation

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
NKTR-118 25 mg
n=534 Participants
NKTR-118 25 mg QD, oral treatment
Usual Care
n=270 Participants
Laxative treatment regimen for OIC determined by the investigator according to his/her best clinical judgment.
Total
n=804 Participants
Total of all reporting groups
Age, Continuous
52.8 Years
STANDARD_DEVIATION 10.09 • n=5 Participants
52.7 Years
STANDARD_DEVIATION 10.24 • n=7 Participants
52.7 Years
STANDARD_DEVIATION 10.13 • n=5 Participants
Sex: Female, Male
Female
353 Participants
n=5 Participants
179 Participants
n=7 Participants
532 Participants
n=5 Participants
Sex: Female, Male
Male
181 Participants
n=5 Participants
91 Participants
n=7 Participants
272 Participants
n=5 Participants
Race/Ethnicity, Customized
White
423 Participants
n=5 Participants
204 Participants
n=7 Participants
627 Participants
n=5 Participants
Race/Ethnicity, Customized
Black or African American
98 Participants
n=5 Participants
60 Participants
n=7 Participants
158 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
4 Participants
n=5 Participants
3 Participants
n=7 Participants
7 Participants
n=5 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
4 Participants
n=5 Participants
1 Participants
n=7 Participants
5 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
5 Participants
n=5 Participants
2 Participants
n=7 Participants
7 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Baseline (Week 0) to end of the follow-up period

Population: The Safety analysis set included all randomized patients who received at least 1 dose of IP and patients who received Usual Care, with the exception of patients who were randomized multiple times within the program at different centers or patients who were randomized at sites where data integrity issues were identified.

The incidence of patients experiencing at least one AE during the randomized treatment and follow-up periods was calculated.

Outcome measures

Outcome measures
Measure
NKTR-118 25 mg
n=534 Participants
NKTR-118 25 mg QD, oral treatment
Usual Care
n=270 Participants
Laxative treatment regimen for OIC determined by the investigator according to his/her best clinical judgment.
Incidence of Patients Experiencing at Least One Adverse Event (AE)
437 Participants
195 Participants

PRIMARY outcome

Timeframe: Baseline (Week 0) to end of the follow-up period

Population: The Safety analysis set included all randomized patients who received at least 1 dose of IP and patients who received Usual Care, with the exception of patients who were randomized multiple times within the program at different centers or patients who were randomized at sites where data integrity issues were identified.

The incidence of patients experiencing AEs that resulted in discontinuation of IP during the randomized treatment or follow-up periods was calculated.

Outcome measures

Outcome measures
Measure
NKTR-118 25 mg
n=534 Participants
NKTR-118 25 mg QD, oral treatment
Usual Care
n=270 Participants
Laxative treatment regimen for OIC determined by the investigator according to his/her best clinical judgment.
Incidence of Patients Experiencing AEs That Resulted in Discontinuation of Investigational Product (IP)
56 Participants
NA Participants
Patients in the Usual Care group were not taking any IP and thus could not be categorized for this parameter.

PRIMARY outcome

Timeframe: Baseline (Week 0) to end of the follow-up period

Population: The Safety analysis set included all randomized patients who received at least 1 dose of IP and patients who received Usual Care, with the exception of patients who were randomized multiple times within the program at different centers or patients who were randomized at sites where data integrity issues were identified.

The incidence of patients experiencing SAEs during the randomized treatment and follow-up periods was calculated.

Outcome measures

Outcome measures
Measure
NKTR-118 25 mg
n=534 Participants
NKTR-118 25 mg QD, oral treatment
Usual Care
n=270 Participants
Laxative treatment regimen for OIC determined by the investigator according to his/her best clinical judgment.
Incidence of Patients Experiencing Severe Adverse Events (SAEs)
51 Participants
30 Participants

Adverse Events

NKTR-118 25 mg

Serious events: 51 serious events
Other events: 365 other events
Deaths: 0 deaths

Usual Care

Serious events: 30 serious events
Other events: 152 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
NKTR-118 25 mg
n=534 participants at risk
Usual Care
n=270 participants at risk
Blood and lymphatic system disorders
ANAEMIA
0.00%
0/534
0.37%
1/270 • Number of events 1
Cardiac disorders
ATRIAL FIBRILLATION
0.37%
2/534 • Number of events 2
0.37%
1/270 • Number of events 1
Cardiac disorders
CARDIAC FAILURE CONGESTIVE
0.00%
0/534
0.37%
1/270 • Number of events 1
Cardiac disorders
MYOCARDIAL ISCHAEMIA
0.00%
0/534
0.37%
1/270 • Number of events 1
Endocrine disorders
THYROID MASS
0.19%
1/534 • Number of events 1
0.00%
0/270
Gastrointestinal disorders
ABDOMINAL PAIN
0.19%
1/534 • Number of events 1
0.00%
0/270
Gastrointestinal disorders
COLITIS ISCHAEMIC
0.00%
0/534
0.37%
1/270 • Number of events 1
Gastrointestinal disorders
PANCREATITIS ACUTE
0.00%
0/534
0.37%
1/270 • Number of events 1
Gastrointestinal disorders
RECTAL HAEMORRHAGE
0.00%
0/534
0.37%
1/270 • Number of events 1
Gastrointestinal disorders
SMALL INTESTINAL OBSTRUCTION
0.19%
1/534 • Number of events 1
0.37%
1/270 • Number of events 1
Gastrointestinal disorders
VOMITING
0.19%
1/534 • Number of events 1
0.00%
0/270
General disorders
ASTHENIA
0.19%
1/534 • Number of events 1
0.00%
0/270
General disorders
DEATH
0.00%
0/534
0.37%
1/270 • Number of events 1
General disorders
NON-CARDIAC CHEST PAIN
0.00%
0/534
0.37%
1/270 • Number of events 1
Hepatobiliary disorders
CHOLECYSTITIS
0.00%
0/534
0.37%
1/270 • Number of events 1
Hepatobiliary disorders
CHOLELITHIASIS OBSTRUCTIVE
0.19%
1/534 • Number of events 1
0.00%
0/270
Immune system disorders
DRUG HYPERSENSITIVITY
0.00%
0/534
0.37%
1/270 • Number of events 1
Infections and infestations
CELLULITIS
0.00%
0/534
0.37%
1/270 • Number of events 1
Infections and infestations
CELLULITIS GANGRENOUS
0.19%
1/534 • Number of events 1
0.00%
0/270
Infections and infestations
EXTRADURAL ABSCESS
0.00%
0/534
0.37%
1/270 • Number of events 1
Infections and infestations
GASTROENTERITIS VIRAL
0.00%
0/534
0.37%
1/270 • Number of events 1
Infections and infestations
LOBAR PNEUMONIA
0.19%
1/534 • Number of events 1
0.00%
0/270
Infections and infestations
PNEUMONIA
0.94%
5/534 • Number of events 5
0.37%
1/270 • Number of events 1
Infections and infestations
PYELONEPHRITIS
0.19%
1/534 • Number of events 1
0.00%
0/270
Infections and infestations
SEPSIS
0.00%
0/534
0.37%
1/270 • Number of events 1
Infections and infestations
SINUSITIS
0.19%
1/534 • Number of events 1
0.00%
0/270
Infections and infestations
STAPHYLOCOCCAL INFECTION
0.00%
0/534
0.37%
1/270 • Number of events 1
Infections and infestations
VULVAL ABSCESS
0.00%
0/534
0.37%
1/270 • Number of events 1
Injury, poisoning and procedural complications
ANKLE FRACTURE
0.19%
1/534 • Number of events 1
0.37%
1/270 • Number of events 1
Injury, poisoning and procedural complications
CONTUSION
0.00%
0/534
0.37%
1/270 • Number of events 1
Injury, poisoning and procedural complications
FALL
0.19%
1/534 • Number of events 1
0.00%
0/270
Injury, poisoning and procedural complications
FIBULA FRACTURE
0.37%
2/534 • Number of events 2
0.00%
0/270
Injury, poisoning and procedural complications
INTENTIONAL OVERDOSE
0.19%
1/534 • Number of events 1
0.00%
0/270
Injury, poisoning and procedural complications
LIMB INJURY
0.19%
1/534 • Number of events 1
0.00%
0/270
Injury, poisoning and procedural complications
OVERDOSE
0.19%
1/534 • Number of events 1
0.00%
0/270
Injury, poisoning and procedural complications
POST PROCEDURAL COMPLICATION
0.19%
1/534 • Number of events 1
0.00%
0/270
Injury, poisoning and procedural complications
RADIUS FRACTURE
0.00%
0/534
0.37%
1/270 • Number of events 1
Injury, poisoning and procedural complications
RIB FRACTURE
0.19%
1/534 • Number of events 1
0.00%
0/270
Injury, poisoning and procedural complications
THORACIC VERTEBRAL FRACTURE
0.37%
2/534 • Number of events 2
0.00%
0/270
Injury, poisoning and procedural complications
TIBIA FRACTURE
0.37%
2/534 • Number of events 2
0.00%
0/270
Injury, poisoning and procedural complications
ULNA FRACTURE
0.00%
0/534
0.37%
1/270 • Number of events 1
Investigations
BLOOD PRESSURE DECREASED
0.00%
0/534
0.37%
1/270 • Number of events 1
Investigations
BLOOD PRESSURE INCREASED
0.19%
1/534 • Number of events 1
0.00%
0/270
Investigations
TRANSAMINASES INCREASED
0.19%
1/534 • Number of events 1
0.00%
0/270
Investigations
TROPONIN INCREASED
0.19%
1/534 • Number of events 1
0.00%
0/270
Metabolism and nutrition disorders
HYPERKALAEMIA
0.19%
1/534 • Number of events 1
0.37%
1/270 • Number of events 1
Metabolism and nutrition disorders
HYPOGLYCAEMIA
0.19%
1/534 • Number of events 1
0.00%
0/270
Musculoskeletal and connective tissue disorders
BACK PAIN
0.37%
2/534 • Number of events 2
0.37%
1/270 • Number of events 1
Musculoskeletal and connective tissue disorders
FLANK PAIN
0.00%
0/534
0.37%
1/270 • Number of events 1
Musculoskeletal and connective tissue disorders
LUMBAR SPINAL STENOSIS
0.19%
1/534 • Number of events 1
0.37%
1/270 • Number of events 1
Musculoskeletal and connective tissue disorders
MUSCULOSKELETAL CHEST PAIN
0.00%
0/534
0.37%
1/270 • Number of events 1
Musculoskeletal and connective tissue disorders
MUSCULOSKELETAL PAIN
0.19%
1/534 • Number of events 1
0.37%
1/270 • Number of events 1
Musculoskeletal and connective tissue disorders
OSTEOARTHRITIS
0.19%
1/534 • Number of events 1
0.37%
1/270 • Number of events 1
Musculoskeletal and connective tissue disorders
OSTEONECROSIS
0.19%
1/534 • Number of events 1
0.00%
0/270
Musculoskeletal and connective tissue disorders
PAIN IN EXTREMITY
0.00%
0/534
0.37%
1/270 • Number of events 1
Musculoskeletal and connective tissue disorders
RHABDOMYOLYSIS
0.19%
1/534 • Number of events 1
0.37%
1/270 • Number of events 1
Musculoskeletal and connective tissue disorders
RHEUMATOID ARTHRITIS
0.19%
1/534 • Number of events 1
0.00%
0/270
Musculoskeletal and connective tissue disorders
ROTATOR CUFF SYNDROME
0.19%
1/534 • Number of events 1
0.00%
0/270
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
BREAST CANCER
0.19%
1/534 • Number of events 1
0.00%
0/270
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
LUNG ADENOCARCINOMA
0.19%
1/534 • Number of events 1
0.00%
0/270
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
LYMPHOMA
0.19%
1/534 • Number of events 1
0.00%
0/270
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
SUPERFICIAL SPREADING MELANOMA STAGE II
0.00%
0/534
0.37%
1/270 • Number of events 1
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
THYROID CANCER RECURRENT
0.19%
1/534 • Number of events 1
0.00%
0/270
Nervous system disorders
AKATHISIA
0.19%
1/534 • Number of events 1
0.00%
0/270
Nervous system disorders
ALTERED STATE OF CONSCIOUSNESS
0.00%
0/534
0.37%
1/270 • Number of events 1
Nervous system disorders
CEREBROVASCULAR ACCIDENT
0.00%
0/534
0.37%
1/270 • Number of events 1
Nervous system disorders
CERVICAL NEURITIS
0.19%
1/534 • Number of events 1
0.00%
0/270
Nervous system disorders
CERVICOBRACHIAL SYNDROME
0.19%
1/534 • Number of events 1
0.00%
0/270
Nervous system disorders
COMPLICATED MIGRAINE
0.00%
0/534
0.37%
1/270 • Number of events 1
Nervous system disorders
HYPOGLYCAEMIC COMA
0.19%
1/534 • Number of events 1
0.00%
0/270
Nervous system disorders
IDIOPATHIC GENERALISED EPILEPSY
0.19%
1/534 • Number of events 1
0.00%
0/270
Nervous system disorders
ISCHAEMIC CEREBRAL INFARCTION
0.00%
0/534
0.37%
1/270 • Number of events 1
Nervous system disorders
RADICULITIS CERVICAL
0.19%
1/534 • Number of events 1
0.00%
0/270
Nervous system disorders
SYNCOPE
0.19%
1/534 • Number of events 1
0.00%
0/270
Psychiatric disorders
BIPOLAR I DISORDER
0.19%
1/534 • Number of events 1
0.00%
0/270
Psychiatric disorders
DEPRESSION
0.19%
1/534 • Number of events 1
0.00%
0/270
Psychiatric disorders
HOMICIDAL IDEATION
0.19%
1/534 • Number of events 1
0.00%
0/270
Psychiatric disorders
MAJOR DEPRESSION
0.00%
0/534
0.37%
1/270 • Number of events 1
Psychiatric disorders
PANIC ATTACK
0.19%
1/534 • Number of events 1
0.00%
0/270
Psychiatric disorders
PSYCHOTIC DISORDER
0.00%
0/534
0.37%
1/270 • Number of events 1
Psychiatric disorders
SCHIZOPHRENIA
0.19%
1/534 • Number of events 1
0.00%
0/270
Psychiatric disorders
SUICIDAL IDEATION
0.19%
1/534 • Number of events 1
0.00%
0/270
Psychiatric disorders
SUICIDE ATTEMPT
0.37%
2/534 • Number of events 2
0.00%
0/270
Renal and urinary disorders
RENAL FAILURE ACUTE
0.00%
0/534
1.1%
3/270 • Number of events 3
Renal and urinary disorders
RENAL INJURY
0.19%
1/534 • Number of events 1
0.00%
0/270
Reproductive system and breast disorders
ENDOMETRIAL HYPERPLASIA
0.19%
1/534 • Number of events 1
0.00%
0/270
Respiratory, thoracic and mediastinal disorders
ASTHMA
0.19%
1/534 • Number of events 1
0.74%
2/270 • Number of events 2
Respiratory, thoracic and mediastinal disorders
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
0.56%
3/534 • Number of events 3
0.37%
1/270 • Number of events 1
Respiratory, thoracic and mediastinal disorders
PNEUMOTHORAX
0.19%
1/534 • Number of events 1
0.00%
0/270
Respiratory, thoracic and mediastinal disorders
PULMONARY CONGESTION
0.00%
0/534
0.37%
1/270 • Number of events 1
Skin and subcutaneous tissue disorders
SKIN DISCOLOURATION
0.00%
0/534
0.37%
1/270 • Number of events 1
Vascular disorders
DEEP VEIN THROMBOSIS
0.19%
1/534 • Number of events 1
0.00%
0/270
Vascular disorders
HYPOVOLAEMIC SHOCK
0.19%
1/534 • Number of events 1
0.00%
0/270
Vascular disorders
ORTHOSTATIC HYPOTENSION
0.19%
1/534 • Number of events 1
0.00%
0/270
Vascular disorders
THROMBOSIS
0.00%
0/534
0.37%
1/270 • Number of events 1

Other adverse events

Other adverse events
Measure
NKTR-118 25 mg
n=534 participants at risk
Usual Care
n=270 participants at risk
Gastrointestinal disorders
ABDOMINAL DISCOMFORT
2.4%
13/534 • Number of events 13
0.37%
1/270 • Number of events 1
Gastrointestinal disorders
ABDOMINAL DISTENSION
2.2%
12/534 • Number of events 12
1.1%
3/270 • Number of events 3
Gastrointestinal disorders
ABDOMINAL PAIN
18.4%
98/534 • Number of events 98
3.3%
9/270 • Number of events 9
Gastrointestinal disorders
ABDOMINAL PAIN UPPER
5.6%
30/534 • Number of events 30
1.1%
3/270 • Number of events 3
Gastrointestinal disorders
DIARRHOEA
13.7%
73/534 • Number of events 73
5.9%
16/270 • Number of events 16
Gastrointestinal disorders
FLATULENCE
7.3%
39/534 • Number of events 39
1.1%
3/270 • Number of events 3
Gastrointestinal disorders
GASTROOESOPHAGEAL REFLUX DISEASE
2.1%
11/534 • Number of events 11
1.9%
5/270 • Number of events 5
Gastrointestinal disorders
NAUSEA
10.5%
56/534 • Number of events 56
4.1%
11/270 • Number of events 11
Gastrointestinal disorders
VOMITING
5.2%
28/534 • Number of events 28
5.6%
15/270 • Number of events 15
General disorders
CHILLS
2.1%
11/534 • Number of events 11
0.00%
0/270
General disorders
FATIGUE
3.4%
18/534 • Number of events 18
1.1%
3/270 • Number of events 3
General disorders
OEDEMA PERIPHERAL
2.4%
13/534 • Number of events 13
3.0%
8/270 • Number of events 8
General disorders
PYREXIA
2.6%
14/534 • Number of events 14
2.2%
6/270 • Number of events 6
Infections and infestations
BRONCHITIS
5.6%
30/534 • Number of events 30
4.4%
12/270 • Number of events 12
Infections and infestations
GASTROENTERITIS VIRAL
3.0%
16/534 • Number of events 16
1.5%
4/270 • Number of events 4
Infections and infestations
INFLUENZA
1.9%
10/534 • Number of events 10
3.0%
8/270 • Number of events 8
Infections and infestations
NASOPHARYNGITIS
6.2%
33/534 • Number of events 33
5.6%
15/270 • Number of events 15
Infections and infestations
SINUSITIS
4.1%
22/534 • Number of events 22
7.0%
19/270 • Number of events 19
Infections and infestations
UPPER RESPIRATORY TRACT INFECTION
5.8%
31/534 • Number of events 31
8.5%
23/270 • Number of events 23
Infections and infestations
URINARY TRACT INFECTION
5.2%
28/534 • Number of events 28
8.9%
24/270 • Number of events 24
Injury, poisoning and procedural complications
CONTUSION
2.1%
11/534 • Number of events 11
0.37%
1/270 • Number of events 1
Injury, poisoning and procedural complications
FALL
3.6%
19/534 • Number of events 19
4.4%
12/270 • Number of events 12
Metabolism and nutrition disorders
DEHYDRATION
0.56%
3/534 • Number of events 3
2.2%
6/270 • Number of events 6
Metabolism and nutrition disorders
HYPERCHOLESTEROLAEMIA
1.1%
6/534 • Number of events 6
2.2%
6/270 • Number of events 6
Musculoskeletal and connective tissue disorders
ARTHRALGIA
6.4%
34/534 • Number of events 34
5.9%
16/270 • Number of events 16
Musculoskeletal and connective tissue disorders
BACK PAIN
9.0%
48/534 • Number of events 48
8.5%
23/270 • Number of events 23
Musculoskeletal and connective tissue disorders
MUSCLE SPASMS
3.2%
17/534 • Number of events 17
3.0%
8/270 • Number of events 8
Musculoskeletal and connective tissue disorders
PAIN IN EXTREMITY
4.1%
22/534 • Number of events 22
2.6%
7/270 • Number of events 7
Nervous system disorders
DIZZINESS
2.2%
12/534 • Number of events 12
1.1%
3/270 • Number of events 3
Nervous system disorders
HEADACHE
9.0%
48/534 • Number of events 48
4.8%
13/270 • Number of events 13
Psychiatric disorders
ANXIETY
3.2%
17/534 • Number of events 17
1.5%
4/270 • Number of events 4
Psychiatric disorders
DEPRESSION
2.4%
13/534 • Number of events 13
3.7%
10/270 • Number of events 10
Psychiatric disorders
INSOMNIA
2.8%
15/534 • Number of events 15
1.9%
5/270 • Number of events 5
Respiratory, thoracic and mediastinal disorders
COUGH
5.1%
27/534 • Number of events 27
3.0%
8/270 • Number of events 8
Respiratory, thoracic and mediastinal disorders
NASAL CONGESTION
2.8%
15/534 • Number of events 15
1.5%
4/270 • Number of events 4
Skin and subcutaneous tissue disorders
HYPERHIDROSIS
3.2%
17/534 • Number of events 17
0.37%
1/270 • Number of events 1
Vascular disorders
HYPERTENSION
3.0%
16/534 • Number of events 16
3.3%
9/270 • Number of events 9

Additional Information

Gerard Lynch

AstraZeneca

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60