Trial Outcomes & Findings for Study to Assess Efficacy and Safety of BNX Sublingual Tablets for the Induction of Treatment of Opioid Dependence (NCT NCT01848054)

NCT ID: NCT01848054

Last Updated: 2017-05-10

Results Overview

Retention in treatment at Day 3 in the per protocol population (n=256) was defined as the number of patients in each induction arm completing the induction phase and who received study medication on Day 3. Treatment with BNX sublingual tablets was considered non-inferior to generic buprenorphine if the lower limit of the 95% confidence interval for the difference between BNX and generic buprenorphine was ≥-10% in the number of patients retained in treatment on Day 3.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

313 participants

Primary outcome timeframe

Day 3

Results posted on

2017-05-10

Participant Flow

A total of 313 patients were enrolled. Three patients who were randomized did not receive study drug, making the participant flow 310.

Participant milestones

Participant milestones
Measure
BNX Sublingual Tablets Induction
Days 1-2: Induction on BNX sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Buprenorphine Induction
Days 1-2: Induction on buprenorphine sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Induction Phase
STARTED
155
155
Induction Phase
COMPLETED
132
147
Induction Phase
NOT COMPLETED
23
8
Stabilization/Maintenance
STARTED
132
147
Stabilization/Maintenance
COMPLETED
92
107
Stabilization/Maintenance
NOT COMPLETED
40
40

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Study to Assess Efficacy and Safety of BNX Sublingual Tablets for the Induction of Treatment of Opioid Dependence

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
BNX Sublingual Tablets Induction
n=155 Participants
Days 1-2: Induction on BNX sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Buprenorphine Induction
n=155 Participants
Days 1-2: Induction on buprenorphine sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Total
n=310 Participants
Total of all reporting groups
Age, Continuous
38.9 years
STANDARD_DEVIATION 10.6 • n=5 Participants
38.0 years
STANDARD_DEVIATION 10.9 • n=7 Participants
38.4 years
STANDARD_DEVIATION 10.7 • n=5 Participants
Sex: Female, Male
Female
55 Participants
n=5 Participants
52 Participants
n=7 Participants
107 Participants
n=5 Participants
Sex: Female, Male
Male
100 Participants
n=5 Participants
103 Participants
n=7 Participants
203 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
19 Participants
n=5 Participants
19 Participants
n=7 Participants
38 Participants
n=5 Participants
Race (NIH/OMB)
White
134 Participants
n=5 Participants
135 Participants
n=7 Participants
269 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Body mass index (BMI)
26.2 kg/m^2
STANDARD_DEVIATION 6.7 • n=5 Participants
25.3 kg/m^2
STANDARD_DEVIATION 5.0 • n=7 Participants
25.7 kg/m^2
STANDARD_DEVIATION 5.9 • n=5 Participants
Duration of opioid dependence
13.3 years
STANDARD_DEVIATION 9.3 • n=5 Participants
11.6 years
STANDARD_DEVIATION 9.2 • n=7 Participants
12.4 years
STANDARD_DEVIATION 9.3 • n=5 Participants

PRIMARY outcome

Timeframe: Day 3

Population: Per protocol population

Retention in treatment at Day 3 in the per protocol population (n=256) was defined as the number of patients in each induction arm completing the induction phase and who received study medication on Day 3. Treatment with BNX sublingual tablets was considered non-inferior to generic buprenorphine if the lower limit of the 95% confidence interval for the difference between BNX and generic buprenorphine was ≥-10% in the number of patients retained in treatment on Day 3.

Outcome measures

Outcome measures
Measure
BNX Sublingual Tablets Induction
n=128 Participants
Days 1-2: Induction on BNX sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Buprenorphine Induction
n=128 Participants
Days 1-2: Induction on buprenorphine sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Retention in Treatment in the Per Protocol Population
113 participants
122 participants

SECONDARY outcome

Timeframe: Pre-dose on Days 1-3 and 0.5, 1, 1.5, 3, and 6 hours post-dose on Day 1

Population: Full analysis population

Least squares mean AUC in COWS total score on Days 1 to 3; COWS scores range from 0-48, with a lower score being more favorable

Outcome measures

Outcome measures
Measure
BNX Sublingual Tablets Induction
n=154 Participants
Days 1-2: Induction on BNX sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Buprenorphine Induction
n=154 Participants
Days 1-2: Induction on buprenorphine sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Area Under the Curve (AUC) in Clinical Opiate Withdrawal Scale (COWS) Total Score on Days 1 to 3 Inclusive
7.21 score x hour
Standard Deviation 4.3
6.88 score x hour
Standard Deviation 4.0

SECONDARY outcome

Timeframe: Pre-dose on Days 1-3 and 0.5, 1, 1.5, 3, and 6 hours post-dose on Day 1

Population: Full analysis population; patients with missing data were excluded from the analysis and are reflected in the number of participants analyzed

Least squares mean AUC day 1 pre-dose through Day 3 in SOWS; SOWS scores range from 0-64, with a lower score being more favorable

Outcome measures

Outcome measures
Measure
BNX Sublingual Tablets Induction
n=147 Participants
Days 1-2: Induction on BNX sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Buprenorphine Induction
n=153 Participants
Days 1-2: Induction on buprenorphine sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
AUC in Subjective Opiate Withdrawal Scale (SOWS) Total Score on Days 1 to 3 Inclusive
17.7 score x hour
Standard Deviation 13.5
17.4 score x hour
Standard Deviation 12.8

SECONDARY outcome

Timeframe: Pre-dose on Days 1-3 and 0.5, 1, 1.5, 3, and 6 hours post-dose on Day 1

Population: Full analysis population; patients with missing data were excluded from the analysis and are reflected in the number of participants analyzed

Least squares mean AUC measurement in VAS score for cravings on Days 1 to 3; the VAS craving scores range from 0 ("no cravings") to 100 ("most intense craving I have ever had")

Outcome measures

Outcome measures
Measure
BNX Sublingual Tablets Induction
n=153 Participants
Days 1-2: Induction on BNX sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Buprenorphine Induction
n=155 Participants
Days 1-2: Induction on buprenorphine sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
AUC in Visual Analog Scale (VAS) Score for Craving on Days 1 to 3 Inclusive
40.0 score x hour
Standard Deviation 25.3
39.5 score x hour
Standard Deviation 24.7

SECONDARY outcome

Timeframe: Predose on Days 4, 8, 15, 22, and 29

Population: Full analysis population; patients with missing data were excluded from the analysis

Mean change from baseline in COWS total scores during the maintenance phase (Days 4, 8, 15, 22, and 29); COWS scores range from 0-48, with a lower score being more favorable

Outcome measures

Outcome measures
Measure
BNX Sublingual Tablets Induction
n=155 Participants
Days 1-2: Induction on BNX sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Buprenorphine Induction
n=155 Participants
Days 1-2: Induction on buprenorphine sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Mean Change From Baseline in COWS Total Score After Day 3 (Maintenance Phase)
Day 15
-11.9 units on a scale
Standard Deviation 4.9
-11.1 units on a scale
Standard Deviation 5.2
Mean Change From Baseline in COWS Total Score After Day 3 (Maintenance Phase)
Day 22
-12.5 units on a scale
Standard Deviation 4.7
-11.6 units on a scale
Standard Deviation 5.0
Mean Change From Baseline in COWS Total Score After Day 3 (Maintenance Phase)
Day 29/premature discontinuation
-12.5 units on a scale
Standard Deviation 5.2
-11.4 units on a scale
Standard Deviation 5.4
Mean Change From Baseline in COWS Total Score After Day 3 (Maintenance Phase)
Day 4
-9.4 units on a scale
Standard Deviation 5.8
-8.5 units on a scale
Standard Deviation 5.7
Mean Change From Baseline in COWS Total Score After Day 3 (Maintenance Phase)
Day 8
-11.2 units on a scale
Standard Deviation 4.9
-10.1 units on a scale
Standard Deviation 5.3

SECONDARY outcome

Timeframe: Pre-dose on Days 4, 8, 15, 22, and 29

Population: Full analysis population; patients with missing data were excluded from the analysis

Mean change from baseline in SOWS total scores during the maintenance phase (Days 4, 8, 15, 22, and 29); SOWS scores range from 0-64, with a lower score being more favorable

Outcome measures

Outcome measures
Measure
BNX Sublingual Tablets Induction
n=155 Participants
Days 1-2: Induction on BNX sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Buprenorphine Induction
n=155 Participants
Days 1-2: Induction on buprenorphine sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Mean Change From Baseline in SOWS Total Score After Day 3 (Maintenance Phase)
Day 4
-24.7 units on a scale
Standard Deviation 16.0
-18.9 units on a scale
Standard Deviation 13.8
Mean Change From Baseline in SOWS Total Score After Day 3 (Maintenance Phase)
Day 8
-27.0 units on a scale
Standard Deviation 15.8
-21.3 units on a scale
Standard Deviation 13.6
Mean Change From Baseline in SOWS Total Score After Day 3 (Maintenance Phase)
Day 15
-29.2 units on a scale
Standard Deviation 15.5
-23.3 units on a scale
Standard Deviation 13.7
Mean Change From Baseline in SOWS Total Score After Day 3 (Maintenance Phase)
Day 22
-30.8 units on a scale
Standard Deviation 15.6
-24.1 units on a scale
Standard Deviation 13.8
Mean Change From Baseline in SOWS Total Score After Day 3 (Maintenance Phase)
Day 29/premature discontinuation
-30.4 units on a scale
Standard Deviation 16.0
-24.3 units on a scale
Standard Deviation 14.2

SECONDARY outcome

Timeframe: Pre-dose on Days 4, 8, 15, 22, and 29

Population: Full analysis population; patients with missing data were excluded from the analysis

Mean change from baseline in VAS scores for cravings during the maintenance phase (Days 4, 8, 15, 22, and 29); the VAS craving scores range from 0 ("no cravings") to 100 ("most intense craving I have ever had")

Outcome measures

Outcome measures
Measure
BNX Sublingual Tablets Induction
n=155 Participants
Days 1-2: Induction on BNX sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Buprenorphine Induction
n=155 Participants
Days 1-2: Induction on buprenorphine sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Mean Change From Baseline in the VAS Score for Cravings After Day 3 (Maintenance Phase)
Day 4
-40.1 units on a scale
Standard Deviation 28.6
-34.2 units on a scale
Standard Deviation 29.4
Mean Change From Baseline in the VAS Score for Cravings After Day 3 (Maintenance Phase)
Day 8
-46.1 units on a scale
Standard Deviation 29.5
-39.9 units on a scale
Standard Deviation 27.7
Mean Change From Baseline in the VAS Score for Cravings After Day 3 (Maintenance Phase)
Day 15
-48.5 units on a scale
Standard Deviation 30.3
-44.3 units on a scale
Standard Deviation 26.1
Mean Change From Baseline in the VAS Score for Cravings After Day 3 (Maintenance Phase)
Day 22
-53.3 units on a scale
Standard Deviation 29.5
-47.2 units on a scale
Standard Deviation 25.3
Mean Change From Baseline in the VAS Score for Cravings After Day 3 (Maintenance Phase)
Day 29
-52.7 units on a scale
Standard Deviation 29.1
-45.1 units on a scale
Standard Deviation 29.8

SECONDARY outcome

Timeframe: Day 3

Population: Full analysis population; patients with missing data were excluded from the analysis

Retention in treatment at Day 3 in the full analysis population (N=310) was defined as the number of patients in each induction arm completing the induction phase and who received study medication on Day 3. Treatment with BNX sublingual tablets was considered non-inferior to generic buprenorphine if the lower limit of the 95% confidence interval for the difference between BNX and generic buprenorphine was ≥-10% in the number of patients retained in treatment on Day 3.

Outcome measures

Outcome measures
Measure
BNX Sublingual Tablets Induction
n=155 Participants
Days 1-2: Induction on BNX sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Buprenorphine Induction
n=155 Participants
Days 1-2: Induction on buprenorphine sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Retention in Treatment in the Full Analysis Population
132 participants
147 participants

Adverse Events

BNX Sublingual Tablets Induction

Serious events: 1 serious events
Other events: 37 other events
Deaths: 0 deaths

Buprenorphine Induction

Serious events: 2 serious events
Other events: 43 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
BNX Sublingual Tablets Induction
n=155 participants at risk
Days 1-2: Induction on BNX sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Buprenorphine Induction
n=155 participants at risk
Days 1-2: Induction on buprenorphine sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Blood and lymphatic system disorders
Diabetic ketoacidosis
0.65%
1/155 • Number of events 1 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.
0.00%
0/155 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.
Psychiatric disorders
Attempted suicide
0.00%
0/155 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.
0.65%
1/155 • Number of events 1 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.
Infections and infestations
Bacteremia secondary to pyelonephritis
0.00%
0/155 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.
0.65%
1/155 • Number of events 1 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.

Other adverse events

Other adverse events
Measure
BNX Sublingual Tablets Induction
n=155 participants at risk
Days 1-2: Induction on BNX sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Buprenorphine Induction
n=155 participants at risk
Days 1-2: Induction on buprenorphine sublingual tablets (blinded); Days 3-28: Maintenance treatment with BNX sublingual tablets (open-label)
Gastrointestinal disorders
Nausea (Induction)
7.7%
12/155 • Number of events 12 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.
8.4%
13/155 • Number of events 13 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.
Nervous system disorders
Headache (Induction)
7.1%
11/155 • Number of events 11 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.
7.1%
11/155 • Number of events 11 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.
Psychiatric disorders
Insomnia (Induction)
3.9%
6/155 • Number of events 6 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.
7.1%
11/155 • Number of events 11 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.
Gastrointestinal disorders
Vomiting (Induction)
5.2%
8/155 • Number of events 8 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.
5.2%
8/155 • Number of events 8 • Blinded Induction Phase (Days 1-2) and Open Label Maintenance Phase (Days 3-28)
The safety population included 310 patients.

Additional Information

Lynn R. Webster, MD

PRA International

Phone: 801-892-5140

Results disclosure agreements

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