Trial Outcomes & Findings for Study of Buprenorphine Sublingual Spray for the Treatment of Moderate to Severe Pain (NCT NCT02634788)

NCT ID: NCT02634788

Last Updated: 2017-08-14

Results Overview

Pain intensity was assessed by the participant using an 11-point NRS from 0=no pain to 10=worst possible pain. Pain intensity scores were collected at Baseline (prior to study drug) and at multiple time points up to 48 hours after Time 0 (administration of first dose of study drug). Pain intensity difference is calculated by subtracting the pain intensity at each time point from the pain intensity at Time 0. The SPID scores are the sum of the differences at each time point multiplied by the duration in hours since the previous time point. Positive numbers indicate a reduction in pain \[maximum(max)=10 at each time point\], and negative numbers indicate an increase in pain \[minimum(min)=-10 at each time point\]. The overall min and max are -10 and 10 times the number of hours specified; SPID-48 range is -480 to 480. The NRS SPID-48 was analyzed using an analysis of covariance (ANCOVA) model, which included treatment and site as main effects and Baseline pain intensity as the covariate.

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

322 participants

Primary outcome timeframe

Baseline and 0 to 48 hours after Time 0

Results posted on

2017-08-14

Participant Flow

Participant milestones

Participant milestones
Measure
Placebo
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Overall Study
STARTED
79
81
80
82
Overall Study
COMPLETED
75
71
75
77
Overall Study
NOT COMPLETED
4
10
5
5

Reasons for withdrawal

Reasons for withdrawal
Measure
Placebo
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Overall Study
Adverse Event
0
8
3
1
Overall Study
Lack of Efficacy
4
0
1
4
Overall Study
Lost to Follow-up
0
1
0
0
Overall Study
Withdrawal by Subject
0
1
1
0

Baseline Characteristics

Study of Buprenorphine Sublingual Spray for the Treatment of Moderate to Severe Pain

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Total
n=322 Participants
Total of all reporting groups
Age, Continuous
45.3 years
STANDARD_DEVIATION 14.55 • n=5 Participants
43.7 years
STANDARD_DEVIATION 14.17 • n=7 Participants
45.6 years
STANDARD_DEVIATION 11.78 • n=5 Participants
48.4 years
STANDARD_DEVIATION 11.75 • n=4 Participants
45.7 years
STANDARD_DEVIATION 13.17 • n=21 Participants
Sex: Female, Male
Female
63 Participants
n=5 Participants
64 Participants
n=7 Participants
64 Participants
n=5 Participants
63 Participants
n=4 Participants
254 Participants
n=21 Participants
Sex: Female, Male
Male
16 Participants
n=5 Participants
17 Participants
n=7 Participants
16 Participants
n=5 Participants
19 Participants
n=4 Participants
68 Participants
n=21 Participants

PRIMARY outcome

Timeframe: Baseline and 0 to 48 hours after Time 0

Population: All randomized participants from the Intent-to-Treat (ITT) Population who did not have missing SPID-48 values. Missing SPID-48 data were not imputed.

Pain intensity was assessed by the participant using an 11-point NRS from 0=no pain to 10=worst possible pain. Pain intensity scores were collected at Baseline (prior to study drug) and at multiple time points up to 48 hours after Time 0 (administration of first dose of study drug). Pain intensity difference is calculated by subtracting the pain intensity at each time point from the pain intensity at Time 0. The SPID scores are the sum of the differences at each time point multiplied by the duration in hours since the previous time point. Positive numbers indicate a reduction in pain \[maximum(max)=10 at each time point\], and negative numbers indicate an increase in pain \[minimum(min)=-10 at each time point\]. The overall min and max are -10 and 10 times the number of hours specified; SPID-48 range is -480 to 480. The NRS SPID-48 was analyzed using an analysis of covariance (ANCOVA) model, which included treatment and site as main effects and Baseline pain intensity as the covariate.

Outcome measures

Outcome measures
Measure
Placebo
n=75 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=72 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=75 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=77 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Numeric Rating Scale (NRS) Summed Pain Intensity Difference (SPID) Over 0 to 48 Hours After Time 0 (NRS SPID-48)
89.40 units on a scale
Standard Error 10.109
171.33 units on a scale
Standard Error 10.316
125.58 units on a scale
Standard Error 10.101
124.85 units on a scale
Standard Error 9.944

SECONDARY outcome

Timeframe: Baseline and 4, 8, 24 and 48 hours after Time 0

Population: All randomized participants from the ITT Population with data available at each timepoint.

Pain intensity was assessed by the participant using an 11-point NRS from 0=no pain to 10=worst possible pain. Pain intensity scores were collected at Baseline (prior to study drug administration) and at multiple time points up to 48 hours after Time 0 (time of administration of the first dose of study drug). NRS PID is defined as the difference in pain at each scheduled timepoint relative to Baseline (PID=pain intensity at baseline - pain intensity at time point). A higher value of NRS PID score indicates a higher decrease in pain from Baseline.

Outcome measures

Outcome measures
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
NRS Mean Pain Intensity Difference (PID) at 4, 8, 24 and 48 Hours After Time 0
48 Hours
3.5 units on a scale
Standard Deviation 2.60
4.9 units on a scale
Standard Deviation 2.33
3.5 units on a scale
Standard Deviation 3.00
4.1 units on a scale
Standard Deviation 2.89
NRS Mean Pain Intensity Difference (PID) at 4, 8, 24 and 48 Hours After Time 0
4 Hours
-0.1 units on a scale
Standard Deviation 2.13
2.6 units on a scale
Standard Deviation 3.26
0.9 units on a scale
Standard Deviation 3.14
1.1 units on a scale
Standard Deviation 3.21
NRS Mean Pain Intensity Difference (PID) at 4, 8, 24 and 48 Hours After Time 0
8 Hours
0.5 units on a scale
Standard Deviation 2.10
2.5 units on a scale
Standard Deviation 3.06
1.2 units on a scale
Standard Deviation 2.78
0.7 units on a scale
Standard Deviation 2.73
NRS Mean Pain Intensity Difference (PID) at 4, 8, 24 and 48 Hours After Time 0
24 Hours
2.2 units on a scale
Standard Deviation 2.59
4.0 units on a scale
Standard Deviation 2.64
3.0 units on a scale
Standard Deviation 2.72
3.2 units on a scale
Standard Deviation 2.98

SECONDARY outcome

Timeframe: 4, 8, 24 and 48 hours after Time 0

Population: All randomized participants from the ITT Population with data available at each timepoint.

Pain intensity was assessed by the participant using an 11-point NRS from 0=no pain to 10=worst possible pain. Pain intensity scores were collected at Baseline (prior to study drug administration) and at multiple time points up to 48 hours after Time 0 (time of administration of the first dose of study drug). A lower value indicates improvement in pain.

Outcome measures

Outcome measures
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
NRS Mean Pain Intensity Score at 4, 8, 24 and 48 Hours After Time 0
48 Hours
2.9 units on a scale
Standard Deviation 2.60
1.9 units on a scale
Standard Deviation 1.95
2.8 units on a scale
Standard Deviation 2.65
2.6 units on a scale
Standard Deviation 2.56
NRS Mean Pain Intensity Score at 4, 8, 24 and 48 Hours After Time 0
4 Hours
6.5 units on a scale
Standard Deviation 2.45
4.1 units on a scale
Standard Deviation 3.46
5.5 units on a scale
Standard Deviation 3.24
5.6 units on a scale
Standard Deviation 3.24
NRS Mean Pain Intensity Score at 4, 8, 24 and 48 Hours After Time 0
8 Hours
5.9 units on a scale
Standard Deviation 2.51
4.2 units on a scale
Standard Deviation 2.76
5.1 units on a scale
Standard Deviation 2.75
5.9 units on a scale
Standard Deviation 2.57
NRS Mean Pain Intensity Score at 4, 8, 24 and 48 Hours After Time 0
24 Hours
4.2 units on a scale
Standard Deviation 2.67
2.7 units on a scale
Standard Deviation 2.39
3.4 units on a scale
Standard Deviation 2.55
3.4 units on a scale
Standard Deviation 2.68

SECONDARY outcome

Timeframe: Baseline and 0 to 4, 0 to 8 and 0 to 24 hours after Time 0

Population: All randomized participants from the Intent-to-Treat (ITT) Population who did not have missing SPID values.

Pain intensity was assessed by the participant using an 11-point NRS from 0=no pain to 10=worst possible pain. Pain intensity scores were collected at Baseline (prior to study drug) and at multiple time points up to 48 hours after Time 0 (administration of first dose of study drug). Pain intensity difference is calculated by subtracting the pain intensity at each time point from the pain intensity at Time 0. The SPID scores are the sum of the differences at each time point multiplied by the duration in hours since the previous time point. Positive numbers indicate a reduction in pain \[max=10 at each time point\] and negative numbers indicate an increase in pain \[min=-10 at each time point\]. The overall min and max are -10 and 10 times the number of hours specified: SPID-4=(-40 to 40), SPID-8=(-80 to 80) and SPID-24=(-240 to 240). The NRS SPID-4, 8 and 24 were analyzed using an ANCOVA model which included treatment and site as main effects and Baseline pain intensity as the covariate.

Outcome measures

Outcome measures
Measure
Placebo
n=78 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
NRS SPID Over 4 Hours (SPID-4), 8 Hours (SPID-8) and 24 Hours (SPID-24) After Time 0
SPID-8
1.32 units on a scale
Standard Deviation 1.851
17.57 units on a scale
Standard Deviation 1.835
8.26 units on a scale
Standard Deviation 1.843
7.08 units on a scale
Standard Deviation 1.837
NRS SPID Over 4 Hours (SPID-4), 8 Hours (SPID-8) and 24 Hours (SPID-24) After Time 0
SPID-4
0.67 units on a scale
Standard Deviation 1.036
7.70 units on a scale
Standard Deviation 1.013
3.67 units on a scale
Standard Deviation 1.023
3.74 units on a scale
Standard Deviation 1.020
NRS SPID Over 4 Hours (SPID-4), 8 Hours (SPID-8) and 24 Hours (SPID-24) After Time 0
SPID-24
24.16 units on a scale
Standard Deviation 5.001
75.67 units on a scale
Standard Deviation 5.066
48.85 units on a scale
Standard Deviation 4.962
44.17 units on a scale
Standard Deviation 4.920

SECONDARY outcome

Timeframe: 4, 8, 24 and 48 hours after Time 0

Population: All randomized participants from the ITT Population with data available at each timepoint.

TOTPAR was assessed by the participant using a 5-point NRS (0=no relief, 1=a little, 2=some, 3=a lot, 4=complete relief). TOTPAR scores were collected at Baseline (prior to study drug) and at multiple time points up to 48 hours after Time 0 (first dose of study drug). The TOTPAR scores are the sum of the pain relief at each time point multiplied by the duration in hours since the previous time point. Larger positive numbers indicate more pain relief (maximum=4 at each time point) and smaller positive numbers indicate less pain relief (minimum=0 at each time point). The overall minimum is 0 for each variable and the overall maximum is 4 times the number of hours specified for the variable: TOTPAR-4=(0 to 16), TOTPAR-8=(0 to 32), TOTPAR-24=(0 to 96) and TOTPAR-48=(0 to 192). TOTPAR-4, TOTPAR-8, TOTPAR-24 and TOTPAR-48 were analyzed using an ANCOVA model with factors for treatment, site and baseline pain intensity.

Outcome measures

Outcome measures
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Total Pain Relief (TOTPAR) Over 4, 8, 24 and 48 Hours After Time 0
TOTPAR-4
2.50 units on a scale
Standard Error 0.467
6.23 units on a scale
Standard Error 0.457
4.07 units on a scale
Standard Error 0.461
4.38 units on a scale
Standard Error 0.460
Total Pain Relief (TOTPAR) Over 4, 8, 24 and 48 Hours After Time 0
TOTPAR-8
5.48 units on a scale
Standard Error 0.848
13.85 units on a scale
Standard Error 0.841
9.22 units on a scale
Standard Error 0.845
8.95 units on a scale
Standard Error 0.842
Total Pain Relief (TOTPAR) Over 4, 8, 24 and 48 Hours After Time 0
TOTPAR-24
27.33 units on a scale
Standard Error 2.304
53.30 units on a scale
Standard Error 2.334
40.50 units on a scale
Standard Error 2.286
40.45 units on a scale
Standard Error 2.267
Total Pain Relief (TOTPAR) Over 4, 8, 24 and 48 Hours After Time 0
TOTPAR-48
73.88 units on a scale
Standard Error 4.684
118.12 units on a scale
Standard Error 4.780
95.73 units on a scale
Standard Error 4.680
100.15 units on a scale
Standard Error 4.607

SECONDARY outcome

Timeframe: From Time 0 (first dose of study drug) to time of confirmed meaningful pain relief (up to 64 minutes)

Population: All randomized participants from the ITT Population.

Time to onset of analgesia was measured as time to first perceptible pain relief confirmed by meaningful pain relief using the 2-stopwatch method. The study staff started 2 stopwatches as soon as the first dose of study drug was administered. Each participant was instructed to stop the first stopwatch when he or she experienced any perceptible pain relief and the second stopwatch when he or she experienced pain relief that was meaningful to them. If the second stopwatch was not stopped, time was censored at the time of the second dose of study drug or the use of rescue medication, whichever came first. If both stopwatches were not stopped time was censored at the time of the second dose of study drug or the use of rescue medication whichever came first. Time to onset of analgesia was defined as the time when the first stopwatch was stopped given that the second stopwatch is stopped.

Outcome measures

Outcome measures
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Time to Onset of Analgesia
NA minutes
Not estimable because less than 50% of participants achieved onset
43.0 minutes
Interval 21.0 to 64.0
NA minutes
Interval 43.0 to
Not estimable because less than 50% of participants achieved onset
NA minutes
Interval 41.0 to
Not estimable because less than 50% of participants achieved onset

SECONDARY outcome

Timeframe: 4, 8, 24 and 48 hours after Time 0 (first dose of study drug)

Population: All randomized participants from the ITT Population

Pain relief was assessed by the participant using a 5-point NRS (0=no relief, 1=a little, 2=some, 3=a lot, 4=complete relief). The percentage of participants with scores in each pain relief category are reported. Missing values were imputed.

Outcome measures

Outcome measures
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
4 Hours - No relief
60.8 percentage of participants
24.7 percentage of participants
43.8 percentage of participants
41.5 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
4 Hours - Complete relief
1.3 percentage of participants
18.5 percentage of participants
6.3 percentage of participants
8.5 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
4 Hours - A lot of relief
1.3 percentage of participants
19.8 percentage of participants
13.8 percentage of participants
13.4 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
8 Hours - No relief
43.0 percentage of participants
18.5 percentage of participants
32.5 percentage of participants
32.9 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
8 Hours - A little relief
35.4 percentage of participants
14.8 percentage of participants
22.5 percentage of participants
28.0 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
8 Hours - Some relief
7.6 percentage of participants
27.2 percentage of participants
21.3 percentage of participants
18.3 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
8 Hours - A lot of relief
10.1 percentage of participants
23.5 percentage of participants
12.5 percentage of participants
12.2 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
8 Hours - Complete relief
1.3 percentage of participants
12.3 percentage of participants
8.8 percentage of participants
3.7 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
24 Hours - No relief
20.3 percentage of participants
6.2 percentage of participants
7.5 percentage of participants
11.0 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
24 Hours - A little relief
19.0 percentage of participants
2.5 percentage of participants
21.3 percentage of participants
12.2 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
24 Hours - Some relief
29.1 percentage of participants
23.5 percentage of participants
25.0 percentage of participants
19.5 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
24 Hours - A lot of relief
17.7 percentage of participants
38.3 percentage of participants
26.3 percentage of participants
39.0 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
24 Hours - Complete relief
8.9 percentage of participants
19.8 percentage of participants
15.0 percentage of participants
12.2 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
48 Hours - No relief
17.7 percentage of participants
2.5 percentage of participants
8.8 percentage of participants
4.9 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
48 Hours - A little relief
13.9 percentage of participants
8.6 percentage of participants
11.3 percentage of participants
6.1 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
48 Hours - Some relief
20.3 percentage of participants
12.3 percentage of participants
20.0 percentage of participants
20.7 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
48 Hours - A lot of relief
27.8 percentage of participants
38.3 percentage of participants
32.5 percentage of participants
35.4 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
48 Hours - Complete relief
15.2 percentage of participants
27.2 percentage of participants
21.3 percentage of participants
26.8 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
4 Hours - A little relief
21.5 percentage of participants
16.0 percentage of participants
22.5 percentage of participants
23.2 percentage of participants
Percentage of Participants With Scores in Each Pain Relief Category at 4, 8, 24 and 48 Hours After Time 0
4 Hours - Some relief
13.9 percentage of participants
21.0 percentage of participants
13.8 percentage of participants
11.0 percentage of participants

SECONDARY outcome

Timeframe: From Time 0 (first dose of study drug) up to 48 hours

Population: All randomized participants from the ITT Population

Peak pain relief is the highest value of pain relief experienced during the study. Pain relief was assessed by the participant using a 5-point NRS (0=no relief, 1=a little, 2=some, 3=a lot, 4=complete relief). The percentage of participants with peak scores in each pain relief category are reported.

Outcome measures

Outcome measures
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Percentage of Participants With Peak Scores in Each Pain Relief Category
No relief
6.3 percentage of participants
0 percentage of participants
1.3 percentage of participants
3.7 percentage of participants
Percentage of Participants With Peak Scores in Each Pain Relief Category
A little relief
11.4 percentage of participants
2.5 percentage of participants
3.8 percentage of participants
1.2 percentage of participants
Percentage of Participants With Peak Scores in Each Pain Relief Category
Some relief
19.0 percentage of participants
9.9 percentage of participants
12.5 percentage of participants
13.4 percentage of participants
Percentage of Participants With Peak Scores in Each Pain Relief Category
A lot of relief
36.7 percentage of participants
42.0 percentage of participants
46.3 percentage of participants
40.2 percentage of participants
Percentage of Participants With Peak Scores in Each Pain Relief Category
Complete relief
26.6 percentage of participants
45.7 percentage of participants
36.3 percentage of participants
41.5 percentage of participants
Percentage of Participants With Peak Scores in Each Pain Relief Category
A lot of relief + Complete relief
63.3 percentage of participants
87.7 percentage of participants
82.6 percentage of participants
81.7 percentage of participants

SECONDARY outcome

Timeframe: From Time 0 (first dose of study drug) to time of peak pain relief (up to 1437 minutes)

Population: All randomized participants from the ITT Population

Time to peak pain relief is the time to the highest value of pain relief experienced during the study. Pain relief was assessed by the participant using a 5-point NRS (0=no relief, 1=a little, 2=some, 3=a lot, 4=complete relief). If no pain relief was observed, then the time was censored at the time of the last pain assessment.

Outcome measures

Outcome measures
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Time to Peak Pain Relief
1200.0 minutes
Interval 720.0 to 1200.0
360.0 minutes
Interval 181.0 to 719.0
720.0 minutes
Interval 420.0 to 960.0
1200.0 minutes
Interval 720.0 to 1437.0

SECONDARY outcome

Timeframe: From Time 0 (first dose of study drug) to time of first perceptible pain relief (up to 83 minutes)

Population: All randomized participants from the ITT Population.

Time to first perceptible pain relief was evaluated using the 2 stopwatch method and is defined as the time when the participant stops the first stopwatch. If it was not stopped time was censored at the time that the second stopwatch was stopped or the time of the second dose or the time that rescue medication was used whichever came first.

Outcome measures

Outcome measures
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Time to First Perceptible Pain Relief
29.0 minutes
Interval 6.0 to 83.0
23.0 minutes
Interval 10.0 to 43.0
15.0 minutes
Interval 11.0 to 42.0
27.0 minutes
Interval 14.0 to 74.0

SECONDARY outcome

Timeframe: From Time 0 (first dose of study drug) to time of meaningful pain relief (up to 227 minutes)

Population: All randomized participants from the ITT Population.

Time to meaningful pain relief was evaluated using the 2 stopwatch method and is defined as the time when the participant stops the second stopwatch. If it was not stopped time was censored at the time that the second stopwatch was stopped or the time of the second dose or the time that rescue medication was used whichever came first.

Outcome measures

Outcome measures
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Time to Meaningful Pain Relief
238.0 minutes
Interval 121.0 to
Not estimable because less than 50% of participants achieved meaningful pain relief
92.0 minutes
Interval 79.0 to 120.0
122.0 minutes
Interval 90.0 to 227.0
166.0 minutes
Interval 87.0 to 240.0

SECONDARY outcome

Timeframe: From Time 0 (first dose of study drug) up to 48 hours

Population: All randomized participants from the ITT Population.

The percentage of participants who needed to take an alternate medication for pain relief during the treatment period.

Outcome measures

Outcome measures
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Percentage of Participants Using Rescue Medication for Pain
97.5 percentage of participants
55.6 percentage of participants
87.5 percentage of participants
87.8 percentage of participants

SECONDARY outcome

Timeframe: From Time 0 to time of first use of rescue medication (up to 280 minutes)

Population: All randomized participants from the ITT Population.

Time to first use of rescue medication is the time from Time 0 (time of administration of the first dose of study drug) to the first use of rescue medication. If rescue medication was not taken the time was censored at the time of the last pain assessment.

Outcome measures

Outcome measures
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Time to First Use of Rescue Medication for Pain
107.0 minutes
Interval 77.0 to 125.0
937.0 minutes
Interval 349.0 to
Not estimable because too few participants used rescue medication
219.5 minutes
Interval 105.0 to 260.0
193.0 minutes
Interval 92.0 to 280.0

SECONDARY outcome

Timeframe: Over 24 and 48 hours after Time 0 (first dose of study drug)

Population: All randomized participants from the ITT Population who used rescue medication during the specified time intervals.

Total use of rescue medication is defined as the number of times a participant took rescue medication.

Outcome measures

Outcome measures
Measure
Placebo
n=77 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=45 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=70 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=72 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Total Use of Rescue Medication Over 0 to 24 Hours and 0 to 48 Hours
0-24 Hours
3.8 number of uses
Standard Deviation 1.98
2.2 number of uses
Standard Deviation 1.69
2.6 number of uses
Standard Deviation 1.62
2.9 number of uses
Standard Deviation 1.67
Total Use of Rescue Medication Over 0 to 24 Hours and 0 to 48 Hours
0-48 Hours
5.6 number of uses
Standard Deviation 3.60
2.9 number of uses
Standard Deviation 2.81
3.7 number of uses
Standard Deviation 2.68
3.9 number of uses
Standard Deviation 2.69

SECONDARY outcome

Timeframe: End of treatment (Day 3) or early termination

Population: All randomized participants from the ITT Population.

Global evaluation of study drug was completed at the end of treatment (Day 3) or before early termination if a participant discontinued early. Participants were asked to provide an overall rating of their study medication in controlling pain on a 5-point NRS, where 0=poor, 1=fair, 2=good, 3=very good, and 4=excellent. The percentage of participants with scores in each pain relief category are reported.

Outcome measures

Outcome measures
Measure
Placebo
n=79 Participants
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 Participants
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 Participants
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 Participants
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Participant's Global Evaluation of Study Drug
Poor
25.3 percentage of participants
2.5 percentage of participants
5.0 percentage of participants
14.6 percentage of participants
Participant's Global Evaluation of Study Drug
Fair
25.3 percentage of participants
7.4 percentage of participants
16.3 percentage of participants
15.9 percentage of participants
Participant's Global Evaluation of Study Drug
Good
19.0 percentage of participants
16.0 percentage of participants
26.3 percentage of participants
14.6 percentage of participants
Participant's Global Evaluation of Study Drug
Very Good
19.0 percentage of participants
32.1 percentage of participants
30.0 percentage of participants
24.4 percentage of participants
Participant's Global Evaluation of Study Drug
Excellent
10.1 percentage of participants
38.3 percentage of participants
18.8 percentage of participants
28.0 percentage of participants

Adverse Events

Placebo

Serious events: 0 serious events
Other events: 38 other events
Deaths: 0 deaths

Buprenorphine 0.5 mg TID

Serious events: 1 serious events
Other events: 76 other events
Deaths: 0 deaths

Buprenorphine 0.25 mg TID

Serious events: 0 serious events
Other events: 67 other events
Deaths: 0 deaths

Buprenorphine 0.125 mg TID

Serious events: 0 serious events
Other events: 57 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Placebo
n=79 participants at risk
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 participants at risk
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 participants at risk
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 participants at risk
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Skin and subcutaneous tissue disorders
Angioedema
0.00%
0/79 • From the first dose of study drug to the Follow-up visit (up to 9 days).
1.2%
1/81 • From the first dose of study drug to the Follow-up visit (up to 9 days).
0.00%
0/80 • From the first dose of study drug to the Follow-up visit (up to 9 days).
0.00%
0/82 • From the first dose of study drug to the Follow-up visit (up to 9 days).

Other adverse events

Other adverse events
Measure
Placebo
n=79 participants at risk
Participants received placebo-matching buprenorphine sublingual (under the tongue) spray TID for two days.
Buprenorphine 0.5 mg TID
n=81 participants at risk
Participants received buprenorphine 0.5 mg sublingual spray three times daily (TID) for two days.
Buprenorphine 0.25 mg TID
n=80 participants at risk
Participants received buprenorphine 0.25 mg sublingual spray TID for two days.
Buprenorphine 0.125 mg TID
n=82 participants at risk
Participants received buprenorphine 0.125 mg sublingual spray TID for two days.
Gastrointestinal disorders
Nausea
16.5%
13/79 • From the first dose of study drug to the Follow-up visit (up to 9 days).
84.0%
68/81 • From the first dose of study drug to the Follow-up visit (up to 9 days).
58.8%
47/80 • From the first dose of study drug to the Follow-up visit (up to 9 days).
43.9%
36/82 • From the first dose of study drug to the Follow-up visit (up to 9 days).
Gastrointestinal disorders
Vomiting
5.1%
4/79 • From the first dose of study drug to the Follow-up visit (up to 9 days).
72.8%
59/81 • From the first dose of study drug to the Follow-up visit (up to 9 days).
41.2%
33/80 • From the first dose of study drug to the Follow-up visit (up to 9 days).
29.3%
24/82 • From the first dose of study drug to the Follow-up visit (up to 9 days).
Gastrointestinal disorders
Constipation
1.3%
1/79 • From the first dose of study drug to the Follow-up visit (up to 9 days).
9.9%
8/81 • From the first dose of study drug to the Follow-up visit (up to 9 days).
7.5%
6/80 • From the first dose of study drug to the Follow-up visit (up to 9 days).
11.0%
9/82 • From the first dose of study drug to the Follow-up visit (up to 9 days).
Nervous system disorders
Dizziness
8.9%
7/79 • From the first dose of study drug to the Follow-up visit (up to 9 days).
54.3%
44/81 • From the first dose of study drug to the Follow-up visit (up to 9 days).
32.5%
26/80 • From the first dose of study drug to the Follow-up visit (up to 9 days).
22.0%
18/82 • From the first dose of study drug to the Follow-up visit (up to 9 days).
Nervous system disorders
Headache
11.4%
9/79 • From the first dose of study drug to the Follow-up visit (up to 9 days).
16.0%
13/81 • From the first dose of study drug to the Follow-up visit (up to 9 days).
28.7%
23/80 • From the first dose of study drug to the Follow-up visit (up to 9 days).
18.3%
15/82 • From the first dose of study drug to the Follow-up visit (up to 9 days).
Nervous system disorders
Somnolence
0.00%
0/79 • From the first dose of study drug to the Follow-up visit (up to 9 days).
13.6%
11/81 • From the first dose of study drug to the Follow-up visit (up to 9 days).
7.5%
6/80 • From the first dose of study drug to the Follow-up visit (up to 9 days).
7.3%
6/82 • From the first dose of study drug to the Follow-up visit (up to 9 days).
Skin and subcutaneous tissue disorders
Pruritus
1.3%
1/79 • From the first dose of study drug to the Follow-up visit (up to 9 days).
13.6%
11/81 • From the first dose of study drug to the Follow-up visit (up to 9 days).
2.5%
2/80 • From the first dose of study drug to the Follow-up visit (up to 9 days).
2.4%
2/82 • From the first dose of study drug to the Follow-up visit (up to 9 days).
Skin and subcutaneous tissue disorders
Hyperhidrosis
0.00%
0/79 • From the first dose of study drug to the Follow-up visit (up to 9 days).
9.9%
8/81 • From the first dose of study drug to the Follow-up visit (up to 9 days).
1.2%
1/80 • From the first dose of study drug to the Follow-up visit (up to 9 days).
2.4%
2/82 • From the first dose of study drug to the Follow-up visit (up to 9 days).
Investigations
Oxygen saturation decreased
5.1%
4/79 • From the first dose of study drug to the Follow-up visit (up to 9 days).
8.6%
7/81 • From the first dose of study drug to the Follow-up visit (up to 9 days).
10.0%
8/80 • From the first dose of study drug to the Follow-up visit (up to 9 days).
7.3%
6/82 • From the first dose of study drug to the Follow-up visit (up to 9 days).
Metabolism and nutrition disorders
Dehydration
0.00%
0/79 • From the first dose of study drug to the Follow-up visit (up to 9 days).
8.6%
7/81 • From the first dose of study drug to the Follow-up visit (up to 9 days).
0.00%
0/80 • From the first dose of study drug to the Follow-up visit (up to 9 days).
0.00%
0/82 • From the first dose of study drug to the Follow-up visit (up to 9 days).
Vascular disorders
Hot flush
1.3%
1/79 • From the first dose of study drug to the Follow-up visit (up to 9 days).
6.2%
5/81 • From the first dose of study drug to the Follow-up visit (up to 9 days).
2.5%
2/80 • From the first dose of study drug to the Follow-up visit (up to 9 days).
2.4%
2/82 • From the first dose of study drug to the Follow-up visit (up to 9 days).

Additional Information

Director, Clinical Development

Insys Therapeutics, Inc.

Phone: 480-500-3105

Results disclosure agreements

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