Multi-Center, Open-Label, 24-Week Study of OX219 Safety and Efficacy for Maintenance Treatment of Opioid Dependence

Phase 4CompletedNCT01903005

Orexo AB668 enrolled

Overview

The purpose of this study was to assess safety, efficacy, and treatment retention following extended treatment with OX219, a higher-bioavailability buprenorphine/naloxone (BNX) sublingual tablet formulation in opioid-dependent patients who completed 1 of 2 primary efficacy and safety studies of OX219.

This was a multicenter, open-label, uncontrolled, single-arm, 24-week, extension study to assess safety, efficacy, and treatment retention during maintenance treatment. Eligible patients had completed 1 of 2 primary efficacy and safety studies of the higher-bioavailability BNX sublingual tablet formulation (primary study OX219-006 \[NCT01908842\] or OX219-007 \[NCT01848054\]). The total duration of study treatment was 24 weeks.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

668

Conditions

Opioid Dependence, on Agonist Therapy

Interventions

Higher bioavailability BNX sublingual tabletsDRUG

Once daily, open-label treatment with higher bioavailability BNX sublingual tablets for 24 weeks

Eligibility

Sex: ALLMin age: 18 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion criteria * Signed informed consent form. * Completion of 1 of 2 primary efficacy safety studies of BNX sublingual tablets (OX219-006 or OX219-007). * Female patients of child bearing potential who used a reliable method of contraception (hormonal, condom with spermicide, intrauterine device) during the previous OX219-006 or OX219-007 study and continue to use it for the OX219-008 study. Females who are not of child-bearing potential who are either surgically sterile (by hysterectomy, bilateral oophorectomy, bilateral salpingectomy, or tubal ligation), or postmenopausal, as defined by being at least 50 years of age and having had an absence of menses for at least 2 years, were also eligible. Exclusion criteria * Females who are pregnant (positive pregnancy test result) or lactating, or planning to become pregnant during the study. * Participants who are unwilling or unable to comply with the requirements of the protocol (eg, pending incarceration) or are in a situation or condition that, in the opinion of the investigator, may interfere with participation in the study. * Participants who are participating in any other clinical study in which medication(s) are being delivered or who had used an investigational drug or device within the last 30 days. * Participants with any known allergy or sensitivity or intolerance to buprenorphine, naloxone, or any related drug, or history of any drug hypersensitivity or intolerance that, in the opinion of the investigator, would compromise the safety of the subject or the study. * Participant with a contra-indicated serious medical condition. * Participants who are at suicidal risk as determined by any of the following: a history of suicidal ideation ≤ 3 months prior to baseline with a score of 4 (intent to act) or 5 (specified plan and intent) on the Columbia Suicide Severity Risk Scale (C-SSRS).

Locations (28)

Unnamed facility

Jefferson County, Alabama, United States

Outcomes

Primary Outcomes

Number of Patients Reporting Treatment-Emergent Adverse Events

Number of patients reporting treatment-emergent adverse events during open-label, extension treatment with higher bioavailability BNX sublingual tablets

Time frame: Day 1 through week 24

Number of Patients Reporting Treatment-Related, Treatment-Emergent Adverse Events

Treatment-emergent adverse events considered related to treatment with the higher bioavailability BNX sublingual tablets

Time frame: Day 1 through week 24

Number of Patients Reporting Treatment-Emergent Serious Adverse Events

Patients reporting treatment-emergent serious adverse events considered either related or not related to treatment with the higher bioavailability BNX sublingual tablets

Time frame: Day 1 throught week 24

Number of Patient Discontinuations Due to Treatment-Emergent Adverse Events

Study discontinuations due to treatment-emergent adverse events that occurred during treatment with bioavailability BNX sublingual tablets

Time frame: Day 1 through week 24

Secondary Outcomes

Retention in Treatment in the Safety Population

Retention in treatment by visit in the safety population at weeks 4, 8, 12, 16, 20, and 24, defined as the number of patients receiving treatment on the day of the visit (± 5 days for each visit)

Time frame: Treatment retention was assessed at weeks 4, 8, 12, 16, 20, and 24

Mean Change From Primary Study Baseline (OX219-006 or OX219-007) in Clinical Opioid Withdrawal Scale (COWS) Score

Mean change from primary study baseline in COWS total scores during the 24-week open-label, extension study; COWS scores range from 0 to 48, with a lower score being more favorable; study endpoint was defined as the last post-baseline value recorded for COWS

Data from ClinicalTrials.gov

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Marion County, Alabama, United States

Unnamed facility

Winston County, Alabama, United States

Unnamed facility

Maricopa County, Arizona, United States

Unnamed facility

Los Angeles County, California, United States

Unnamed facility

San Diego County, California, United States

Unnamed facility

Broward County, Florida, United States

Unnamed facility

Columbia County, Florida, United States

Unnamed facility

Duval County, Florida, United States

Unnamed facility

Jacksonville Metropolitan Area, Florida, United States

...and 18 more locations

Time frame: Prior to dosing on day 1, at weeks 4, 8,12,16, 20, 24, and at study endpoint

Mean Change From Primary Study Baseline (OX219-006 or OX219-007) in Subjective Opioid Withdrawal Scale (SOWS) Score

Mean change from primary study baseline in SOWS total scores during the 24-week open-label, extension study; SOWS scores range from 0 to 64, with a lower score being more favorable; study endpoint was defined as the last post-baseline value recorded for SOWS

Time frame: Prior to dosing on day 1, at weeks 4, 8,12,16, 20, and 24, and at study endpoint

Mean Change From Primary Study Baseline (OX219-006 and OX219-007) in Visual Analog Scale (VAS) Craving Scores

Mean change from primary study baseline in VAS craving scores during the 24-week open-label, extension study; VAS craving scores range from 0 ("no cravings") to 100 mm ("most intense craving I have ever had"); study endpoint was defined as the last post-baseline value recorded for VAS craving

Time frame: Prior to dosing on day 1, at weeks 4, 8, 12, 16, 20, and 24, and at study endpoint

Percent Change From Primary Study Baseline (OX219-006 or OX219-007) for Question 1 of the Work Productivity/Activity Impairment: 6-Question Specific Health Problem Questionnaire (WPAI:SHP)

Question 1 of the WPAI:SHP asks patients to provide a "yes" or "no" response to the question "Are you employed?"; The percentage of patients employed at the end of the 24-week open-label, extension study was calculated by subtracting the percentage of previously employed patients not employed at study end from the percentage of previously unemployed patients who were employed by study end

Time frame: Study Endpoint

Mean Change From Primary Study Baseline (OX219-006 or OX219-007) for Questions 2-4 of the WPAI:SHP

Mean change from primary study baseline to week 24 of the open-label, extension study for questions 2-4 of the WPAI:SHP; Question 2: During the past 7 days, how many hours did you miss from work because of problems associated with your opioid dependence?; Question 3: During the past 7 days, how many hours did you miss from work because of any other reason, such as vacation, holidays, time off to participate in this study?; Question 4: During the past 7 days, how many hours did you actually work?

Time frame: Week 24

Mean Change From Primary Study Baseline (OX219-006 or OX219-007) for Questions 5-6 of the WPAI:SHP

Mean change from primary study baseline to week 24 of the open-label extension study for questions 5-6 of the WPAI:SHP; Question 5: During the past 7 days, how much did your opioid dependence affect your productivity while you were working?; Question 6: During the past 7 days, how much did your opioid dependence affect your ability to do regular daily activities, other than work at a job?; Questions 5 and 6 of the WPAI:SHP are scored on an 11-point scale (0 = problem had no effect; 10 = problem completely prevented me from doing my work/daily activities)

Time frame: Week 24