Kopecky Ernest A, Fleming Alison B, Levy-Cooperman Naama, O'Connor Melinda, M Sellers Edward
Collegium Pharmaceutical Inc, Canton, MA, USA.
Altreos Research Partners Inc, Toronto, Ontario, Canada.
J Clin Pharmacol. 2017 Apr;57(4):500-512. doi: 10.1002/jcph.833. Epub 2016 Nov 1.
Oxycodone DETERx (Collegium Pharmaceutical Inc, Canton, Massachusetts) is an extended-release, microsphere-in-capsule, abuse-deterrent formulation designed to retain its extended-release properties after tampering (eg, chewing/crushing). This randomized, double-blind, placebo-controlled, triple-dummy study evaluated the oral abuse potential of intact and chewed oxycodone DETERx capsules compared with crushed immediate-release oxycodone. Subjects with a history of recreational opioid use who were nondependent/nontolerant to opioids were enrolled. Treatments included intact oxycodone DETERx (high-fat, high-calorie meal and fasted), chewed oxycodone DETERx (high-fat, high-calorie meal and fasted), crushed immediate-release oxycodone (fasted), and placebo (high-fat, high-calorie meal). Plasma samples were collected to determine pharmacokinetic parameters. The primary endpoint was drug liking at the moment; other endpoints included drug effects questionnaire scores, Addiction Research Center Inventory/Morphine Benzedrine Group score, pupillometry measurements, and safety. Thirty-eight subjects completed the study. Chewed and intact oxycodone DETERx were bioequivalent, unlike crushed immediate-release oxycodone, which yielded higher peak oxycodone plasma concentrations compared with all methods of oxycodone DETERx administration. The mean maximum (peak) effect (E ) for drug liking was significantly lower for chewed and intact oxycodone DETERx than for crushed immediate-release oxycodone (P < .01). The time to E was significantly longer for chewed and intact oxycodone DETERx than for crushed immediate-release oxycodone (P < .0001). Scores for feeling high and Addiction Research Center Inventory/Morphine Benzedrine Group scores demonstrated lower abuse potential for chewed and intact oxycodone DETERx compared with crushed immediate-release oxycodone. Study treatments were well tolerated; no subjects experienced serious adverse events. These results demonstrate the lower oral abuse potential of chewed and intact oxycodone DETERx than crushed immediate-release oxycodone.
奥施康定DETERx(美国马萨诸塞州坎顿市的科勒吉姆制药公司)是一种缓释、胶囊内微球、具有滥用威慑作用的制剂,旨在防止在被篡改(如咀嚼/碾碎)后仍保持其缓释特性。这项随机、双盲、安慰剂对照、三模拟研究评估了完整和咀嚼后的奥施康定DETERx胶囊与碾碎的速释奥施康定相比的口服滥用可能性。招募了有娱乐性阿片类药物使用史且对阿片类药物无依赖/无耐受性的受试者。治疗方案包括完整的奥施康定DETERx(高脂、高热量餐食和空腹)、咀嚼后的奥施康定DETERx(高脂、高热量餐食和空腹)、碾碎的速释奥施康定(空腹)和安慰剂(高脂、高热量餐食)。采集血浆样本以确定药代动力学参数。主要终点是当时的药物喜好度;其他终点包括药物效应问卷评分、成瘾研究中心量表/吗啡苯丙胺组评分、瞳孔测量和安全性。38名受试者完成了研究。咀嚼后的奥施康定DETERx与完整的奥施康定DETERx生物等效,与碾碎的速释奥施康定不同,碾碎的速释奥施康定与所有奥施康定DETERx给药方法相比,产生的奥施康定血浆峰值浓度更高。咀嚼后的奥施康定DETERx和完整的奥施康定DETERx在药物喜好度方面的平均最大(峰值)效应(E)显著低于碾碎的速释奥施康定(P <.01)。咀嚼后的奥施康定DETERx和完整的奥施康定DETERx达到E的时间显著长于碾碎的速释奥施康定(P <.0001)。与碾碎的速释奥施康定相比,咀嚼后的奥施康定DETERx和完整的奥施康定DETERx在感觉兴奋方面的评分以及成瘾研究中心量表/吗啡苯丙胺组评分显示出较低的滥用可能性。研究治疗方案耐受性良好;没有受试者经历严重不良事件。这些结果表明,咀嚼后的奥施康定DETERx和完整的奥施康定DETERx的口服滥用可能性低于碾碎的速释奥施康定。