PRA Health Sciences, Department of Scientific Affairs, Salt Lake City, Utah.
Inspirion Delivery Sciences, LLC, Morristown, New Jersey, USA.
Pain Med. 2019 Apr 1;20(4):747-757. doi: 10.1093/pm/pny043.
Prescription opioid abuse continues to be a public health concern. Oxycodone ARIR is an immediate-release (IR) oxycodone tablet composed of multiple overlapping barriers that deter manipulation of the tablet for non-oral abuse.
This randomized, double-blind, double-dummy, active- and placebo-controlled, four-way crossover, intranasal human abuse potential study assessed the pharmacodynamics and pharmacokinetics of crushed intranasal oxycodone ARIR compared with crushed intranasal IR oxycodone and intact oral oxycodone ARIR.
Pharmacodynamic end points included mean maximum drug liking (Emax), as measured by subjects on a bipolar 100-mm visual analog scale (primary), and desire to take the drug again, overall drug liking, drug high, and good effects (secondary). Pharmacokinetic assessments included peak concentration and time to peak concentration.
Twenty-nine subjects completed the treatment phase. Crushed intranasal oxycodone ARIR demonstrated a significant reduction of 46.9% and 23.4% in drug liking Emax compared with crushed intranasal IR oxycodone and intact oral oxycodone ARIR, respectively (P < 0.0001 for both). Significant reductions also were observed in desire to take the drug again, drug high, overall drug liking, and good effects when comparing crushed intranasal oxycodone ARIR with crushed intranasal IR oxycodone and intact oral oxycodone ARIR (P < 0.001 for all). Crushed intranasal oxycodone ARIR exhibited lower peak oxycodone plasma concentrations and slower time to peak concentration compared with crushed intranasal IR oxycodone and intact oral oxycodone ARIR. All treatments were well tolerated; adverse effects were typical of opioids or intranasal administration.
These data indicate that oxycodone ARIR has the potential to reduce abuse via the intranasal route.
处方类阿片类药物滥用仍是一个公共卫生关注点。盐酸羟考酮 AR 是一种由多个重叠障碍组成的即时释放(IR)羟考酮片剂,可阻止对片剂进行非口服滥用的操作。
这项随机、双盲、双模拟、活性药物和安慰剂对照、四交叉、经鼻人类滥用潜力研究评估了粉碎后经鼻内使用盐酸羟考酮 AR 与粉碎后经鼻内使用盐酸羟考酮 IR 和完整口服盐酸羟考酮 AR 的药效学和药代动力学。
药效学终点包括通过受试者在双极 100 毫米视觉模拟量表上测量的平均最大药物喜好(Emax)(主要终点),以及再次服用药物的意愿、总体药物喜好、药物欣快和良好效果(次要终点)。药代动力学评估包括峰值浓度和达峰时间。
29 名受试者完成了治疗阶段。与粉碎后经鼻内使用盐酸羟考酮 IR 和完整口服盐酸羟考酮 AR 相比,粉碎后经鼻内使用盐酸羟考酮 AR 显著降低了药物喜好 Emax 分别为 46.9%和 23.4%(两者均 P < 0.0001)。当与粉碎后经鼻内使用盐酸羟考酮 IR 和完整口服盐酸羟考酮 AR 相比时,再次服用药物的意愿、药物欣快、总体药物喜好和良好效果也显著降低(所有均 P < 0.001)。与粉碎后经鼻内使用盐酸羟考酮 IR 和完整口服盐酸羟考酮 AR 相比,粉碎后经鼻内使用盐酸羟考酮 AR 表现出较低的羟考酮血浆峰浓度和较慢的达峰时间。所有治疗均耐受良好;不良反应是阿片类药物或经鼻内给药的典型表现。
这些数据表明,盐酸羟考酮 AR 有可能通过经鼻途径减少滥用。