Meske Diana, Kopecky Ernest A, Passik Steven, Shram Megan J
Manager, Clinical Development & Scientific Affairs, Collegium Pharmaceutical, Inc., Canton, Massachusetts.
Vice President, Clinical Development; Head, Neuroscience, Collegium Pharmaceutical, Inc., Canton, Massachusetts.
J Opioid Manag. 2018 Sep/Oct;14(5):359-372. doi: 10.5055/jom.2018.0468.
To further characterize the human abuse potential and pharmacokinetics (PK) of Oxycodone DETERx (Xtampza® ER) after intact and chewed oral administration.
Randomized, double-blind, triple-dummy, active- and placebo-controlled, single-dose, six-period, crossover comparison study.
Clinical research unit.
Adult, nondependent recreational opioid users who liked the effects of crushed immediate-release (IR) oxycodone in solution and were able to differentiate the effects from placebo solution.
Oral administration of intact Oxycodone DETERx (fasted and fed), chewed Oxycodone DETERx (fasted and fed), crushed IR oxycodone (fasted), and placebo (fed).
Subject ratings (100-point visual analog scales) of Drug Liking (primary measure) and Take Drug Again (key secondary measure).
The pharmacodynamic (PD) analysis included 52 subjects who completed the study; the PK analysis included 71 subjects. Compared with crushed IR oxycodone fasted, the least-squares mean maximum effect (E) was statistically significant (p < 0.01) for Drug Liking and Take Drug Again, respectively, for chewed Oxycodone DETERx fasted (LS mean difference ± standard error of the mean: 13.1 ± 2.2 and 10.0 ± 3.2 points) and fed (10.9 ± 2.2 and 9.7 ± 3.3 points) and intact Oxycodone DETERx fasted (12.2 ± 2.2 and 9.3 ± 3.3 points) and fed (10.3 ± 2.2 and 9.2 ± 3.3 points). Results were consistent for other PD measures (Good Effects, Feeling High). Chewed Oxycodone DETERx fasted and fed treatments were bioequivalent to the respective intact treatments based on PK parameters.
This study showed that when chewed or swallowed intact, under fasted or fed conditions, Oxycodone DETERx had statistically significantly lower abuse potential via the oral route compared with IR oxycodone.
进一步明确口服完整及嚼碎后的羟考酮控释片(Xtampza® ER)的人体滥用潜力及药代动力学(PK)特征。
随机、双盲、三模拟、活性药物及安慰剂对照、单剂量、六周期交叉比较研究。
临床研究单位。
成年、非依赖型娱乐性阿片类药物使用者,他们喜欢速释(IR)羟考酮碾碎后在溶液中的效果,且能够区分其与安慰剂溶液的效果。
口服完整的羟考酮控释片(空腹及进食后)、嚼碎的羟考酮控释片(空腹及进食后)、碾碎的速释羟考酮(空腹)及安慰剂(进食后)。
受试者对药物喜好程度(主要指标)和再次用药意愿(关键次要指标)的评分(100分视觉模拟量表)。
药效学(PD)分析纳入了52名完成研究的受试者;PK分析纳入了71名受试者。与空腹碾碎的速释羟考酮相比,空腹嚼碎的羟考酮控释片(最小二乘均值差异±均值标准误:13.1±2.2和10.0±3.2分)和进食后嚼碎的羟考酮控释片(10.9±2.2和9.7±3.3分)以及空腹完整的羟考酮控释片(12.2±2.2和9.3±3.3分)和进食后完整的羟考酮控释片(10.3±2.2和9.2±3.3分)的药物喜好程度和再次用药意愿的最小二乘均值最大效应(E)在统计学上均有显著差异(p<0.01)。其他PD指标(良好效果、感觉兴奋)的结果一致。基于PK参数,空腹和进食后嚼碎的羟考酮控释片治疗与各自完整治疗的生物等效性良好。
本研究表明,在空腹或进食条件下,无论嚼碎还是完整吞服,羟考酮控释片经口服途径的滥用潜力在统计学上均显著低于速释羟考酮。