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    Clinical Trial Results:
    An Open-label, Extension Study to Assess the Long-Term Safety of Twice Daily Oxycodone Hydrochloride Controlled-release Tablets in Opioid Experienced Children Who Completed the OTR3001 Study

    Summary
    EudraCT number
    2011-002235-26
    Trial protocol
    SE   EE   ES   FI   DE   GR   GB   SK   BE   HU   PL  
    Global end of trial date
    09 Dec 2013

    Results information
    Results version number
    v1(current)
    This version publication date
    21 Jul 2016
    First version publication date
    07 Aug 2015
    Other versions
    Summary report(s)
    OTR3002 Study report Synopsis

    Trial information

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    Trial identification
    Sponsor protocol code
    OTR3002
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01369615
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Purdue Pharma L.P
    Sponsor organisation address
    One Stamford Forum, Stamford, United States, CT 06901-3431
    Public contact
    Purdue Pediatric Call Centre, PRA International, +1 434 951 4115, PurduePediatric@praintl.com
    Scientific contact
    Purdue Pediatric Call Centre, PRA International, +1 434 951 4115, PurduePediatric@praintl.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    Yes
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    04 Sep 2014
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    09 Dec 2013
    Global end of trial reached?
    Yes
    Global end of trial date
    09 Dec 2013
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To characterize the long-term safety of oxycodone HCl CR tablets in opioid experienced pediatric patients aged 6 to 17 years, inclusive, with moderate to severe malignant and/or non malignant pain requiring opioid therapy who completed the 4 -week treatment period in OTR3001.
    Protection of trial subjects
    The DMC met periodically during the course of the study to review safety data and make recommendations to Purdue Pharma L.P. regarding early stopping of the study, continuation of the study, or modification of the study protocol, as needed.
    Background therapy
    NA
    Evidence for comparator
    NA
    Actual start date of recruitment
    05 Jan 2012
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    Yes
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Israel: 1
    Country: Number of subjects enrolled
    United States: 22
    Worldwide total number of subjects
    23
    EEA total number of subjects
    0
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    9
    Adolescents (12-17 years)
    14
    Adults (18-64 years)
    0
    From 65 to 84 years
    0
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    First patient First Visit: 05 January 2012; Last Patient Last Visit: 09 December 2013. The study was conducted at 14 medical /research sites in the United States and Israel

    Pre-assignment
    Screening details
    Opioid-experienced pediatric patients with moderate ot severe malignant and/or nonmalignant pain requiring around the clock opioid therapy were eligible for open-lable Extension Study OTR3002 if they completed the 4-week treatment period Core Study OTR3001 and could benefit from continued treatment with oxycodone HCI CR 20 to 240 mg total daily

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Not applicable
    Blinding used
    Not blinded
    Blinding implementation details
    This was an open lable study potential subjects were assigned a subject number at the time of screening

    Arms
    Arm title
    Open label treatment
    Arm description
    Twice Daily Oxycodone Hydrochloride Controlled-release Tablets
    Arm type
    Experimental

    Investigational medicinal product name
    Oxycodone Hydrochloride Twice Daily Controlled-release
    Investigational medicinal product code
    Oxycodone HCl CR
    Other name
    NA
    Pharmaceutical forms
    Prolonged-release tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Oxycodone HCl controlled-release (CR) twice daily tablets, at strengths of 10, 15, 20, 30, or 40 mg (20 to 240 mg daily), every 12 hours taken orally with water

    Number of subjects in period 1
    Open label treatment
    Started
    23
    Completed
    21
    Not completed
    2
         Consent withdrawn by subject
    1
         Lost to follow-up
    1

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Overall Study
    Reporting group description
    -

    Reporting group values
    Overall Study Total
    Number of subjects
    23 23
    Age categorical
    Units: Subjects
        In utero
    0 0
        Preterm newborn infants (gestational age < 37 wks)
    0 0
        Newborns (0-27 days)
    0 0
        Infants and toddlers (28 days-23 months)
    0 0
        Children (2-11 years)
    9 9
        Adolescents (12-17 years)
    14 14
        Adults (18-64 years)
    0 0
        From 65-84 years
    0 0
        85 years and over
    0 0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    12.6 ( 2.69 ) -
    Gender categorical
    Units: Subjects
        Female
    13 13
        Male
    10 10
    Race/Ethnicity
    Units: Subjects
        White
    16 16
        Black or African American
    7 7
    Subject analysis sets

    Subject analysis set title
    age group 6 to <12 years of age
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Children 6 to <12 years of age

    Subject analysis set title
    age group >=12 to <=16 years of age
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Children 12 to <=16 years of age

    Subject analysis sets values
    age group 6 to <12 years of age age group >=12 to <=16 years of age
    Number of subjects
    9
    14
    Age categorical
    Units: Subjects
        In utero
    0
    0
        Preterm newborn infants (gestational age < 37 wks)
    0
    0
        Newborns (0-27 days)
    0
    0
        Infants and toddlers (28 days-23 months)
    0
    0
        Children (2-11 years)
    9
    0
        Adolescents (12-17 years)
    0
    14
        Adults (18-64 years)
    0
    0
        From 65-84 years
    0
    0
        85 years and over
    0
    0
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    9.9 ( 1.76 )
    14.3 ( 1.49 )
    Gender categorical
    Units: Subjects
        Female
    6
    7
        Male
    3
    7
    Race/Ethnicity
    Units: Subjects
        White
    6
    10
        Black or African American
    3
    4

    End points

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    End points reporting groups
    Reporting group title
    Open label treatment
    Reporting group description
    Twice Daily Oxycodone Hydrochloride Controlled-release Tablets

    Subject analysis set title
    age group 6 to <12 years of age
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Children 6 to <12 years of age

    Subject analysis set title
    age group >=12 to <=16 years of age
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    Children 12 to <=16 years of age

    Primary: Number of patients with adverse events as a mesure of safety

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    End point title
    Number of patients with adverse events as a mesure of safety [1]
    End point description
    Safety assessments included adverse events ( AEs), vital sign measurements, clinical laboratory test results, and somnolence ( University of Michigan Sedation Scale (UMSS)). Safety variables were summarized descriptively within age group for the extension safety population
    End point type
    Primary
    End point timeframe
    Up to 6 months ( during the study) and 7-10 days poststudy ( safety follow-up assessment)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: No comparative inferential analysis is performed for the data from this open-lable study in wich all patients receive oxycodone HCI CR treatment. No adjustments for covariates are necessary for the analysis of this study. Data will be summarized overall and by age group where appropriate
    End point values
    age group 6 to <12 years of age age group >=12 to <=16 years of age
    Number of subjects analysed
    9
    14
    Units: participants
        Serious adverse events
    3
    2
        All other AE in more or equal than 5% of patients
    8
    8
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    Adverse Events (AEs) were reported from start of study participation through the period beyond study completion.
    Adverse event reporting additional description
    AEs were learned of through spontaneous reports and/or patient interview, or were observed during physical examinations or other safety assessments. Ongoing AEs were followed until resolution/30 days after last study drug dose. SAEs up to 30 days following the last study drug visit were followed until the AE or sequelae resolved or stabilized
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    13.0
    Reporting groups
    Reporting group title
    6 to < 12 years
    Reporting group description
    children 6 to < 12 years

    Reporting group title
    >=12 to <=16 years
    Reporting group description
    Children >=12 to <=16 years

    Serious adverse events
    6 to < 12 years >=12 to <=16 years
    Total subjects affected by serious adverse events
         subjects affected / exposed
    3 / 9 (33.33%)
    2 / 14 (14.29%)
         number of deaths (all causes)
    0
    0
         number of deaths resulting from adverse events
    0
    0
    Congenital, familial and genetic disorders
    Sickle cell anaemia with crisis
         subjects affected / exposed
    1 / 9 (11.11%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Nervous system disorders
    Headache
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Pyrexia
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences causally related to treatment / all
    1 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Vomiting
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    6 to < 12 years >=12 to <=16 years
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    8 / 9 (88.89%)
    8 / 14 (57.14%)
    Vascular disorders
    flushing
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Hypertension
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Hypotension
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Surgical and medical procedures
    Scar excision
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    General disorders and administration site conditions
    Adverse drug reaction
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Cyst
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Fatigue
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    2
    Inflammation
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Mucosal inflammation
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Pain
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Pyrexia
         subjects affected / exposed
    3 / 9 (33.33%)
    2 / 14 (14.29%)
         occurrences all number
    4
    2
    Immune system disorders
    Drug hypersensitivity
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Respiratory, thoracic and mediastinal disorders
    atelectasis
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    dyspnoea
         subjects affected / exposed
    1 / 9 (11.11%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    Epistaxis
         subjects affected / exposed
    2 / 9 (22.22%)
    0 / 14 (0.00%)
         occurrences all number
    2
    0
    Respiratory depression
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    1
    Respiratory distress
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Psychiatric disorders
    Depression
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Investigations
    Blood bilirubin increased
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Blood magnesium decreased
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Haemoglobin decreased
         subjects affected / exposed
    1 / 9 (11.11%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    Neutrophil count decreased
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    Oxygen saturation decreased
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Platelet count decreased
         subjects affected / exposed
    1 / 9 (11.11%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    Respiratory rate
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Transaminases increased
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    weight decreased
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    White blood cell count decreased
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    Congenital, familial and genetic disorders
    Sickle cell anaemia with crisis
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    1
    1
    Nervous system disorders
    Headache
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    4
    Sedation
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Somnolence
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    2
    2
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    2
    0
    Lymphadenopathy
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Ear and labyrinth disorders
    Auricular swelling
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    External ear pain
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Eye disorders
    Conjunctivitis
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Eye pain
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Mydriasis
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Gastrointestinal disorders
    Abdominal pain
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Constipation
         subjects affected / exposed
    1 / 9 (11.11%)
    1 / 14 (7.14%)
         occurrences all number
    1
    3
    Diarrhoea
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    3
    1
    Nausea
         subjects affected / exposed
    1 / 9 (11.11%)
    1 / 14 (7.14%)
         occurrences all number
    1
    4
    Oral pain
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Stomatitis
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Vomiting
         subjects affected / exposed
    2 / 9 (22.22%)
    2 / 14 (14.29%)
         occurrences all number
    3
    3
    Skin and subcutaneous tissue disorders
    dry skin
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Photosensitivity reaction
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Pruritus
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    2
    1
    Rash
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Scar
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Seborrhoea
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Skin ulcer
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Musculoskeletal and connective tissue disorders
    Myalgia
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Pain in extremity
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Oral candidiasis
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Sinusitis
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    urinary tract infection
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    1
    Vaginal infection
         subjects affected / exposed
    0 / 9 (0.00%)
    1 / 14 (7.14%)
         occurrences all number
    0
    1
    Metabolism and nutrition disorders
    Dehydration
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0
    Hypocalcaemia
         subjects affected / exposed
    1 / 9 (11.11%)
    0 / 14 (0.00%)
         occurrences all number
    1
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    28 Jun 2011
    A. Provide more specific instructions for post-study opioid management, including a tapering procedure for patients no longer requiring opioid treatment and a method of conversion to other opioids. B. Provide specific instructions for down-titration during the study to avoid potential opioid withdrawal syndrome.
    24 Jan 2012
    A. To increase the number of patients from 135 to 154 to account for the total number of patients required to be exposed to oxycodone for the evaluation of the safety of oxycodone in children, including all studies in the program. B. To clarify that only a limited number of patients were expected to complete OTR3001 and enter OTR3002. C. Based on spontaneous post-marketing reports, including reports of intestinal obstruction and exacerbation of diverticulitis, warnings and precautions were added to the OxyContin® package insert in Oct 2011 advising physicians to use caution when prescribing OxyContin® to patients who have an underlying gastrointestinal disorder predisposing them to obstruction. To ensure adherence with the guidelines added to the package insert, similar language was included in the exclusion criteria such that patients who were predisposed to these types of conditions would not be enrolled into the study. D. To correct an error and clarify that somnolence assessments would be performed by the parents/caregivers, rather than the patients. E. To modify the values used to define ranges of bilirubin displayed in listings to be more inclusive and provide information on more patients with potentially clinically significant bilirubin levels F. To revise the language in various sections as, in most cases, data would be presented only for the extension safety population and to clarify when data from OTR3001 would be included in the summary analyses. G. To update language for reporting of CSPCs to reflect the current process.
    11 Jun 2012
    The amendment was submitted only to sites that requested it. The rationale for the amendment was the following: A. To allow patients having difficulty getting to the site for a visit to have the visits conducted at the patient’s home if deemed appropriate by the investigator.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Enrollement for study OTR3002 was closed by Purdue Pharma L.P on 01-January-2014 due to administrative reasons not related to safety. Interpretation is limited by the samall number of patients in each age group in this study
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
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