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    Summary
    EudraCT Number:2020-004826-47
    Sponsor's Protocol Code Number:23956082
    National Competent Authority:Denmark - DHMA
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2020-10-22
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedDenmark - DHMA
    A.2EudraCT number2020-004826-47
    A.3Full title of the trial
    Intraoperative methadone for postoperative pain management in spinal fusion surgery: a prospective, double-blind, randomised controlled trial
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Methadone for pain following spinal surgery
    A.3.2Name or abbreviated title of the trial where available
    METASPINE
    A.4.1Sponsor's protocol code number23956082
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorLone Nikolajsen
    B.1.3.4CountryDenmark
    B.3.1 and B.3.2Status of the sponsorNon-Commercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportAarhus University Hospital
    B.4.2CountryDenmark
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAarhus University Hospital
    B.5.2Functional name of contact pointLone Nikolajsen
    B.5.3 Address:
    B.5.3.1Street AddressPalle Juul Jensens Blvd. 99
    B.5.3.2Town/ cityAarhus
    B.5.3.3Post code8200
    B.5.3.4CountryDenmark
    B.5.4Telephone number004578464317
    B.5.6E-maillone.nikolajsen@clin.au.dk
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Methadone Streuli Sol Inj 10 mg/ml 10 AMPS 1 ML
    D.2.1.1.2Name of the Marketing Authorisation holderStreuli Pharma AG
    D.2.1.2Country which granted the Marketing AuthorisationSwitzerland
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameMethadon Streuli
    D.3.2Product code NO7BCO2
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country which granted the Marketing AuthorisationDenmark
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameMorphine
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Low back pain
    E.1.1.1Medical condition in easily understood language
    Low back pain
    E.1.1.2Therapeutic area Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Anesthesia and Analgesia [E03]
    MedDRA Classification
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    • Opioid consumption at 24 hours (mean cumulative opioid consumption)
    • Opioid consumption at 6 hours after extubation (mean cumulative opioid consumption)
    E.2.2Secondary objectives of the trial
    • Pain intensity (NRS, 0-10) in the surgical area at rest and coughing at 1, 3, 6, 24, 48 and 72 hours after extubation
    • Pain intensity (NRS 0-10) in the legs (left and right, respectively) at 24 and 48 hours
    • Patient satisfaction (NRS, 0-10) with pain management at 24 hours after extubation
    • Nausea and/or vomiting (PONV) on a 4 point Likert scale (none/mild/moderate/severe) at 6 and 24 hours
    • Time from arrival to readiness for discharge from PACU (hours and minutes).
    • Level of sedation at observation at the PACU (Ramsay Sedation Scale) at 1 hour after extubation
    • Any adverse events during observation at the PACU:
    o Hypoventilation (respiratory rate < 10/minutes)
    o Hypoxemia (peripheral oxygen saturation < 94%)
    • Given treatment accordin to patient and investigator (24h)
    • 3 months follow-up: EQ-5D, opioid consumption and pain intensity
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    All patients (≥18 years) scheduled for elective spine surgery are screened for inclusion.
    E.4Principal exclusion criteria
    • Allergy to study drugs
    • American Society of Anaesthesiologists (ASA) physical status IV or V
    • Prolonged QTc-interval assessed by electrocardiogram (Male: >450 milliseconds, Female: >460 milliseconds)
    • Inability to provide informed consent
    • Severe respiratory insufficiency (Oxygen treatment at home)
    • Heart failure
    • Acute alcohol intoxication/delirium tremens
    • Increased intracranial pressure
    • Acute liver disease
    • Acute abdominal pain
    • Liver insufficiency
    • Kidney insufficiency (eGFR<30)
    • Pregnancy or breastfeeding
    • Existing treatment with medications prolonging the QT-interval (see appendix for details)
    • Existing treatment with opioids (at least the last 7 days) exceeding 60 mg morphine equivalents daily
    • Planned postoperative treatment with epidural analgesics and/or ketamine infusion
    • Treatment with rifampicin
    • Spinal surgery due to malignant disease
    E.5 End points
    E.5.1Primary end point(s)
    Opioid consumption
    E.5.1.1Timepoint(s) of evaluation of this end point
    At 6 and 24 hours after extubation
    E.5.2Secondary end point(s)
    • Pain intensity (NRS, 0-10) in the surgical area at rest and coughing
    • Pain intensity (NRS 0-10) in the legs (left and right, respectively)
    • Patient satisfaction (NRS, 0-10) with pain management
    • Nausea and/or vomiting (PONV) on a 4 point Likert scale (none/mild/moderate/severe)
    • Time from arrival to readiness for discharge from PACU (hours and minutes).
    • Level of sedation at observation at the PACU (Ramsay Sedation Scale)
    • Any adverse events during observation at the PACU:
    o Hypoventilation (respiratory rate < 10/minutes)
    o Hypoxemia (peripheral oxygen saturation < 94%)
    • Given treatment accordin to patient and investigator
    • Follow-up: EQ-5D, opioid consumption and pain intensity
    E.5.2.1Timepoint(s) of evaluation of this end point
    Pain intensity, back: 1, 3, 6, 24, 48 and 72 hours after extubation
    Pain intensity, legs: 24 and 48 hours
    Patient satisfaction: 24 hours after extubation
    PONV: 6 and 24 hours
    Sedation: 1 hours
    Given treatment: 24 hours
    Followup: 3 months
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis Yes
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) Yes
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial3
    E.8.3 The trial involves single site in the Member State concerned Yes
    E.8.4 The trial involves multiple sites in the Member State concerned No
    E.8.5The trial involves multiple Member States No
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    3 months following LVLS (due to followup)
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months
    E.8.9.1In the Member State concerned days
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 90
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 60
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations No
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state150
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    None
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2020-12-16
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2020-12-03
    P. End of Trial
    P.End of Trial StatusOngoing
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