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Open-Label Safety and Efficacy of the Sufentanil Sublingual Tablet 30 mcg for Acute Pain

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT02447848
Recruitment Status : Completed
First Posted : May 19, 2015
Results First Posted : October 19, 2017
Last Update Posted : October 19, 2017
U.S. Army Medical Research and Development Command
Information provided by (Responsible Party):
AcelRx Pharmaceuticals, Inc.

Brief Summary:
To evaluate the safety and efficacy of sufentanil tablet (ST) 30 mcg in the management of moderate-to-severe acute pain in patients in an emergency room (ER) setting.

Condition or disease Intervention/treatment Phase
Moderate-to-severe Acute Pain Drug: sufentanil sublingual 30 mcg tablet Phase 3

Detailed Description:

The study is a multicenter, open-label trial, in patients 18 years and older, who present to the ER with moderate-to-severe acute pain due to obvious trauma or injury evident on physical examination.

Upon meeting all entrance criteria, patients will be administered up to four doses of sufentanil 30 mcg and remain in the study for 5 hours for safety and efficacy measurements.

Safety will be monitored via periodic measurement of vital signs and continuous monitoring of oxygen saturation, as well as assessment of adverse events (AEs) and the use of concomitant medications.

Efficacy will be assessed by patient reports of pain intensity (PI) and pain relief. A Six-Item Screener (SIS) will be administered before and 1 hour after study drug administration to measure cognitive impairment. The Patient Global Assessment (PGA) and the Healthcare Professional Global Assessment (HPGA) will assess global satisfaction with the method of pain control.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 76 participants
Allocation: N/A
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Multicenter, Open-Label Trial to Evaluate the Safety and Efficacy of the Sufentanil Sublingual Tablet 30 mcg for the Treatment of Acute Pain in Patients in Emergency Room Setting
Study Start Date : October 2015
Actual Primary Completion Date : June 2016
Actual Study Completion Date : July 2016

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Experimental: sufentanil sublingual tablet 30 mcg
Patients may be administered one tablet every 60 minutes as needed during the study period
Drug: sufentanil sublingual 30 mcg tablet

Primary Outcome Measures :
  1. Time-weighted Summed Pain Intensity Difference (SPID) Over the 1-hour (SPID1). [ Time Frame: One hour ]

    The primary efficacy endpoint is the time-weighted SPID1 evaluated from the patient questionnaire data. Pain intensity (PI) will be measured using an 11-point numerical rating scale (NRS) with 0 (no pain) and 10 (worst possible pain).

    The patient's rating of PI will be measured at baseline and at 0.25 (15 min), 0.5 (30 min), 0.75 (45 min), 1, 2, 3, 4, and 5 hours following the first dose of study drug.

    The PID at each evaluation time point after the initiation of the first dose is the difference in PI at the specific evaluation time point and baseline pain intensity [PID (evaluation time after the first dose) = PI(baseline) - PI(evaluation time after the first dose)]. The time-weighted SPID1 is the time-weighted summed PID over the 1-hour study period.

    The observed SPID scores ranged from -.70 to 8.00. A negative score indicates an increase in pain intensity and a positive score indicates a decrease in pain intensity.

Secondary Outcome Measures :
  1. TOTPAR1 (Time-weighted) [ Time Frame: 1-hour ]

    The total pain relief (TOTPAR) is the time-weighted sum of the pain relief scores over the first hour (15 minutes, 30 minutes, 45 minutes and 1-hour after the first dose of study drug is taken) of the study period.

    The minimum score is 0.00 and the maximum score is 4.00. A higher score indicates greater pain relief.

  2. PI at Each Evaluation Time Point [ Time Frame: 5 hours ]
    Pain intensity at each evaluation time point after the first dose of study drug up through 5 hours is evaluated using an 11-point NRS where 0 equals no pain and 10 equals worst possible pain. The score was obtained at Baseline, 15- , 30-, 45- minutes, 1-hour, and 2-hours after the first dose for all patients, and at hours 3, 4, and 5 for cohort 2 (patients 41-76). Scores ranged from 0 -10 for the first two hours, and 2 - 10 for hours three to five.

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Patients who present to the ER with moderate-to-severe pain due to obvious trauma or injury evident on physical examination.
  • Patients classified as American Society of Anesthesiologists (ASA) class I-III
  • Patients who are willing and capable of understanding and cooperating with the requirements of the study.
  • Patients able to understand and communicate in English.
  • Patients who have provided written informed consent and signed the IRB approved consent form.

Exclusion Criteria:

  • Patients who have taken an opioid for more than 30 consecutive days, at a daily dose of more than 15 mg of morphine (or equivalent), within the past 3 months (e.g. more than 3 doses per day of Vicodin®, Norco®, Lortab® with 5 mg hydrocodone per tablet).
  • Patients who have used any illicit drugs of abuse, abused prescription medication or alcohol (4 or more drinks per day) within one year before the start of the study.
  • Patients with an allergy or hypersensitivity to opioids.
  • Patients who are currently taking monoamine oxidase inhibitors (MAOIs) or have taken MAOIs within 14 days of the dose of study drug.
  • Patients with current sleep apnea that has been documented by a sleep laboratory study or are on home continuous positive airway pressure (CPAP).
  • Female patients who are pregnant (positive pregnancy test) or breastfeeding.
  • Patients with a medical condition that, in the Investigator's opinion, could adversely impact the patient's participation or safety, conduct of the study, or interfere with the pain assessments, including chronic pain or active infection.
  • Patients who present to the ER using supplemental oxygen.
  • Patients who have participated in a clinical trial of an investigational drug or device within 30 days of enrollment.
  • Patients who are active or reserve duty with the US military.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT02447848

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United States, Minnesota
Hennepin County Medical Center
Minneapolis, Minnesota, United States, 55415
United States, Texas
Hermann Memorial Medical Center
Houston, Texas, United States, 77024
Ben Taub General Hospital
Houston, Texas, United States, 77030
Sponsors and Collaborators
AcelRx Pharmaceuticals, Inc.
U.S. Army Medical Research and Development Command
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Study Director: Pamela P. Palmer, MD, PhD AcelRx Pharmaceuticals, Inc.
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Responsible Party: AcelRx Pharmaceuticals, Inc. Identifier: NCT02447848    
Other Study ID Numbers: SAP302
First Posted: May 19, 2015    Key Record Dates
Results First Posted: October 19, 2017
Last Update Posted: October 19, 2017
Last Verified: July 2017
Additional relevant MeSH terms:
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Acute Pain
Neurologic Manifestations
Analgesics, Opioid
Central Nervous System Depressants
Physiological Effects of Drugs
Sensory System Agents
Peripheral Nervous System Agents
Adjuvants, Anesthesia
Anesthetics, Intravenous
Anesthetics, General