Title

Safety and Efficacy of Buprenorphine Transdermal System (BTDS) in Subjects With Moderate to Severe Low Back Pain
A Multicenter, Randomized, Double-blind, Active Comparator Study to Determine the Efficacy and Safety of BTDS 20 or Oxycodone Immediate-release Versus BTDS 5 in Subjects With Moderate to Severe Low Back Pain
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Study Participants

    660
The objective of this study is to demonstrate the effectiveness and tolerability of the buprenorphine transdermal system (BTDS) 20 in comparison to the buprenorphine transdermal system (BTDS) 5 and oxycodone immediate-release in subjects with moderate to severe low back pain currently treated with oral opioids. The double-blind treatment intervention duration is 12 weeks during which time supplemental analgesic medication (acetaminophen, ibuprofen) will be provided to all subjects in addition to study drug.
Buprenorphine is a synthetic opioid analgesic with over 25 years of international clinical experience indicating it to be safe and effective in a variety of therapeutic situations for the relief of moderate to severe pain.
Study Started
Feb 29
2004
Primary Completion
Sep 30
2005
Study Completion
Sep 30
2005
Results Posted
Sep 29
2010
Estimate
Last Update
Sep 03
2012
Estimate

Drug Buprenorphine

Buprenorphine transdermal patch 5 mcg/h applied for 7-day wear.

  • Other names: Butrans™

Drug Buprenorphine

Buprenorphine transdermal patch 20 mcg/h applied for 7-day wear

  • Other names: Butrans™

Drug Oxycodone Immediate-Release

Oxycodone HCl immediate-release 40 mg (two 5-mg capsules every 6 hours).

BTDS 5 Active Comparator

Buprenorphine transdermal patch 5 mcg/h applied for 7-day wear.

BTDS 20 Experimental

Buprenorphine transdermal patch 20 mcg/h applied for 7-day wear.

Oxycodone Immediate-Release Experimental

Oxycodone immediate-release 40 mg (two 5-mg capsules every 6 hours).

Criteria

Inclusion Criteria:

low back pain for 3 months or longer, confirmed by radiographic evidence.
receiving a stable dose of an opioid analgesic for low back pain.

Exclusion Criteria:

taking more than 80 mg per day of oral morphine sulfate or equivalent within 30 days of enrollment.
requiring frequent analgesic therapy for chronic condition(s), in addition to low back pain.

Other protocol-specific exclusion/inclusion criteria may apply.

Summary

Double-blind BTDS 5

Double-blind BTDS 20

Double-blind Oxycodone Immediate-Release

Open-label Run-in Period, BTDS 10/20

All Events

Event Type Organ System Event Term Double-blind BTDS 5 Double-blind BTDS 20 Double-blind Oxycodone Immediate-Release Open-label Run-in Period, BTDS 10/20

Average Pain Over the Last 24 Hours Score at Weeks 4, 8, and 12.

Subjects were evaluated during the double-blind phase for "average pain over the last 24 hours" prior to the study visits. Pain scale is 11 points (0 = no pain to 10 = pain as bad as you can imagine)

Double-blind BTDS 5

Prerandomization

2.84
units on a scale (Mean)
Standard Error: 0.075

Screening

6.36
units on a scale (Mean)
Standard Error: 0.075

Week 12

4.02
units on a scale (Mean)
Standard Error: 0.179

Week 4

3.79
units on a scale (Mean)
Standard Error: 0.149

Week 8

3.83
units on a scale (Mean)
Standard Error: 0.162

Double-blind BTDS 20

Prerandomization

2.91
units on a scale (Mean)
Standard Error: 0.075

Screening

6.46
units on a scale (Mean)
Standard Error: 0.084

Week 12

3.35
units on a scale (Mean)
Standard Error: 0.139

Week 4

3.4
units on a scale (Mean)
Standard Error: 0.128

Week 8

3.35
units on a scale (Mean)
Standard Error: 0.140

Double-blind Oxycodone Immediate-Release

Prerandomization

2.74
units on a scale (Mean)
Standard Error: 0.074

Screening

6.46
units on a scale (Mean)
Standard Error: 0.079

Week 12

3.26
units on a scale (Mean)
Standard Error: 0.152

Week 4

3.14
units on a scale (Mean)
Standard Error: 0.125

Week 8

3.24
units on a scale (Mean)
Standard Error: 0.145

Mean Daily Number of Supplemental Analgesic Tablets

The mean daily number of tablets of supplemental analgesic medications used during the double-blind phase

Double-blind BTDS 5

3.8
tablets (Mean)
Standard Error: 0.12

Double-blind BTDS 20

3.3
tablets (Mean)
Standard Error: 0.13

Double-blind Oxycodone Immediate-Release

3.5
tablets (Mean)
Standard Error: .13

Oswestry Disability Index (ODI) Score (V 2.0)

The ODI (version 2) is a low back pain-specific, validated instrument that consists of questions related to limitations in performing specific activities of daily living and 1 question related to pain intensity. The ODI is a self-administered questionnaire that is usually completed in less than 5 minutes. The ODI consists of 10 sections. Each section consists of 6 statements ranked from 0 to 5 (0 = good to 5 = worse). (Note: A higher score represents greater disability.)

Double-blind BTDS 5

Week 12

36.3
units on a scale (Mean)
Standard Error: 1.392

Week 4

34.8
units on a scale (Mean)
Standard Error: 1.066

Week 8

35.69
units on a scale (Mean)
Standard Error: 1.245

Double-blind BTDS 20

Week 12

33.06
units on a scale (Mean)
Standard Error: 1.231

Week 4

33.04
units on a scale (Mean)
Standard Error: 1.019

Week 8

34.27
units on a scale (Mean)
Standard Error: 1.094

Double-blind Oxycodone Immediate-Release

Week 12

32.96
units on a scale (Mean)
Standard Error: 1.243

Week 4

30.79
units on a scale (Mean)
Standard Error: 1.124

Week 8

31.64
units on a scale (Mean)
Standard Error: 1.165

The Sleep Disturbance Subscale in the MOS-Sleep Scale at Weeks 4, 8, and 12.

The MOS-Sleep Scale consists of 12 individual items: (4 sleep disturbance, 2 sleep adequacy, 1 quantity/ optimal sleep, 3 somnolence, 1 snoring, and 1 shortness of breath). Question 1 is scored on a scale of 1 to 5 and Questions 3 to 12 are scored on a scale of 1 to 6. The Sleep Disturbance Subscale score is derived from the scores to Questions 1, 3, 7 and 8, and ranges from 0 to 100, where higher scores indicate greater sleep disturbance.

Double-blind BTDS 5

Week 12

40.85
units on a scale (Mean)
Standard Error: 2.376

Week 4

40.67
units on a scale (Mean)
Standard Error: 2.025

Week 8

42.28
units on a scale (Mean)
Standard Error: 2.264

Double-blind BTDS 20

Week 12

33.65
units on a scale (Mean)
Standard Error: 1.941

Week 4

34.65
units on a scale (Mean)
Standard Error: 1.607

Week 8

35.69
units on a scale (Mean)
Standard Error: 1.721

Double-blind Oxycodone Immediate-Release

Week 12

41.6
units on a scale (Mean)
Standard Error: 2.205

Week 4

38.1
units on a scale (Mean)
Standard Error: 1.788

Week 8

39.17
units on a scale (Mean)
Standard Error: 1.924

Total

660
Participants

Age Continuous

50.0
years (Mean)
Standard Deviation: 12.39

Sex: Female, Male

Overall Study

Double-blind BTDS 5

Double-blind BTDS 20

Double-blind Oxycodone Immediate-Release

Drop/Withdrawal Reasons

Double-blind BTDS 5

Double-blind BTDS 20

Double-blind Oxycodone Immediate-Release