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Total Knee ArthroplastyPhase 2NCT02922582

Study of Local Administration of DepoTXA for Reduced Postsurgical Bleeding in Subjects Undergoing TKA

A Phase 2 study testing DepoTXA and Tranexamic Acid in people with Total Knee Arthroplasty, run by Pacira Pharmaceuticals, Inc at 5 sites in United States.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

This is a Phase 2, randomized, single-blind, active-controlled dose-ranging study in subjects scheduled to undergo total knee arthroplasty (TKA). Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Total Knee Arthroplasty
What is being tested?
DepoTXA and Tranexamic Acid
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
16 participants
Where
5 sitesUnited States
Study dates
28 Oct 2016to 27 Nov 2017
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Male or female, ≥18 years of age at screening.
  • Scheduled to undergo elective unilateral open TKA under general, spinal, or regional anesthesia.
  • American Society of Anesthesiology (ASA) physical status 1, 2, or 3.
  • Female subject must be surgically sterile; or at least 2 years postmenopausal; or have a monogamous partner who is surgically sterile; or practicing double-barrier contraception; or practicing abstinence (must agree to use double-barrier contraception in the event of sexual activity); or using an insertable, injectable, or transdermal, contraceptive approved by the FDA for greater than 2 months prior to screening and commit to the use of an acceptable form of birth control for the duration of the study and for 30 days after completion of the study.
  • Able to provide informed consent, adhere to the study visit schedule, and complete all study assessments.

Who cannot join

  • Currently pregnant, nursing, or planning to become pregnant during the study or within 1 month after study drug administration.
  • Planned concurrent surgical procedure (e.g., bilateral TKA).
  • Prior open knee surgery on ipsilateral knee. Prior arthroscopy is permitted.
  • Subjects taking a medication with a known procoagulant effect (e.g., combination hormonal contraceptives, Factor IX complex concentrates or anti-inhibitor coagulant concentrates, or all-trans retinoic acid).
  • Contraindication or hypersensitivity to TXA.
  • History of thrombosis or prior Venous thromboembolism (VTE).
Show all 20Show fewer
  • Known coagulopathy or active intravascular clotting.
  • Prior myocardial infarction.
  • Prior cardiovascular accident (stroke) or subarachnoid hemorrhage.
  • History of epilepsy.
  • Presence of an intravascular stent.
  • History of impaired kidney function, chronic respiratory disease, rheumatoid arthritis, coagulopathy, or loss of sensation in extremities.
  • Renal insufficiency (serum creatinine level >2 mg/dL).
  • Anemia (Hb level <10 g/dL).
  • Uncontrolled anxiety, psychiatric, or neurological disorder that might interfere with study assessments.
  • Acquired defective color vision.
  • Malignancy in the last 2 years, with the exception of non-metastatic basal cell or squamous cell carcinoma of the skin or localized carcinoma in situ of the cervix.
  • Suspected or known history of drug or alcohol abuse within the previous year.
  • Body weight <50 kg (110 pounds) or a body mass index >44 kg/m2.
  • Administration of an investigational drug within 30 days or 5 elimination half-lives of such investigational drug, whichever is longer, prior to study drug administration, or planned administration of another investigational product or procedure during the subject's participation in this study.

Trial locations and contacts

5 sites in 1 country.

5 sites in 1 country

United States5 sites
  • Medical University of South Carolina

    Charleston, South Carolina, 29425

  • Ohio State University/Wexner Medical Center

    Columbus, Ohio, 43210

  • Ortho Arizona

    Gilbert, Arizona, 85296

  • University of Miami Hospital

    Miami, Florida, 33136

  • Kendall Regional Medical Center

    Miami, Florida, 33175

Other trials in United States

About this study

Official title: A Randomized, Single-Blind, Active-Controlled, Dose-Ranging Study to Evaluate the Pharmacokinetics, Safety, and Efficacy of Local Administration of DepoTXA for Reduced Postsurgical Bleeding in Subjects Undergoing Total Knee Arthroplasty

This is a Phase 2, randomized, single-blind, active-controlled dose-ranging study in subjects scheduled to undergo total knee arthroplasty (TKA).

Read the detailed description

Approximately 60 subjects (15 per arm) are planned for enrollment. Subjects will be randomized in a 1:1:1:1 ratio to receive either DepoTXA 400 mg, DepoTXA 800 mg, DepoTXA 1200 mg, or IV TXA (Cyklokapron® 1 gram).

Being tested
DepoTXA, Tranexamic Acid

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

Study groups in NCT02922582
Study groupRoleWhat they receive
DepoTXA 400mgExperimental400mg Intracapsular at the end of surgery one time
Receives: Drug: DepoTXA
DepoTXA 800mgExperimental800mg Intracapsular at the end of surgery one time
Receives: Drug: DepoTXA
DepoTXA 1200mgExperimental1200mg Intracapsular at the end of surgery one time
Receives: Drug: DepoTXA
IV Tranexamic acid (TXA)Active comparator1 g of IV TXA at the end of surgery
Receives: Drug: Tranexamic Acid

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Area Under the Plasma Concentration-versus-time Curve From Time 0 Extrapolated to Infinity After Drug Administration

    Measured: Baseline; 5, 15, and 30 min; at 1, 2, 4, 6, 8, 12, 16, and 24 hours after study drug administration for all treatment groups. Additional blood samples were collected at 36, 48, 60, 72, and 96 hours for DepoTXA-treated subjects.

  2. Area Under the Plasma Concentration-versus-time Curve From Time 0 to the Last Collection Time After Drug Administration

    Measured: Baseline; 5, 15, and 30 min; at 1, 2, 4, 6, 8, 12, 16, and 24 hours after study drug administration for all treatment groups. Additional blood samples were collected at 36, 48, 60, 72, and 96 hours for DepoTXA-treated subjects.

  3. Maximum Plasma Concentration (Cmax)

    Measured: Baseline; 5, 15, and 30 min; at 1, 2, 4, 6, 8, 12, 16, and 24 hours after study drug administration for all treatment groups. Additional blood samples were collected at 36, 48, 60, 72, and 96 hours for DepoTXA-treated subjects.

  4. Time to Maximum Plasma Concentration (Tmax)

    Measured: Baseline; 5, 15, and 30 min; at 1, 2, 4, 6, 8, 12, 16, and 24 hours after study drug administration for all treatment groups. Additional blood samples were collected at 36, 48, 60, 72, and 96 hours for DepoTXA-treated subjects.

  5. The Apparent Terminal Elimination Rate Constant

    Measured: Baseline; 5, 15, and 30 min; at 1, 2, 4, 6, 8, 12, 16, and 24 hours after study drug administration for all treatment groups. Additional blood samples were collected at 36, 48, 60, 72, and 96 hours for DepoTXA-treated subjects.

  6. The Apparent Terminal Elimination Half-life

    Measured: Baseline; 5, 15, and 30 min; at 1, 2, 4, 6, 8, 12, 16, and 24 hours after study drug administration for all treatment groups. Additional blood samples were collected at 36, 48, 60, 72, and 96 hours for DepoTXA-treated subjects.

Secondary outcomes (7)
  1. Summary of Neurological Assessments (Proportion of Subjects Who Were Oriented and Proportion of Subjects Who Had Any of the Neurologic Events) at Each Assessed Timepoint

    Neurological assessment at 12, 24, 36, 48, 60, 72, and 96 hours after study drug administration

    Measured: 12, 24, 36, 48, 60, 72, and 96 hours after study drug administration

  2. Incidence of Reoperation Due to Hematoma or Wound Dehiscence

    Number of subjects who underwent reoperation due to hematoma or wound dehiscence

    Measured: Through day 60

  3. Incidence of Transfusion (Number of Units, Number of Units/Subject, Number of Subjects Transfused)

    Measured: Day 60

  4. Number of Participants With 90˚ Passive and Active Knee Flexion

    Measured: 24, 48, and 72 hours

  5. Time to Complete Timed Up-and-Go (TUG) Test

    Physical therapy assessment (Timed Up-and-Go (TUG) test) was conducted once postsurgically on Day 1; at approximately 8:00 am and 8:00 pm (±2 hours) daily from Day 2 through hospital discharge; and on Day 7

    Measured: Day 1; at approximately 8:00 am and 8:00 pm (±2 hours) daily from Day 2 through hospital discharge; and on Day 7

  6. Change in Knee and Thigh Measurements

    Leg difference in change from baseline is calculated by = (Operated Leg Change from Baseline) - (Non-Operated Leg Change from Baseline)

    Measured: 48 hours and Day 7

  7. Area Under the Curve (AUC) of NRS From 0-24 Hours, 0-48 Hours, and 24-48 Hours

    Numerical rating scale (NRS) at rest pain score (0 [no pain] to 10 [worst possible pain]) upon arrival at the PACU; at each in-hospital vital sign assessment beginning with the 2-hour assessment and ending with the 48-hour assessment; and the Day-7 follow-up visit. Summary is provided as area under the curve (AUC) of NRS from timepoint 0 to 24 hours, 0 to 48 hours, and 24 to 48 hours.

    Measured: Preoperative; arrival in Post-Anesthesia Care Unit (PACU); 2, 4, 6, 8, 12, 16, 24, 36, 48 hours, Day 7

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted4 Oct 2016 (estimated)
  2. Study start28 Oct 2016
  3. Primary completion27 Nov 2017
  4. Study completion27 Nov 2017

Why it stopped: Slow Enrollment

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Participant
Enrolment
16 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02922582
Sponsor's protocol ID
404-C-201
Status last verified
Dec 2020
First submitted
28 Sep 2016
Last updated
11 Dec 2020
Data monitoring committee
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing DepoTXA and Tranexamic Acid in people with Total Knee Arthroplasty, run by Pacira Pharmaceuticals, Inc at 5 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 20 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 11 Dec 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 5 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 11 Dec 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Area Under the Plasma Concentration-versus-time Curve From Time 0 Extrapolated to Infinity After Drug Administration (time frame: Baseline; 5, 15, and 30 min; at 1, 2, 4, 6, 8, 12, 16, and 24 hours after study drug administration for all treatment groups. Additional blood samples were collected at 36, 48, 60, 72, and 96 hours for DepoTXA-treated subjects.). The study lists 6 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 11 Dec 2020.

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