Clinical trial NCT01322360: Safety and Pharmacokinetic Study of Oral Morphine Sulfate in Pediatric Subjects
Official title: A Multicenter, Open Label, Safety and Pharmacokinetic Study of Oral Morphine Sulfate Administration in Pediatric Subjects 2 Years Old Through 17 Years Old With Postoperative Pain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE4
Conditions: Pain
Lead sponsor: West-Ward Pharmaceutical
Sponsor class: INDUSTRY
First posted: 2011-03-24
Enrollment: 50
Sex: ALL
Minimum age (years): 2
Maximum age (years): 17
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to evaluate the tolerability and safety of oral morphine sulfate in the treatment of postoperative pain in different pediatric age groups following multiple-dose administration.

To determine multiple-dose pharmacokinetics (PK) of morphine sulfate in pediatric subjects.

To compare plasma concentration of morphine sulfate in each age group of pediatric subjects with adult plasma morphine sulfate concentrations.


Eligibility criteria: Inclusion Criteria:

* parent or guardian provided written parental permission/informed consent, with subject assent (if required by local IRB).
* The child is 2 years old through 17 years old, inclusive (at the time of informed consent signing).
* A routine pediatric procedure is expected to require inpatient hospitalization postoperatively.
* Must be an inpatient for the study treatment period.
* Is expected by the investigator to require use of oral opioid for the treatment of postoperative pain.
* Has the ability to read and understand the study procedures and has the ability to communicate meaningfully with the study investigator and staff (if the subject is of preverbal age or cannot read or communicate meaningfully, then the subject's parent or guardian must meet this criterion).
* Child is expected to experience moderate to severe postoperative pain, in the investigator's opinion, during the immediate postoperative period after discontinuation of intermittent administration of IV opioid (preferably morphine) and is able to tolerate oral medications.
* If female subject is of childbearing potential, she must have a negative pregnancy test result at screening (serum) and on the day of surgery prior to surgery (urine).
* Must have vascular access to facilitate blood draws.

Exclusion Criteria:

* Has significant medical disease(s), laboratory abnormalities, or conditions(s) that in the investigator's judgment could compromise the subject's welfare, ability to communicate with study staff, complete study activities, or would otherwise contraindicate study participation. There is no minimum value for SpO2 for inclusion in the study; this should be based on the investigator's judgment.
* Has used opioids chronically (e.g., codeine, morphine, oxycodone, or hydromorphone, for \>7 calendar days) within the previous 30 days.
* Has known hypersensitivity or contraindication to receiving oral opioid(s).
* Has a current active enteral malabsorption disorder.
* Has impaired liver function (e.g., alanine aminotransferase \[ALT\] ≥3 times the upper limit of normal \[ULN\], or bilirubin ≥3 times ULN), known active hepatic disease (e.g., hepatitis), evidence of clinically significant chronic liver disease or other condition affecting the liver (e.g., chronic hepatitis) that may suggest the potential for an increased susceptibility to hepatic toxicity with oral morphine exposure. Subjects with no previous history of liver function impairment may be enrolled prior to receipt of screening laboratory testing results.
* Has significantly impaired renal function or disease, as evidenced by an estimated glomerular filtration rate (i.e., from creatinine levels using the Schwartz formula) calculated to be less than one-third of normal for the applicable age of this study population. Subjects with no previous history of kidney function impairment may be enrolled prior to receipt of screening laboratory testing results.
* Has a history of substance abuse or there is evidence of current substance abuse, in the investigator's opinion.
* Has received epidural or regional anesthesia within 12 hours prior to the first dose of oral morphine sulfate.
* Has participated in an interventional clinical study (investigational or marketed product) within 30 days before screening, or plans to participate in another clinical trial in the next 30 days.

Primary outcomes:
measure: Number of Subjects Who Experienced Adverse Events That Led to Study Discontinuation
timeFrame: Up to 21 days
Secondary outcomes:
measure: Number of Subjects Who Experienced Adverse Events of Moderate to Severe Intensity / Grade
timeFrame: Up to 21 days
Other outcomes:
Locations:
city: Phoenix
country: United States
facility: Maricopa Integrated Health System
state: Arizona
city: Little Rock
country: United States
facility: Arkansas Children's Hospital
state: Arkansas
city: Stanford
country: United States
facility: Stanford University Medical Center
state: California
city: New Haven
country: United States
facility: Yale New Haven Children's Hospital
state: Connecticut
city: Washington
country: United States
facility: Children's National Medical Center
state: District of Columbia
city: Detroit
country: United States
facility: Children's Hospital of Michigan
state: Michigan
city: Akron
country: United States
facility: Children's Hospital Medical Center of Akron d/b/a Akron Children's Hospital
state: Ohio
city: Hershey
country: United States
facility: Penn State Milton S. Hershey Medical Center
state: Pennsylvania
city: Nashville
country: United States
facility: Monroe Carell Jr. Children's Hospital at Vanderbilt
state: Tennessee
city: Dallas
country: United States
facility: University of Texas Southwestern Medical Center
state: Texas
city: Houston
country: United States
facility: University of Texas Health Science Center of Houston
state: Texas
Study officials:
affiliation: Quintiles, Inc.
name: Dante Landucci, M.D.
role: STUDY_DIRECTOR
References: