A Repeated-Dose Evaluation of a Pain Relieving Drug Use and Safety of OROS Hydromorphone HCI in Patients With Chronic Non-Malignant Pain
Information source: Alza Corporation, DE, USA
Information obtained from ClinicalTrials.gov on June 20, 2008
Link to the current ClinicalTrials.gov record.
Condition(s) targeted: Opioid; Analgesics; Pain
Intervention: OROS Hydromorphone HCI (Drug)
Phase: Phase 3
Sponsored by: Alza Corporation, DE, USA
Official(s) and/or principal investigator(s):
Alza Corporation Clinical Trial, Study Director, Affiliation: Alza Corporation, DE, USA
The purpose of this repeated dose study is to develop recommended dosing information for
initiation of therapy with OROS Hydromorphone in patients with chronic non-malignant pain
converting from other strong oral or transdermal opioids. It will also assist in the
development of a recommended starting dose by which patients can be titrated to an
appropriate maintenance dose of OROS Hydromorphone HCI. The safety profile for OROS
Hydromorphone HCI will also be evaluated.
Official title: A Repeated-Dose Evaluation of Analgesic Use and Safety of Dilaudid SR (Hydromorphone HCI) in Patients With Chronic Non-Malignant Pain
Study design: Treatment, Non-Randomized, Single Blind, Single Group Assignment, Safety/Efficacy Study
Primary outcome: No primary efficacy variable was defined in report. Protocol variables measured included: Total daily dose of OROS hydromorphone, daily use of rescue medication, daily pain relief scores, and time/number of steps needed for dose stabilization.
This single-blind (with respect to dose), repeated dose study evaluating patients with
chronic non-malignant pain was conducted in tandem with a similar protocol in patients with
chronic cancer pain. A total of 463 patients were enrolled and evaluated in these studies.
Patients receiving chronic opioid therapy were converted to once daily OROS hydromorphone
using oral morphine equivalents. Supplementary immediate-release (IR) hydromorphone was
provided for breakthrough pain. The dose of OROS hydromorphone was escalated after every 2
days of therapy until no more than 3 doses of immediate-release(IR) hydromorphone were
required in a 24-hour period. Once a patient could be maintained on a stable dose of OROS
hydromorphone for 3 consecutive days, the patient entered a 2-week maintenance phase.
Patients who completed the study were eligible for participation in an OROS hydromorphone
long-term extension study, Study DO-109. The hypothesis is the 24-hour controlled-release
form of oral hydromorphone may provide consistent pain relief, convenient dosing, and
enhanced compliance while possibly decreasing the incidence of side effects associated with
peak (high) and trough (low) fluctuations in plasma drug concentrations typically seen with
immediate-release dosage formulations.
Patients received OROS Hydromorphone HCI at Visit 2,3, and 4(either 8,16,32, and/or 64mg
tablets) taken orally. OROS Hydromorphone HCI doses were titrated after every two days of
therapy as necessary until dose stabilization occurred, followed by a two week Maintenance
Minimum age: 18 Years.
Maximum age: N/A.
- Patients who have chronic non-malignant pain, including pain associated with AIDS, who
are currently receiving strong oral or transdermal opioid analgesics, or patients who
are currently receiving opioids plus non-opioid combination analgesics, and have
- Patients who require at least 45 mg of oral morphine or opioid equivalent every 24
hours for the management of chronic non-malignant pain
- Patients who can reasonably be expected to have stable opioid requirements for the
duration of the study
- Patients intolerant of or hypersensitive to hydromorphone (or other opioid agonists)
- Patients who have dysphagia or are unable to swallow tablets
- Patients who are pregnant or breast-feeding
- Patients with severe respiratory compromise or severely depressed ventilatory
- Patients with any gastrointestinal disorder, including pre-existing severe GI
narrowing(pathologic or iatrogenic), that may affect the absorption or transit of
orally administered drugs or have an acute abdominal condition that may be obscured by
- Patients with clinically significant impaired renal or hepatic function, Addison's
disease, hypothyroidism, prostatic hypertrophy, or urethral stricture
- Patients who are known active drug abusers or alcoholics
- Patients with any significant CNS disorder, including but not limited to head injury,
intracranial lesion, increased intracranial pressure, seizure disorder, stroke within
the past 6 months, and disorders of cognition
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Ending date: February 1999
Last updated: April 17, 2008