Evaluation of the oral human abuse potential of Oxycodone DETERx® formulation (Xtampza® ER)

Authors

  • Diana Meske, PhD
  • Ernest A. Kopecky, PhD
  • Steven Passik, PhD
  • Megan J. Shram, PhD

DOI:

https://doi.org/10.5055/jom.2018.0468

Keywords:

extended-release, oxycodone, DETERx, opioid analgesics, abuse potential

Abstract

Objective: To further characterize the human abuse potential and pharmacokinetics (PK) of Oxycodone DETERx (Xtampza® ER) after intact and chewed oral administration.

Design: Randomized, double-blind, triple-dummy, active- and placebo-controlled, single-dose, six-period, crossover comparison study.

Setting: Clinical research unit.

Subjects: Adult, nondependent recreational opioid users who liked the effects of crushed immediate-release (IR) oxycodone in solution and were able to differentiate the effects from placebo solution.

Interventions: Oral administration of intact Oxycodone DETERx (fasted and fed), chewed Oxycodone DETERx (fasted and fed), crushed IR oxycodone (fasted), and placebo (fed).

Main Outcome Measures: Subject ratings (100-point visual analog scales) of Drug Liking (primary measure) and Take Drug Again (key secondary measure).

Results: The pharmacodynamic (PD) analysis included 52 subjects who completed the study; the PK analysis included 71 subjects. Compared with crushed IR oxycodone fasted, the least-squares mean maximum effect (Emax) was statistically significant (p < 0.01) for Drug Liking and Take Drug Again, respectively, for chewed Oxycodone DETERx fasted (LS mean difference ± standard error of the mean: 13.1 ± 2.2 and 10.0 ± 3.2 points) and fed (10.9 ± 2.2 and 9.7 ± 3.3 points) and intact Oxycodone DETERx fasted (12.2 ± 2.2 and 9.3 ± 3.3 points) and fed (10.3 ± 2.2 and 9.2 ± 3.3 points). Results were consistent for other PD measures (Good Effects, Feeling High). Chewed Oxycodone DETERx fasted and fed treatments were bioequivalent to the respective intact treatments based on PK parameters.

Conclusions: This study showed that when chewed or swallowed intact, under fasted or fed conditions, Oxycodone DETERx had statistically significantly lower abuse potential via the oral route compared with IR oxycodone.

Author Biographies

Diana Meske, PhD

Manager, Clinical Development & Scientific Affairs, Collegium Pharmaceutical, Inc., Canton, Massachusetts

Ernest A. Kopecky, PhD

Vice President, Clinical Development; Head, Neuroscience, Collegium Pharmaceutical, Inc., Canton, Massachusetts

Steven Passik, PhD

Vice President, Scientific Affairs, Collegium Pharmaceutical, Inc., Canton, Massachusetts

Megan J. Shram, PhD

Director, Altreos Research Partners, Inc., Toronto, Ontario, Canada

References

Nicholson B: Benefits of extended-release opioid analgesic formulations in the treatment of chronic pain. Pain Pract. 2009; 9(1): 71-81.

Chou R, Fanciullo GJ, Fine PG, et al.: Clinical guidelines for the use of chronic opioid therapy in chronic noncancer pain. J Pain. 2009; 10(2): 113-130.

Butler SF, Black RA, Cassidy TA, et al.: Abuse risks and routes of administration of different prescription opioid compounds and formulations. Harm Reduct J. 2011; 8: 29.

Substance Abuse and Mental Health Services Administration. Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits. HHS Publication No. (SMA) 13-4760, DAWN Series D-39. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013.

U.S. Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research. Abuse-Deterrent Opioids—Evaluation and Labeling: Guidance for Industry. Silver Spring, MD: US Food and Drug Administration, 2015.

Butler SF, Cassidy TA, Chilcoat H, et al.: Abuse rates and routes of administration of reformulated extended-release oxycodone: Initial findings from a sentinel surveillance sample of individuals assessed for substance abuse treatment. J Pain. 2013; 14(4): 351-358.

Coplan PM, Chilcoat HD, Butler SF, et al.: The effect of an abuse-deterrent opioid formulation (OxyContin) on opioid abuse-related outcomes in the postmarketing setting. Clin Pharmacol Ther. 2016; 100(3): 275-286.

Kunins HV: Abuse-deterrent opioid formulations: Part of a public health strategy to reverse the opioid epidemic. JAMA Intern Med. 2015; 175(6): 987-988.

XTAMPZA ER (oxycodone) extended-release capsules, for oral use, CII [package insert]. Cincinnati, OH: Patheon Pharmaceuticals, 2016.

Lamb YN, Garnock-Jones KP, Keam SJ: Oxycodone DETERx® ER capsules: A review in severe, chronic pain. Drugs. 2016; 76(18): 1759-1769.

Gudin J: Oxycodone DETERx®: A novel abuse-deterrent, extended-release analgesic option for the treatment of patients with chronic pain. Pain Ther. 2016; 5(2): 171-186.

Kopecky EA, Fleming AB, Noonan PK, et al.: Impact of physical manipulation on in vitro and in vivo release profiles of Oxycodone DETERx®: An extended-release, abuse-deterrent formulation. J Opioid Manag. 2014; 10(4): 233-246.

Fleming AB, Scungio TA, Grima MP, et al.: In vitro assessment of the potential for abuse via the intravenous route of Oxycodone DETERx® microspheres. J Opioid Manag. 2016; 12(1): 57-65.

Fleming AB, Carlson DR, Varanasi RK, et al.: Evaluation of an extended-release, abuse-deterrent, microsphere-in-capsule analgesic for the management of patients with chronic pain with dysphagia (CPD). Pain Pract. 2016; 16(3): 334-344.

Mayock SP, Saim S, Fleming AB: In vitro drug release after crushing: Evaluation of Xtampza® ER and other ER opioid formulations. Clin Drug Investig. 2017; 37(12): 1117-1124.

Gudin J, Levy-Cooperman N, Kopecky EA, et al.: Comparing the effect of tampering on the oral pharmacokinetic profiles of two extended-release oxycodone formulations with abuse-deterrent properties. Pain Med. 2015; 16(11): 2142-2151.

Kopecky EA, Fleming AB, Levy-Cooperman N, et al.: Oral human abuse potential of Oxycodone DETERx® (Xtampza® ER). J Clin Pharmacol. 2017; 57(4): 500-512.

US Department of Health & Human Services, US Food and Drug Administration, Center for Drug Evaluation and Research. Assessment of Abuse Potential of Drugs. Guidance for Industry. Silver Spring, MD: US Department of Health & Human Services, 2017.

Eaton TA, Comer SD, Revicki DA, et al.: Determining the clinically important difference in visual analog scale scores in abuse liability studies evaluating novel opioid formulations. Qual Life Res. 2012; 21(6): 975-981.

Tompkins DA, Bigelow GE, Harrison JA, et al.: Concurrent validation of the Clinical Opiate Withdrawal Scale (COWS) and single-item indices against the Clinical Institute Narcotic Assessment (CINA) opioid withdrawal instrument. Drug Alcohol Depend. 2009; 105(1-2): 154-159.

Wesson DR, Ling W: The Clinical Opiate Withdrawal Scale (COWS). J Psychoactive Drugs. 2003; 35(2): 253-259.

US Department of Health and Human Services, Food and Drug Administration, Center for Drug Evaluation and Research. Food-Effect Bioavailability and Fed Bioequivalence Studies. Rockville, MD: Food and Drug Administration, 2002.

Comer SD, Zacny JP, Dworkin RH, et al.: Core outcome measures for opioid abuse liability laboratory assessment studies in humans: IMMPACT recommendations. Pain. 2012; 153(12): 2315-2324.

Griffiths RR, Bigelow GE, Ator NA: Principles of initial experimental drug abuse liability assessment in humans. Drug Alcohol Depend. 2003; 70(3 Suppl): S41-S54.

Bigelow GE: Human drug abuse liability assessment: Opioids and analgesics. Br J Addict. 1991; 86(12): 1615-1623.

Haertzen CA, Hickey JE: Addiction research center inventory (ARCI): Measurement of euphoria and other drug effects. In: Bozarth MA (ed.): Methods of Assessing the Reinforcing Properties of Abused Drugs. New York, NY: Springer-Verlag, 1987: 489-524.

Webster LR, Kopecky EA, Smith MD, et al.: A randomized, double-blind, double-dummy study to evaluate the intranasal human abuse potential and pharmacokinetics of a novel extended-release abuse-deterrent formulation of oxycodone. Pain Med. 2016; 17(6): 1112-1130.

Moorman-Li R, Motycka CA, Inge LD, et al.: A review of abuse-deterrent opioids for chronic nonmalignant pain. P T. 2012; 37(7): 412-418.

Chen L: Principles and methods of statistical assessment of abuse-deterrent opioids. Ther Innov Regul Sci. 2017; 52(1): 7-13.

Webster LR, Bath B, Medve RA, et al.: Randomized, double-blind, placebo-controlled study of the abuse potential of different formulations of oral oxycodone. Pain Med. 2012; 13(6): 790-801.

Katz N, Dart RC, Bailey E, et al.: Tampering with prescription opioids: Nature and extent of the problem, health consequences, and solutions. Am J Drug Alcohol Abuse. 2011; 37(4): 205-217.

Severtson SG, Ellis MS, Kurtz SP, et al.: Sustained reduction of diversion and abuse after introduction of an abuse deterrent formulation of extended release oxycodone. Drug Alcohol Depend. 2016; 168: 219-229.

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Published

09/01/2018

How to Cite

Meske, PhD, D., E. A. Kopecky, PhD, S. Passik, PhD, and M. J. Shram, PhD. “Evaluation of the Oral Human Abuse Potential of Oxycodone DETERx® Formulation (Xtampza® ER)”. Journal of Opioid Management, vol. 14, no. 5, Sept. 2018, pp. 359-72, doi:10.5055/jom.2018.0468.