Trial Outcomes & Findings for Evaluation of Long-term Buprenorphine Plasma Exposure (NCT NCT03752528)

NCT ID: NCT03752528

Last Updated: 2020-08-21

Results Overview

The qualitative UDS (immunoassay) is the primary test used for the initial screening for opioids in patients in clinical practice. It provides only a qualitative assessment of buprenorphine exposure (i.e., positive or negative) with a low limit of quantification (LLOQ) of 5 ng/mL. The qualitative UDS is reported for Part A Cohort (Visit 1) and Part B Cohort (Visits 1, 2 and 3). Participants' last subcutaneous injections of extended release buprenorphine (SUBLOCADE™) was 22 - 38 months prior during previous phase III studies.

Recruitment status

COMPLETED

Target enrollment

53 participants

Primary outcome timeframe

Days 1, 30, 60

Results posted on

2020-08-21

Participant Flow

All investigators sites were in the U.S.

54 subjects were screened. One did not meet eligibility criteria.

Participant milestones

Participant milestones
Measure
All Study Participants
All study participants who enrolled into the Part A Cohort. These participants previously participated in study RB-US-13-0003 or both studies RB-US-13-0003 and INDV-6000-301 and who received at least 2 doses of SUBLOCADE 12-36 months prior. Some of the participants continued into study Part B after completing Part A.
Part A
STARTED
53
Part A
COMPLETED
51
Part A
NOT COMPLETED
2
Part B
STARTED
24
Part B
COMPLETED
20
Part B
NOT COMPLETED
4

Reasons for withdrawal

Reasons for withdrawal
Measure
All Study Participants
All study participants who enrolled into the Part A Cohort. These participants previously participated in study RB-US-13-0003 or both studies RB-US-13-0003 and INDV-6000-301 and who received at least 2 doses of SUBLOCADE 12-36 months prior. Some of the participants continued into study Part B after completing Part A.
Part A
Lost to Follow-up
1
Part A
Protocol Violation
1
Part B
Protocol Violation
1
Part B
Study terminated by sponsor
3

Baseline Characteristics

Evaluation of Long-term Buprenorphine Plasma Exposure

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
All Study Participants
n=53 Participants
All study participants who enrolled into the Part A Cohort. These participants previously participated in study RB-US-13-0003 or both studies RB-US-13-0003 and INDV-6000-301 and who received at least 2 doses of SUBLOCADE 12-36 months prior. Some of the participants continued into study Part B after completing Part A.
Age, Continuous
43.0 years
STANDARD_DEVIATION 11.46 • n=99 Participants
Age, Customized
18 - 44 years
32 Participants
n=99 Participants
Age, Customized
45 - 64 years
19 Participants
n=99 Participants
Age, Customized
.>= 65 years
2 Participants
n=99 Participants
Sex: Female, Male
Female
21 Participants
n=99 Participants
Sex: Female, Male
Male
32 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
3 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
50 Participants
n=99 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
Race/Ethnicity, Customized
Black or African American
16 Participants
n=99 Participants
Race/Ethnicity, Customized
White
37 Participants
n=99 Participants
Region of Enrollment
United States
53 participants
n=99 Participants
Weight
79.7 kg
STANDARD_DEVIATION 18.51 • n=99 Participants
Body Mass Index
26.5 kg/m^2
STANDARD_DEVIATION 5.58 • n=99 Participants
Body Mass Index Group
< 18.5 kg/m^2
1 Participants
n=99 Participants
Body Mass Index Group
>= 18.5 and < 25 kg/m^2
24 Participants
n=99 Participants
Body Mass Index Group
>= 25 and < 30 kg/m^2
15 Participants
n=99 Participants
Body Mass Index Group
>= 30 kg/m^2
13 Participants
n=99 Participants

PRIMARY outcome

Timeframe: Days 1, 30, 60

Population: Full analysis set includes participants who have at least one measure of buprenorphine or norbuprenorphine concentration in plasma or in urine in Part A. Four participants who tested positive for naloxone in urine were excluded from summary results. One participant was terminated from the study prior to Part B, Visit 2.

The qualitative UDS (immunoassay) is the primary test used for the initial screening for opioids in patients in clinical practice. It provides only a qualitative assessment of buprenorphine exposure (i.e., positive or negative) with a low limit of quantification (LLOQ) of 5 ng/mL. The qualitative UDS is reported for Part A Cohort (Visit 1) and Part B Cohort (Visits 1, 2 and 3). Participants' last subcutaneous injections of extended release buprenorphine (SUBLOCADE™) was 22 - 38 months prior during previous phase III studies.

Outcome measures

Outcome measures
Measure
Part A Cohort: Visit 1
n=49 Participants
Representative data set of participants from study RB-US-13-0003 or both studies RB-US-13-0003 and INDV-6000-301 who received at least 2 doses of SUBLOCADE 12-36 months prior. Part A consists of a single visit (Visit 1) for both screening and collection of blood and urine samples.
Part B Cohort: Visit 1
n=24 Participants
Part A participants with a quantifiable (i.e. positive) result for buprenorphine and/or norbuprenorphine and a non-quantifiable (i.e. negative) result for naloxone continue in the study for two additional visits (Part B, Visits 2 and 3). This cohort reports Visit 1 results for those participants who continued into Part B of the study.
Part B Cohort: Visit 2
n=23 Participants
Part A participants with a quantifiable (i.e. positive) result for buprenorphine and/or norbuprenorphine and a non-quantifiable (i.e. negative) result for naloxone continue in the study for two additional visits (Part B, Visits 2 and 3). This cohort reports Visit 2 (Day 30) results for those participants who continued into Part B of the study.
Part B Cohort: Visit 3
n=20 Participants
Part A participants with a quantifiable (i.e. positive) result for buprenorphine and/or norbuprenorphine and a non-quantifiable (i.e. negative) result for naloxone continue in the study for two additional visits (Part B, Visits 2 and 3). This cohort reports Visit 3 (Day 60) results for those participants who continued into Part B of the study.
Qualitative Urinary Drug Screen (UDS) for Buprenorphine in Parts A + B
Positive
27 Participants
19 Participants
16 Participants
15 Participants
Qualitative Urinary Drug Screen (UDS) for Buprenorphine in Parts A + B
Negative
22 Participants
5 Participants
7 Participants
5 Participants

PRIMARY outcome

Timeframe: Days 1, 30, 60

Population: Full analysis set includes participants who have at least one measure of buprenorphine or norbuprenorphine concentration in plasma or in urine in Part A. Four participants who tested positive for naloxone in urine were excluded from summary results. One participant was terminated from the study prior to Part B, Visit 2.

The quantitative UDS measures both buprenorphine and its glucuronide, or both norbuprenorphine and its glucuronide, with an LLOQ of 2 ng/mL. It is typically used by physicians for the confirmation of a positive result on the qualitative UDS. Data are reported for Part A Cohort (Visit 1) and Part B Cohort (Visits 1, 2 and 3). For Bup+Nor (abbreviation for Buprenorphine + Norbuprenorphine), the result is negative if results for both are negative, the result is positive if either result is positive. If both are missing/not available, or one is negative and the other is missing/not evaluable, the result is "Not Available" Participants' last subcutaneous injections of extended release buprenorphine (SUBLOCADE™) was 22 - 38 months prior during previous phase III studies.

Outcome measures

Outcome measures
Measure
Part A Cohort: Visit 1
n=49 Participants
Representative data set of participants from study RB-US-13-0003 or both studies RB-US-13-0003 and INDV-6000-301 who received at least 2 doses of SUBLOCADE 12-36 months prior. Part A consists of a single visit (Visit 1) for both screening and collection of blood and urine samples.
Part B Cohort: Visit 1
n=24 Participants
Part A participants with a quantifiable (i.e. positive) result for buprenorphine and/or norbuprenorphine and a non-quantifiable (i.e. negative) result for naloxone continue in the study for two additional visits (Part B, Visits 2 and 3). This cohort reports Visit 1 results for those participants who continued into Part B of the study.
Part B Cohort: Visit 2
n=23 Participants
Part A participants with a quantifiable (i.e. positive) result for buprenorphine and/or norbuprenorphine and a non-quantifiable (i.e. negative) result for naloxone continue in the study for two additional visits (Part B, Visits 2 and 3). This cohort reports Visit 2 (Day 30) results for those participants who continued into Part B of the study.
Part B Cohort: Visit 3
n=20 Participants
Part A participants with a quantifiable (i.e. positive) result for buprenorphine and/or norbuprenorphine and a non-quantifiable (i.e. negative) result for naloxone continue in the study for two additional visits (Part B, Visits 2 and 3). This cohort reports Visit 3 (Day 60) results for those participants who continued into Part B of the study.
Quantitative Urine Drug Screen (UDS) for Buprenorphine and Norbuprenorphine in Parts A + B
Buprenorphine - Positive
31 Participants
23 Participants
19 Participants
17 Participants
Quantitative Urine Drug Screen (UDS) for Buprenorphine and Norbuprenorphine in Parts A + B
Buprenorphine - Negative
18 Participants
1 Participants
4 Participants
3 Participants
Quantitative Urine Drug Screen (UDS) for Buprenorphine and Norbuprenorphine in Parts A + B
Norbuprenorphine- Not Available
1 Participants
1 Participants
0 Participants
0 Participants
Quantitative Urine Drug Screen (UDS) for Buprenorphine and Norbuprenorphine in Parts A + B
Bup + Nor - Positive
32 Participants
24 Participants
20 Participants
18 Participants
Quantitative Urine Drug Screen (UDS) for Buprenorphine and Norbuprenorphine in Parts A + B
Buprenorphine - Not Available
0 Participants
0 Participants
0 Participants
0 Participants
Quantitative Urine Drug Screen (UDS) for Buprenorphine and Norbuprenorphine in Parts A + B
Norbuprenorphine - Positive
29 Participants
21 Participants
19 Participants
17 Participants
Quantitative Urine Drug Screen (UDS) for Buprenorphine and Norbuprenorphine in Parts A + B
Norbuprenorphine - Negative
19 Participants
2 Participants
4 Participants
3 Participants
Quantitative Urine Drug Screen (UDS) for Buprenorphine and Norbuprenorphine in Parts A + B
Bup + Nor - Negative
17 Participants
0 Participants
3 Participants
2 Participants
Quantitative Urine Drug Screen (UDS) for Buprenorphine and Norbuprenorphine in Parts A + B
Bup + Nor - Not Available
0 Participants
0 Participants
0 Participants
0 Participants

PRIMARY outcome

Timeframe: Days 1, 30, 60

Population: Full analysis set includes participants who have at least one measure of buprenorphine or norbuprenorphine concentration in plasma or in urine in Part A. Four participants who tested positive for naloxone in urine were excluded from summary results. One participant was terminated from the study prior to Part B, Visit 2.

The urine free drug test only measures the "free" buprenorphine and "free" norbuprenorphine (without their glucuronides) with an LLOQ of 0.02 ng/mL. Data are reported for Part A Cohort (Visit 1) and Part B Cohort (Visits 1, 2 and 3). For Bup+Nor (abbreviation for Buprenorphine + Norbuprenorphine), the result is negative if results for both are negative, the result is positive if either result is positive. If both are missing/not available, or one is negative and the other is missing/not evaluable, the result is "Not Available" Participants' last subcutaneous injections of extended release buprenorphine (SUBLOCADE™) was 22 - 38 months prior during previous phase III studies.

Outcome measures

Outcome measures
Measure
Part A Cohort: Visit 1
n=49 Participants
Representative data set of participants from study RB-US-13-0003 or both studies RB-US-13-0003 and INDV-6000-301 who received at least 2 doses of SUBLOCADE 12-36 months prior. Part A consists of a single visit (Visit 1) for both screening and collection of blood and urine samples.
Part B Cohort: Visit 1
n=24 Participants
Part A participants with a quantifiable (i.e. positive) result for buprenorphine and/or norbuprenorphine and a non-quantifiable (i.e. negative) result for naloxone continue in the study for two additional visits (Part B, Visits 2 and 3). This cohort reports Visit 1 results for those participants who continued into Part B of the study.
Part B Cohort: Visit 2
n=23 Participants
Part A participants with a quantifiable (i.e. positive) result for buprenorphine and/or norbuprenorphine and a non-quantifiable (i.e. negative) result for naloxone continue in the study for two additional visits (Part B, Visits 2 and 3). This cohort reports Visit 2 (Day 30) results for those participants who continued into Part B of the study.
Part B Cohort: Visit 3
n=20 Participants
Part A participants with a quantifiable (i.e. positive) result for buprenorphine and/or norbuprenorphine and a non-quantifiable (i.e. negative) result for naloxone continue in the study for two additional visits (Part B, Visits 2 and 3). This cohort reports Visit 3 (Day 60) results for those participants who continued into Part B of the study.
Urine Free Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Buprenorphine - Negative
19 Participants
5 Participants
5 Participants
3 Participants
Urine Free Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Norbuprenorphine - Positive
46 Participants
24 Participants
21 Participants
20 Participants
Urine Free Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Bup + Nor - Positive
46 Participants
24 Participants
21 Participants
20 Participants
Urine Free Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Bup + Nor - Not Available
0 Participants
0 Participants
1 Participants
0 Participants
Urine Free Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Buprenorphine - Positive
30 Participants
19 Participants
17 Participants
17 Participants
Urine Free Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Buprenorphine - Not Available
0 Participants
0 Participants
1 Participants
0 Participants
Urine Free Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Norbuprenorphine - Negative
3 Participants
0 Participants
1 Participants
0 Participants
Urine Free Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Norbuprenorphine- Not Available
0 Participants
0 Participants
1 Participants
0 Participants
Urine Free Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Bup + Nor - Negative
3 Participants
0 Participants
1 Participants
0 Participants

PRIMARY outcome

Timeframe: Days 1, 30, 60

Population: Full analysis set includes participants who have at least one measure of buprenorphine or norbuprenorphine concentration in plasma or in urine in Part A. Four participants who tested positive for naloxone in urine were excluded from summary results. One participant was terminated from the study prior to Part B, Visit 2.

A sensitive liquid chromatography with tandem mass spectrometry (LC-MS/MS) method was used to assess the plasma exposure to buprenorphine and norbuprenorphine, its major metabolite. The LLOQ was 0.02 ng/mL for both analytes, which is much lower than the LLOQ of plasma/serum assays conducted by diagnostic laboratories. Data are reported for Part A Cohort (Visit 1) and Part B Cohort (Visits 1, 2 and 3). For Bup+Nor (abbreviation for Buprenorphine + Norbuprenorphine), the result is negative if results for both are negative, the result is positive if either result is positive. If both are missing/not available, or one is negative and the other is missing/not evaluable, the result is "Not Available" Participants' last subcutaneous injections of extended release buprenorphine (SUBLOCADE™) was 22 - 38 months prior during previous phase III studies.

Outcome measures

Outcome measures
Measure
Part A Cohort: Visit 1
n=49 Participants
Representative data set of participants from study RB-US-13-0003 or both studies RB-US-13-0003 and INDV-6000-301 who received at least 2 doses of SUBLOCADE 12-36 months prior. Part A consists of a single visit (Visit 1) for both screening and collection of blood and urine samples.
Part B Cohort: Visit 1
n=24 Participants
Part A participants with a quantifiable (i.e. positive) result for buprenorphine and/or norbuprenorphine and a non-quantifiable (i.e. negative) result for naloxone continue in the study for two additional visits (Part B, Visits 2 and 3). This cohort reports Visit 1 results for those participants who continued into Part B of the study.
Part B Cohort: Visit 2
n=23 Participants
Part A participants with a quantifiable (i.e. positive) result for buprenorphine and/or norbuprenorphine and a non-quantifiable (i.e. negative) result for naloxone continue in the study for two additional visits (Part B, Visits 2 and 3). This cohort reports Visit 2 (Day 30) results for those participants who continued into Part B of the study.
Part B Cohort: Visit 3
n=20 Participants
Part A participants with a quantifiable (i.e. positive) result for buprenorphine and/or norbuprenorphine and a non-quantifiable (i.e. negative) result for naloxone continue in the study for two additional visits (Part B, Visits 2 and 3). This cohort reports Visit 3 (Day 60) results for those participants who continued into Part B of the study.
Plasma Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Norbuprenorphine - Negative
27 Participants
11 Participants
11 Participants
8 Participants
Plasma Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Bup + Nor - Positive
32 Participants
20 Participants
18 Participants
16 Participants
Plasma Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Bup + Nor - Negative
15 Participants
3 Participants
4 Participants
3 Participants
Plasma Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Buprenorphine - Positive
32 Participants
20 Participants
18 Participants
16 Participants
Plasma Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Buprenorphine - Negative
15 Participants
3 Participants
4 Participants
3 Participants
Plasma Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Buprenorphine - Not Available
2 Participants
1 Participants
1 Participants
1 Participants
Plasma Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Norbuprenorphine - Positive
20 Participants
12 Participants
11 Participants
11 Participants
Plasma Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Norbuprenorphine- Not Available
2 Participants
1 Participants
1 Participants
1 Participants
Plasma Drug Test for Buprenorphine and Norbuprenorphine in Parts A + B
Bup + Nor - Not Available
2 Participants
1 Participants
1 Participants
1 Participants

Adverse Events

All Study Participants

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Global Director, Clinical Development

Indivior, Inc.

Phone: 804-379-1090

Results disclosure agreements

  • Principal investigator is a sponsor employee Proposed publications shall be submitted to Sponsor 30 days prior to submission for publication, and may be withheld for an additional period, up to 90 days, to allow Sponsor to file patent applications. If a multi-center publication isn't submitted for publication within 12 months of the conclusion of the Study at all sites, or is published in a shorter period, the results from the institution's site may be published individually.
  • Publication restrictions are in place

Restriction type: OTHER