Pain Study to Assess Local Anesthetic Efficacy and Safety of CTY-5339 on Gingival Mucosal Tissue in Normal Volunteers

NCT03233737 | Completed Phase 2 Results FDA Drug

• 1 other identifier: C-003
• Study Type: interventional
• Target: 75
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to determine if the topical application to gingival tissue of the combination of benzocaine and tetracaine has a longer duration of local anesthetic activity than benzocaine alone.

Conditions

No Disease State or Condition

Keywords

local anesthesia; pain tolerance; experimental pain

Outcome Measures

Primary Outcomes (4)

• Stage II: Duration of Anesthesia as Measured by Pin Prick Test (PPT) for One Spray CTY-5339-A Compared to One Spray CTY-5339-CB

  The duration of effect, was defined as the length of time in minutes from onset of anesthesia to the absence of anesthesia.Onset was the time point at which the PPT average pain score was less than the Baseline PPT average score by any amount. Also, in 10 minutes or less, the subject must have had a lower PPT average pain score of ≥ 1 unit than Baseline. Absence of anesthesia was defined as follows: After Onset had been established, absence was the first of two time points with consecutive occurrences of regression of absence of analgesia. Reports of less pain by ≥1 unit than Baseline indicated analgesia; while a report of similar (\< 1 unit) or more pain than Baseline indicated regression or absence of analgesia. The minimum onset time was 1 minute. PPT scores were assessed using a 0 (no pain) to 10 (severe pain) Numerical Rating Scale at a frequency of every 1 minute for the first 5 minutes and then every 5 minutes thereafter until the final 60 minute time point. Stage II outcome.

  Up to one hour post-application

• Stage II: Duration of Anesthesia as Measured by Heat Sensation Threshold (QST Heat) for One Spray CTY-5339-A Compared to One Spray CTY-5339-CB

  The duration of effect, was defined as the time from onset to treatment failure, as measured by QST Heat score. QST Heat scores were the temperature where the sensation of a heat stimuli was felt: ranging from 35 ºC to a maximum of 50.5 ºC with intervals of 0.5 ºC, at a frequency of every 1 minute for the first 5 minutes and then every 5 minutes thereafter until the final 60 minute time point. The QST Heat-based "Duration of effect" was calculated by the length of time in minutes from onset of anesthesia to the absence of anesthesia where Onset of anesthesia was defined by PPT unless specific QST thresholds were not met. After Onset had been established, absence of analgesia or offset was the first of two time points with consecutive occurrences of regression or absence of analgesia. Reports of QST heat pain temperature by ≥ 3 °C of the Baseline QST indicated analgesia; while a report of similar (\<3 °C) than Baseline indicated regression or absence of analgesia. Stage

  Up to one hour post-application

• Stage I: Duration of Anesthesia as Measured by Pin Prick Test (PPT) for One Spray CTY-5339-A Compared to One Spray CTY-5339-CB Compared to One Spray CTY-5339-P (Placebo: Vehicle Control)

  The duration of effect, was defined as the length of time in minutes from onset of anesthesia to the absence of anesthesia.Onset was the time point at which the PPT average pain score was less than the Baseline PPT average score by any amount. Also, in 10 minutes or less, the subject must have had a lower PPT average pain score of ≥ 1 unit than Baseline. Absence of anesthesia was defined as follows: After Onset had been established, absence was the first of two time points with consecutive occurrences of regression of absence of analgesia. Reports of less pain by ≥1 unit than Baseline indicated analgesia; while a report of similar (\< 1 unit) or more pain than Baseline indicated regression or absence of analgesia. The minimum onset time was 1 minute. PPT scores were assessed using a 0 (no pain) to 10 (severe pain) Numerical Rating Scale at a frequency of every 1 minute for the first 5 minutes and then every 5 minutes thereafter until the final 60 minute time point. Stage I outcome.

  Up to one hour post-application

• Stage I: Duration of Anesthesia as Measured by Heat Sensation Threshold (QST Heat) for One Spray CTY-5339-A Compared to One Spray CTY-5339-CB Compared to One Spray CTY-5339-P (Placebo: Vehicle Control)

  The duration of effect, was defined as the time from onset to treatment failure, as measured by QST Heat score. QST Heat scores were the temperature where the sensation of a heat stimuli was felt: ranging from 35 ºC to a maximum of 50.5 ºC with intervals of 0.5 ºC, at a frequency of every 1 minute for the first 5 minutes and then every 5 minutes thereafter until the final 60 minute time point. The QST Heat-based "Duration of effect" was calculated by the length of time in minutes from onset of anesthesia to the absence of anesthesia where Onset of anesthesia was defined by PPT unless specific QST thresholds were not met. After Onset had been established, absence of analgesia or offset was the first of two time points with consecutive occurrences of regression or absence of analgesia. Reports of QST heat pain temperature by ≥ 3 °C of the Baseline QST indicated analgesia; while a report of similar (\<3 °C) than Baseline indicated regression or absence of analgesia. Stage I outcome.

  Up to one hour post-application

Secondary Outcomes (18)

• Stage II: Onset of Anesthesia for Pin Prick Test (PPT)

  Up to one hour post-application

• Stage II: Onset of Anesthesia for Heat Sensation Threshold (QST Heat)

  Up to one hour post-application

• Stage II: Percentage of Responders for Pin Prick Test (PPT) at Each Time Point

  Up to one hour post-application

• Stage II: Percentage of Responders for Heat Sensation Threshold (QST Heat) at Each Time Point

  Up to one hour post-application

• Stage II: Percentage of Subjects Reaching Minimal Pain on Pin Prick Test (PPT) (≤2 on Numerical Rating Scale Pain Scale)

  Any time within one hour post-application

Study Arms (5)

Stage II: One spray CTY-5339-A, then one spray CTY-5339-CB

EXPERIMENTAL

A single spray of CTY-5339-A Anesthetic Spray (14.0% benzocaine and 2.0% tetracaine HCl) tested over a 60 minute session, followed by a 4-14 day washout period, followed by a single spray of CTY-5339-CB Anesthetic Spray (14.0% benzocaine) tested over a 60 minute session. Used in Stage II of the study only.

Combination Product: One spray CTY-5339-A; Device: One spray CTY-5339-CB

Stage II: One spray of CTY-5339-CB, then one spray CTY-5339-A

ACTIVE COMPARATOR

A single spray of CTY-5339-CB Anesthetic Spray (14.0% benzocaine) tested over a 60 minute session, followed by a 4-14 day washout period, followed by a single spray of CTY-5339-A Anesthetic Spray (14.0% benzocaine and 2.0% tetracaine HCl) tested over a 60 minute session. Used in Stage II of the study only.

Combination Product: One spray CTY-5339-A; Device: One spray CTY-5339-CB

Stage I: One spray CTY-5339-A

EXPERIMENTAL

Metered spray bottle with ≈200 uL total spray volume. Contains the active ingredients: 14.0% Benzocaine (USP = 28 mg) and 2.0% Tetracaine Hydrochloride (USP = 4 mg). Administered in a single anesthetic spray. Tested over a 60 minute session. Used in Stage I of the study only.

Combination Product: One spray CTY-5339-A

Stage I: One spray CTY-5339-CB

ACTIVE COMPARATOR

Metered spray bottle with ≈200 uL total spray volume. Contains the active ingredient: 14.0% Benzocaine (USP = 28 mg). Administered in a single anesthetic spray. Tested over a 60 minute session. Used in Stage I of the study only.

Device: One spray CTY-5339-CB

Stage I: One spray CTY-5339-P

PLACEBO COMPARATOR

Metered spray bottle with ≈200 uL total spray volume. Contains no active ingredient (placebo: vehicle control). Administered in a single anesthetic spray. Tested over a 60 minute session. Used in Stage I of the study only.

Device: One spray CTY-5339-P

Interventions

One spray CTY-5339-A COMBINATION_PRODUCT

Metered spray bottle with ≈200 uL total spray volume. Contains the active ingredients: 14.0% Benzocaine (USP = 28 mg) and 2.0% Tetracaine Hydrochloride (USP = 4 mg). Administered in a single anesthetic spray.

Also known as: CTY-5339-A, CTY-5339 Anesthetic Spray, benzocaine, tetracaine, tetracaine HCl, 14.0% benzocaine, 2.0% tetracaine HCl, 2.0% tetracaine, 14.0% benzocaine and 2.0% tetracaine HCl, 14.0% benzocaine and 2.0% tetracaine, benzocaine and tetracaine HCl, benzocaine and tetracaine

Stage I: One spray CTY-5339-A; Stage II: One spray CTY-5339-A, then one spray CTY-5339-CB; Stage II: One spray of CTY-5339-CB, then one spray CTY-5339-A

One spray CTY-5339-CB DEVICE

Metered spray bottle with ≈200 uL total spray volume. Contains the active ingredient: 14.0% Benzocaine (USP = 28 mg). Administered in a single anesthetic spray.

Also known as: CTY-5339-CB, benzocaine, 14.0% benzocaine

Stage I: One spray CTY-5339-CB; Stage II: One spray CTY-5339-A, then one spray CTY-5339-CB; Stage II: One spray of CTY-5339-CB, then one spray CTY-5339-A

One spray CTY-5339-P DEVICE

Placebo. Metered spray bottle with ≈200 uL total spray volume. Contains no active ingredient (vehicle control).

Also known as: CTY-5339-P, placebo, vehicle control

Stage I: One spray CTY-5339-P

Eligibility Criteria

• Age: 18 Years - 75 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Male and female subjects between 18-75 years of age with a Body Mass Index (BMI) ≤32;
• Subjects are category I or II on the American Society of Anesthesiologists physical status classification system (ASA category I or II) and are in normal physical health as judged by physical and laboratory examinations;
• Subjects have normal appearance of the oral mucosal tissues;
• At screening and at Baseline during Stage 1 and Sessions 1 and 2, of Stage 2 subjects with Pin-Prick-Test (PPT) scores of at least "3" (on a 10 point numerical rating scale \[NRS\]) on the 2 readings, 1 of which must be a score of at least "4";
• Subjects have mean quantitative sensory test of heat (QST-Heat) pain sensation temperature assessments on the gingival mucosa of 46.5 °C or less based on the average of the 2 readings at screening and at the Baseline Study Sessions for Stages 1 and 2;
• Subjects must agree to refrain from ingesting any systemic or topical analgesic medication for 3 days or 5 half-lives of the drug prior to and during the study period and alcohol for 1 day prior to and during the study period;
• Subjects must agree to refrain from using mouth rinses, cough drops or throat lozenges on the day of each test session;
• Female subjects must be physically incapable of childbearing potential (postmenopausal for more than 1 year or surgically sterile) or practicing an acceptable method of contraception (hormonal, barrier with spermicide, intrauterine device, vasectomized or same sex partner, or abstinence). Subjects using hormonal birth control must have been on a stable dose of treatment for at least 30 days and received at least 1 cycle of treatment prior to randomization. At Screening and at Baseline of both sessions, all females of childbearing potential must have a negative urine pregnancy test and not be breastfeeding;
• Negative urine drug screen for drugs of abuse at Screening and at Baseline for each Study Session. A positive drug screen result may be permitted if the subject has been on a stable dose of an allowed medication for \>30 days;
• Subjects must be capable of reading, comprehending, and signing the informed consent form.

You may not qualify if:

• Subjects with a history of any significant hepatic, renal, endocrine, cardiac, neurological, psychiatric, gastrointestinal, pulmonary, hematologic, or metabolic disorders, including glaucoma, diabetes, emphysema, and chronic bronchitis;
• Subjects with a history of any type of cancer other than skin related cancers;
• Subjects with conditions that affect the absorption, metabolism, or passage of drugs out of the body, (e.g., sprue, celiac disease, Crohn's disease, colitis, or liver, kidney, or thyroid conditions);
• Subjects with any history of alcohol or substance abuse (including a positive drug screen test);
• Subjects that currently have or have a history of uncontrolled hypertension;
• Subjects with a known hypersensitivity to any local anesthetic drug;
• Subjects with a hematocrit level significantly below the normal range on the screening laboratory examination (as judged by the PI);
• Subjects with any clinically significant abnormal lab result (as judged by the PI);
• Subjects with any condition or history felt by the Investigator to place the subject at increased risk;
• Subjects who have smoked or chewed tobacco-containing substances within 6 months prior to the start of the study;
• Subjects judged by the Investigator to be unable or unwilling to comply with the requirements of the protocol;
• Subjects who have used an investigational drug within 30 days prior to entering the study;
• Subjects who have donated blood within 3 months prior to the start of the study;
• Subjects who have previously participated in the trial;
• Subjects who are members of the study site staff directly involved with the study or a relative of the Sponsor or other personnel involved with the study.

Sponsors & Collaborators

• Cetylite Industries: lead

Study Sites (1)

University of Pennsylvania, School of Dental Medicine

Philadelphia, Pennsylvania, 19104, United States

Location

Related Publications (1)

• Hersh EV, Secreto S, Wang S, Giannakopoulos H, Mousavian M, Lesavoy B, Hutcheson MC, Farrar JT, Wang P, Doyle G, Cooper SA. A Proof-of-concept Study Using Quantitative Sensory Threshold Analysis to Compare Two Intraoral Topical Anesthetics. Clin Ther. 2019 Feb;41(2):291-302. doi: 10.1016/j.clinthera.2018.12.009. Epub 2019 Jan 17.

  PMID: 30660443 DERIVED

MeSH Terms

Interventions

Benzocaine; Tetracaine

Intervention Hierarchy (Ancestors)

para-Aminobenzoates; Aminobenzoates; Benzoates; Acids, Carbocyclic; Carboxylic Acids; Organic Chemicals; Benzene Derivatives; Hydrocarbons, Aromatic; Hydrocarbons, Cyclic; Hydrocarbons

Results Point of Contact

• Title: Elliot V Hersh, DMD, Ph.D., Director Clinical Pharmacology Research
• Organization: University of Pennsylvania, School of Dental Medicine

evhersh@pobox.upenn.edu

215-898-9686

Study Officials

• Stephen A Cooper, DMD, PhD

  STUDY CHAIR

Publication Agreements

• PI is Sponsor Employee: No
• Restrictive Agreement: No

Study Design

• Study Type: interventional
• Phase: phase 2
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Purpose: PREVENTION
• Intervention Model: CROSSOVER
• Sponsor Type: INDUSTRY
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: July 26, 2017
• First Posted: July 31, 2017
• Study Start: June 15, 2017
• Primary Completion: February 20, 2018
• Study Completion: February 20, 2018
• Last Updated: August 21, 2019
• Results First Posted: August 21, 2019

Record last verified: 2019-08

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)