Approval Probability
TA Base Rate
Adjusted LOA
ML Risk
HTX-011 · 12 trials · 4 indications
The Visual Analog Scale (VAS) consists of a straight 10-cm line that represents pain ranging from "no pain" to "pain as bad as it could be". Subjects were asked to mark their current pain level on the line.
Pain intensity is assessed using an 11-point NRS (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable" (using windowed worst observation carried forward to adjust for opioid rescue medication use). The theoretical range of AUC0-72 is 0-720. The prescribed activity for NRS-A is sitting with the plantar surface of the ball of the surgically attended foot touching the floor (no weight bearing).
Pain intensity scores are assessed using an 11-point Numeric Rating Scale (NRS) (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable". NRS scores are recorded with activity (NRS-A), sitting with the plantar surface of the ball of the surgically attended foot touching the floor (no weight-bearing).
Pain intensity is assessed using an 11-point NRS (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable" (using windowed worst observation carried forward to adjust for opioid rescue medication use). The theoretical range of AUC0-24 is 0-240. The prescribed activity for NRS-A is keeping the elbows at the side and against the body and then raising both hands in front of the abdomen with hands clasped and holding that position for at least 5 seconds.
Pain intensity is assessed at rest using an 11-point NRS (0-10) where 0 represents "no pain" and 10 represents "worst pain imaginable" (using windowed worst observation carried forward to adjust for opioid rescue medication use). The theoretical range of AUC0-48 is 0-480.
Subjects assessed pain intensity for their current pain with the 11-point (0 to 10) Numeric Rating Scale NRS where "0" equated to "no pain" and "10" equated to "the worst pain imaginable". Pain intensity was assessed at rest (NRS-R) after the subject had been supine for a minimum of 5 minutes and with activity (NRS-A) sitting up from a supine position. The SPI is derived by summing the pain intensity score weighted by the scheduled time duration. SPI0-24 was calculated by summing the Pain intensity (PI) score at the relevant time points weighted by the scheduled time duration since the prior PI assessment as follows: SPI0-24= PI1+PI2+2\*PI4+2\*PI6+2\*PI8+2\*PI10+2\*PI12+2\*PI14+4\*PI18+6\*PI24. Min = 0 (if PI=0 at every time) and Max = 240 (if PI=10 at every time).
Summed Pain Intensity (SPI) Scores over the first 24 hours, which was the sum of the pain intensity scores at the scheduled 1 hour assessment, the assessments scheduled for every 2 hours between Hours 2 and 14, and the assessments scheduled at Hours 18 and 24; with the assessments at Hours 1 and 2 each weighted by 1, the assessments between Hours 4 and 14 each weighted by 2, the assessment at Hour 18 weighted by 4, and the assessment at Hour 24 weighted by 6. Pain was assessed using an 11-point scale, where 0 equaled no pain and 10 equaled the worst pain imaginable. Thus, the minimum and maximum possible SPI0-24 scores were 0 and 240, respectively.
| Arm | Type | Description |
|---|---|---|
| Cohort 1 | EXPERIMENTAL | HTX-011 + MMA |
| Cohort 2 | EXPERIMENTAL | HTX-011 + MMA |
| Cohort 3 | EXPERIMENTAL | HTX-011 + MMA |
| Cohort 4 | EXPERIMENTAL | HTX-011 + MMA |
| HTX-011 + Alternating MMA Regimen | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 300 mg/9 mg via instillation; non-opioid multimodal analgesic (MMA) regimen of ibuprofen and acetaminophen, alternating (one or the other every 3 hours), while awake. |
| HTX-011 + Concurrent MMA Regimen | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 300 mg/9 mg via instillation; non-opioid multimodal analgesic (MMA) regimen of ibuprofen and acetaminophen, together every 6 hours, while awake. |
| Treatment Group 1: HTX-011 | EXPERIMENTAL | HTX 011 (bupivacaine/meloxicam) |
| Treatment Group 2: Saline Placebo | PLACEBO_COMPARATOR | Saline placebo |
| Treatment Group 3: Bupivacaine HCI | ACTIVE_COMPARATOR | Bupivacaine HCl |
| Treatment Group 2: Bupivacaine HCI | ACTIVE_COMPARATOR | Bupivacaine HCl |
| Treatment Group 3: Saline Placebo | PLACEBO_COMPARATOR | Saline placebo |
| Cohort 1: Bupivacaine HCl | EXPERIMENTAL | Bupivacaine HCl without epinephrine, via injection into the surgical site. |
| Cohort 2: HTX-011 | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam) via application into the surgical site. |
| Cohort 3: HTX-011 | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam) via application into the surgical site. |
| Treatment Group 1 | EXPERIMENTAL | A single dose of HTX-011 administered via instillation into the surgical site. |
| Treatment Group 2 | EXPERIMENTAL | A single dose of HTX-011 administered via instillation into the surgical site and a scheduled non-opioid multimodal analgesic (MMA) regimen. |
| Treatment Group 2: HTX-011 + Aprepitant | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation; Aprepitant, three single doses of aprepitant will be administered orally. |
| Treatment Group 3: HTX-011 + Non-Opioid MMA Regimen | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation and a scheduled multimodal analgesic (MMA) regimen. |
| Cohort 1: HTX-011 + MMA Regimen | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 300 mg/9 mg via instillation; non-opioid multimodal analgesic (MMA) regimen. |
| Cohort 2: HTX-011 + MMA Regimen + Ketorolac | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 300 mg/9 mg via instillation; non-opioid multimodal analgesic (MMA) regimen and IV ketorolac. |
| Group 1: HTX-011 | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 60 mg/1.8 mg via nerve block. |
| Group 2: HTX-011 | EXPERIMENTAL | HTX-011(bupivacaine/meloxicam), 120 mg/3.6 mg via nerve block. |
| Group 3: HTX-011 | EXPERIMENTAL | HTX-011(bupivacaine/meloxicam), 240 mg/7.2 mg via nerve block. |
| Group 4: HTX-011 | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 400 mg/12 mg via nerve block. |
| Group 5: HTX-011 | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 400 mg/ 12 mg via instillation. |
| Group 6: Bupivacaine HCl | ACTIVE_COMPARATOR | Bupivacaine HCl without epinephrine, 50 mg via nerve block. |
| Group 7: Saline Placebo | PLACEBO_COMPARATOR | Saline placebo via nerve block. |
| Cohort 1, Group 1: HTX-011 | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 200 mg/6 mg via instillation |
| Cohort 1, Group 2: HTX-011 | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 200 mg/6 mg via injection and instillation (combination) |
| Cohort 1, Group 3: Saline Placebo | PLACEBO_COMPARATOR | Saline placebo via injection |
| Cohort 1, Group 4: Bupivacaine HCI | ACTIVE_COMPARATOR | Bupivacaine HCl without epinephrine, 125 mg via injection |
| Cohort 2, Group 1: HTX-011 | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 400 mg/12 mg via instillation |
| Cohort 2, Group 2: HTX-011 + Ropivacaine | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 400 mg/12 mg via instillation; Ropivacaine, 50 mg via injection |
| Cohort 2, Group 3: Saline Placebo | PLACEBO_COMPARATOR | Saline placebo via injection |
| Cohort 2, Group 4: Bupivacaine HCI | ACTIVE_COMPARATOR | Bupivacaine HCl without epinephrine, 125 mg via injection |
| Part A, Cohort A | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 200 mg/6 mg by injection. |
| Part A, Cohort B | EXPERIMENTAL | HTX-011(bupivacaine/meloxicam), 400 mg/12 mg by injection. |
| Part A, Cohort C | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 200 mg/6 mg by instillation. |
| Part A, Cohort D | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 400 mg/12 mg by instillation. |
| Part A, Cohort E | EXPERIMENTAL | HTX-011 (bupivacaine/meloxicam), 400 mg/12 mg by injection and instillation (combination). |
| Part A, Cohort F | PLACEBO_COMPARATOR | Saline placebo by injection. |
| Part B, Cohort A | EXPERIMENTAL | HTX-011A (bupivacaine/meloxicam), 200 mg/6 mg by injection. |
| Part B, Cohort B | EXPERIMENTAL | HTX-011A (bupivacaine/meloxicam) 400 mg12 mg by injection. |
| Part B, Cohort C | EXPERIMENTAL | HTX-011B (bupivacaine/meloxicam), 200 mg/6 mg by injection. |
| Part B, Cohort D | EXPERIMENTAL | HTX-011B (bupivacaine/meloxicam), 400 mg/12 mg by injection. |
| Part B, Cohort E | PLACEBO_COMPARATOR | Saline placebo by injection. |
| Part C, Cohort A | EXPERIMENTAL | HTX-002, 200 mg by injection or instillation. |
| Part B, Cohort F | EXPERIMENTAL | HTX-002, 400 mg by injection or instillation. |
| Part C, Cohort B | EXPERIMENTAL | HTX-011B (bupivacaine/meloxicam), 200 mg/6 mg by instillation. |
| Part B, Cohort G | EXPERIMENTAL | HTX-011B (bupivacaine/meloxicam), 400 mg/12 mg by instillation. |
| Part C, Cohort C | PLACEBO_COMPARATOR | Saline placebo by instillation. |
| Part C, Cohort D | ACTIVE_COMPARATOR | Bupivacaine HCI (Marcaine), 75 mg by injection. |
| Part D, Cohort A | EXPERIMENTAL | HTX-011B (bupivacaine/meloxicam), 400 mg/13 mg via a combination of injection and instillation. |
| Part E, Cohort A | EXPERIMENTAL | HTX-009, 12 mg by injection and instillation (combination). |
| Part F, Cohort A | EXPERIMENTAL | HTX-011B (bupivacaine/meloxicam), 300 mg/9 mg by instillation. |
| Part F, Cohort B | EXPERIMENTAL | Bupivacaine HCI (Marcaine), 75 mg by injection. |
| Part F, Cohort C | PLACEBO_COMPARATOR | Saline placebo by injection. |
| HTX-011 | EXPERIMENTAL | Evaluate the analgesic efficacy of HTX-011 |
| Placebo | PLACEBO_COMPARATOR | Saline |
| Name | Type | Description |
|---|---|---|
| HTX-011 | DRUG | Dual-acting local anesthetic. Dose 1. |
| Ibuprofen | DRUG | NSAID. |
| Acetaminophen | DRUG | Analgesic. |
| Celecoxib | DRUG | NSAID. |
| +/- Bupivacaine HCl | DRUG | Local anesthetic. |
| Luer Lock Applicator | DEVICE | Applicator for instillation. |
| Saline Placebo | DRUG | Saline placebo by instillation |
| Bupivacaine HCl | DRUG | Bupivacaine HCl without epinephrine, 50 mg by injection |
| Luer-lock applicator | DEVICE | Applicator for instillation |
| Vial access device | DEVICE | Device for withdrawal of drug product |
| Bupivacaine HCI without epinephrine | DRUG | 100 mg administered via injection into the surgical site. |
| aprepitant | DRUG | Aprepitant, three single doses of aprepitant will be administered orally. |
| Ketorolac | DRUG | Intraoperative IV ketorolac. |
| Bupivacaine HCl without epinephrine | DRUG | Bupivacaine HCl without epinephrine, 50 mg via nerve block. |
| Bupivicaine HCl | DRUG | Bupivacaine HCl without epinephrine |
| Ropivacaine | DRUG | Ropivacaine, via injection |
| Placebo | DRUG | Saline placebo by injection. |
| HTX-002 | DRUG | HTX-002, by injection or instillation (pooled). |
| Bupivacaine HCI (Marcaine) | DRUG | Bupivacaine HCI (Marcaine) by injection. |
| HTX-011A | DRUG | HTX-011A (bupivacaine/meloxicam) by injection. |
| HTX-011B | DRUG | HTX-011B (bupivacaine/meloxicam) by injection, instillation or combination. |
| HTX-009 | DRUG | HTX-009 by injection and instillation (combination). |
Inclusion Criteria: * Is scheduled to undergo primary unilateral TKA under spinal anesthesia. * Has not previously undergone TKA in either knee. * Has an American Society of Anesthesiologists (ASA) Physical Status of I, II, or III. * Is able to walk at least 20 feet with optional use of a 4-legged ...
HTX-011 is an investigational small molecule being developed for post-operative pain and analgesia. It is designed to provide pain relief following surgical procedures. The drug is currently in Phase 3 clinical development and is not yet approved by regulatory authorities.
HTX-011 is being developed by Heron Therapeutics, Inc., a biopharmaceutical company. Heron Therapeutics is publicly traded under the ticker symbol HRTX on the NASDAQ stock exchange.
HTX-011 is in Phase 3 clinical development for post-operative pain and analgesia. The drug is investigational and has not been approved by the FDA. It has completed seven clinical trials, including Phase 3 studies, with a total enrollment of 1,962 participants.
HTX-011 has been studied in several clinical trials, including NCT02471898 for post-bunionectomy analgesia, NCT03907176 for post-herniorrhaphy pain, NCT03955211 for pain after caesarean section, and NCT03974932 for total knee arthroplasty. All trials have been completed.
HTX-011 is the investigational name for the drug that Heron Therapeutics has also marketed under the brand name ZYNRELEF. ZYNRELEF is the trade name for the bupivacaine and meloxicam extended-release solution used for postoperative analgesia.