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Ondansetron - Parts A + B

Phase 1

Healthy | Small molecule | Pain |Indivior Pharmaceuticals, Inc.|Last Updated: Mar 13, 2025

Success Probability
Approval Probability 71%
TA Base Rate26%
Adjusted LOA41%
ML RiskLOW_RISK
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Market & Valuation
rNPV $3.2B
Market Size $9.4B
Revenue Basis $1.6B
Competitors 6
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Trial Design
RandomizedCONTROLLEDBiomarker
Total Trials1
Total Enrollment22
FDA Designations
No designations recorded
Clinical Trials (1)
NCT IDTitlePhaseStatusEnrollmentVelocityDesignStartCompletionLast UpdatedSitesCountries
NCT03747341Buprenorphine-Fentanyl Interaction StudyPHASE1 COMPLETED 22Mar 22, 2018Jan 4, 2019Mar 13, 20251 Netherlands
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Study Endpoints
Primary Endpoints
Changes in peak ventilatory depression will be measured.
6 hours (during study drug infusion)

Peak ventilatory depression (change in minute ventilation) will be calculated based on a 1-minute average of the ventilation data of each individual subject/patient. For buprenorphine or placebo, absolute changes and percentage changes are calculated from the baseline value. For fentanyl, absolute changes and percentage changes for each bolus are calculated from the baseline value and from the pre-fentanyl baseline value immediately before the first fentanyl bolus

Secondary Endpoints
Number (percentage) of subjects who experience apnoea for each fentanyl dose during the placebo treatment vs. the buprenorphine treatment
6 hours
Number (percentage) of subjects who require stimulation for breathing for each fentanyl dose during the placebo treatment vs. the buprenorphine treatment.
6 hours
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Study Design & Arms
AllocationRANDOMIZED
MaskingSINGLE
ModelCROSSOVER
PurposePREVENTION
Treatment Arms
ArmTypeDescription
Part A (Healthy Participants): Placebo-Buprenorphine LowEXPERIMENTALThree treatment periods consisting of 3 days each of investigational treatment * 1=placebo + fentanyl, * 2=low dose buprenorphine + fentanyl, * 3 (optional)=low dose buprenorphine only Fentanyl was administered as a bolus over 90 seconds in escalating doses of 0.075, 0.15, 0.25 and 0.35 mg/70 kg. Each dosing period was followed by 10-17 days of washout.
Part A (Healthy Participants): Placebo-Buprenorphine HighEXPERIMENTALThree treatment periods consisting of 3 days each of investigational treatment * 1=placebo + fentanyl, * 2=high dose buprenorphine + fentanyl, * 3 (optional)=high dose buprenorphine only Fentanyl was administered as a bolus over 90 seconds in escalating doses of 0.075, 0.15, 0.25 and 0.35 mg/70 kg. Each dosing period was followed by 10-17 days of washout.
Part A (Healthy Participants): Buprenorphine Low-PlaceboEXPERIMENTALThree treatment periods consisting of 3 days each of investigational treatment * 1=low dose buprenorphine + fentanyl, * 2=placebo + fentanyl, * 3 (optional)=low dose buprenorphine only Fentanyl was administered as a bolus over 90 seconds in escalating doses of 0.075, 0.15, 0.25 and 0.35 mg/70 kg. Each dosing period was followed by 10-17 days of washout.
Part A (Healthy Participants): Buprenorphine High-PlaceboEXPERIMENTALThree treatment periods consisting of 3 days each of investigational treatment * 1=high dose buprenorphine + fentanyl, * 2=placebo + fentanyl, * 3 (optional)=high dose buprenorphine only Fentanyl was administered as a bolus over 90 seconds in escalating doses of 0.075, 0.15, 0.25 and 0.35 mg/70 kg. Each dosing period was followed by 10-17 days of washout.
Part B (Opioid-Tolerant): Placebo-Buprenorphine LowEXPERIMENTALOpioid-tolerant participants in Part B undergo a washout of their own opioids during which these were replaced with oral oxycodone, and continue at stable doses of oxycodone from at least 48 hours before Period 1 to the end of Period 2. Two treatment periods: * 1=placebo (Day 1), * 2=low dose buprenorphine + fentanyl (Day 3) Fentanyl was administered as a bolus over 90 seconds in escalating doses of 0.25, 0.35, 0.5 and 0.7 mg/70 kg.
Part B (Opioid-Tolerant): Placebo-Buprenorphine MidEXPERIMENTALOpioid-tolerant participants in Part B undergo a washout of their own opioids during which these were replaced with oral oxycodone, and continue at stable doses of oxycodone from at least 48 hours before Period 1 to the end of Period 2. Two treatment periods: * 1=placebo (Day 1), * 2=mid dose buprenorphine + fentanyl (Day 3) Fentanyl was administered as a bolus over 90 seconds in escalating doses of 0.25, 0.35, 0.5 and 0.7 mg/70 kg.
Part B (Opioid-Tolerant): Placebo-Buprenorphine HighEXPERIMENTALOpioid-tolerant participants in Part B undergo a washout of their own opioids during which these were replaced with oral oxycodone, and continue at stable doses of oxycodone from at least 48 hours before Period 1 to the end of Period 2. Two treatment periods: * 1=placebo (Day 1), * 2=high dose buprenorphine + fentanyl (Day 3) Fentanyl was administered as a bolus over 90 seconds in escalating doses of 0.25, 0.35, 0.5 and 0.7 mg/70 kg.
Interventions
NameTypeDescription
Buprenorphine Injectable Solution - Part ADRUGBuprenorphine intravenous (IV) injection given as a primed-continuous infusion. Low Dose: initial bolus (0.05 mg/70 kg) administered over 15 minutes and infusion continued (0.02 mg/70 kg/hour infusion rate) to complete 360 minutes of administration targeting 0.2 ng/ml. High Dose: initial bolus (0.125 mg/70 kg) administered over 15 minutes and infusion continued (0.05 mg/70 kg/hour infusion rate) to complete 360 minutes of administration targeting 0.5 ng/ml. Administration of buprenorphine was flexible and infusion rates were selected to target approximately 25 to 50% respiratory depression.
Placebo - Parts A + BDRUG0.9% normal saline for IV administration was used as placebo matching the buprenorphine formulation and administration.
Fentanyl - Part ADRUGParticipant received up to four fentanyl doses: 0.075, 0.15, 0.25, and 0.35 mg/70 kg in Periods 1 and 2. Fentanyl boluses were administered over 90 seconds by dose escalation +2hr, +3hr, +4hr and +5hr after starting administration of buprenorphine/ placebo. Administration of fentanyl was flexible and bolus doses were selected to elicit moderate to more severe respiratory depression with apnoea ≥20 seconds.
Ondansetron - Parts A + BDRUGA non-investigational intervention administered as an infusion prior to investigation intervention. 4 mg of ondansetron was administered to manage the expected gastrointestinal side effect (nausea, vomiting) to buprenorphine.
Buprenorphine Injectable Solution - Part BDRUGBuprenorphine intravenous (IV) injection given as a primed-continuous infusion. Low Dose: initial bolus (0.25 mg/70 kg) administered over 15 minutes and infusion continued (0.1 mg/70 kg/hour infusion rate) to complete 360 minutes of administration targeting 1 ng/ml. Mid Dose: initial bolus (0.5 mg/70 kg) administered over 15 minutes and infusion continued (0.2 mg/70 kg/hour infusion rate) to complete 360 minutes of administration targeting 2 ng/ml. High Dose: initial bolus (1.25 mg/70 kg) administered over 15 minutes and infusion continued (0.5 mg/70 kg/hour infusion rate) to complete 360 minutes of administration targeting 5 ng/ml.
Fentanyl - Part BDRUGParticipant received up to four fentanyl doses: 0.25, 0.35, 0.5, and 0.7 mg/70 kg in Periods 1 and 2. Fentanyl boluses were administered over 90 seconds by dose escalation +2hr, +3hr, +4hr and +5hr after starting administration of buprenorphine/ placebo.
Oxycodone - Part BDRUGAll opioid-tolerant participants in Part B were transitioned to oral oxycodone at least 48 hours before Period 1 to ensure washout of the participants' regular opioids and a stable dose of oxycodone with an adequate bridging schedule reached. Oxycodone is a non-investigational intervention.
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Eligibility Criteria
Age Range18 Years — 55 Years
SexALL
Healthy VolunteersYes
Study Sites1

Inclusion Criteria: * Part A-Healthy Subjects: 1. Signed the informed consent form (ICF) and able to comply with study requirements and restrictions 2. Age 18- 45, inclusive years for this part 3. Women of childbearing potential must have a negative serum pregnancy test prior to enrolment an...

Countries:Netherlands
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