Skip to main content
Top
Published in: Pain and Therapy 2/2016

Open Access 01-12-2016 | Review

Oxycodone DETERx®: A Novel Abuse-Deterrent, Extended-Release Analgesic Option for the Treatment of Patients with Chronic Pain

Author: Jeff Gudin

Published in: Pain and Therapy | Issue 2/2016

Login to get access

Abstract

Background

Extended-release (ER) opioid analgesics are commonly used to provide safe and effective pain relief to treat pain severe enough to require around-the-clock, long-term dosing. These ER opioid formulations usually contain more drug per dosage unit than immediate-release (IR) agents, and therefore bring with them challenges related to both opioid abuse and misuse, often through manipulation of the dosage form. Oxycodone DETERx® (Xtampza® ER, Collegium Pharmaceutical, Inc.) is a novel abuse-deterrent, ER formulation developed to deter common methods of manipulation. In addition to having abuse-deterrent properties, oxycodone DETERx was developed to provide alternative modes of administration for patients with chronic pain and difficulty swallowing.

Scope

Using published articles, abstracts, and prescribing information, data supporting the use of oxycodone DETERx are reviewed.

Findings

Oxycodone DETERx was effective at reducing chronic pain in patients enrolled in a pivotal clinical trial, and had a tolerability profile expected of opioids. In addition to administration of the intact capsule, oxycodone DETERx can also be administered by sprinkling directly into the mouth from a dosing cup, onto soft foods, or through nasogastric or gastrostomy tubes, thus providing flexible dosing options for patients who have difficulty swallowing. In vitro studies demonstrated the reduced ability of oxycodone DETERx to be manipulated by common techniques used by abusers to defeat the ER characteristics or prepare the formulation for injection. Pharmacokinetic studies demonstrated that the ER characteristics of oxycodone DETERx are maintained if chewed or crushed. As a result, oxycodone DETERx is currently the only ER-formulated opioid without a boxed warning against crushing or chewing. Human abuse-potential studies conducted in a population of recreational opioid users demonstrated lower drug-liking scores for oxycodone DETERx administered intranasally and orally when compared with IR oxycodone.

Funding

Collegium Pharmaceutical, Inc.
Literature
2.
go back to reference 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):113–30.CrossRefPubMedPubMedCentral 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):113–30.CrossRefPubMedPubMedCentral
3.
go back to reference Nicholson B. Benefits of extended-release opioid analgesic formulations in the treatment of chronic pain. Pain Pract. 2009;9(1):71–81.CrossRefPubMed Nicholson B. Benefits of extended-release opioid analgesic formulations in the treatment of chronic pain. Pain Pract. 2009;9(1):71–81.CrossRefPubMed
4.
go back to reference Smith SM, Dart RC, Katz NP, et al. Classification and definition of misuse, abuse, and related events in clinical trials: ACTTION systematic review and recommendations. Pain. 2013;154(11):2287–96.CrossRefPubMed Smith SM, Dart RC, Katz NP, et al. Classification and definition of misuse, abuse, and related events in clinical trials: ACTTION systematic review and recommendations. Pain. 2013;154(11):2287–96.CrossRefPubMed
5.
go back to reference Webster L. Update on abuse-resistant and abuse-deterrent approaches to opioid formulations. Pain Med. 2009;10(Suppl 2):S124–33.CrossRefPubMed Webster L. Update on abuse-resistant and abuse-deterrent approaches to opioid formulations. Pain Med. 2009;10(Suppl 2):S124–33.CrossRefPubMed
6.
go back to reference Actavis, Inc. Kadian (morphine sulfate extended-relase capsules, for oral use, CII). Morristown, NJ: Actavis, Inc.; 2007. Actavis, Inc. Kadian (morphine sulfate extended-relase capsules, for oral use, CII). Morristown, NJ: Actavis, Inc.; 2007.
7.
go back to reference Pfizer, Inc. Avinza (morphine sulfate extended-release capsules). New York, NY: Pfizer, Inc.; 2003. Pfizer, Inc. Avinza (morphine sulfate extended-release capsules). New York, NY: Pfizer, Inc.; 2003.
8.
go back to reference Purdue Pharma, LP. OxyContin (oxycodone hydrochloride) extended-release tablets, for oral use, CII. Stamford, CT: Purdue Pharma, LP; 2015. Purdue Pharma, LP. OxyContin (oxycodone hydrochloride) extended-release tablets, for oral use, CII. Stamford, CT: Purdue Pharma, LP; 2015.
9.
go back to reference Endo Pharmaceuticals, Inc. Opana ER (oxymorphone hydrochloride) extended-release tablets, for oral use, CII. Malvern, PA: Endo Pharmaceuticals, Inc.; 2014. Endo Pharmaceuticals, Inc. Opana ER (oxymorphone hydrochloride) extended-release tablets, for oral use, CII. Malvern, PA: Endo Pharmaceuticals, Inc.; 2014.
10.
go back to reference Purdue Pharma, LP. Hysingla (hydrocodone bitartrate) extended-release tablets, for oral use, CII. Stamford, CT: Purdue Pharma, LP; 2015. Purdue Pharma, LP. Hysingla (hydrocodone bitartrate) extended-release tablets, for oral use, CII. Stamford, CT: Purdue Pharma, LP; 2015.
11.
go back to reference Pergolizzi JV Jr, Taylor R Jr, Nalamachu S, et al. Challenges of treating patients with chronic pain with dysphagia (CPD): physician and patient perspectives. Curr Med Res Opin. 2014;30(2):191–202.CrossRefPubMed Pergolizzi JV Jr, Taylor R Jr, Nalamachu S, et al. Challenges of treating patients with chronic pain with dysphagia (CPD): physician and patient perspectives. Curr Med Res Opin. 2014;30(2):191–202.CrossRefPubMed
12.
go back to reference Argoff CE, Kopecky EA. Patients with chronic pain and dysphagia (CPD): unmet medical needs and pharmacologic treatment options. Curr Med Res Opin. 2014;30(12):2543–59.CrossRefPubMed Argoff CE, Kopecky EA. Patients with chronic pain and dysphagia (CPD): unmet medical needs and pharmacologic treatment options. Curr Med Res Opin. 2014;30(12):2543–59.CrossRefPubMed
13.
go back to reference Pfizer, Inc. Embeda (morphine sulfate and naltrexone hydrochloride) extended-relase capsules, for oral use, CII. New York, NY: Pfizer, Inc.; 2014. Pfizer, Inc. Embeda (morphine sulfate and naltrexone hydrochloride) extended-relase capsules, for oral use, CII. New York, NY: Pfizer, Inc.; 2014.
15.
go back to reference Vowles KE, McEntee ML, Julnes PS, Frohe T, Ney JP, van der Goes DN. Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain. 2015;156(4):569–76.CrossRefPubMed Vowles KE, McEntee ML, Julnes PS, Frohe T, Ney JP, van der Goes DN. Rates of opioid misuse, abuse, and addiction in chronic pain: a systematic review and data synthesis. Pain. 2015;156(4):569–76.CrossRefPubMed
17.
go back to reference Cicero TJ, Ellis MS, Surratt HL. Effect of abuse-deterrent formulation of OxyContin. N Engl J Med. 2012;367(2):187–9.CrossRefPubMed Cicero TJ, Ellis MS, Surratt HL. Effect of abuse-deterrent formulation of OxyContin. N Engl J Med. 2012;367(2):187–9.CrossRefPubMed
18.
go back to reference 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):351–8.CrossRefPubMed 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):351–8.CrossRefPubMed
19.
go back to reference Butler SF, Black RA, Fleming AB, editors. Relative abuse of abuse deterrent formulations via alternative oral routes. In: 35th Annual Scientific Meeting of the American Pain Society; 2016 May 11–14; Austin, TX (USA). Butler SF, Black RA, Fleming AB, editors. Relative abuse of abuse deterrent formulations via alternative oral routes. In: 35th Annual Scientific Meeting of the American Pain Society; 2016 May 11–14; Austin, TX (USA).
20.
go back to reference Collegium Pharmaceutical, Inc. Xtampza ER (oxycodone DETERx extended-release capsules, for oral use, CII). Canton, MA: Collegium Pharmaceutical, Inc.; 2016. Collegium Pharmaceutical, Inc. Xtampza ER (oxycodone DETERx extended-release capsules, for oral use, CII). Canton, MA: Collegium Pharmaceutical, Inc.; 2016.
21.
go back to reference 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):334–44.CrossRefPubMed 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):334–44.CrossRefPubMed
22.
go back to reference McCarberg BH, Kopecky EA, O’Connor M, et al. An abuse-deterrent, microsphere-in-capsule formulation of extended-release oxycodone: alternative modes of administration to facilitate pain management in patients with dysphagia. Curr Med Res Opin. 2016. doi:10.1080/03007995.2016.1222517.PubMed McCarberg BH, Kopecky EA, O’Connor M, et al. An abuse-deterrent, microsphere-in-capsule formulation of extended-release oxycodone: alternative modes of administration to facilitate pain management in patients with dysphagia. Curr Med Res Opin. 2016. doi:10.​1080/​03007995.​2016.​1222517.PubMed
23.
go back to reference 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):233–46.CrossRefPubMed 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):233–46.CrossRefPubMed
24.
go back to reference Katz N, Kopecky EA, O’Connor M, Brown RH, Fleming AB. A phase 3, multicenter, randomized, double-blind, placebo-controlled, safety, tolerability, and efficacy study of Xtampza ER in patients with moderate-to-severe chronic low back pain. Pain. 2015;156(12):2458–67.CrossRefPubMed Katz N, Kopecky EA, O’Connor M, Brown RH, Fleming AB. A phase 3, multicenter, randomized, double-blind, placebo-controlled, safety, tolerability, and efficacy study of Xtampza ER in patients with moderate-to-severe chronic low back pain. Pain. 2015;156(12):2458–67.CrossRefPubMed
25.
go back to reference Gudin J, Levy-Cooperman N, Kopecky EA, Fleming AB. 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):2142–51.CrossRefPubMed Gudin J, Levy-Cooperman N, Kopecky EA, Fleming AB. 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):2142–51.CrossRefPubMed
26.
go back to reference Webster LR, Kopecky EA, Smith MD, Fleming AB. 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):1112–30.PubMed Webster LR, Kopecky EA, Smith MD, Fleming AB. 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):1112–30.PubMed
27.
go back to reference Kopecky EA, Fleming AB, Levy-Cooperman N, O’Connor M, Sellers E. Oral human abuse potential of oxycodone DETERx® (Xtampza® ER). J Clin Pharmacol. 2016. doi:10.1002/jcph.833.PubMed Kopecky EA, Fleming AB, Levy-Cooperman N, O’Connor M, Sellers E. Oral human abuse potential of oxycodone DETERx® (Xtampza® ER). J Clin Pharmacol. 2016. doi:10.​1002/​jcph.​833.PubMed
28.
go back to reference Fleming AB, Scungio TA, Grima MP, Mayock SP. In vitro assessment of the potential for abuse via the intravenous route of oxycodone DETERx(R) microspheres. J Opioid Manag. 2016;12(1):57–65.CrossRefPubMed Fleming AB, Scungio TA, Grima MP, Mayock SP. In vitro assessment of the potential for abuse via the intravenous route of oxycodone DETERx(R) microspheres. J Opioid Manag. 2016;12(1):57–65.CrossRefPubMed
29.
go back to reference Katz N, Dart RC, Bailey E, Trudeau J, Osgood E, Paillard F. Tampering with prescription opioids: nature and extent of the problem, health consequences, and solutions. Am J Drug Alcohol Abuse. 2011;37(4):205–17.CrossRefPubMed Katz N, Dart RC, Bailey E, Trudeau J, Osgood E, Paillard F. Tampering with prescription opioids: nature and extent of the problem, health consequences, and solutions. Am J Drug Alcohol Abuse. 2011;37(4):205–17.CrossRefPubMed
Metadata
Title
Oxycodone DETERx®: A Novel Abuse-Deterrent, Extended-Release Analgesic Option for the Treatment of Patients with Chronic Pain
Author
Jeff Gudin
Publication date
01-12-2016
Publisher
Springer Healthcare
Published in
Pain and Therapy / Issue 2/2016
Print ISSN: 2193-8237
Electronic ISSN: 2193-651X
DOI
https://doi.org/10.1007/s40122-016-0062-1

Other articles of this Issue 2/2016

Pain and Therapy 2/2016 Go to the issue