Vertex Announces Results from Phase 2 Study of VX-993 for the Treatment of Acute Pain
– Treatment with the selective NaV1.8 pain signal inhibitor VX-993 after bunionectomy surgery did not meet the primary endpoint –
– Treatment with VX-993 was generally safe and well tolerated, with safety profile similar to placebo arm –
VX-993 was generally safe and well tolerated. Most adverse events (AEs) were mild to moderate, and there were no serious adverse events (SAEs) related to VX-993.
Based on these results,
“This proof-of-concept study was powered to test whether VX-993 would result in higher clinical efficacy than previously demonstrated with the NaV1.8 pathway,” said
Primary Efficacy Outcomes Chart
Treatment Groups |
Placebo n = 71 |
High-dose VX-993 (180 mg first dose/90 mg every 12 hours) n = 71 |
Mid-dose VX-993 (70 mg first dose/35 mg every 12 hours) n = 77 |
Low-dose VX-993 (10 mg first dose/5 mg every 12 hours) n = 73 |
Hydrocodone bitartrate /acetaminophen reference arm (5 mg/325 mg every 6 hours) n = 75 |
Mean SPID48 |
50.2 |
74.5 |
71.5 |
54.0 |
94.4 |
Mean SPID48 difference from placebo
P value vs. placebo |
-- |
24.3
(-6.3, 54.9)
0.1190 |
21.2
(-8.7, 51.2)
0.1643 |
3.7
(-26.7,34.1)
0.8094 |
44.2
(14.0, 74.4)
0.0043 |
367 patients were enrolled in the study
All p-values are based on individual comparisons to placebo
CI: confidence interval
Safety Results
VX-993 was generally safe and well tolerated at all doses studied in the trial. The overall incidence of adverse events on VX-993 was similar to placebo. The majority of the AEs were mild or moderate in severity. There were no SAEs related to VX-993 in the study. No patients treated with VX-993 discontinued study drug due to AEs.
The most common AEs (incidence >5% in either combined VX-993, hydrocodone bitartrate/acetaminophen (HB/APAP) or placebo group, respectively) were nausea (4.1%, 14.7%, 11.3%), headache (2.7%, 6.7%, 1.4%), dizziness (1.4%, 5.3%, 1.4%) and vomiting (1.4%, 5.3%, 2.8%). Adverse events were generally consistent with the post-surgical setting.
About the VX-993 Phase 2 Acute Pain Study
The Phase 2 study was a randomized, double-blind, placebo-controlled, dose-ranging study that evaluated three different doses of VX-993 administered orally in 367 patients with acute pain following bunionectomy surgery. The study also included a hydrocodone bitartrate/acetaminophen (HB/APAP) reference arm. The primary endpoint was the time-weighted Sum of the Pain Intensity Difference (SPID) over the first 48 hours of treatment, as recorded on the 11-point Numeric Pain Rating Scale (NPRS), compared to placebo. The study was designed to test whether greater NaV1.8 inhibition with VX-993 would translate to higher efficacy than what has already been demonstrated with other NaV1.8 inhibitors. The study was powered accordingly to demonstrate a treatment effect higher than previously achieved. Patients were randomized to 5 treatment arms: VX-993 high dose — 180 mg first dose and 90 mg every 12 hours (at 12, 24 and 36 hours after the first dose), VX-993 mid dose — 70 mg first dose and 35 mg every 12 hours (at 12, 24 and 36 hours after the first dose), or VX-993 low dose — 10 mg first dose and 5 mg every 12 hours (at 12, 24 and 36 hours after the first dose), the reference arm of HB/APAP 5 mg/325 mg administered orally every 6 hours over 42 hours, or placebo. Patients reported their pain intensity on the NPRS at each scheduled time point through 48 hours. The first dose of study drug was administered on the day of surgery, approximately 3 hours post-operatively on average. In order to maximize pain severity, a popliteal block was not used in this study. VX-993 is investigational and has not been approved by health authorities globally.
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