ClinicalTrials.gg
CompletedNCT03718039Updated Mar 2, 2026Results posted

Phase 2 Bunionectomy HTX-011 Administration Study

A Phase 2 interventional study of HTX-011 and Luer Lock applicator in Postoperative Pain, sponsored by Heron Therapeutics. Completed at 1 site in United States. Open to participants aged 18 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-03-02.

Sponsored by Heron Therapeutics · Phase 2, Interventional, and Prevention

Phase
Phase 2
Study type
Interventional
Enrollment
78
Allocation
Non-randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a Phase 2, open-label, multi-cohort study to evaluate the analgesic efficacy, safety, and pharmacokinetics (PK) of a single, individualized dose of HTX-011 administered into the surgical site as a monotherapy or with other medications to enhance analgesia in subjects undergoing unilateral simple bunionectomy.

02

Conditions studied

  • Postoperative Pain

Keywords

  • bunion
  • bunionectomy
  • bunion surgery
  • postoperative pain
03

In context

Pain, Postoperative

5,640 studies on the registry are indexed under Pain, Postoperative; 1,230 are open to participants now.

This study's enrollment of 78 is close to the median of 75 across 4,821 interventional studies indexed under Pain, Postoperative.

Browse Pain, Postoperative studies →

Lead sponsor

Heron Therapeutics is the lead sponsor of 26 studies on the registry; none are open to participants now.

Of its 14 completed or terminated interventional studies of FDA-regulated products, 12 (86%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Is scheduled to undergo a primary unilateral, distal, first metatarsal bunionectomy with osteotomy and internal fixation under regional anesthesia.
  • Has an Physical Status of I, II, or III.
  • Female subjects are eligible only if not pregnant, not lactating, not planning to become pregnant during the study, sterile; or using acceptable . For cohort 2, acceptable contraceptives excludes hormonal contraceptives.

Exclusion criteria

Exclusion Criteria:

  • Has had a contralateral foot bunionectomy in the past 3 months prior to the scheduled surgery.
  • Has a planned concurrent surgical procedure (eg, bilateral bunionectomy or collateral procedures on the surgical foot).
  • Has a pre-existing concurrent acute or chronic painful physical/restrictive condition expected to require analgesic treatment in the postoperative period for pain.
  • Has a or a known or suspected history of or idiosyncratic reaction to required study medications.
  • Has known or suspected daily use of opioids for 7 or more consecutive days within the previous 6 months.
  • Has taken any NSAIDs within at least 10 days prior to the scheduled surgery.
  • Has taken long-acting opioids within 3 days prior to the scheduled surgery.
  • Has taken any opioids within 24 hours prior to the scheduled surgery.
  • Has been administered bupivacaine within 5 days prior to the scheduled surgery.
  • For Cohort 2 only, has been administered aprepitant or another NK1 receptor antagonist within 5 days prior to the scheduled surgery.
  • Has been administered any local anesthetic within 72 hours prior to the scheduled surgery.
  • Has initiated treatment with study medications within 1 month prior to study drug administration that can impact pain control.
  • Has been administered systemic within 5 half-lives or 10 days prior to administration of study drug.
  • Has a medical condition such that, in the opinion of the Investigator, participating in the study would pose a health risk to the subject or confound the postoperative assessments.
  • As per subject history and/or medical records, has active infection or is currently undergoing treatment for , , or (HIV).
  • Has uncontrolled anxiety, psychiatric, or neurological disorder.
  • For Cohort 2 only, is receiving pimozide, a strong or moderate inhibitor, or a strong CYP3A4 inducer.
  • Had a in the last year, with the exception of nonmetastatic basal cell or squamous cell carcinoma of the skin or localized carcinoma in situ of the cervix.
  • Has a known or suspected history of drug abuse, a positive drug screen on the day of surgery, or a recent history of alcohol abuse. Note: Subjects with a positive drug screen who are taking an allowed, prescribed medication that is known to result in a positive drug test (eg, amphetamine and dextroamphetamine for attention-deficit/hyperactivity disorder, benzodiazepine for anxiety disorder) may be eligible for participation in the study at the discretion of the Sponsor. Subjects taking any marijuana (medical or recreational) are not allowed to participate in the study.
  • Previously participated in an HTX-011 study.
  • Received an product or device in a clinical trial within 30 days or within 5 elimination half-lives.
  • Has undergone 3 or more surgeries within 12 months.
  • Has a (BMI) >39 kg/m2.
Terms in these criteria, in plain language(13)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

ASA physical status

The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

CYP3A (CYP3A4) inhibitors and inducers

CYP3A is a group of enzymes, mainly CYP3A4, in the liver and gut that break down many medicines. Some medicines, supplements and foods (grapefruit, St John’s wort) slow them down or speed them up, which changes how much of a study drug stays in the body.

Studies list them so they can be avoided or switched; bring a list of everything you take, including supplements.

Cancer (malignancy)

Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.

Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

05

Study design

Phase
Phase 2
Primary purpose
Prevention
Allocation
Non-randomized
Intervention model
Single group
Masking
None (open label)
Enrollment
78 participants (actual)

Study arms

  • Experimental
    Treatment Group 1: HTX-011

    HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation.

    Drug: HTX-011 · Device: Luer Lock applicator · Device: Vial access device

  • Experimental
    Treatment Group 2: HTX-011 + Aprepitant

    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.

    Drug: HTX-011 · Device: Luer Lock applicator · Device: Vial access device · Drug: aprepitant

  • Experimental
    Treatment Group 3: HTX-011 + Non-Opioid MMA Regimen

    HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation and a scheduled multimodal analgesic (MMA) regimen.

    Drug: HTX-011 · Device: Luer Lock applicator · Device: Vial access device

Interventions

  • DrugHTX-011

    Drug pages: Bupivacaine · Meloxicam

    HTX-011 (bupivacaine/meloxicam), up to but not to exceed 60 mg/1.8 mg, via instillation.

  • DeviceLuer Lock applicator

    Applicator for instillation.

  • DeviceVial access device

    Device for withdrawal of drug product.

  • Aprepitant, three single doses of aprepitant will be administered orally.

06

What researchers measure

Primary outcomes

  1. Mean Area Under the Curve (AUC) of the NRS-A (Windowed Worst Observation Carried Forward) Pain Intensity Scores

    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).

    Time frame: 72 hours

Secondary outcomes

  1. Mean Total Postoperative Opioid Consumption (in Morphine Equivalents) Through 72 Hours

    Time frame: 72 hours

  2. Percentage of Subjects Receiving no Opioid Rescue

    Time frame: 72 hours

  3. Percentage of Subjects Receiving no Opioid Rescue

    Only subjects in Cohort 3 received a scheduled, non-opioid MMA regimen following surgery.

    Time frame: Day 7 and Day 28

  4. Mean Area Under the Curve (AUC) of the NRS-R (Windowed Worst Observation Carried Forward) Pain Intensity Scores

    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 measured at rest.

    Time frame: 72 hours

07

Results

Posted Jun 26, 2023

Participant flow

Participant flow — Overall Study
MilestoneTreatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA Regimen
Started301731
Completed301731
Not completed000

Outcome measures

PrimaryMean Area Under the Curve (AUC) of the NRS-A (Windowed Worst Observation Carried Forward) Pain Intensity Scores

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).

Time frame:
72 hours
Reported as:
Mean · pain intensity score*hr
Mean Area Under the Curve (AUC) of the NRS-A (Windowed Worst Observation Carried Forward) Pain Intensity Scores
pain intensity score*hrTreatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA Regimen
Mean Area Under the Curve (AUC) of the NRS-A (Windowed Worst Observation Carried Forward) Pain Intensity Scores278.36 ± 151.085288.23 ± 115.790126.93 ± 129.819
SecondaryMean Total Postoperative Opioid Consumption (in Morphine Equivalents) Through 72 Hours
Time frame:
72 hours
Reported as:
Mean · MME, morphine milligram equivalents
Mean Total Postoperative Opioid Consumption (in Morphine Equivalents) Through 72 Hours
MME, morphine milligram equivalentsTreatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA Regimen
Mean Total Postoperative Opioid Consumption (in Morphine Equivalents) Through 72 Hours11.47 ± 10.19821.88 ± 13.3051.61 ± 3.449
SecondaryPercentage of Subjects Receiving no Opioid Rescue
Time frame:
72 hours
Reported as:
Count of participants · Participants
Percentage of Subjects Receiving no Opioid Rescue
ParticipantsTreatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA Regimen
Percentage of Subjects Receiving no Opioid Rescue6024
SecondaryPercentage of Subjects Receiving no Opioid Rescue

Only subjects in Cohort 3 received a scheduled, non-opioid MMA regimen following surgery.

Time frame:
Day 7 and Day 28
Reported as:
Count of participants · Participants
Percentage of Subjects Receiving no Opioid Rescue
ParticipantsTreatment Group 3: HTX-011 + Non-Opioid MMA Regimen
Day 724
Day 2824
SecondaryMean Area Under the Curve (AUC) of the NRS-R (Windowed Worst Observation Carried Forward) Pain Intensity Scores

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 measured at rest.

Time frame:
72 hours
Reported as:
Mean · pain intensity score*hr
Mean Area Under the Curve (AUC) of the NRS-R (Windowed Worst Observation Carried Forward) Pain Intensity Scores
pain intensity score*hrTreatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA Regimen
Mean Area Under the Curve (AUC) of the NRS-R (Windowed Worst Observation Carried Forward) Pain Intensity Scores251.92 ± 127.319252.39 ± 112.996113.10 ± 124.696

Adverse events

Collected over 42 Days.. Non-serious events are listed at a 5% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Treatment Group 1: HTX-0110/30 (0%)0/30 (0%)13/30 (43.3%)
Treatment Group 2: HTX-011 + Aprepitant0/17 (0%)1/17 (5.9%)13/17 (76.5%)
Treatment Group 3: HTX-011 + Non-Opioid MMA Regimen0/31 (0%)0/31 (0%)16/31 (51.6%)
Most frequent serious events
Most frequent serious events
EventTreatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA Regimen
CellulitisInfections and infestations0/301/170/31
Postoperative abscessInfections and infestations0/301/170/31
Most frequent other events
Showing 10 of 33
Most frequent other events
EventTreatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA Regimen
NauseaGastrointestinal disorders5/306/177/31
ConstipationGastrointestinal disorders0/305/172/31
HeadacheNervous system disorders8/301/171/31
PruritusSkin and subcutaneous tissue disorders0/302/171/31
PyrexiaGeneral disorders0/302/170/31
VomitingGastrointestinal disorders0/301/173/31
Decreased appetiteMetabolism and nutrition disorders2/300/171/31
DizzinessNervous system disorders2/300/170/31
Localised infectionInfections and infestations0/300/172/31
Abdominal discomfortGastrointestinal disorders0/301/172/31

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Treatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA RegimenTotal
<=18 years0000
Between 18 and 65 years30162975
>=65 years0123
Age, Continuous
Age, Continuous(years)Treatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA RegimenTotal
Mean47.3 ± 11.5843.7 ± 14.7349.1 ± 12.6647.2 ± 12.74
Sex: Female, Male
Sex: Female, Male(Participants)Treatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA RegimenTotal
Female28132970
Male2428
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Treatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA RegimenTotal
Hispanic or Latino15121542
Not Hispanic or Latino1551636
Unknown or Not Reported0000
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Treatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA RegimenTotal
American Indian or Alaska Native0000
Asian1001
Native Hawaiian or Other Pacific Islander0000
Black or African American1146
White28162771
More than one race0000
Unknown or Not Reported0000
Region of Enrollment
Region of Enrollment(participants)Treatment Group 1: HTX-011Treatment Group 2: HTX-011 + AprepitantTreatment Group 3: HTX-011 + Non-Opioid MMA RegimenTotal
United States30173178
08

Study locations

1 site
  • Endeavor Clinical Trials, LLC
    San Antonio, Texas 78229, United States
09

References and documents

Study documents

PDFs hosted by the registry, ClinicalTrials.gov.

Individual participant data

Plan to share: Undecided

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Mar 2, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
11

Registry details

Key details

Study ID
NCT03718039
Lead sponsor
Heron Therapeutics
Responsible party
Sponsor
First posted
Oct 24, 2018
Start date
Oct 24, 2018
Primary completion
Jan 31, 2019
Completion
Mar 11, 2019
Results posted
Jun 26, 2023
Last update
Mar 2, 2026

Oversight

FDA-regulated drug
Yes
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Feb 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drugs tested here: Bupivacaine · Meloxicam

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