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NCT03887650

LIBERATE - LIposomal Bupivacaine vERsus Adjuncts in Total shouldErs

Completed Phase 4 Results posted Last updated 15 September 2023
What this trial tests

Phase 4 trial testing Liposomal Bupivicaine 1.3% in Post-operative Pain in 90 participants. Completed in 8 March 2022.

Timeline
11 March 2019
Primary endpoint
11 January 2022
8 March 2022

Quick facts

Lead sponsorHartford Hospital
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designparallel
Maskingtriple
Primary purposetreatment
Enrollment90
Start date11 March 2019
Primary completion11 January 2022
Estimated completion8 March 2022
Sites1 location across United States

Drugs / interventions tested

Conditions studied

Sponsor

Hartford Hospital

Who can join

Adults 18 to 100, any sex, with Post-operative Pain or Total Shoulder Arthroplasty. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Total Opioid Consumption Primary · Up to 120 postoperative hours

Total opioids used for the first 120 postoperative hours after TSA, standardized to morphine milligram equivalents (MMEs)

GroupValue95% CI
Liposomal Bupivacaine 1.3%71.2543.00 – 120.00
Bupivacaine 0.5% With Adjuncts90.3057.37 – 133.43
Time to First Opioid Medication Secondary · from the time of the block injection until discharge, assessed up to 72 postoperative hours.

From block time to the first dose of opioids given, measured in hours.

GroupValue95% CI
Liposomal Bupivacaine 1.3%10.56675.800 – 20.850
Bupivacaine 0.5% With Adjuncts12.0254.404 – 21.983
Pain Assessment at Post Anesthesia Care Unit (PACU)-96 Postoperative Hours Secondary · 24, 24-48, 48-72, and 72-96 hours postoperation, and at day 60

Pain assessment is categorized as minimum, maximum, and average pain scores reported by patients using questions from the Modified Brief Pain Inventory-short form (MBPI-SF) during the following intervals; PACU-24, 24-48, 48-72, and 72-96 postoperative hours, and at day 60. This form collected minimum, maximum, and average on a numeric pain scale (0-10) where 0 is no pain and 10 is the worst pain.

PACU
GroupValue95% CI
Liposomal Bupivacaine 1.3%0.000.00 – 1.00
Bupivacaine 0.5% With Adjuncts0.000.00 – 1.50
PACU-24 hours Minimum
GroupValue95% CI
Liposomal Bupivacaine 1.3%0.000.00 – 1.00
Bupivacaine 0.5% With Adjuncts0.000.00 – 0.00
PACU-24 hours Maximum
GroupValue95% CI
Liposomal Bupivacaine 1.3%2.000.00 – 4.50
Bupivacaine 0.5% With Adjuncts1.000.00 – 4.50
PACU-24 hours Average
GroupValue95% CI
Liposomal Bupivacaine 1.3%1.000.00 – 2.00
Bupivacaine 0.5% With Adjuncts0.000.00 – 3.50
24-48 hours Minimum
GroupValue95% CI
Liposomal Bupivacaine 1.3%0.000.00 – 2.00
Bupivacaine 0.5% With Adjuncts2.000.00 – 3.75
24-48 hours Maximum
GroupValue95% CI
Liposomal Bupivacaine 1.3%4.501.00 – 6.00
Bupivacaine 0.5% With Adjuncts7.005.00 – 8.00
24-48 hours Average
GroupValue95% CI
Liposomal Bupivacaine 1.3%2.000.00 – 3.75
Bupivacaine 0.5% With Adjuncts4.003.00 – 5.00
48-72 hours Minimum
GroupValue95% CI
Liposomal Bupivacaine 1.3%1.000.00 – 2.00
Bupivacaine 0.5% With Adjuncts2.001.00 – 3.00
Hospital Length-of-stay Secondary · From the date of admission until discharge, assessed up to 72 hours.

From the date and time of admission to the date and time of discharge, Measured in hours.

GroupValue95% CI
Liposomal Bupivacaine 1.3%31.0529.67 – 32.53
Bupivacaine 0.5% With Adjuncts31.6330.63 – 36.58
Assessment of Patient Overall Satisfaction With Pain Control Secondary · POD4 - 60 days

Patient overall satisfaction with pain control was assessed two times; on the fourth and the 60th postoperative days. It was assessed using a numeric scale (0-10) where 0 is very dissatisfied while 10 is extremely satisfied. The results indicated only the percentage of participants who reported a 10/10 satisfaction rate.

POD4
GroupValue95% CI
Liposomal Bupivacaine 1.3%32
Bupivacaine 0.5% With Adjuncts24
Liposomal Bupivacaine 1.3%9
Bupivacaine 0.5% With Adjuncts17
Liposomal Bupivacaine 1.3%4
Bupivacaine 0.5% With Adjuncts1
POD60
GroupValue95% CI
Liposomal Bupivacaine 1.3%27
Bupivacaine 0.5% With Adjuncts28
Liposomal Bupivacaine 1.3%12
Bupivacaine 0.5% With Adjuncts13
Liposomal Bupivacaine 1.3%5
Bupivacaine 0.5% With Adjuncts1
Incidence of Distress From Block Numbness Secondary · At PACU and Postoperative day 2

On a distress scale of (0 -10) with 0 = not at all and 10 = very much distressed, the scores were gathered and the results are grouped to show the percentage of either the presence of distress (any positive score) or no distress, assessed at two times; at the PACU and the second postoperative day.

PACU distress
GroupValue95% CI
Liposomal Bupivacaine 1.3%31
Bupivacaine 0.5% With Adjuncts31
Liposomal Bupivacaine 1.3%14
Bupivacaine 0.5% With Adjuncts14
Liposomal Bupivacaine 1.3%0
Bupivacaine 0.5% With Adjuncts0
POD2 Distress
GroupValue95% CI
Liposomal Bupivacaine 1.3%32
Bupivacaine 0.5% With Adjuncts31
Liposomal Bupivacaine 1.3%12
Bupivacaine 0.5% With Adjuncts12
Liposomal Bupivacaine 1.3%1
Bupivacaine 0.5% With Adjuncts2
Duration of Sensory Nerve Block Secondary · Day 1, after Day 1 (day 2 to 60), and at postoperative day 60

Using the sensory assessment test, the results show the percentage of participants who had the return of first sensation and full sensation either on Day 1, after Day 1 (day 2 to 60), and at postoperative day 60.

Full sensation
GroupValue95% CI
Liposomal Bupivacaine 1.3%11
Bupivacaine 0.5% With Adjuncts11
Liposomal Bupivacaine 1.3%27
Bupivacaine 0.5% With Adjuncts27
Liposomal Bupivacaine 1.3%0
Bupivacaine 0.5% With Adjuncts2
Liposomal Bupivacaine 1.3%7
Bupivacaine 0.5% With Adjuncts5
First sensation
GroupValue95% CI
Liposomal Bupivacaine 1.3%35
Bupivacaine 0.5% With Adjuncts33
Liposomal Bupivacaine 1.3%9
Bupivacaine 0.5% With Adjuncts10
Liposomal Bupivacaine 1.3%0
Bupivacaine 0.5% With Adjuncts0
Liposomal Bupivacaine 1.3%1
Bupivacaine 0.5% With Adjuncts2
Day of the Final Opioids Used Secondary · 0-96 postoperative hours

The postoperative day that patients in each group took their last opioid, from the end of surgery up to 96 postoperative hours.

GroupValue95% CI
Liposomal Bupivacaine 1.3%41.5 – 4
Bupivacaine 0.5% With Adjuncts41 – 4
Motor Recovery Secondary · PACU, Day 1, after Day 1 (day 2 and 60), and at postoperative day 60.

The Motor function was assessed by shoulder abduction and elbow flexion using the Oxford scale of muscle strength grading (Muscle Grading Scores 0-5): 0= No detectable muscle contraction (visible or palpation) 1. Detectable contraction (visible or palpation), but no movement achieved 2. Limb movement achieved, but unable to move against gravity 3. Limb movement against the resistance of gravity 4. Limb movement against gravity and external resistance 5. Normal strength The results were grouped to show the return of any movement at the PACU, Day 1, after Day 1 (day2-60), and on day 60. And t

Any movement in PACU
GroupValue95% CI
Liposomal Bupivacaine 1.3%1
Bupivacaine 0.5% With Adjuncts11
Any movement in day1
GroupValue95% CI
Liposomal Bupivacaine 1.3%4
Bupivacaine 0.5% With Adjuncts3
Any movement after day1
GroupValue95% CI
Liposomal Bupivacaine 1.3%38
Bupivacaine 0.5% With Adjuncts29
Any movement missing data
GroupValue95% CI
Liposomal Bupivacaine 1.3%2
Bupivacaine 0.5% With Adjuncts2
Return of full movement day 2-60
GroupValue95% CI
Liposomal Bupivacaine 1.3%32
Bupivacaine 0.5% With Adjuncts31
Not yet by day 60
GroupValue95% CI
Liposomal Bupivacaine 1.3%3
Bupivacaine 0.5% With Adjuncts6
Return of full movement missing data
GroupValue95% CI
Liposomal Bupivacaine 1.3%10
Bupivacaine 0.5% With Adjuncts8
Total Amount of Opioid Consumed During the Indicated Time Periods Secondary · 0-24, 24-48, 48-72, and 72-120 postoperative hours.

Opioid use was calculated using the Morphine MilliEquevalent per day, this was assessed daily during the postoperative period, 0-24, 24-48, 48-72, and 72-120 postoperative hours.

0-24 hours
GroupValue95% CI
Liposomal Bupivacaine 1.3%25.0025.00 – 39.37
Bupivacaine 0.5% With Adjuncts25.0025.00 – 37.50
24-48 hours
GroupValue95% CI
Liposomal Bupivacaine 1.3%16.000.00 – 38.75
Bupivacaine 0.5% With Adjuncts23.259.75 – 39.37
48-72 hours
GroupValue95% CI
Liposomal Bupivacaine 1.3%2.000.00 – 8.00
Bupivacaine 0.5% With Adjuncts5.000.00 – 15.00
72-120 hours
GroupValue95% CI
Liposomal Bupivacaine 1.3%10.000.00 – 27.00
Bupivacaine 0.5% With Adjuncts15.000.00 – 37.50

Adverse events — posted to ClinicalTrials.gov

Time frame: Adverse events were collected up to 60 postoperative days.. Reporting threshold: 0%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

Liposomal Bupivacaine 1.3%
Serious: 0/45 (0%)
Deaths: 0/45
Bupivacaine 0.5% With Adjuncts
Serious: 0/45 (0%)
Deaths: 0/45
Other adverse events (7 terms — click to expand)

ReactionSystemLiposomal Bupivacaine 1.3%Bupivacaine 0.5% With Adju…
Nausea and vomitingGeneral disorders
BruisingSurgical and medical procedures
RashSkin and subcutaneous tissue disorders
SwellingSurgical and medical procedures
InflammationSurgical and medical procedures
Ringing in earsEar and labyrinth disorders
Numbness and tinglingNervous system disorders

Data from ClinicalTrials.gov NCT03887650 adverse events section.

Sponsor's own description

This will be a single-center, prospective, randomized controlled cross-sectional study comparing interscalene brachial plexus block with liposomal bupivacaine versus bupivacaine with epinephrine and PF dexamethasone in patients undergoing primary shoulder arthroplasty. Primary endpoint will be total opioid consumption in the first three post-operative days.

Publications & conference data

No peer-reviewed publications indexed yet for this trial. Completed trials usually publish results within 12-18 months.

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