A Study of the Effect on Pain Control of Treatment With Fentanyl, Administered Through the Skin, in Patients With Rheumatoid Arthritis or Osteoarthritis

November 24, 2010 updated by: Janssen Pharmaceutica N.V., Belgium

Open-Label Study To Assess The Effect On Pain Control Of Durogesic (Fentanyl Transdermic Therapeutic System) Treatment In Subjects With Rheumatoid Arthritis Or Osteoarthritis Of The Knee Or Hip.

The purpose of this study is to assess the degree of pain control achieved by treatment with fentanyl, administered via adhesive patches applied to the skin ('transdermal system") in patients with rheumatoid arthritis or osteoarthritis of the knee or hip. Treatment will be administered fo r4 weeks, added on to existing therapy with other medications.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Chronic, non-cancer pain may result from injury or illness, such as rheumatoid arthritis or osteoarthritis, which causes suffering and a reduction in the quality of life. Opioids, such as fentanyl, are beneficial as potent pain-relieving drugs in patients with continuous pain. This is an open-label, prospective study to assess the degree of pain control provided by treatment with fentanyl administered through the skin via adhesive patches ("transdermal system") for 28 days in patients with rheumatoid arthritis or osteoarthritis of the hip or knee, whose pain is inadequately controlled by other medications. During the first week of treatment, a prophylactic anti-nausea and vomiting agent will be given to patients to control these symptoms that can occur during opioid therapy. After 28 days, patients who do not respond adequately to treatment will be tapered off by gradually reducing the dose of fentanyl. Assessment of effectiveness will include a rating of pain control (excellent, good, moderate, poor, very poor), Pain Assessment Questionnaire, Quality of Life Questionnaire (SF-36), Health Assessment Questionnaire (HAQ), recording of the usage of any additional pain-relieving medications, and an evaluation of the anti-nausea and vomiting treatment. Safety evaluations include incidence of adverse events, and physical examinations. The study hypothesis is that patients with rheumatoid arthritis or osteoarthritis of the hip or knee whose pain is not adequately controlled by other medications will show an improvement in pain control after 28 days of treatment with the fentanyl transdermal system. Fentanyl transdermal patches to deliver from 25 micrograms/hr to 100 micrograms/hr, changed every 3 days, for 28 days; doses may be adjusted for adequate pain control, Anti-nausea tablets (Metoclopramide, 10 mg, 3 times/day) during first week. Paracetamol tablets (500mg) to supplement pain control.

Study Type

Interventional

Enrollment (Actual)

264

Phase

  • Phase 4

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Patients must meet the American College of Rheumatology criteria for rheumatoid arthritis (RA) or osteoarthritis (OA) of the hip or knee and have moderate or severe pain that is not adequately controlled by other medications (paracetamol (acetaminophen), NSAIDs, COX-2 inhibitors, weak opioids)
  • OA patients must be in need of and waiting for hip or knee replacement
  • RA patients using disease modifying antirheumatic drugs (DMARDs) must have been on stable dose of medication for >=3 months.

Exclusion Criteria:

  • Patients who have received regular treatment with strong opioids during the month prior to study
  • another continuous pain that stands out compared to RA or OA pain
  • skin disease or known allergy or hypersensitivity to fentanyl or to the adhesives
  • history of liver disease
  • new physical therapy or change in that therapy within one month of study
  • pregnant or nursing females, or those without adequate contraception.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Non-Randomized
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Assessment of pain control (excellent, good, moderate, poor, very poor) and Pain Assessment Questionnaire at baseline and then weekly through Day 28.

Secondary Outcome Measures

Outcome Measure
Incidence of adverse events throughout study; efficacy of anti-nausea treatment (weekly); SF-36 Quality of Life Questionnaire and Health Assessment Questionnaire (HAQ) at start of treatment and Day 28.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Janssen Pharmaceutica N.V., Belgium

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

July 1, 2001

Study Completion (Actual)

December 1, 2002

Study Registration Dates

First Submitted

August 31, 2007

First Submitted That Met QC Criteria

August 31, 2007

First Posted (Estimate)

September 3, 2007

Study Record Updates

Last Update Posted (Estimate)

November 25, 2010

Last Update Submitted That Met QC Criteria

November 24, 2010

Last Verified

November 1, 2010

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • CR001981

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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