- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01089556
A Study in Painful Diabetic Neuropathy (COMBO-DN)
Use of Duloxetine or Pregabalin in Monotherapy Versus Combination Therapy of Both Drugs in Patients With Painful Diabetic Neuropathy "The COMBO - DN (COmbination vs Monotherapy of pregaBalin and dulOxetine in Diabetic Neuropathy) Study"
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Actual)
Phase
- Phase 3
Contacts and Locations
Study Locations
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New South Wales
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Newcastle, New South Wales, Australia, 2292
- For additional information regarding investigative sites for this trial, contact 1-877-CTLILLY (1-877-285-4559, 1-317-615-4559) Mon - Fri from 9 AM to 5 PM Eastern Time (UTC/GMT - 5 hours, EST), or speak with your personal physician.
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Warrawong, New South Wales, Australia, 2502
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South Australia
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Elizabeth Vale, South Australia, Australia, 5112
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British Columbia
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Kelowna, British Columbia, Canada, V1Y 1Z9
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Vancouver, British Columbia, Canada, V6H 3X8
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Manitoba
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Winnipeg, Manitoba, Canada, R3P 3P4
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Nova Scotia
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Halifax, Nova Scotia, Canada, B3H 3A7
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Ontario
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Cambridge, Ontario, Canada, N1R 7L6
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Quebec
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Laval, Quebec, Canada, H7T 2P5
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Osijek, Croatia, 31000
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Rijeka, Croatia, HR-51000
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Varazdin, Croatia, 42000
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Zagreb, Croatia, 10000
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Angers, France, 49933
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Antibes Juan Les Pins, France, 06600
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Bourges, France, 18000
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Nevers, France, 58000
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Nimes, France, 30029
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Paris, France, 75018
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Valenciennes, France, 59322
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Vierzon, France, 18100
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Vieux Conde, France, 59690
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Dresden, Germany, 01307
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Schkeuditz, Germany, 04435
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Ampelokipoi, Greece, 11527
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Athens, Greece, 11521
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Melissia, Greece, 15126
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Catania, Italy, 95100
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Milano, Italy, 20162
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Napoli, Italy, 80131
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Rome, Italy, 00161
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Seoul, Korea, Republic of, 138-736
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Mexico City, Mexico, 38000
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Eindhoven, Netherlands, 5623 EJ
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Maastricht, Netherlands, 6229 HX
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Bialystok, Poland, 15-445
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Lublin, Poland, 20-538
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Szczecin, Poland, 70-506
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Wroclaw, Poland, 50-127
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Girona, Spain, 17007
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Valencia, Spain, 46010
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Falkoping, Sweden, SE 52143
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Huddinge, Sweden, SE 141 86
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Lund, Sweden, 22185
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Stockholm, Sweden, 11522
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Zuerich, Switzerland, CH-8091
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Ankara, Turkey, 06100
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Izmir, Turkey, 35340
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Ashton-Under-Lyne, United Kingdom, OL6 9RW
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Chorley, United Kingdom, PR7 1PP
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Greater Manchester
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Manchester, Greater Manchester, United Kingdom, M13 0JE
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Scotland
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Ayrshire, Scotland, United Kingdom, KA6 6DX
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Warwickshire
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Nuneaton, Warwickshire, United Kingdom, CV10 7BL
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West Lothian
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Livingston, West Lothian, United Kingdom, EH54 6PP
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Pain due to bilateral peripheral neuropathy (caused by type 1 or type 2 diabetes mellitus. Pain must begin in the feet, with relatively symmetrical onset. Daily pain should be present for more than 3 months [assessed by questioning patient]).
- Score of at least 4 on the 24-hour average pain severity score on an 11-point Likert scale [on Brief Pain Inventory (BPI) Modified Short Form] at screening and at randomization.
- Patient is currently not receiving treatment for diabetic peripheral neuropathic pain (DPNP) or was receiving treatment for DPNP, with a drug other than pregabalin or duloxetine, and completed the required washout
- Patient has never received treatment with duloxetine or pregabalin. (However, a short course of less than 15 days of treatment, at any time previously, will be allowed.)
- Stable glycemic control, as assessed by a physician investigator, and hemoglobin A1c (HbA1c) less than or equal to 12% at screening.
Exclusion Criteria:
- Have a known hypersensitivity to duloxetine or pregabalin or any of the inactive ingredients or have any contraindication for the use of duloxetine or pregabalin.
- Have uncontrolled narrow-angle glaucoma.
- Have received treatment with a monoamine oxidase inhibitor (MAOI) within 14 days prior to randomization, or have a potential need to use a MAOI during the study or within 5 days after discontinuation of study drug.
- Have received fluoxetine within 30 days prior to randomization.
- Have acute liver injury (such as hepatitis) or severe cirrhosis (Child-Pugh Class C).
- Have a serum creatinine greater than or equal to 1.5 milligram per deciliter (mg/dL) or a creatinine clearance less than 60 milliliter per minute (mL/min), at screening.
- Are judged clinically by the investigator to be at suicidal risk or as defined by a score of 2 or greater on Question 9 of the Beck Depression Inventory-II (BDI-II), at screening or randomization
- Have a historical exposure to drugs known to cause neuropathy (for example, vincristine), or a history of a medical condition, including pernicious anemia and hypothyroidism, that could have been responsible for neuropathy.
- Have pain that cannot be clearly differentiated from or conditions that interfere with the assessment of the DPNP.
- Have serious or unstable cardiovascular, hepatic, renal, respiratory or hematological illness; symptomatic peripheral vascular disease; a history of seizure disorder; or other medical (including unstable hypertension and not clinically euthyroid) or psychological conditions that, in the opinion of the investigator, would compromise participation or be likely to require hospitalization during the course of the study.
- Have received non-pharmacological treatment for pain within 14 days prior to randomization, or do not agree to abstain from non-pharmacological treatment during the study.
- Have a history of frequent and/or severe allergic reactions with multiple medications.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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Experimental: Duloxetine
Initial Treatment: Duloxetine 30 milligram (mg) daily for 1 week Duloxetine 60 mg daily for 7 weeks Intensive Treatment: Duloxetine 90 mg (60 mg in the morning, 30 mg in the evening) daily for 1 week Duloxetine 120 mg (60 mg twice daily) daily for 7 weeks |
Administered orally
Other Names:
Administered orally, daily as a blind for duloxetine and/or pregabalin for 8 or 16 weeks
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Experimental: Pregabalin+Duloxetine
Initial Treatment: Pregabalin 150 mg daily for 1 week Pregabalin 300 mg (150 mg twice daily) daily for 7 weeks Intensive Treatment: Pregabalin 300 mg (150 mg twice daily) daily for 8 weeks Duloxetine 30 mg daily for 1 week Duloxetine 60 mg daily for 7 weeks |
Administered orally
Other Names:
Administered orally
Administered orally, daily as a blind for duloxetine and/or pregabalin for 8 or 16 weeks
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Experimental: Pregabalin
Initial Treatment: Pregabalin 150 mg daily for 1 week Pregabalin 300 mg (150 mg twice daily) daily for 7 weeks Intensive Treatment: Pregabalin 450 mg (300 mg in the morning, 150 mg in the evening) daily for 1 week Pregabalin 600 mg (300 mg twice daily) daily for 7 weeks |
Administered orally
Administered orally, daily as a blind for duloxetine and/or pregabalin for 8 or 16 weeks
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Experimental: Duloxetine + Pregabalin
Initial Treatment: Duloxetine 30 mg daily for 1 week Duloxetine 60 mg daily for 7 weeks Intensive Treatment: Duloxetine 60 mg daily for 8 weeks Pregabalin 150 mg daily for 1 week Pregabalin 300 mg (150 mg twice daily) daily for 7 weeks |
Administered orally
Other Names:
Administered orally
Administered orally, daily as a blind for duloxetine and/or pregabalin for 8 or 16 weeks
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Change From Week 8 to Week 16 Endpoint in 24 Hour Average Pain Item Score on the Brief Pain Inventory (BPI) Modified Short Form
Time Frame: Week 8, Week 16
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BPI Modified Short Form 24-Hour average pain item score is a self-reported scale that measures the severity of pain based on the average pain experienced over the past 24 hours.
The severity scores range from 0 (no pain) to 10 (pain as severe as you can imagine).
Mixed-effects model repeated measures (MMRM) analysis was used to calculate Least Squares (LS) Mean and 95% Confidence Interval (CI).
LS Mean values are controlled for treatment, site, baseline value, visit, treatment*visit, baseline*visit and treatment in Study Period II.
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Week 8, Week 16
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Mean Change From Week 8 to Week 16 Endpoint in Items of the Brief Pain Inventory (BPI) Modified Short Form Worst Pain Score
Time Frame: Week 8, Week 16
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BPI Modified Short Form worst pain score is a self-reported scale that measures the severity of pain based on the worst pain experienced over the past 24 hours.
The severity scores range from 0 (no pain) to 10 (pain as severe as you can imagine).
Mixed-effects model repeated measures (MMRM) analysis was used to calculate Least Squares (LS) Mean and 95% Confidence Interval (CI).
LS Mean values are controlled for treatment, site, baseline value, visit, treatment*visit, baseline*visit and treatment in Study Period II.
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Week 8, Week 16
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Percentage of Participants With a Reduction of Greater Than or Equal to 30% on Brief Pain Inventory (BPI) Modified Short Form 24-Hour Average Pain Item Score at Week 16 Endpoint
Time Frame: Week 8 through Week 16
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BPI Modified Short Form 24-Hour average pain item score is a self-reported scale that measures the severity of pain based on the average pain experienced over the past 24 hours.
The severity scores range from 0 (no pain) to 10 (pain as severe as you can imagine).
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Week 8 through Week 16
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Percentage of Participants With a Reduction of Greater Than or Equal to 50% on Brief Pain Inventory (BPI) Modified Short Form 24-Hour Average Pain Item Score at Week 16 Endpoint
Time Frame: Week 8 through Week 16
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BPI Modified Short Form 24-Hour average pain item score is a self-reported scale that measures the severity of pain based on the average pain experienced over the past 24 hours.
The severity scores range from 0 (no pain) to 10 (pain as severe as you can imagine).
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Week 8 through Week 16
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Percentage of Participants With a Decrease of Greater Than or Equal to 2 Points on Brief Pain Inventory (BPI) Modified Short Form 24-Hour Average Pain Item Score at Week 16 Endpoint
Time Frame: Week 8 through Week 16
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BPI Modified Short Form 24-Hour average pain item score is a self-reported scale that measures the severity of pain based on the average pain experienced over the past 24 hours.
The severity scores range from 0 (no pain) to 10 (pain as severe as you can imagine).
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Week 8 through Week 16
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Clinical Global Impression of Improvement (CGI-I) at Week 16 Endpoint
Time Frame: Week 16
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Measures clinician's perception of participant improvement at the time of assessment compared with the start of treatment for Study Period III.
Scores range from 1 (very much better) to 7 (very much worse).
Mixed-effects model repeated measures (MMRM) analysis was used to calculate Least Squares (LS) Mean and 95% Confidence Interval (CI).
LS Mean values are controlled for treatment, site, baseline value, visit, treatment*visit, baseline*visit and treatment in Study Period II.
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Week 16
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Mean Change From Week 8 to Week 16 Endpoint on the Neuropathic Pain Symptom Inventory (NPSI) Questionnaire
Time Frame: Week 8, Week 16
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The NPSI is a 12-item self-administered questionnaire to assess 5 different dimensions of neuropathic pain: superficial spontaneous burning pain, deep spontaneous pressing pain, paroxysmal pain, evoked pains, and paresthesias/dysesthesias. A total score ranges from 0 to 100.
Higher score indicates a greater intensity of pain.
Mixed-effects model repeated measures (MMRM) analysis was used to calculate Least Squares (LS) Mean and 95% Confidence Interval (CI).
LS Mean values are controlled for treatment, site, baseline value, visit, treatment*visit, baseline*visit and treatment in Study Period II.
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Week 8, Week 16
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Mean Change From Week 8 to Week 16 Endpoint in Sheehan Disability Scale (SDS)
Time Frame: Week 8, Week 16
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The SDS is completed by the participant and is used to assess the effect of the participant's symptoms on their work (Item 1), social (Item 2), and family life (Item 3).
Each item is measured on a 0 (not at all) to 10 (extremely) point scale with higher values indicating greater disruption.
Total scores is the sum of the 3 items and range from 0 to 30 with higher values indicating greater disruption in the participant's work/social/family life.
Least Squares (LS) Mean values are controlled for treatment, site, baseline value, treatment*site and treatment in Study Period II.
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Week 8, Week 16
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Mean Change From Week 8 to Week 16 Endpoint in Hospital Anxiety and Depression Scale (HADS)
Time Frame: Week 8, Week 16
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A 14-item questionnaire with 2 subscales: anxiety and depression.
Each item is rated on a 4-point scale (0-3), giving maximum scores of 21 for anxiety and for depression.
Scores of 11 or more on either subscale are considered to be a significant case of psychological morbidity, while scores of 8-10 represent 'borderline' and 0-7 represent 'normal.' Mixed-effects model repeated measures (MMRM) analysis was used to calculate Least Squares (LS) Mean and 95% Confidence Interval (CI).
LS Mean values are controlled for treatment, site, baseline value, visit, treatment*visit, baseline*visit and treatment in Study Period II.
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Week 8, Week 16
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Resource Utilization (Number of Days Hospitalized, Number of Days of Sick Leave) Week 8 Through Week 16
Time Frame: Week 8 through Week 16
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Data presented are the number of days hospitalized and work/school missed (sick leave) due to diabetic peripheral neuropathic pain (DPNP) during the last 8 weeks.
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Week 8 through Week 16
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Patient Global Impression of Improvement (PGI-I) Score at Week 16 Endpoint
Time Frame: Week 16
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Measures participant's perception of improvement at the time of assessment compared with the start of treatment for Study Period III.
The score ranges from 1 (very much better) to 7 (very much worse).
Mixed-effects model repeated measures (MMRM) analysis was used to calculate Least Squares (LS) Mean and 95% Confidence Interval (CI).
LS Mean values are controlled for treatment, site, baseline value, visit, treatment*visit, baseline*visit and treatment in Study Period II.
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Week 16
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Mean Change in Blood Pressure (BP) From Week 8 to Week 16 Endpoint
Time Frame: Week 8, Week 16
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Least Squares (LS) mean values are controlled for treatment, site, baseline value, treatment*site and treatment in Study Period II.
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Week 8, Week 16
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|
Mean Change in Heart Rate From Week 8 to Week 16 Endpoint
Time Frame: Week 8, Week 16
|
Least Squares (LS) mean values are controlled for treatment, site, baseline value, treatment*site and treatment in Study Period II.
|
Week 8, Week 16
|
|
Number of Participants With Treatment Emergent Adverse Events (TEAEs) Between Week 8 and Week 16 Endpoint
Time Frame: Week 8 through Week 16
|
TEAEs in Study Period III are events that began or worsened after Week 8 compared with the period before Week 8.
|
Week 8 through Week 16
|
|
Number of Participants Who Discontinued From Study Between Week 8 and Week 16 Endpoint
Time Frame: Week 8 through Week 16
|
Week 8 through Week 16
|
Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Mean Change From Baseline to Week 8 Endpoint in 24 Hour Average Pain Item Score on the Brief Pain Inventory (BPI) Modified Short Form
Time Frame: Baseline, Week 8
|
BPI Modified Short Form 24-Hour average pain item score is a self-reported scale that measures the severity of pain based on the average pain experienced over the past 24 hours.
The severity scores range from 0 (no pain) to 10 (pain as severe as you can imagine).
Mixed-effects model repeated measures (MMRM) analysis was used to calculate Least Squares (LS) Mean and 95% Confidence Interval (CI).
LS Mean values are controlled for treatment, site, baseline value, visit, treatment*visit and baseline*visit.
|
Baseline, Week 8
|
|
Percentage of Participants With a Reduction of Greater Than or Equal to 30% on Brief Pain Inventory (BPI) Modified Short Form 24-Hour Average Pain Item Score at Week 8 Endpoint
Time Frame: Baseline through Week 8
|
BPI Modified Short Form 24-Hour average pain item score is a self-reported scale that measures the severity of pain based on the average pain experienced over the past 24 hours.
The severity scores range from 0 (no pain) to 10 (pain as severe as you can imagine).
|
Baseline through Week 8
|
|
Percentage of Participants With a Reduction of Greater Than or Equal to 50% on Brief Pain Inventory (BPI) Modified Short Form 24-Hour Average Pain Item Score at Week 8 Endpoint
Time Frame: Baseline through Week 8
|
BPI Modified Short Form 24-Hour average pain item score is a self-reported scale that measures the severity of pain based on the average pain experienced over the past 24 hours.
The severity scores range from 0 (no pain) to 10 (pain as severe as you can imagine).
|
Baseline through Week 8
|
|
Percentage of Participants With a Decrease of Greater Than or Equal to 2 Points on Brief Pain Inventory (BPI) Modified Short Form 24-Hour Average Pain Item Score at Week 8 Endpoint
Time Frame: Baseline through Week 8
|
BPI Modified Short Form 24-Hour average pain item score is a self-reported scale that measures the severity of pain based on the average pain experienced over the past 24 hours.
The severity scores range from 0 (no pain) to 10 (pain as severe as you can imagine).
|
Baseline through Week 8
|
|
Clinical Global Impression of Improvement (CGI-I) at Week 8 Endpoint
Time Frame: Week 8
|
Measures clinician's perception of participant improvement at the time of assessment compared with the start of treatment.
Scores range from 1 (very much better) to 7 (very much worse).
Mixed-effects model repeated measures (MMRM) analysis was used to calculate Least Squares (LS) Mean and 95% Confidence Interval (CI).
LS Mean values are controlled for treatment, site, visit, and treatment*visit.
|
Week 8
|
|
Mean Change From Baseline to Week 8 Endpoint on the Neuropathic Pain Symptom Inventory (NPSI) Questionnaire
Time Frame: Baseline, Week 8
|
The NPSI is a 12-item self-administered questionnaire to assess 5 different dimensions of neuropathic pain: superficial spontaneous burning pain, deep spontaneous pressing pain, paroxysmal pain, evoked pains, and paresthesias/dysesthesias. A total score ranges from 0 to 100.
Higher score indicates a greater intensity of pain.
Mixed-effects model repeated measures (MMRM) analysis was used to calculate Least Squares (LS) Mean and 95% Confidence Interval (CI).
LS Mean values are controlled for treatment, site, baseline value, visit, treatment*visit and baseline*visit.
|
Baseline, Week 8
|
|
Mean Change From Baseline to Week 8 Endpoint in Sheehan Disability Scale (SDS)
Time Frame: Baseline, Week 8
|
The SDS is completed by the participant and is used to assess the effect of the participant's symptoms on their work (Item 1), social (Item 2), and family life (Item 3).
Each item is measured on a 0 (not at all) to 10 (extremely) point scale with higher values indicating greater disruption.
Total scores is the sum of the 3 items and range from 0 to 30 with higher values indicating greater disruption in the participant's work/social/family life.
Least Squares (LS) mean values are controlled for treatment, site, baseline value and treatment*site.
|
Baseline, Week 8
|
|
Mean Change From Baseline to Week 8 Endpoint in Hospital Anxiety and Depression Scale (HADS)
Time Frame: Baseline, Week 8
|
A 14-item questionnaire with 2 subscales: anxiety and depression.
Each item is rated on a 4-point scale (0-3), giving maximum scores of 21 for anxiety and for depression.
Scores of 11 or more on either subscale are considered to be a significant case of psychological morbidity, while scores of 8-10 represent 'borderline' and 0-7 represent 'normal.' Mixed-effects model repeated measures (MMRM) analysis was used to calculate Least Squares (LS) Mean and 95% Confidence Interval (CI).
LS Mean values are controlled for treatment, site, baseline value, visit, treatment*visit and baseline*visit.
|
Baseline, Week 8
|
|
Resource Utilization (Number of Days Hospitalized, Number of Days of Sick Leave) Baseline Through Week 8
Time Frame: Baseline through Week 8
|
Data presented are the number of days hospitalized and work/school missed (sick leave) due to diabetic peripheral neuropathic pain (DPNP) during the last 8 weeks.
|
Baseline through Week 8
|
|
Average Number of Hours Worked for Pay Per Week Baseline Through Week 8
Time Frame: Baseline through Week 8
|
Data presented are the average number of hours worked for pay per week during the last 8 weeks.
|
Baseline through Week 8
|
|
Average Number of Hours Worked for Pay Per Week Week 8 Through Week 16
Time Frame: Week 8 through Week 16
|
Data presented are the average number of hours worked for pay per week during the last 8 weeks.
|
Week 8 through Week 16
|
|
Patient Global Impression of Improvement (PGI-I) Score at Week 8 Endpoint
Time Frame: Week 8
|
Measures participant's perception of improvement at the time of assessment compared with the start of treatment.
The score ranges from 1 (very much better) to 7 (very much worse).
Mixed-effects model repeated measures (MMRM) analysis was used to calculate Least Squares (LS) Mean and 95% Confidence Interval (CI).
LS Mean values are controlled for treatment, site, visit, and treatment*visit.
|
Week 8
|
|
Mean Change in Blood Pressure (BP) From Baseline to Week 8 Endpoint
Time Frame: Baseline, Week 8
|
Least Squares (LS) mean values are controlled for treatment, site, baseline value, and treatment*site.
|
Baseline, Week 8
|
|
Mean Change in Heart Rate From Baseline to Week 8 Endpoint
Time Frame: Baseline, Week 8
|
Least Squares (LS) mean values are controlled for treatment, site, baseline value, and treatment*site.
|
Baseline, Week 8
|
|
Number of Participants With Treatment Emergent Adverse Events (TEAE) Between Baseline and Week 8 Endpoint
Time Frame: Baseline through Week 8
|
TEAEs in Study Period II are events that began or worsened after Week 0 compared with the period before Week 0.
|
Baseline through Week 8
|
|
Number of Participants Who Discontinued From Study Between Baseline and Week 8 Endpoint
Time Frame: Baseline through Week 8
|
Baseline through Week 8
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Director: Call 1-877-CTLILLY (1-877-285-4559) or 1-317-615-4559 Mon - Fri 9 AM - 5AM Eastern time (UTC/GMT - 5 hours, EST), Eli Lilly and Company
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Nervous System Diseases
- Neurologic Manifestations
- Endocrine System Diseases
- Diabetes Complications
- Diabetes Mellitus
- Neuromuscular Diseases
- Peripheral Nervous System Diseases
- Pain
- Diabetic Neuropathies
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Central Nervous System Depressants
- Peripheral Nervous System Agents
- Analgesics
- Sensory System Agents
- Tranquilizing Agents
- Psychotropic Drugs
- Neurotransmitter Uptake Inhibitors
- Membrane Transport Modulators
- Antidepressive Agents
- Dopamine Agents
- Anti-Anxiety Agents
- Anticonvulsants
- Serotonin and Noradrenaline Reuptake Inhibitors
- Calcium-Regulating Hormones and Agents
- Calcium Channel Blockers
- Duloxetine Hydrochloride
- Pregabalin
Other Study ID Numbers
- 13084
- F1J-EW-HMGQ (Other Identifier: Eli Lilly and Company)
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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