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Pregabalin in CIPN

25 avril 2019 mis à jour par: simon.haroutounian, Washington University School of Medicine

Investigation of Somatosensory Predictors of Response to Pregabalin in Painful Chemotherapy-induced Peripheral Neuropathy (CIPN)

The investigators seek to investigate certain patient characteristics that would predict the response to a currently approved analgesic, pregabalin, in patients with chronic pain due to nerve damage caused by chemotherapy. Patients with this painful condition, called chemotherapy-induced peripheral neuropathy (CIPN) have a current or recent history of chemotherapy with particular chemotherapy agents called taxanes or oxaliplatin. The investigators will recruit potential subjects from both the Siteman Cancer Center and the Washington University Pain Management Center. Those patients who meet the inclusion and satisfy the exclusion criteria will be enrolled. Subjects will undergo mechanical and thermal sensitivity testing on their extremities, will provide quality of life information by completing questionnaires and will receive pregabalin followed by placebo, or placebo followed by pregabalin [crossover design] in order to assess how well the sensory tests predict the analgesic effect of pregabalin (compared to placebo).

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Type d'étude

Interventionnel

Inscription (Réel)

26

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • États-Unis
    • Missouri
      • Saint Louis, Missouri, États-Unis, 63110
        • Washington University School of Medicine/Barnes Jewish Hospital

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  1. Age >18
  2. Distal symmetric pain distribution (both feet, with or without pain in hands).
  3. The pain appeared during or up to 12 weeks after treatment with oxaliplatin, paclitaxel, docetaxel or any combination of these.
  4. Score of 4 or more on DN4 (Douleur Neuropathique 4) neuropathic pain questionnaire
  5. Pain duration > 2 months.
  6. Patient report of average daily pain intensity in the last week >3 on 0-10 Numerical Rating Scale (NRS).
  7. Women of childbearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control, abstinence) prior to study entry and for the duration of study participation.
  8. Able and willing to sign an IRB-approved written informed consent.

Exclusion Criteria:

  1. Hypersensitivity to pregabalin.
  2. Current treatment with pregabalin.
  3. Current treatment with a vinca alkaloid (e.g. vincristine, vinblastine), or CIPN that may be associated with previous treatment with a vinca alkaloid.
  4. History of diabetes mellitus or a neurological disorder with any previous signs of distal symmetric polyneuropathy.
  5. Moderate to severe renal failure (Creatinine clearance < 30mL/min, by Cockcroft-Gault formula).
  6. ALT (alanine aminotransferase) or AST (aspartate aminotransferase ) > 3 times the upper limit of normal.
  7. Planned surgeries or radiation treatment within 10 weeks following study inclusion.
  8. Inability to complete pain self-report.
  9. Pregnancy or lactation
  10. Patients with seizure disorders treated with anticonvulsants
  11. Current participation in a trial with another investigational agent.

  12. Concomitant medication as follows:

    • Subjects treated with gabapentin or other anticonvulsant for neuropathic pain will be required to taper the medication and discontinue for at least 2 weeks prior to study initiation.
    • Patients on antidepressant treatment for pain or depression (TCAs, SSRI, SNRIs etc. will be allowed to continue their medications provided they have been on a stable dose for at least 4 weeks before study initiation. No dose regimen changes of antidepressants will be allowed during the study period.
    • Patients on around-the clock opioid treatment (including tramadol) will be allowed to continue their medication provided they have been on a stable dose for at least 4 weeks before study initiation. The maximum allowed dose of opioid will be equivalent to 60mg oral morphine sulphate. Patients with higher doses will be required to taper down their opioid dose to maximum 60mg oral morphine equivalent, and continue on stable dose for 4 weeks before enrollment in the study. Short-acting opioids for painful CIPN treatment will not be allowed.
    • Treatment with non-steroidal anti-inflammatory drugs (NSAIDs) will be discontinued at least 2 weeks before study initiation. However, low-dose aspirin (≤325mg/day) will be allowed.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Autre
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation croisée
  • Masquage: Double

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: Pregabalin
Pregabalin administered for 4 weeks, titrated to highest tolerated dose up to 600 mg/day.
Médicament: Pregabalin
Anticonvulsant
Autres noms:
  • Lyrique
Médicament: Placebo
Identical, matching inactive substance
Comparateur placebo: Placebo
Identical, matching inactive substance administered for 4 weeks following the same dosing regimen.
Médicament: Pregabalin
Anticonvulsant
Autres noms:
  • Lyrique
Médicament: Placebo
Identical, matching inactive substance

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Change in Spontaneous Pain Intensity as a Function of Baseline MPT
Délai: Baseline to week 4
Correlation between Mechanical Pain Threshold (MPT in mN) at baseline and reduction in spontaneous pain intensity (% reduction on 0-10 NRS) at the end of 4-week treatment. The slopes (Pearson coefficients) of the correlation obtained from pregabalin vs. placebo will be compared.
Baseline to week 4

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Absolute Change in Pain Intensity, Measured on 0-10 Numerical Rating Scale (NRS)
Délai: Baseline to week 4
Absolute change in pain intensity on 0-10 numerical rating scale (NRS) from baseline to 4 weeks with pregabalin vs. placebo NRS: 0= no pain, 10= worst pain
Baseline to week 4
Change in NPSI Outcomes
Délai: Baseline to week 4
Change from baseline to week 4 in total NPSI (Neuropathic Pain Symptom Inventory) score The total NPSI score is comprised by adding 5 sub-scores (Burning pain, Pressing pain, Paroxysmal pain, Evoked pain, and Paresthesia/Dysesthesia) and is expressed on a 0-100 scale; 0-minimum (least), and 100 maximum (worst) score
Baseline to week 4
Change in BPI Outcomes (SEVERITY)
Délai: Baseline to week 4
Change from baseline to week 4 in BPI (Brief Pain Inventory) pain severity severity score BPI severity score is expressed on 0-10 scale, with 0 being the minimum (least), and 10 being the maximum (worst) pain severity
Baseline to week 4
Change in Sleep Problem Index (SPI) Outcomes
Délai: Baseline to week 4
Change from baseline to week 4 in SPI (Sleep Problem Index) score, on 0-100 scale, where 0= best (least) score, and 100= maximum (worst) score
Baseline to week 4
Change in BPI Outcomes (INTERFERENCE)
Délai: baseline to week 4
Change from baseline to week 4 in BPI (Brief Pain Inventory) pain interference score BPI interference score is expressed on 0-10 scale, with 0 being the minimum (least), and 10 being the maximum (worst) pain interference
baseline to week 4
Number of Patients With Significant Pain Reduction
Délai: Baseline to week 4
Number of patients who experienced 50% or more reduction in average daily pain (on 0-10 NRS, Numerical Rating Scale, where 0=least pain, 10=worst pain)
Baseline to week 4

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Washington University School of Medicine

Les enquêteurs

  • Chercheur principal: Simon Haroutounian, PhD, Washington University School of Medicine

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude

1 avril 2015

Achèvement primaire (Réel)

2 avril 2018

Achèvement de l'étude (Réel)

2 avril 2018

Dates d'inscription aux études

Première soumission

4 mars 2015

Première soumission répondant aux critères de contrôle qualité

16 mars 2015

Première publication (Estimation)

20 mars 2015

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

14 mai 2019

Dernière mise à jour soumise répondant aux critères de contrôle qualité

25 avril 2019

Dernière vérification

1 avril 2019

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • 201501067

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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