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Pregabalin in CIPN

25. april 2019 oppdatert av: 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).

Studieoversikt

Status

Fullført

Forhold

Intervensjon / Behandling

Studietype

Intervensjonell

Registrering (Faktiske)

26

Fase

  • Ikke aktuelt

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Forente stater
    • Missouri
      • Saint Louis, Missouri, Forente stater, 63110
        • Washington University School of Medicine/Barnes Jewish Hospital

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

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.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Annen
  • Tildeling: Randomisert
  • Intervensjonsmodell: Crossover-oppdrag
  • Masking: Dobbelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Pregabalin
Pregabalin administered for 4 weeks, titrated to highest tolerated dose up to 600 mg/day.
Legemiddel: Pregabalin
Anticonvulsant
Andre navn:
  • Lyrica
Legemiddel: Placebo
Identical, matching inactive substance
Placebo komparator: Placebo
Identical, matching inactive substance administered for 4 weeks following the same dosing regimen.
Legemiddel: Pregabalin
Anticonvulsant
Andre navn:
  • Lyrica
Legemiddel: Placebo
Identical, matching inactive substance

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change in Spontaneous Pain Intensity as a Function of Baseline MPT
Tidsramme: 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

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Absolute Change in Pain Intensity, Measured on 0-10 Numerical Rating Scale (NRS)
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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)
Tidsramme: 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
Tidsramme: 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

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

Washington University School of Medicine

Etterforskere

  • Hovedetterforsker: Simon Haroutounian, PhD, Washington University School of Medicine

Studierekorddatoer

Disse datoene sporer fremdriften for innsending av studieposter og sammendragsresultater til ClinicalTrials.gov. Studieposter og rapporterte resultater gjennomgås av National Library of Medicine (NLM) for å sikre at de oppfyller spesifikke kvalitetskontrollstandarder før de legges ut på det offentlige nettstedet.

Studer hoveddatoer

Studiestart

1. april 2015

Primær fullføring (Faktiske)

2. april 2018

Studiet fullført (Faktiske)

2. april 2018

Datoer for studieregistrering

Først innsendt

4. mars 2015

Først innsendt som oppfylte QC-kriteriene

16. mars 2015

Først lagt ut (Anslag)

20. mars 2015

Oppdateringer av studieposter

Sist oppdatering lagt ut (Faktiske)

14. mai 2019

Siste oppdatering sendt inn som oppfylte QC-kriteriene

25. april 2019

Sist bekreftet

1. april 2019

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 201501067

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