A Randomised, Double Blind Study to Evaluate the Safety and Efficacy of the p38 Kinase Inhibitor, GW856553, in Subjects With Neuropathic Pain From Lumbosacral Radiculopathy

GlaxoSmithKline1 site in 1 country142 target enrollmentJanuary 7, 2010

ConditionsPain, Neuropathic

InterventionsGS856553 Placebo

DrugsPlacebo GS856553

Overview

Phase: Phase 2
Intervention: GS856553
Conditions: Pain, Neuropathic
Sponsor: GlaxoSmithKline
Enrollment: 142
Locations: 1
Primary Endpoint: Change in average daily neuropathic pain score from Baseline up to Week 5 (Week 4 of double blind treatment) of treatment
Status: Completed
Last Updated: 8 years ago

Overview Investigators Eligibility Criteria Arms & Interventions Outcomes Sites Similar Trials

Overview

Brief Summary

This study will be a double-blind, placebo-controlled, parallel group study. After enrolment and initial assessments, subjects will receive 35 days of study medication. During this treatment period, they will be randomised to either oral GW856553 7.5mg BID or matching placebo in a 1:1 ratio. Sufficient numbers of subjects will be recruited to obtain 128 evaluable subjects.

Detailed Description

This is a double-blind, randomised, placebo-controlled, parallel group study. Subjects will undertake a screening period which may last up to approximately 3 weeks, followed by a baseline period of 1 week, a randomised treatment period of 5 weeks and a follow-up period of approximately 2 weeks. This is a multi-centre, double-blind, randomised, placebo-controlled study in subjects who have at least moderate intensity of neuropathic pain resulting from lumbosacral radiculipathy. It will investigate the efficacy, safety and tolerability of GW856553. Approximately 142 subjects will be randomised to ensure 128 evaluable subjects. Randomisation ratio will be 1:1 for placebo or GW856553 respectively. The dose of GW856553 will be 7.5 mg BID.

Registry

clinicaltrials.gov

Start Date

January 7, 2010

End Date

August 23, 2010

Last Updated

8 years ago

Study Type

Interventional

Study Design

Parallel

Sex

All

Investigators

Sponsor

GlaxoSmithKline

Responsible Party

Sponsor

Eligibility Criteria

Inclusion Criteria

•Male or female subjects aged 18 - 80 years inclusive, at the time of signing the informed consent.
•A female subject is eligible to participate if she is of:
•Non-childbearing potential defined as pre-menopausal females with a documented tubal ligation or hysterectomy; or postmenopausal defined as 12 months of spontaneous amenorrhea Child-bearing potential and agrees to use one of the contraception methods listed in the protocol for an appropriate period of time (as determined by the product label or investigator) prior to the start of dosing to sufficiently minimize the risk of pregnancy at that point. Female subjects must agree to use contraception until 14 days after the last dose of study medication. Male subjects must agree to use the contraception methods listed in the protocol
•A diagnosis of neuropathic pain due to lumbosacral radiculopathy with the following characteristics:
•Pain perceived in one or both lower limbs at sites consistent with the area innervated by the L4, L5 or S1 nerve roots, with or without other sensory symptoms in the affected areas; (typically, the pain may be perceived in the buttock, thigh, calf, leg, foot or toes).
•History of the pain suggestive that the cause of lumbosacral radiculopathy is due to injury of the lumbosacral nerve root(s) by degenerative disease of the vertebrae in the lumbosacral spine or associated soft tissues including the intervertebral discs, or secondary to spinal injury and not due to infection/abscess, haematoma or malignancy.
•Duration of pain should be at least 12 weeks since onset.
•Intensity of pain should be stable for the 2 weeks prior to Screening, based on clinical history.
•As part of the neurological examination, the investigator must also conduct the procedures specified in the Standardised Evaluation of Pain \[Neuropathic Pain\] (StEP) instrument \[Scholz, 2009\]2, and to calculate the total score. In the clinical opinion of the investigator, the diagnosis of lumbosacral radiculopathy should be supported by at least one of the following features at Screening or documented in the medical notes in relation to the current symptoms:
•Pain/sensory disturbance in dermatomal/myotomal distribution precipitated or exacerbated by straight leg raising (the straight leg raising test should be performed as specified in StEP; Neurological examination of lower limbs shows impaired muscle power, sensory function or deep tendon reflexes in the territory of the affected nerve roots; The total StEP score is greater than 4 (indicative of lumbosacral radiculopathy as the cause of the pain); Electromyographic (EMG) evidence of denervation in muscles innervated by the affected nerve roots; Quantitative sensory tests (QST) showing evidence of altered sensory thresholds in dermatomes innerved by the affected nerve roots;

Exclusion Criteria

•Subjects who, in the opinion of the Investigator, are unable to reliably delineate or assess their own pain by anatomical location/distribution (e.g. can the subject reliably tell the difference between their back pain and their lower limb pain and rate their intensity separately ?).
•Subjects with lumbar canal stenosis in which the pain in the lower limbs occur solely on walking and not at rest.
•Subjects with causes for their neuropathic pain other than that specified in the inclusion criteria \[e.g. post-herpetic neuralgia, painful diabetic neuropathy, mononeuritis multiplex, central post-stroke pain, failed back surgery in relation to the presenting episode of radiculopathy, spinal abscess/infection/haematoma/malignancy, phantom limb pain, peripheral neuropathy due to alcoholism, malignancy, HIV, syphilis, drug abuse, vitamin B12 deficiency, hypothyroidism, liver disease, toxic exposure\], pain associated with a substantial somatic pain component \[e.g.non-neuropathic / musculoskeletal pain in lower limbs or other parts of the body apart from the back\] or more than one cause or potential cause for pain symptoms or any concurrent rheumatic disease such as but not limited to fibromyalgia, rheumatoid arthritis or significant osteoarthritis. Any question regarding the acceptability of aetiology of the neuropathic pain should be discussed with the GSK medical monitor.
•A positive pre-study drug/alcohol screen.
•A positive test for HIV antibody or positive history of HIV.
•A positive pre-study Hepatitis B surface antigen or positive Hepatitis C antibody result within 3 months of screening
•History of any liver disease within the last 6 months \[with the exception of known Gilbert's disease\].
•History of excessive regular alcohol consumption within 6 months of the study.
•History or presence of significant cardiovascular, gastro-intestinal, or renal disease or other condition known to interfere with the absorption, distribution, metabolism, or excretion of drugs which, in the opinion of the Investigator may interfere with the study procedures or compromise subject safety.
•History or presence of any clinically significant abnormality in vital signs / ECG / laboratory tests, or have any medical or psychiatric condition, which, in the opinion of the Investigator, may interfere with the study procedures or compromise subject safety.

Arms & Interventions

Active

GW856553

Intervention: GS856553

Placebo

Intervention: Placebo

Outcomes

Primary Outcomes

Change in average daily neuropathic pain score from Baseline up to Week 5 (Week 4 of double blind treatment) of treatment

Time Frame: Baseline (Day -7 to Day -1) and up to 5 weeks

The scores were analyzed based on the 11 point Pain Intensity Numerical Rating Scale (PI-NRS) with 0 score indicating no pain and score of 10 indicating maximum pain. The adjusted mean values are represented as least square mean (LS mean) values.

Secondary Outcomes

Change in pain quality on the Short-Form McGill Pain Questionnaire (SF-MPQ) from Baseline up to 5 weeks.(Baseline (Day -7 to Day -1) and up to 5 weeks)
Change in average daily pain intensity rating score (PI-NRS) from Baseline (Day -7 to Day -1) to 5 Weeks(Baseline (Day -7 to Day -1) and up to 5 weeks)
Number of participants with intensities of pain by SF-MPQ method over 5 weeks(From Baseline (Day -7 to Day -1) up to 5 weeks)
Change in Galer Neuropathic Pain Scale score from Baseline up to Week 5(Baseline (Day -7 to Day -1) and up to 5 weeks)
Percentage of participants with more than or equal to (>=) 30% and >=50% reduction in average daily pain score relative to baseline up to 5 weeks(Baseline (Day -7 to Day -1) and up to 5 weeks)
Percentage of participants who improved, much improved or very much improved relative to Baseline on the Patient Global Impression of Change (PGIC) and Clinical Global Impression of Change (CGIC) over 5 weeks(Baseline (Day -7 to Day -1) and up to 5 weeks)
Change in the score of the Oswestry Disability Index (ODI) from Baseline (Day -7 to Day -1) up to 5 weeks(Baseline (Day -7 to Day -1) and up to 5 weeks)
Average total daily dose of rescue medication over 5 weeks(Up to 5 weeks)
Change in total Profile of Mood States (POMS) score and POMS domains scores from Baseline to Weeks 3 and 5 of treatment(Baseline, Week 3 (Day 21), and Week 5 (Day 35))
Change in Sleep Interference Scale (SIS) from Baseline over 5 weeks(Baseline (Day -7 to Day -1) and up to 5 weeks)
Change from Baseline (Day -7 to Day -1) in SF-36 Health over period(Baseline (Day -7 to Day -1) and Week 4)
Change in time to complete timed walk (20 m) from Baseline up to 5 weeks(Baseline (Day -7 to Day -1) and Week 4)
Change in walking-associated pain during timed walk from Baseline up to 5 weeks(Baseline and Week 4)
Number of participants with death, adverse events (AEs) and serious adverse events (SAEs)(Up to 5 weeks)
Number of participants with vital signs outside the range of Potential Clinical Importance (PCI)(Up to 5 weeks)
Number of participants with abnormal electrocardiogram (ECG) findings over period(Up to 5 weeks)
Number of participants with abnormal clinical chemistry, hematology, and urinalysis parameters over period(From Baseline up to 5 weeks)