A clinical trial to study the effects of Ralfinamide in patients with chronic neuropathic low back pain.
- Registration Number
- CTRI/2009/091/000078
- Lead Sponsor
- ewron Pharmaceuticals S.p.A.
- Brief Summary
Not available
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Completed
- Sex
- Not specified
- Target Recruitment
- 0
1.Patient presents in the physical/neurological examination with low back pain with or without radiation into the lower limb that must display a topography compatible with the L1 to S1 territory and/or respective sensory or motoric impairments.
2.Patient must have chronic neuropathic low back pain with a minimum intensity of ?40 mm? (moderate) or greater on the Visual Analogue Scale (VAS; 100-mm) at screening, and an average of ?40 mm? or more at baseline (based on prior 7 days).
3.The onset of pain has occurred at least three months, but not longer than 3 years, prior to the screening visit, as assessed by the investigator in the patient?s medical history.
4.Patient is affected by current neuropathic pain (pain provoked by a lesion of the peripheral nervous system). The diagnosis should be made by a neurologist/anaesthesiologist/pain specialist and based on history, clinical evaluation and/or laboratory findings (rule out systemic cause, e.g., hypothyroidism, rheumatoid arthritis, nephropathy, diabetes [MNSI score >2]) in accordance with the taxonomy of the diagnostic criteria documented in the International Association for the Study of Pain (IASP) Classification of Chronic Pain. A neurological disease must be directly correlated with pain, including pain due to spinal root compression.
If radiologic data supporting the diagnosis had been obtained previously it should be documented in the patient?s records. In case radiologic examinations are not available, the Investigator should consider performing these examinations, if necessary to support the diagnosis, during the screening phase.
5.Patient has one of the following causes of neuropathic low back pain: Non-cancer lumbar pain due to compression radiculopathy or post-traumatic/post-surgical lumbar radiculopathy.
6.Patient?s low back pain has a clear neuropathic component, as indicated by a rating on the Pain Detect Questionnaire (PD-Q) of greater than 18.
7.Patient is 18-85 years of age, inclusive.
8.Patient is willing and able to understand and sign an approved Informed Consent Form.
1.Females who are pregnant or lactating, or of childbearing potential, defined as follows: surgically sterilized for less than one year; aged ≥ 50 years and post-menopausal condition started less than 24 months prior to the screening visit; or aged < 50 years and post-menopausal condition started less than 24 months prior, and/or post-menopausal status has not been confirmed by determination of the serum levels of FSH and 17-β estradiol; or fecund and not practicing double contraception method (e.g., hormonal contraceptive plus barrier method).
2.Patients with any other cause of peripheral or central neuropathic pain (including psychogenic and nociceptive pain), pain due to metabolic (including diabetes; MNSI score > 2) infectious or proliferative diseases, or pain due to any condition that is as severe as the neuropathic pain.
3.Patients with a history of migrating pain and former mononeuropathy or neuralgias in other anatomical territories.
4.Based on medical history or ophthalmological examination, patient has one of the following conditions:
?is albino
?family history of hereditary retinal disease
?progressive and/or severe diminution of visual acuity, i.e. 20/70
?retinitis pigmentosa
?retinal pigmentation due to any cause
?any active retinopathy or ocular inflammation (uveitis),
?severe diabetic retinopathy, or
?moderate proliferative retinopathy.
5.Patients with severe trophic changes, severe swelling, joint deformities or stiff joint with limited passive movement, or patients who may be candidates for back surgery within 52 weeks after baseline.
6.History or current diagnosis of positive test for Hepatitis B or C (unless vaccinated).
7.Clinically significant, uncontrolled gastrointestinal, renal, hepatic, endocrine, pulmonary or cardiovascular disease (including non well-controlled hypertension), asthma, uncompensated chronic obstructive pulmonary disease (COPD), severe uncontrolled diabetes (HbA1c > 10.0).
8.Second- or third-degree atrioventricular block or sick sinus syndrome, uncontrolled atrial fibrillation, severe or unstable angina, congestive heart failure, myocardial infarction within 3 months of the screening visit, significant ECG abnormalities or QTc ≥ 450 msec (males) or ≥ 470 msec (females), where QTc is based on Bazett?s correction method.
9.Concomitant disease likely to interfere with the study drug (e.g. capable of altering absorption, metabolism or elimination of drugs).
10.History of psychosis (e.g. schizophrenia or psychotic depression) or any current DSM-IV Axis I diagnosis including dementia, depression (BDI > 13), psychosis, anxiety disorders, mental retardation, etc.
11.Neoplastic disorder which is either active or has been in remission for less than one year.
12.History or concomitant diagnosis of seizure disorder, or severe dizziness or fainting on standing due to postural hypotension.
13.History of allergic response, hypersensitivity or contraindications to anticonvulsant drugs or MAO-B inhibitors, history of prior drug interactions, or past characterisation as a ?slow metaboliser?.
14.Treatment with potentially hepatotoxic (e.g., tamoxifen), nephrotoxic, or antineoplastic drugs within the past the 6 months, depot neuroleptics in the previous 6 months, or oral neuroleptics in the 30 days prior to randomisation.
15.Patients who participated in prior trials with ralfinamide or received any investigational drug or device within
Study & Design
- Study Type
- Interventional
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method The efficacy of ralfinamide will be based on the mean change from baseline to Week 12 or endpoint (in case of premature termination) on the 11-point Likert categorical scale (daily pain assessment).Timepoint: The efficacy of ralfinamide will be based on the mean change from baseline to Week 12 or endpoint (in case of premature termination) on the 11-point Likert categorical scale (daily pain assessment).
- Secondary Outcome Measures
Name Time Method