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Efficacy and Safety of Topical Versus Systemic Treatment in Postherpetic Neuralgia and Diabetic Polyneuropathic Pain

Phase 3
Completed
Conditions
Neuropathic Pain
Interventions
Drug: Topical analgesic
Drug: oral intake
Registration Number
NCT00414349
Lead Sponsor
Grünenthal GmbH
Brief Summary

The purpose of this study is to evaluate lidocaine as topical treatment for peripheral neuropathic pain (as stand-alone treatment and in combination with systemic treatment)

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
431
Inclusion Criteria
  • Male or female subjects with >= 18 years of age
  • Intact skin in the area of topical treatment
  • Creatinine clearance CLCR >= 30 mL/min
  • NRS-3 > 4 (recalled average pain intensity during the last 3 days)

Subjects with DPN

  • Controlled, treated type 1 or 2 diabetes mellitus with glycosylated hemoglobin (Hba1c)<= 11%
  • Painful, distal symmetrical, sensomotor polyneuropathy of the lower extremities for >= 3 months (below the knees on both extremities) with at least 2 of the following symptoms present: burning, sensation, tingling or prickling, numbness from time to time, painful heat or cold sensation (e.g. warm or cold water)

Subjects with PHN

  • Subjects with PHN and neuropathic pain present for >= 3 months after healing of the herpes zoster skin rash.
  • Without neurolytic neurosurgical therapy for their condition.
Exclusion Criteria

General

  • Evidence or history of alcohol, medication or drug abuse and/or dependency in the past 2 years, unstable psychological personality requiring intermittent or permanent treatment.
  • Psychiatric illness (subjects with well-controlled depression or anxiety disorder may participate if they are not taking any of the prohibited medications defined (below), epilepsy or suicide risk.
  • Pregnant or breastfeeding women
  • Women of childbearing potential who are sexually active without satisfactory contraception for at least 28 days prior to enrollment, during the trial, and until 28 days after the follow-up visit.
  • Subjects with severe cardiac impairment e.g. NYHA class > 3, myocardial infarction less than 6 months prior to enrollment, and/or unstable angina pectoris.
  • Subjects with severe hepatic disorder and/or AST or ALT >= 3x the upper limit of normal.
  • Subjects with known or suspected severe renal failure (CLCR < 30 mL/min).
  • Anticipated need for surgery during the trial, requiring at least regional or general anesthesia.
  • Subjects who are undergoing active treatment for cancer, are known to be infected with HIV or being acutely and intensively immunosuppressed following transplantation.
  • Participation in another trial of investigational medicinal products or devices parallel to or less than 1 month before entry into the trial, or previous participation in this trial.

Trial specific:

  • Any concomitant use of drugs for the treatment of neuropathic pain or commonly used for the treatment of neuropathic pain.
  • Use of transcutaneous electrical nerve stimulations (TENS) after enrollment.
  • CLCR < 30 mL/min
  • Evidence of another cause for pain in the area of neuropathic pain such as lumbar radiculopathy, surgery trauma, restless legs syndrome, if this coud confound the assessment or self-evaluation of the neuropathic pain.
  • Presence of other severe pain that could confound the assessment or self-evaluation of the neuropathic pain.
  • History of malignancy within the past 5 years (with the exception of basal cell carcinoma).

Subjects with PHN

  • Active herpes zoster lesion or dermatitis of any origin at the affected site with PHN.
  • Subjects who had neurological ablation by block or neurosurgical intervention for control of pain in PHN.

Subjects with DPN

  • No palpable pulse of the arteria dorsalis pedis in both feet.
  • Clinical signs for venous insufficiency and/or postthrombotic syndrome Sage III/IV (i.e. extensive varicoses)
  • Ulcers on the lower extremities.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
1Topical analgesic-
2oral intake-
3Topical analgesic-
Primary Outcome Measures
NameTimeMethod
Reduction of pain expressed by response rate after 4 weeks treatment every 4 weeks of single or combination treatment: change in neuropathic pain, change in quality of life, change in sleep quality4 weeks
Secondary Outcome Measures
NameTimeMethod
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