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Trial Comparing the Effects of Xyrem (Sodium Oxybate) With Placebo for the Treatment of Fibromyalgia

Primary Purpose

Fibromyalgia

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Xyrem (sodium oxybate) oral solution
Xyrem (sodium oxybate) oral solution
Placebo
Sponsored by
Jazz Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Fibromyalgia focused on measuring Fibromyalgia, Pain

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria Sign & date informed consent Willing & able to complete trial as described in protocol > 18 years of age Meet American College of Rheumatology criteria for Fibromyalgia [Widespread pain for at least 3 months, including all of the following: (1) Pain on right & left sides of body; (2) Pain above & below waist; (3) Pain in axial skeleton; 4) Pain on digital palpation with approximately 4kg force in at least 11 of 18 tender point sites] (Study continuation) Have an average VAS pain score > 4 on a scale of 0 to 10 as recorded in patient diary the last week before Visit 4. Discontinue all prescription medication taken for fibromyalgia, including opiates, benzodiazepines, anticonvulsants taken for pain, antidepressants, cyclobenzaprine (Flexeril), and/or tramadol (Ultram) until study completion Continue all pre-existing nutritional and/or exercise regimens and/or behavioral, massage, acupuncture, physical or cognitive therapies on an unchanged, consistent & regular schedule throughout study Use only acetaminophen or over-the-counter non-steroidal anti-inflammatory drugs as rescue pain medications & to limit dose to the labeled over-the-counter maximum. Aspirin may only be used as a cardiac protectant; formulations with caffeine are excluded. Forego ingestion of alcohol for duration of study. Fertile females must use a medically accepted method of birth control (e.g., barrier method with spermicide, oral contraceptive, or abstinence) for duration of trial. Exclusion Criteria Have any of the following medical conditions: Other rheumatic disease, such as rheumatoid arthritis, osteoarthritis, or systemic lupus erythematosis Uncontrolled hypo- or hyper-thyroidism of any type Unstable cardiovascular, endocrine, neoplastic (excluding localized basal cell carcinoma), gastrointestinal, hematologic, hepatic, immunologic, metabolic, neurological, pulmonary, and/or renal disease which would place patient at risk during trial or compromise objectives outlined in protocol Myocardial infarction within last six months On their screening PSG (polysomnogram) have an Apnea Index greater than 10 per hour or an Apnea Hypopnea Index greater than 15 per hour. Note: patients with sleep apnea are not excluded if their indices are below these thresholds while sleeping with CPAP (Continuous Positive Airway Pressure) and they are compliant with CPAP therapy. Problems that, in the investigator's opinion, would preclude the patient's participation and completion of this trial or compromise reliable representation of subjective symptoms. If a patient will have to discontinue antidepressant medication taken for depression, the investigator must make an evaluation as to any risks from cessation of anti-depressant therapy. If, in the opinion of the investigator, a reasonable risk of resultant patient harm exists, patient is excluded from study participation Current or recent history of substance abuse including alcohol abuse History of seizure disorder, history of head trauma, migraine headaches or intracranial surgery, & are taking anticonvulsants Succinic semialdehyde dehydrogenase deficiency Have taken any of these therapies: gamma-hydroxybutyrate (sodium oxybate) in 30 days prior to signing informed consent any investigational therapy in 30 days prior to signing informed consent ever taken anticonvulsants to treat epilepsy or any other convulsions Unwilling to stop these therapies during course of trial: anticonvulsants prescribed solely for pain all antidepressants medication for sleep Have any of the following clinical laboratory results: Serum creatinine > 2.0 mg/dL TSH (Thyroid Stimulating Hormone) < 0.3 μU/mL OR TSH > 6 μU/mL abnormal liver function tests (SGOT [AST] or SGPT [ALT] more than twice the upper limit of normal) elevated serum bilirubin (more than 1.5 times the upper limit of normal) pre-trial ECG with arrhythmia, greater than a first degree AV block positive pregnancy test at any time during trial Have any of the following socio-economic factors: Pending worker's compensation litigation or related other monetary settlements Have an occupation that requires variable shift work or routine night shifts

Sites / Locations

  • Radiant Research
  • Osteoporosis Medical Center
  • Wallace Rheumatic Study Center
  • Miami Research Associates
  • Radiant Research, Inc.
  • Central Kentucky Research Associates, Inc.
  • LSU Health Sciences Center
  • Richard N. Podell, MD
  • Duke University Medical Center
  • Alvin Daughtridge Arthritis Center
  • C.A.R.E. Center
  • Cleveland Sleep Center
  • Lynn Health Science Institute
  • Oregon Health and Science University
  • Altoona Center for Clinical Research
  • Abigail Rebecca Neiman, MD
  • The University of Texas Health Science Center
  • Stress Medicine Clinic -- HealthSouth Rehabilitation Hospital
  • Pacific Rheumatology Research, Inc.
  • Seattle Rheumatology Associates

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Placebo Comparator

Experimental

Arm Label

2

3

1

Arm Description

Sodium oxybate 6.0 g per day.

Placebo (one of two doses matching active treatment by volume).

Sodium oxybate 4.5 g per day.

Outcomes

Primary Outcome Measures

The Primary Outcome Measure Was a Composite of Changes From Baseline in Three Co-primary Self Report Measures: Pain Visual Analog Scale (PVAS, Electronic Diaries), Fibromyalgia Impact Questionnaire (FIQ), and Patient Global Impression of Change (PGI-C).
The percentage of participants who met all 3 of the following criteria: Reduction of >=20% from baseline to week 8 in both PVAS & FIQ total score and PGI-C response of "very much better" or "much better". Analysis was based on LOCF (Last Observation Carried Forward) data. The PVAS ranges from 0 (no pain) to 100 (worst imaginable pain). The FIQ ranges from 0 (best function) to 100 (worst function). PGI-C is a 7 point likert scale measuring change in the participant's fibromyalgia symptoms that ranges from "very much worse" to "very much better"

Secondary Outcome Measures

Full Information

First Posted
July 12, 2004
Last Updated
January 20, 2012
Sponsor
Jazz Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00087555
Brief Title
Trial Comparing the Effects of Xyrem (Sodium Oxybate) With Placebo for the Treatment of Fibromyalgia
Official Title
Randomized, Double-Blind, Placebo-Controlled, Parallel-Group, Multi-Center Trial Comparing the Effects of Orally Administered Xyrem(R) (Sodium Oxybate) With Placebo for the Treatment of Fibromyalgia
Study Type
Interventional

2. Study Status

Record Verification Date
January 2012
Overall Recruitment Status
Completed
Study Start Date
July 2004 (undefined)
Primary Completion Date
April 2005 (Actual)
Study Completion Date
January 2006 (Actual)

3. Sponsor/Collaborators

Name of the Sponsor
Jazz Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine whether Xyrem (sodium oxybate) is effective when used alone to treat the pain and sleep disturbances of fibromyalgia.
Detailed Description
Fibromyalgia affects millions of Americans, yet there are no FDA approved drugs to treat this debilitating condition. Besides causing pain, it also disrupts normal sleep patterns in many of its victims. Pain and lack of sleep reinforce each other, making patients progressively more miserable. Xyrem is a potent hypnotic that induces and consolidates sleep. In a few small studies Xyrem has been reported to offer relief to some fibromyalgia patients. This trial is designed to test this hypothesis. Patients who enroll in this study will stop taking any prescription medications for fibromyalgia (over-the-counter pain relievers will be permitted). They will then take either Xyrem alone or placebo alone. Patients will be followed for eight weeks to evaluate any relief of the pain or functional impairment of fibromyalgia from their study treatment. Sleep characteristics will also be assessed subjectively and by polysomnographic recordings at baseline and twice during the treatment phase.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Fibromyalgia
Keywords
Fibromyalgia, Pain

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
195 (Actual)

8. Arms, Groups, and Interventions

Arm Title
2
Arm Type
Experimental
Arm Description
Sodium oxybate 6.0 g per day.
Arm Title
3
Arm Type
Placebo Comparator
Arm Description
Placebo (one of two doses matching active treatment by volume).
Arm Title
1
Arm Type
Experimental
Arm Description
Sodium oxybate 4.5 g per day.
Intervention Type
Drug
Intervention Name(s)
Xyrem (sodium oxybate) oral solution
Intervention Description
Xyrem (sodium oxybate) oral solution 4.5 g per day in divided doses, 2.25 g at bedtime and another 2.5 g two and a half to four hours later for 8 weeks.
Intervention Type
Drug
Intervention Name(s)
Xyrem (sodium oxybate) oral solution
Intervention Description
Xyrem (sodium oxybate) oral solution 6.0 g per night in divided doses of 3 g at bedtime and 3 g at 2.5 to 4 hours later for 8 weeks.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Placebo one of two doses matching active treatment by volume for 8 weeks.
Primary Outcome Measure Information:
Title
The Primary Outcome Measure Was a Composite of Changes From Baseline in Three Co-primary Self Report Measures: Pain Visual Analog Scale (PVAS, Electronic Diaries), Fibromyalgia Impact Questionnaire (FIQ), and Patient Global Impression of Change (PGI-C).
Description
The percentage of participants who met all 3 of the following criteria: Reduction of >=20% from baseline to week 8 in both PVAS & FIQ total score and PGI-C response of "very much better" or "much better". Analysis was based on LOCF (Last Observation Carried Forward) data. The PVAS ranges from 0 (no pain) to 100 (worst imaginable pain). The FIQ ranges from 0 (best function) to 100 (worst function). PGI-C is a 7 point likert scale measuring change in the participant's fibromyalgia symptoms that ranges from "very much worse" to "very much better"
Time Frame
Baseline to week 8

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Sign & date informed consent Willing & able to complete trial as described in protocol > 18 years of age Meet American College of Rheumatology criteria for Fibromyalgia [Widespread pain for at least 3 months, including all of the following: (1) Pain on right & left sides of body; (2) Pain above & below waist; (3) Pain in axial skeleton; 4) Pain on digital palpation with approximately 4kg force in at least 11 of 18 tender point sites] (Study continuation) Have an average VAS pain score > 4 on a scale of 0 to 10 as recorded in patient diary the last week before Visit 4. Discontinue all prescription medication taken for fibromyalgia, including opiates, benzodiazepines, anticonvulsants taken for pain, antidepressants, cyclobenzaprine (Flexeril), and/or tramadol (Ultram) until study completion Continue all pre-existing nutritional and/or exercise regimens and/or behavioral, massage, acupuncture, physical or cognitive therapies on an unchanged, consistent & regular schedule throughout study Use only acetaminophen or over-the-counter non-steroidal anti-inflammatory drugs as rescue pain medications & to limit dose to the labeled over-the-counter maximum. Aspirin may only be used as a cardiac protectant; formulations with caffeine are excluded. Forego ingestion of alcohol for duration of study. Fertile females must use a medically accepted method of birth control (e.g., barrier method with spermicide, oral contraceptive, or abstinence) for duration of trial. Exclusion Criteria Have any of the following medical conditions: Other rheumatic disease, such as rheumatoid arthritis, osteoarthritis, or systemic lupus erythematosis Uncontrolled hypo- or hyper-thyroidism of any type Unstable cardiovascular, endocrine, neoplastic (excluding localized basal cell carcinoma), gastrointestinal, hematologic, hepatic, immunologic, metabolic, neurological, pulmonary, and/or renal disease which would place patient at risk during trial or compromise objectives outlined in protocol Myocardial infarction within last six months On their screening PSG (polysomnogram) have an Apnea Index greater than 10 per hour or an Apnea Hypopnea Index greater than 15 per hour. Note: patients with sleep apnea are not excluded if their indices are below these thresholds while sleeping with CPAP (Continuous Positive Airway Pressure) and they are compliant with CPAP therapy. Problems that, in the investigator's opinion, would preclude the patient's participation and completion of this trial or compromise reliable representation of subjective symptoms. If a patient will have to discontinue antidepressant medication taken for depression, the investigator must make an evaluation as to any risks from cessation of anti-depressant therapy. If, in the opinion of the investigator, a reasonable risk of resultant patient harm exists, patient is excluded from study participation Current or recent history of substance abuse including alcohol abuse History of seizure disorder, history of head trauma, migraine headaches or intracranial surgery, & are taking anticonvulsants Succinic semialdehyde dehydrogenase deficiency Have taken any of these therapies: gamma-hydroxybutyrate (sodium oxybate) in 30 days prior to signing informed consent any investigational therapy in 30 days prior to signing informed consent ever taken anticonvulsants to treat epilepsy or any other convulsions Unwilling to stop these therapies during course of trial: anticonvulsants prescribed solely for pain all antidepressants medication for sleep Have any of the following clinical laboratory results: Serum creatinine > 2.0 mg/dL TSH (Thyroid Stimulating Hormone) < 0.3 μU/mL OR TSH > 6 μU/mL abnormal liver function tests (SGOT [AST] or SGPT [ALT] more than twice the upper limit of normal) elevated serum bilirubin (more than 1.5 times the upper limit of normal) pre-trial ECG with arrhythmia, greater than a first degree AV block positive pregnancy test at any time during trial Have any of the following socio-economic factors: Pending worker's compensation litigation or related other monetary settlements Have an occupation that requires variable shift work or routine night shifts
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Yanping Zheng, MD
Organizational Affiliation
Jazz Pharmaceuticals, Inc
Official's Role
Study Director
Facility Information:
Facility Name
Radiant Research
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85251
Country
United States
Facility Name
Osteoporosis Medical Center
City
Beverly Hills
State/Province
California
ZIP/Postal Code
90211
Country
United States
Facility Name
Wallace Rheumatic Study Center
City
Los Angeles
State/Province
California
ZIP/Postal Code
90048
Country
United States
Facility Name
Miami Research Associates
City
Miami
State/Province
Florida
ZIP/Postal Code
33173
Country
United States
Facility Name
Radiant Research, Inc.
City
West Palm Beach
State/Province
Florida
ZIP/Postal Code
33407
Country
United States
Facility Name
Central Kentucky Research Associates, Inc.
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40509
Country
United States
Facility Name
LSU Health Sciences Center
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71130-3932
Country
United States
Facility Name
Richard N. Podell, MD
City
Springfield
State/Province
New Jersey
ZIP/Postal Code
07081
Country
United States
Facility Name
Duke University Medical Center
City
Durham
State/Province
North Carolina
ZIP/Postal Code
27710
Country
United States
Facility Name
Alvin Daughtridge Arthritis Center
City
Lenoir
State/Province
North Carolina
ZIP/Postal Code
28645
Country
United States
Facility Name
C.A.R.E. Center
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27609
Country
United States
Facility Name
Cleveland Sleep Center
City
Middlebrook Heights
State/Province
Ohio
ZIP/Postal Code
44130
Country
United States
Facility Name
Lynn Health Science Institute
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73112
Country
United States
Facility Name
Oregon Health and Science University
City
Portland
State/Province
Oregon
ZIP/Postal Code
97239
Country
United States
Facility Name
Altoona Center for Clinical Research
City
Duncansville
State/Province
Pennsylvania
ZIP/Postal Code
16635
Country
United States
Facility Name
Abigail Rebecca Neiman, MD
City
Katy
State/Province
Texas
ZIP/Postal Code
77450
Country
United States
Facility Name
The University of Texas Health Science Center
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Stress Medicine Clinic -- HealthSouth Rehabilitation Hospital
City
Sandy
State/Province
Utah
ZIP/Postal Code
84094
Country
United States
Facility Name
Pacific Rheumatology Research, Inc.
City
Renton
State/Province
Washington
ZIP/Postal Code
98055
Country
United States
Facility Name
Seattle Rheumatology Associates
City
Seattle
State/Province
Washington
ZIP/Postal Code
98104
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
11833860
Citation
A randomized, double blind, placebo-controlled multicenter trial comparing the effects of three doses of orally administered sodium oxybate with placebo for the treatment of narcolepsy. Sleep. 2002 Feb 1;25(1):42-9.
Results Reference
background
PubMed Identifier
12627729
Citation
A 12-month, open-label, multicenter extension trial of orally administered sodium oxybate for the treatment of narcolepsy. Sleep. 2003 Feb 1;26(1):31-5.
Results Reference
background
PubMed Identifier
15033130
Citation
U.S. Xyrem Multicenter Study Group. Sodium oxybate demonstrates long-term efficacy for the treatment of cataplexy in patients with narcolepsy. Sleep Med. 2004 Mar;5(2):119-23. doi: 10.1016/j.sleep.2003.11.002.
Results Reference
background
PubMed Identifier
12733850
Citation
The abrupt cessation of therapeutically administered sodium oxybate (GHB) does not cause withdrawal symptoms. J Toxicol Clin Toxicol. 2003;41(2):131-5. doi: 10.1081/clt-120019128.
Results Reference
background
PubMed Identifier
12734908
Citation
Scharf MB, Baumann M, Berkowitz DV. The effects of sodium oxybate on clinical symptoms and sleep patterns in patients with fibromyalgia. J Rheumatol. 2003 May;30(5):1070-4.
Results Reference
background
PubMed Identifier
19116896
Citation
Russell IJ, Perkins AT, Michalek JE; Oxybate SXB-26 Fibromyalgia Syndrome Study Group. Sodium oxybate relieves pain and improves function in fibromyalgia syndrome: a randomized, double-blind, placebo-controlled, multicenter clinical trial. Arthritis Rheum. 2009 Jan;60(1):299-309. doi: 10.1002/art.24142.
Results Reference
background

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Trial Comparing the Effects of Xyrem (Sodium Oxybate) With Placebo for the Treatment of Fibromyalgia

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