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Nonivamide/Nicoboxil Ointment in Acute Low Back Pain

Primary Purpose

Acute Low Back Pain

Status
Completed
Phase
Phase 3
Locations
Germany
Study Type
Interventional
Intervention
nicoboxil
placebo matching nonivamide + nicoboxil
nonivamide + nicoboxil (Finalgon)
nonivamide
Sponsored by
Boehringer Ingelheim
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Low Back Pain

Eligibility Criteria

18 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion criteria:

  • Patients must sign and date an Informed Consent consistent with International Conference on Hermonisation (ICH)/Good Clinical Practice (GCP) guidelines and local regulation prior to participation in the trial.
  • Patients must agree to cooperate with all trial evaluations and perform all required tasks.
  • Acute low back pain for more than 2 days and less than 21 days (= 3 weeks)
  • Male or female patients aged 18 to 65 years
  • Low back pain rating >5 on a 0-10 numerical rating scale (NRS).
  • Female patients of childbearing potential may participate only in case of availability of a negative urine pregnancy test and a confirmed menstrual period prior to study entry and using a highly effective method of birth control. Highly effective methods of birth control are defined as those which result in a low failure rate (i.e. less than 1 % per year) when used consistently and correctly such as implants, injectables, combined oral contraceptives, appropriate intrauterine devices, sexual abstinence or vasectomised partner. Barrier methods of contraception (e.g. condom, diaphragma or occlusive cap) are accepted if used in combination with spermicides (e.g. foam, gel). Female patients will be considered being of childbearing potential unless surgically sterilised by bilateral tubal ligation/salpingectomy or hysterectomy or post-menopausal for at least one year.

Exclusion criteria:

  • Multilocular pain or panalgesia
  • History of more than three low back pain episodes in the last six months
  • Abnormal findings in at least one of the following assessments: Achilles tendon reflex, patella reflex, heel walking, toe walking, cutaneous sensitivity of the legs (including gluteal region), paresis tests in supine position upon dorsiflexion, plantarflexion, hip flexion, knee extension
  • Bladder and/or rectum dysfunction
  • Acute low back pain due to vertebral collapse or neoplastic, inflammatory (ankylosing spondylitis), traumatic, or infective origins
  • Any condition, disease or concomitant treatment that in the judgement of the Investigator will affect the subject's ability to participate in the clinical trial or which will influence the test methodology used
  • Negative experience in the past with heat treatment for muscle complaints (e. g. hot water bottle, heat pads, hyperemisation-inducing topical creams, ointments or patches)
  • History of treatment of back pain with centrally acting analgesics (e. g. opioids) and muscle relaxants
  • Surgery due to back pain or rehabilitation due to back pain in the last 12 months
  • Spinal injection back pain treatment within 6 months prior to enrollment
  • Intake of antidepressant/antipsychotic medication within 4 weeks prior to enrollment
  • Treatment of the recent low back pain period with oral analgesics for more than 4 consecutive days
  • Locally applied medication to the back within 48 hours prior to enrollment (topical treatments, injections)
  • Administration of other analgesics within 24 h prior to enrollment (exception: acetyl salicylic acid (ASS) up to 100 mg/daily for anti platelet-aggregation therapy)
  • Non-pharmacological low back pain treatment (physiotherapy, heat treatment (e.g. hot water bottle, heat patch, or massages) within 12 h prior to enrollment
  • Participation in an investigational drug or device trial within 4 weeks prior to enrollment
  • Hypersensitivity to Nicoboxil, Nonivamide, or paracetamol
  • Known hypersensitivity to any other ingredient, especially to sorbic acid/sorbate, to citronella oil containing e.g. the fragrance compounds geraniol, citronellol and citronellal, or to relevant flowers containing these compounds such as geranium, lavender, jasmine or rose. For patients with known hypersensitivity to perfumes or known type IV hypersensitivity to fragrance-mix I, the application of the investigational product should be performed only with particular caution.
  • Skin lesions (e. g., rash, dermatitis, bruising, laceration) in the back region
  • Drug dependence and/or alcohol abuse
  • Severe hepatocellular insufficiency
  • Patients who are pregnant or breast-feeding

Sites / Locations

  • 69.52.49007 Boehringer Ingelheim Investigational Site
  • 69.52.49003 Boehringer Ingelheim Investigational Site
  • 69.52.49004 Boehringer Ingelheim Investigational Site
  • 69.52.49026 Boehringer Ingelheim Investigational Site
  • 69.52.49032 Boehringer Ingelheim Investigational Site
  • 69.52.49033 Boehringer Ingelheim Investigational Site
  • 69.52.49041 Boehringer Ingelheim Investigational Site
  • 69.52.49002 Boehringer Ingelheim Investigational Site
  • 69.52.49024 Boehringer Ingelheim Investigational Site
  • 69.52.49031 Boehringer Ingelheim Investigational Site
  • 69.52.49036 Boehringer Ingelheim Investigational Site
  • 69.52.49005 Boehringer Ingelheim Investigational Site
  • 69.52.49039 Boehringer Ingelheim Investigational Site
  • 69.52.49018 Boehringer Ingelheim Investigational Site
  • 69.52.49025 Boehringer Ingelheim Investigational Site
  • 69.52.49022 Boehringer Ingelheim Investigational Site
  • 69.52.49009 Boehringer Ingelheim Investigational Site
  • 69.52.49019 Boehringer Ingelheim Investigational Site
  • 69.52.49015 Boehringer Ingelheim Investigational Site
  • 69.52.49042 Boehringer Ingelheim Investigational Site
  • 69.52.49027 Boehringer Ingelheim Investigational Site
  • 69.52.49035 Boehringer Ingelheim Investigational Site
  • 69.52.49040 Boehringer Ingelheim Investigational Site
  • 69.52.49013 Boehringer Ingelheim Investigational Site
  • 69.52.49014 Boehringer Ingelheim Investigational Site
  • 69.52.49034 Boehringer Ingelheim Investigational Site
  • 69.52.49028 Boehringer Ingelheim Investigational Site
  • 69.52.49030 Boehringer Ingelheim Investigational Site
  • 69.52.49029 Boehringer Ingelheim Investigational Site
  • 69.52.49012 Boehringer Ingelheim Investigational Site
  • 69.52.49020 Boehringer Ingelheim Investigational Site
  • 69.52.49037 Boehringer Ingelheim Investigational Site
  • 69.52.49016 Boehringer Ingelheim Investigational Site
  • 69.52.49010 Boehringer Ingelheim Investigational Site
  • 69.52.49021 Boehringer Ingelheim Investigational Site
  • 69.52.49023 Boehringer Ingelheim Investigational Site
  • 69.52.49011 Boehringer Ingelheim Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Active Comparator

Active Comparator

Placebo Comparator

Arm Label

nonivamide + nicoboxil (Finalgon)

nonivamide

nicoboxil

placebo

Arm Description

2cm ointment line for a skin area of approximately 20 cm x 20 cm up to 3 times in a 24h period

2cm ointment line for a skin area of approximately 20 cm x 20 cm up to 3 times in a 24h period

2cm ointment line for a skin area of approximately 20 cm x 20 cm up to 3 times in a 24h period

2cm ointment line for a skin area of approximately 20 cm x 20 cm up to 3 times in a 24h period

Outcomes

Primary Outcome Measures

Pain Intensity Difference (PID) Between Pre-dose Baseline and 8hours After First Application
Pain intensity (PI) was assessed on a 11-point numerical rating scale ranging from 0 (no pain) to 10 (worst pain possible) at pre-dose baseline and 0.5, 1, 2, 3, 4, 6 and 8 hours after first ointment application. Means were adjusted for centre effect and baseline value.

Secondary Outcome Measures

Pain Intensity Difference (PID) Between Pre-dose Baseline and 4 Hours After First Application
Pain intensity was assessed on a 11-point numerical rating scale ranging from 0 (no pain) to 10 (worst pain possible) at pre-dose baseline and 0.5, 1, 2, 3 and 4 hours after first ointment application. Means were adjusted for centre effect and baseline value.
Difference Between Baseline Pain Intensity and Average Pain Intensity on the Last Individual Treatment Day
Average pain intensity was assessed in the evening of days 1, 2, 3 and 4 on a 11-point numerical rating scale ranging from 0 (no pain) to 10 (worst pain possible). The last individual treatment day is the last day with diary-recorded ointment application. Means were adjusted for centre effect and baseline value.
Patient Assessment of Efficacy on the Last Individual Treatment Day
Patient assessment of efficacy was assessed on a 4-point verbal rating scale (VRS, 0 = 'poor', 1 = 'fair', 2 = 'good', 3 = 'very good' relief of the patients' low back pain) in the evening of days 1, 2, 3 and 4. The last individual treatment day is the last day with diary-recorded ointment application

Full Information

First Posted
October 16, 2012
Last Updated
May 20, 2014
Sponsor
Boehringer Ingelheim
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1. Study Identification

Unique Protocol Identification Number
NCT01708915
Brief Title
Nonivamide/Nicoboxil Ointment in Acute Low Back Pain
Official Title
A Multi-centre, Double-blind, Randomised, Parallel Group Study to Assess the Efficacy and Safety of Multiple Doses of Topically Applied Hyperemisation-inducing Ointment (2cm Ointment Line Per Application; up to 3 Times Daily for up to 4 Days) Containing 2.5% Nicoboxil/0.4% Nonivamide Versus 2.5% Nicoboxil, 0.4% Nonivamide and Placebo in Patients 18 to 65 Years of Age With Acute Low Back Pain
Study Type
Interventional

2. Study Status

Record Verification Date
May 2014
Overall Recruitment Status
Completed
Study Start Date
October 2012 (undefined)
Primary Completion Date
April 2013 (Actual)
Study Completion Date
April 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Boehringer Ingelheim

4. Oversight

5. Study Description

Brief Summary
The aim of this study is to assess the efficacy and tolerability of Nicoboxil/Nonivamide ointment in comparison to Nicoboxil, Nonivamide, and placebo ointments for the treatment of acute low back pain.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Low Back Pain

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Double
Allocation
Randomized
Enrollment
805 (Actual)

8. Arms, Groups, and Interventions

Arm Title
nonivamide + nicoboxil (Finalgon)
Arm Type
Active Comparator
Arm Description
2cm ointment line for a skin area of approximately 20 cm x 20 cm up to 3 times in a 24h period
Arm Title
nonivamide
Arm Type
Active Comparator
Arm Description
2cm ointment line for a skin area of approximately 20 cm x 20 cm up to 3 times in a 24h period
Arm Title
nicoboxil
Arm Type
Active Comparator
Arm Description
2cm ointment line for a skin area of approximately 20 cm x 20 cm up to 3 times in a 24h period
Arm Title
placebo
Arm Type
Placebo Comparator
Arm Description
2cm ointment line for a skin area of approximately 20 cm x 20 cm up to 3 times in a 24h period
Intervention Type
Drug
Intervention Name(s)
nicoboxil
Intervention Description
2cm ointment line for a skin area of approximately 20 cm x 20 cm up to 3 times in a 24h period
Intervention Type
Drug
Intervention Name(s)
placebo matching nonivamide + nicoboxil
Intervention Description
2cm ointment line for a skin area of approximately 20 cm x 20 cm up to 3 times in a 24h period
Intervention Type
Drug
Intervention Name(s)
nonivamide + nicoboxil (Finalgon)
Intervention Description
2cm ointment line for a skin area of approximately 20 cm x 20 cm up to 3 times in a 24h period
Intervention Type
Drug
Intervention Name(s)
nonivamide
Intervention Description
2cm ointment line for a skin area of approximately 20 cm x 20 cm up to 3 times in a 24h period
Primary Outcome Measure Information:
Title
Pain Intensity Difference (PID) Between Pre-dose Baseline and 8hours After First Application
Description
Pain intensity (PI) was assessed on a 11-point numerical rating scale ranging from 0 (no pain) to 10 (worst pain possible) at pre-dose baseline and 0.5, 1, 2, 3, 4, 6 and 8 hours after first ointment application. Means were adjusted for centre effect and baseline value.
Time Frame
Baseline and 8 hours after first ointment application
Secondary Outcome Measure Information:
Title
Pain Intensity Difference (PID) Between Pre-dose Baseline and 4 Hours After First Application
Description
Pain intensity was assessed on a 11-point numerical rating scale ranging from 0 (no pain) to 10 (worst pain possible) at pre-dose baseline and 0.5, 1, 2, 3 and 4 hours after first ointment application. Means were adjusted for centre effect and baseline value.
Time Frame
Baseline and 4 hours after first ointment application
Title
Difference Between Baseline Pain Intensity and Average Pain Intensity on the Last Individual Treatment Day
Description
Average pain intensity was assessed in the evening of days 1, 2, 3 and 4 on a 11-point numerical rating scale ranging from 0 (no pain) to 10 (worst pain possible). The last individual treatment day is the last day with diary-recorded ointment application. Means were adjusted for centre effect and baseline value.
Time Frame
Baseline and 1 to 4 days
Title
Patient Assessment of Efficacy on the Last Individual Treatment Day
Description
Patient assessment of efficacy was assessed on a 4-point verbal rating scale (VRS, 0 = 'poor', 1 = 'fair', 2 = 'good', 3 = 'very good' relief of the patients' low back pain) in the evening of days 1, 2, 3 and 4. The last individual treatment day is the last day with diary-recorded ointment application
Time Frame
1 to 4 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria: Patients must sign and date an Informed Consent consistent with International Conference on Hermonisation (ICH)/Good Clinical Practice (GCP) guidelines and local regulation prior to participation in the trial. Patients must agree to cooperate with all trial evaluations and perform all required tasks. Acute low back pain for more than 2 days and less than 21 days (= 3 weeks) Male or female patients aged 18 to 65 years Low back pain rating >5 on a 0-10 numerical rating scale (NRS). Female patients of childbearing potential may participate only in case of availability of a negative urine pregnancy test and a confirmed menstrual period prior to study entry and using a highly effective method of birth control. Highly effective methods of birth control are defined as those which result in a low failure rate (i.e. less than 1 % per year) when used consistently and correctly such as implants, injectables, combined oral contraceptives, appropriate intrauterine devices, sexual abstinence or vasectomised partner. Barrier methods of contraception (e.g. condom, diaphragma or occlusive cap) are accepted if used in combination with spermicides (e.g. foam, gel). Female patients will be considered being of childbearing potential unless surgically sterilised by bilateral tubal ligation/salpingectomy or hysterectomy or post-menopausal for at least one year. Exclusion criteria: Multilocular pain or panalgesia History of more than three low back pain episodes in the last six months Abnormal findings in at least one of the following assessments: Achilles tendon reflex, patella reflex, heel walking, toe walking, cutaneous sensitivity of the legs (including gluteal region), paresis tests in supine position upon dorsiflexion, plantarflexion, hip flexion, knee extension Bladder and/or rectum dysfunction Acute low back pain due to vertebral collapse or neoplastic, inflammatory (ankylosing spondylitis), traumatic, or infective origins Any condition, disease or concomitant treatment that in the judgement of the Investigator will affect the subject's ability to participate in the clinical trial or which will influence the test methodology used Negative experience in the past with heat treatment for muscle complaints (e. g. hot water bottle, heat pads, hyperemisation-inducing topical creams, ointments or patches) History of treatment of back pain with centrally acting analgesics (e. g. opioids) and muscle relaxants Surgery due to back pain or rehabilitation due to back pain in the last 12 months Spinal injection back pain treatment within 6 months prior to enrollment Intake of antidepressant/antipsychotic medication within 4 weeks prior to enrollment Treatment of the recent low back pain period with oral analgesics for more than 4 consecutive days Locally applied medication to the back within 48 hours prior to enrollment (topical treatments, injections) Administration of other analgesics within 24 h prior to enrollment (exception: acetyl salicylic acid (ASS) up to 100 mg/daily for anti platelet-aggregation therapy) Non-pharmacological low back pain treatment (physiotherapy, heat treatment (e.g. hot water bottle, heat patch, or massages) within 12 h prior to enrollment Participation in an investigational drug or device trial within 4 weeks prior to enrollment Hypersensitivity to Nicoboxil, Nonivamide, or paracetamol Known hypersensitivity to any other ingredient, especially to sorbic acid/sorbate, to citronella oil containing e.g. the fragrance compounds geraniol, citronellol and citronellal, or to relevant flowers containing these compounds such as geranium, lavender, jasmine or rose. For patients with known hypersensitivity to perfumes or known type IV hypersensitivity to fragrance-mix I, the application of the investigational product should be performed only with particular caution. Skin lesions (e. g., rash, dermatitis, bruising, laceration) in the back region Drug dependence and/or alcohol abuse Severe hepatocellular insufficiency Patients who are pregnant or breast-feeding
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Boehringer Ingelheim
Organizational Affiliation
Boehringer Ingelheim
Official's Role
Study Chair
Facility Information:
Facility Name
69.52.49007 Boehringer Ingelheim Investigational Site
City
Bad Lippspringe
Country
Germany
Facility Name
69.52.49003 Boehringer Ingelheim Investigational Site
City
Berlin
Country
Germany
Facility Name
69.52.49004 Boehringer Ingelheim Investigational Site
City
Berlin
Country
Germany
Facility Name
69.52.49026 Boehringer Ingelheim Investigational Site
City
Berlin
Country
Germany
Facility Name
69.52.49032 Boehringer Ingelheim Investigational Site
City
Berlin
Country
Germany
Facility Name
69.52.49033 Boehringer Ingelheim Investigational Site
City
Berlin
Country
Germany
Facility Name
69.52.49041 Boehringer Ingelheim Investigational Site
City
Berlin
Country
Germany
Facility Name
69.52.49002 Boehringer Ingelheim Investigational Site
City
Einbeck
Country
Germany
Facility Name
69.52.49024 Boehringer Ingelheim Investigational Site
City
Essen
Country
Germany
Facility Name
69.52.49031 Boehringer Ingelheim Investigational Site
City
Essen
Country
Germany
Facility Name
69.52.49036 Boehringer Ingelheim Investigational Site
City
Essen
Country
Germany
Facility Name
69.52.49005 Boehringer Ingelheim Investigational Site
City
Everswinkel
Country
Germany
Facility Name
69.52.49039 Boehringer Ingelheim Investigational Site
City
Fürth
Country
Germany
Facility Name
69.52.49018 Boehringer Ingelheim Investigational Site
City
Goch
Country
Germany
Facility Name
69.52.49025 Boehringer Ingelheim Investigational Site
City
Großheirath-Rossach
Country
Germany
Facility Name
69.52.49022 Boehringer Ingelheim Investigational Site
City
Haag
Country
Germany
Facility Name
69.52.49009 Boehringer Ingelheim Investigational Site
City
Hamburg
Country
Germany
Facility Name
69.52.49019 Boehringer Ingelheim Investigational Site
City
Hamburg
Country
Germany
Facility Name
69.52.49015 Boehringer Ingelheim Investigational Site
City
Kaarst
Country
Germany
Facility Name
69.52.49042 Boehringer Ingelheim Investigational Site
City
Karlsruhe-Rüppurr
Country
Germany
Facility Name
69.52.49027 Boehringer Ingelheim Investigational Site
City
Köln
Country
Germany
Facility Name
69.52.49035 Boehringer Ingelheim Investigational Site
City
Köln
Country
Germany
Facility Name
69.52.49040 Boehringer Ingelheim Investigational Site
City
Köln
Country
Germany
Facility Name
69.52.49013 Boehringer Ingelheim Investigational Site
City
Köthen
Country
Germany
Facility Name
69.52.49014 Boehringer Ingelheim Investigational Site
City
Künzing
Country
Germany
Facility Name
69.52.49034 Boehringer Ingelheim Investigational Site
City
Ludwigshafen
Country
Germany
Facility Name
69.52.49028 Boehringer Ingelheim Investigational Site
City
Meßkirch
Country
Germany
Facility Name
69.52.49030 Boehringer Ingelheim Investigational Site
City
Meßkirch
Country
Germany
Facility Name
69.52.49029 Boehringer Ingelheim Investigational Site
City
Münster
Country
Germany
Facility Name
69.52.49012 Boehringer Ingelheim Investigational Site
City
Neunkirchen
Country
Germany
Facility Name
69.52.49020 Boehringer Ingelheim Investigational Site
City
Rodgau
Country
Germany
Facility Name
69.52.49037 Boehringer Ingelheim Investigational Site
City
Siegen
Country
Germany
Facility Name
69.52.49016 Boehringer Ingelheim Investigational Site
City
Stockach
Country
Germany
Facility Name
69.52.49010 Boehringer Ingelheim Investigational Site
City
Straßkirchen
Country
Germany
Facility Name
69.52.49021 Boehringer Ingelheim Investigational Site
City
Villingen-Schwenningen
Country
Germany
Facility Name
69.52.49023 Boehringer Ingelheim Investigational Site
City
Wangen
Country
Germany
Facility Name
69.52.49011 Boehringer Ingelheim Investigational Site
City
Weilburg
Country
Germany

12. IPD Sharing Statement

Citations:
PubMed Identifier
25929250
Citation
Gaubitz M, Schiffer T, Holm C, Richter E, Pisternick-Ruf W, Weiser T. Efficacy and safety of nicoboxil/nonivamide ointment for the treatment of acute pain in the low back - A randomized, controlled trial. Eur J Pain. 2016 Feb;20(2):263-73. doi: 10.1002/ejp.719. Epub 2015 Apr 30.
Results Reference
derived
Links:
URL
http://trials.boehringer-ingelheim.com/content/dam/internet/opu/clinicaltrial/com_EN/results/69/69.52_U13-2315-01.pdf
Description
Related Info

Learn more about this trial

Nonivamide/Nicoboxil Ointment in Acute Low Back Pain

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