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Randomized, Double-Blind, Placebo-Controlled Pilot Study on the Safety and Effectiveness of LUCEMYRA During an Opioid Taper in Treatment of Withdrawal (TAPER)

Primary Purpose

Opioid Withdrawal (Disorder)

Status
Suspended
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Lofexidine
Placebo
Sponsored by
USWM, LLC (dba US WorldMeds)
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Opioid Withdrawal (Disorder) focused on measuring Opioid Withdrawal Syndrome, OWS, Opioid taper, Opioid withdrawal, Opioid reduction, Stopping opioids, Opioid discontinuation, non-opioid pain management

Eligibility Criteria

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

Inclusion Criteria:

  • Subject can provide written informed consent.
  • Chronic non-cancer pain diagnosis such as low back pain, chronic neck pain, osteoarthritis, and prolonged post-surgical pain with daily pain for a minimum of 6 months.
  • Self-reported use of prescribed oral opioid medication(s) (tablets, pills or capsules) of at least 50 morphine mg equivalent (MME) but no higher than 240 mg MME daily or near daily (≥5 days per week) for at least 12 weeks and seeking to discontinue their opioid medication.
  • Willing to be treated with non-opioid treatments for pain (in addition to opioid being tapered) for duration of study.
  • Willing to abstain from alcohol use during the study.
  • Willing to partner with his or her pain physician on a subject-centered pain management plan during the study.
  • In generally good health, in the opinion of the Investigator, other than the underlying chronic pain syndrome
  • Women of childbearing potential must have a negative pregnancy test at Screening.
  • Non-pregnant, non-lactating women who are postmenopausal, naturally or surgically sterile, or who agree to use acceptable contraceptive methods throughout the course of the study.
  • Other criteria will be discussed in detail with potential subjects by Site Investigator

Exclusion Criteria:

  • Has a primary diagnosis of complex regional pain syndrome, central neuropathic pain, somatoform pain syndromes, acute nerve root compression, any acute or progressive infectious, inflammatory, or neurological process.
  • Taking methadone, buprenorphine, fentanyl rapid acting products, tapentadol, tramadol, butorphanol, meperidine, or levorphanol for any reason
  • Liver disease that requires medication or medical treatment, and/or AST or ALT levels greater than 3 x ULN.
  • Gastrointestinal or renal disease, which would significantly impair absorption, metabolism or excretion of study drug, or would require medication or medical treatment.
  • Has a diagnosis of epilepsy or history of seizures.
  • Cardiovascular abnormalities at Screening and before randomization (stable hypertension permitted)
  • Self-reported or evidence of opioid use disorder (OUD) or other substance use disorder within last 12 months
  • Any severe or unstable psychiatric disorder including post-traumatic stress disorder, schizophrenia, bipolar disorder, major depression, substance abuse, or suicidality as determined by the Investigator.
  • Subject answers "yes" to "suicidal ideation" in prior 24 months to any items 1 through 5 on the C-SSRS, or subject answers "yes" to any lifetime "suicidal behavior" item on the C-SSRS.
  • Any anticipated or scheduled surgery during the study period or within 30 days before Screening.
  • Other criteria will be discussed in detail with potential subjects by site Investigator

Sites / Locations

  • Westview Clinical Research, LLC
  • Vitamed Research
  • Gold Coast Research, LLC
  • Georgia Clinical Research, LLC
  • Injury Care Research
  • Global Scientific Innovations
  • Integrated Clinical Trial Services, Inc.
  • Neuroscience Research Center, LLC
  • Otrimed Corporation (Otrimed Clinical Research Center)
  • University of Rochester
  • Duke Innovation Pain Therapies Clinic at Brier Creek
  • The Center for Clinical Research, LLC

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

Lofexidine

Placebo

Arm Description

Outcomes

Primary Outcome Measures

Number of treatment emergent AEs and SAEs by system organ class and preferred term
Number and percent of subjects reporting TEAEs resulting in study drug discontinuation
Percentage of subjects with treatment-emergent elevated liver function tests
Percentage of subjects identified as suicide risk with Columbia Suicide Severity Rating Scale
Change in Blood Pressure
Change in Pulse

Secondary Outcome Measures

Percentage of subjects who successfully complete each scheduled dose reduction and the opioid taper to complete opioid discontinuation
Change in Clinical Opiate Withdrawal Scale (COWS)
Change in the Short Opiate Withdrawal Scale of Gossop (SOWS-G)
Change in Subjective Opiate WIthdrawal Scale of Handelsman (SOWS-H)
Modified Clinical Global Impression - Rater Version (MCGI-R)
Modified Clinical Global Impression - Subject Version (MCGI-S)
Time to study drug discontinuation
Number of non-opioid concomitant medications for withdrawal symptoms used by study day
Change in EuroQol 5-Dimension 5-Level (EQ-5D-5L) scale
Change in Short Form Health Survey (SF-36) scale
Change in Insomnia Severity Index (ISI)
Change in Hospital Anxiety and Depression Scale (HADS)
Change in Average Chronic Pain as measured by the Numeric Rating Scale (NRS)
Change in Average Overall Pain as measured by the Numeric Rating Scale (NRS)
Change in Worst Chronic Pain as measured by the Numeric Rating Scale (NRS)
Change in Worst Overall Pain as measured by the Numeric Rating Scale (NRS)
Change in daily opioid dose expressed as morphine equivalent dose (MED)
Change in daily opioid dose as a percentage of the baseline MED

Full Information

First Posted
July 2, 2019
Last Updated
March 11, 2022
Sponsor
USWM, LLC (dba US WorldMeds)
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1. Study Identification

Unique Protocol Identification Number
NCT04070157
Brief Title
Randomized, Double-Blind, Placebo-Controlled Pilot Study on the Safety and Effectiveness of LUCEMYRA During an Opioid Taper in Treatment of Withdrawal
Acronym
TAPER
Official Title
A Randomized, Double-Blind, Placebo-Controlled Pilot Study to Evaluate the Safety and Effectiveness of LUCEMYRA in the Treatment of Opioid Withdrawal During an Opioid Taper in Subjects With Chronic Non-Cancer Pain
Study Type
Interventional

2. Study Status

Record Verification Date
March 2022
Overall Recruitment Status
Suspended
Why Stopped
COVID pandemic and enrollment issues necessitating an adjustment to the study design.
Study Start Date
August 2, 2019 (Actual)
Primary Completion Date
October 31, 2022 (Anticipated)
Study Completion Date
October 31, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
USWM, LLC (dba US WorldMeds)

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No

5. Study Description

Brief Summary
Stopping prescription opioid pain medications can be difficult due to withdrawal symptoms. This study will test if LUCEMYRA helps reduce withdrawal symptoms and helps more people reduce their opioid dose compared to placebo.
Detailed Description
This randomized, double-blind, placebo-controlled pilot study will evaluate the safety and effectiveness of LUCEMYRA in the treatment of opioid withdrawal during an opioid taper in subjects with chronic non-cancer pain. Subjects will begin a planned 14-day complete taper of their pre-study opioid medications and will be randomly assigned (1:1) to either LUCEMYRA or matching placebo. Study drug will be administered through the opioid taper and for 5 days after the opioid taper is completed. Study drug will then be tapered over a 4-day period for a total of approximately 21 days exposure to study drug.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Opioid Withdrawal (Disorder)
Keywords
Opioid Withdrawal Syndrome, OWS, Opioid taper, Opioid withdrawal, Opioid reduction, Stopping opioids, Opioid discontinuation, non-opioid pain management

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Masking Description
All subjects, study personnel (including the Investigator, study coordinator(s), pharmacist/designee), and the Sponsor will be blinded to the identity of the study drug (active or placebo) administered to subjects.
Allocation
Randomized
Enrollment
60 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Lofexidine
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
Lofexidine
Other Intervention Name(s)
lofexidine hydrochloride, LUCEMYRA
Intervention Description
Lofexidine 0.18 mg tablets. Dosing will begin with 1 tablet administered every 5-6 hours, up to 4 times day. The dose may be titrated but not to exceed 4 tablets 4 times a day.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching placebo tablets. Dosing will begin with 1 tablet administered every 5-6 hours, up to 4 times day. The dose may be titrated but not to exceed 4 tablets 4 times a day.
Primary Outcome Measure Information:
Title
Number of treatment emergent AEs and SAEs by system organ class and preferred term
Time Frame
Day 1 through Day 28
Title
Number and percent of subjects reporting TEAEs resulting in study drug discontinuation
Time Frame
Day 1 through Day 28
Title
Percentage of subjects with treatment-emergent elevated liver function tests
Time Frame
Day 1 through Day 28
Title
Percentage of subjects identified as suicide risk with Columbia Suicide Severity Rating Scale
Time Frame
Day 1 through Day 28
Title
Change in Blood Pressure
Time Frame
Baseline to Days 1, 2, 3, 7, 8, 14, 15, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27 and 28
Title
Change in Pulse
Time Frame
Baseline to Days 1, 2, 3, 7, 8, 14, 15, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27 and 28
Secondary Outcome Measure Information:
Title
Percentage of subjects who successfully complete each scheduled dose reduction and the opioid taper to complete opioid discontinuation
Time Frame
Day 1 through Day 28
Title
Change in Clinical Opiate Withdrawal Scale (COWS)
Time Frame
Day 1 (pre-1st dose) to Days 3, 8, 15, 22 and 28
Title
Change in the Short Opiate Withdrawal Scale of Gossop (SOWS-G)
Time Frame
Day 1 (pre-1st dose) to Days 1 (at bedtime), 2, 3, 4, 5, 6, 7, 8, 9, 10,11, 12,13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27 and 28
Title
Change in Subjective Opiate WIthdrawal Scale of Handelsman (SOWS-H)
Time Frame
Day 1 (pre-1st dose) to Days 1 (at bedtime), 2, 3, 4, 5, 6, 7, 8, 9, 10,11, 12,13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27 and 28
Title
Modified Clinical Global Impression - Rater Version (MCGI-R)
Time Frame
Each scheduled evaluation (Day 1 through Day 28)
Title
Modified Clinical Global Impression - Subject Version (MCGI-S)
Time Frame
Each scheduled evaluation (Day 1 through Day 28)
Title
Time to study drug discontinuation
Time Frame
Day 1 through Day 28
Title
Number of non-opioid concomitant medications for withdrawal symptoms used by study day
Time Frame
Day 1 through Day 28
Title
Change in EuroQol 5-Dimension 5-Level (EQ-5D-5L) scale
Time Frame
Baseline to Days 28 and 51
Title
Change in Short Form Health Survey (SF-36) scale
Time Frame
Baseline to Day 28
Title
Change in Insomnia Severity Index (ISI)
Time Frame
Baseline to Days 15 and 28
Title
Change in Hospital Anxiety and Depression Scale (HADS)
Time Frame
Baseline to Day 28
Title
Change in Average Chronic Pain as measured by the Numeric Rating Scale (NRS)
Time Frame
Baseline through Day 51 (assessed daily)
Title
Change in Average Overall Pain as measured by the Numeric Rating Scale (NRS)
Time Frame
Day 1 through Day 28 (assessed daily)
Title
Change in Worst Chronic Pain as measured by the Numeric Rating Scale (NRS)
Time Frame
Baseline through Day 51 (assessed daily)
Title
Change in Worst Overall Pain as measured by the Numeric Rating Scale (NRS)
Time Frame
Day 1 through Day 28 (assessed daily)
Title
Change in daily opioid dose expressed as morphine equivalent dose (MED)
Time Frame
Baseline through Day 28
Title
Change in daily opioid dose as a percentage of the baseline MED
Time Frame
Baseline through Day 28

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject can provide written informed consent. Chronic non-cancer pain diagnosis such as low back pain, chronic neck pain, osteoarthritis, and prolonged post-surgical pain with daily pain for a minimum of 6 months. Self-reported use of prescribed oral opioid medication(s) (tablets, pills or capsules) of at least 50 morphine mg equivalent (MME) but no higher than 240 mg MME daily or near daily (≥5 days per week) for at least 12 weeks and seeking to discontinue their opioid medication. Willing to be treated with non-opioid treatments for pain (in addition to opioid being tapered) for duration of study. Willing to abstain from alcohol use during the study. Willing to partner with his or her pain physician on a subject-centered pain management plan during the study. In generally good health, in the opinion of the Investigator, other than the underlying chronic pain syndrome Women of childbearing potential must have a negative pregnancy test at Screening. Non-pregnant, non-lactating women who are postmenopausal, naturally or surgically sterile, or who agree to use acceptable contraceptive methods throughout the course of the study. Other criteria will be discussed in detail with potential subjects by Site Investigator Exclusion Criteria: Has a primary diagnosis of complex regional pain syndrome, central neuropathic pain, somatoform pain syndromes, acute nerve root compression, any acute or progressive infectious, inflammatory, or neurological process. Taking methadone, buprenorphine, fentanyl rapid acting products, tapentadol, tramadol, butorphanol, meperidine, or levorphanol for any reason Liver disease that requires medication or medical treatment, and/or AST or ALT levels greater than 3 x ULN. Gastrointestinal or renal disease, which would significantly impair absorption, metabolism or excretion of study drug, or would require medication or medical treatment. Has a diagnosis of epilepsy or history of seizures. Cardiovascular abnormalities at Screening and before randomization (stable hypertension permitted) Self-reported or evidence of opioid use disorder (OUD) or other substance use disorder within last 12 months Any severe or unstable psychiatric disorder including post-traumatic stress disorder, schizophrenia, bipolar disorder, major depression, substance abuse, or suicidality as determined by the Investigator. Subject answers "yes" to "suicidal ideation" in prior 24 months to any items 1 through 5 on the C-SSRS, or subject answers "yes" to any lifetime "suicidal behavior" item on the C-SSRS. Any anticipated or scheduled surgery during the study period or within 30 days before Screening. Other criteria will be discussed in detail with potential subjects by site Investigator
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
John Peppin, DO
Organizational Affiliation
US WorldMeds Contract Medical Monitor
Official's Role
Study Director
Facility Information:
Facility Name
Westview Clinical Research, LLC
City
Placentia
State/Province
California
ZIP/Postal Code
92870
Country
United States
Facility Name
Vitamed Research
City
Rancho Mirage
State/Province
California
ZIP/Postal Code
92270
Country
United States
Facility Name
Gold Coast Research, LLC
City
Plantation
State/Province
Florida
ZIP/Postal Code
33317
Country
United States
Facility Name
Georgia Clinical Research, LLC
City
Lawrenceville
State/Province
Georgia
ZIP/Postal Code
30044
Country
United States
Facility Name
Injury Care Research
City
Boise
State/Province
Idaho
ZIP/Postal Code
83713
Country
United States
Facility Name
Global Scientific Innovations
City
Evansville
State/Province
Indiana
ZIP/Postal Code
47714
Country
United States
Facility Name
Integrated Clinical Trial Services, Inc.
City
West Des Moines
State/Province
Iowa
ZIP/Postal Code
50265
Country
United States
Facility Name
Neuroscience Research Center, LLC
City
Overland Park
State/Province
Kansas
ZIP/Postal Code
66210
Country
United States
Facility Name
Otrimed Corporation (Otrimed Clinical Research Center)
City
Edgewood
State/Province
Kentucky
ZIP/Postal Code
41017
Country
United States
Facility Name
University of Rochester
City
Rochester
State/Province
New York
ZIP/Postal Code
14624
Country
United States
Facility Name
Duke Innovation Pain Therapies Clinic at Brier Creek
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27617
Country
United States
Facility Name
The Center for Clinical Research, LLC
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

Randomized, Double-Blind, Placebo-Controlled Pilot Study on the Safety and Effectiveness of LUCEMYRA During an Opioid Taper in Treatment of Withdrawal

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