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A Study to Learn How Safe BAY2395840 is and How Well it Works in Participants Who Have Diabetic Nerve Pain

Primary Purpose

Neuropathic Pain Associated With Diabetic Peripheral Neuropathy, Peripheral Neuropathic Pain, Diabetes Mellitus

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
BAY2395840
Placebo for BAY2395840
Sponsored by
Bayer
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neuropathic Pain Associated With Diabetic Peripheral Neuropathy focused on measuring Neuropathic Pain

Eligibility Criteria

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

Inclusion Criteria:

  • Adults ≥ 18 years of age at the time of signing the informed consent.
  • Have documented diagnosis of type 1 OR type 2 diabetes mellitus (DM).
  • Have painful distal symmetrical sensorimotor diabetic neuropathy for at least 6 months prior to the screening and confirmed at screening via the modified Toronto Clinical Neuropathy Score with a score of at least 3.
  • Weekly mean 24-hour average pain Numeric Rating Scale (NRS) ≥ 4 with adequate variability (not the same score on all daily pain ratings) and compliance (non-missing pain score on at least 6 out of 7 consecutive days) in daily pain recording during the 7-day NRS baseline period.
  • Neuropathic pain according to the Douleur Neuropathique 4 Questions (DN4 questionnaire) at screening visit with a score of at least 4 out of 10.
  • Participant should be on stable antidiabetic treatment for at least 3 months prior to the screening visit and there should be no pre-planned changes to antidiabetic treatment during this study.
  • Participant is willing to use only rescue medication provided by the site and is willing to withdraw temporarily all other neuropathic pain medications which were in use before study participation.
  • Participant is willing and able to use the electronic hand-held device on their own.
  • Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.

Exclusion Criteria:

  • Clinically significant cardiovascular or cerebrovascular disease including Acute coronary syndrome (ACS)/myocardial infarction /stroke/Transient ischemic attack (TIA) within previous 3 months before screening visit.
  • Major depressive episode within 6 months prior to screening. Patients with stable depression and on stable antidepressant dose (no change in medication and /or dosing regimen) for the past 6 months are allowed to participate, provided the antidepressant used is not listed under prohibited medications.
  • Any differential diagnosis of peripheral diabetic neuropathy (PDN) including but not limited to other neuropathies (e.g. vitamin B12 deficiency, Chronic Inflammatory Demyelinating Polyneuropathy), polyradiculopathies, central disorders (e.g. demyelinating disease), or rheumatological disease (e.g. foot arthritis, plantar fasciitis).
  • Concurrent malignancy or history of cancer (exception of basal cell or squamous cell carcinoma of the skin) within the last 5 years prior to screening.
  • Any other diseases or conditions that according to the investigator can compromise the function of the body systems and could result in altered absorption, excessive accumulation, impaired metabolism, or altered excretion of the study intervention (e.g. chronic bowel disease, Crohn's disease, and ulcerative colitis).
  • Any serious or unstable diseases or conditions including psychiatric disorders that might interfere with the conduct of the study or the interpretation of the results.
  • Major surgery or radiological procedures (e.g. Percutaneous transluminal angioplasty (PTA) and stenting of peripheral vascular lesions in lower extremities) within 3 months before screening visit or scheduled during the study period, which might interfere pain response evaluation.
  • Symptomatic peripheral arterial disease in lower or upper extremities, including diabetic ulcers.
  • Use of live, attenuated, replication-competent vaccines.
  • Previous use of strong opioids (e.g. oxymorphone, oxycodone) for neuropathic pain anytime, or topical use of capsaicin within 3 months prior to the screening visit.
  • History or current diagnosis of electrocardiogram (ECG) abnormalities indicating significant risk of safety for study participants.
  • Moderate-to-severe hepatic impairment defined as Child-Pugh Class B or C.
  • Have platelets ≤ 100 x 109/L, or neutrophil count < 1.2 x 109/L (or equivalent), hemoglobin ≤ 100 g/L for women or hemoglobin ≤ 110 g/L for men at screening.
  • Glycemic control unstable (hemoglobin HbA1c ≥11% or 97 mmol/mol) within 3 months prior to screening (e.g. ketoacidosis requiring hospitalization, any recent episode of hypoglycemia requiring assistance through medical intervention, uncontrolled hyperglycemia).
  • ALT >2xULN, or AST >2xULN, or total bilirubin greater than ULN, or alkaline phosphatase (AP) >2x ULN, or INR greater than ULN (unless related to anticoagulation treatment) at screening.
  • Positive hepatitis B virus surface antigen (HBsAg) or positive hepatitis C virus antibodies (anti-HCV) and detection of mRNA (HCV-mRNA tested only if hepatitis C virus antibodies detected).
  • Estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m^2 calculated by Modification of Diet in Renal Disease (MDRD) formula.
  • Uncontrolled hypertension despite optimal treatment with antihypertensive(s), indicated by a sitting systolic blood pressure ≥ 180 mmHg and/or diastolic blood pressure ≥ 110 mmHg.

Sites / Locations

  • NEUROHK s.r.o
  • Interni a diabetologicka ambulance - Krnov
  • Fakultni nemocnice Ostrava
  • Vseobecna fakultni nemocnice v Praze
  • Praglandia
  • Vestra Clinics s.r.o.
  • Diabetologicka ambulance Vlasim
  • Klinische Forschung Karlsruhe GmbH
  • Klinische Forschung Schwerin GmbH
  • Klinische Forschung Hannover-Mitte GmbH
  • Herz- und Diabeteszentrum Nordrhein-Westfalen (HDZ NRW)
  • InnoDiab Forschung GmbH
  • Klinische Forschung Berlin GbR
  • DRC Gyogyszervizsgalo Kozpont Kft.
  • Clinexpert Kft.
  • Coromed Smo Kft
  • ALIAN s.r.o.
  • NEUROPOINT sro, Neurologicka ambulancia
  • Internal and Diabetes Clinic - IN-DIA s.r.o. | Lucenec, Slovakia
  • Svet zdravia, a.s. Vseobecna nemocnica v Ziari nad Hronom
  • Neuron - D.T. sro, Neurologicka ambulancia
  • Medivasa s.r.o.
  • Complexo HU Ferrol | Endocrinología y Nutrición
  • Hospital Univ. Bellvitge | Anestesiología y Unidad del Dolor
  • Complejo Hospitalario Universitario A Coruña
  • Hospital General Universitario de Alicante
  • Hospital General Universitario Gregorio Marañón | Endo
  • MAC Clinical Research - Teesside
  • King's College Hospital - NHS Foundation Trust
  • MAC Research Centre - Manchester

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

Group 1 (BAY2395840 - placebo)

Group 2 (Placebo - BAY2395840)

Arm Description

Participants will be randomly assigned to treatment regimen of double-blind BAY2395840, and after an interim single blind period for washout will switch to double-blind placebo.

Participants will start with a treatment regimen of double-blind placebo, and after an interim single blind period for washout will switch to double-blind BAY2395840.

Outcomes

Primary Outcome Measures

Change in weekly mean 24-hour average pain intensity score using the 11-point Numeric Rating Scale (NRS) from baseline to the end of intervention
NRS is an one-item assessment of average neuropathic pain intensity which is presented as an 11-point Likert scale with 0 as "no pain" and 10 as "worst imaginable pain".

Secondary Outcome Measures

Change in Neuropathic Pain Symptom Inventory (NPSI) score from baseline to the end of intervention.
The Neuropathic Pain Symptom Inventory (NPSI) is a PRO developed to evaluate different symptoms of neuropathic pain.
Change in Patient Global Impression of Severity (PGI-S) score from baseline to the end of intervention.
The PGI-S is a one-item self-reported instrument used to assess to assess patients' impression of disease severity with a 6-point scale response options, scores ranging from 1 ("none") to 6 ("very severe).
The proportion of participants achieving a ≥30% and a ≥50% reduction in weekly mean 24-hour average pain intensity score (i.e. responder rates using NRS)
Number of participants with treatment emergent adverse events (TEAE)

Full Information

First Posted
January 21, 2022
Last Updated
December 14, 2022
Sponsor
Bayer
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1. Study Identification

Unique Protocol Identification Number
NCT05219812
Brief Title
A Study to Learn How Safe BAY2395840 is and How Well it Works in Participants Who Have Diabetic Nerve Pain
Official Title
A Randomized, Double-blind, Cross-over, Placebo-controlled, Multi-center, Phase 2a Study to Assess the Safety and Signal in Efficacy of BAY 2395840 in Patients With Diabetic Neuropathic Pain
Study Type
Interventional

2. Study Status

Record Verification Date
December 2022
Overall Recruitment Status
Completed
Study Start Date
February 16, 2022 (Actual)
Primary Completion Date
November 7, 2022 (Actual)
Study Completion Date
November 21, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Bayer

4. Oversight

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

5. Study Description

Brief Summary
Researchers are looking for a better way to treat people who have diabetic neuropathic pain (DNP), a condition in which diabetes results in pain due to nerve damage. People with diabetes have high blood sugar levels. Over the time, high blood sugar levels can cause damage to the nerves in the body, which results in DNP. The nerve damage in this condition is localized in a stocking and glove like pattern and starts in the feet and can move upwards on your legs. Some patients also progress having pain in their fingers/hands. People with DNP have pain in these areas as well as reduction/loss of feeling, and at times light touch can feel like pain. In this study, the researchers want to learn more about a new study treatment called BAY 2395840. BAY 2395840 works by blocking a receptor called the bradykinin B1 receptor, or B1R. This receptor is has been shown to play a role in pain perception. The researchers also want to learn how well BAY 2395840 helps to reduce pain in the study participants. To answer this question, the researchers will measure how the participants' pain changes after taking BAY 2395840 compared to a placebo. A placebo looks like a treatment but does not have any medicine in it. The researchers also want to learn how safe BAY 2395840 is for the participants to take. The study will include adults. This will be a "crossover" study. In a crossover study, all the participants will receive both treatments (BAY 2395840 and placebo), but in a different order. All participants in this study will take BAY 2395840 and a placebo as tablets by mouth. There will be 2 periods in the study. Participants taking BAY 2395840 during period 1 will switch to placebo during period 2 and vice versa. There will some time for the switch from one period to another to make sure that whatever tablet you received in period 1 is gone from your system before period 2 starts to allow for the best possible evaluation of each tablet without any confusing effects. The study is double blinded meaning that neither you nor your doctor will know which drug you are on. The sequence of double-blind placebo and BAY treatment will be determined randomly by a computerized system. During the study, the participants will visit their study site 13 times. Each participant will be in the study for about 16 weeks. The treatment duration will be about 11 weeks. During the study, the study team will: take blood and urine samples do physical examinations check the participants' overall health check the participants' heart health using an electrocardiogram (ECG) ask the participants about any medications they have been taking, and what adverse events they are having An adverse event is any medical problem that a participant has during a study. Doctors keep track of all adverse events that happen in studies, even if they do not think the adverse events might be related to the study treatments.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neuropathic Pain Associated With Diabetic Peripheral Neuropathy, Peripheral Neuropathic Pain, Diabetes Mellitus
Keywords
Neuropathic Pain

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
80 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Group 1 (BAY2395840 - placebo)
Arm Type
Experimental
Arm Description
Participants will be randomly assigned to treatment regimen of double-blind BAY2395840, and after an interim single blind period for washout will switch to double-blind placebo.
Arm Title
Group 2 (Placebo - BAY2395840)
Arm Type
Experimental
Arm Description
Participants will start with a treatment regimen of double-blind placebo, and after an interim single blind period for washout will switch to double-blind BAY2395840.
Intervention Type
Drug
Intervention Name(s)
BAY2395840
Intervention Description
Tablet, intake orally.
Intervention Type
Drug
Intervention Name(s)
Placebo for BAY2395840
Intervention Description
Tablet, intake orally.
Primary Outcome Measure Information:
Title
Change in weekly mean 24-hour average pain intensity score using the 11-point Numeric Rating Scale (NRS) from baseline to the end of intervention
Description
NRS is an one-item assessment of average neuropathic pain intensity which is presented as an 11-point Likert scale with 0 as "no pain" and 10 as "worst imaginable pain".
Time Frame
Baseline to end of intervention (in total up to 16 weeks)
Secondary Outcome Measure Information:
Title
Change in Neuropathic Pain Symptom Inventory (NPSI) score from baseline to the end of intervention.
Description
The Neuropathic Pain Symptom Inventory (NPSI) is a PRO developed to evaluate different symptoms of neuropathic pain.
Time Frame
At visit 2, visit 4, visit 6, visit 8, visit 10 and at visit 12 end of intervention (EOI).
Title
Change in Patient Global Impression of Severity (PGI-S) score from baseline to the end of intervention.
Description
The PGI-S is a one-item self-reported instrument used to assess to assess patients' impression of disease severity with a 6-point scale response options, scores ranging from 1 ("none") to 6 ("very severe).
Time Frame
At visit 2, visit 4, visit 6, visit 8, visit 10 and at visit 12 end of intervention (EOI).
Title
The proportion of participants achieving a ≥30% and a ≥50% reduction in weekly mean 24-hour average pain intensity score (i.e. responder rates using NRS)
Time Frame
From baseline to end of intervention (in total up to 12 weeks)
Title
Number of participants with treatment emergent adverse events (TEAE)
Time Frame
From start of study intervention to 14 days after last dose.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adults ≥ 18 years of age at the time of signing the informed consent. Have documented diagnosis of type 1 OR type 2 diabetes mellitus (DM). Have painful distal symmetrical sensorimotor diabetic neuropathy for at least 6 months prior to the screening and confirmed at screening via the modified Toronto Clinical Neuropathy Score with a score of at least 3. Weekly mean 24-hour average pain Numeric Rating Scale (NRS) ≥ 4 with adequate variability (not the same score on all daily pain ratings) and compliance (non-missing pain score on at least 6 out of 7 consecutive days) in daily pain recording during the 7-day NRS baseline period. Neuropathic pain according to the Douleur Neuropathique 4 Questions (DN4 questionnaire) at screening visit with a score of at least 4 out of 10. Participant should be on stable antidiabetic treatment for at least 3 months prior to the screening visit and there should be no pre-planned changes to antidiabetic treatment during this study. Participant is willing to use only rescue medication provided by the site and is willing to withdraw temporarily all other neuropathic pain medications which were in use before study participation. Participant is willing and able to use the electronic hand-held device on their own. Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies. Exclusion Criteria: Clinically significant cardiovascular or cerebrovascular disease including Acute coronary syndrome (ACS)/myocardial infarction /stroke/Transient ischemic attack (TIA) within previous 3 months before screening visit. Major depressive episode within 6 months prior to screening. Patients with stable depression and on stable antidepressant dose (no change in medication and /or dosing regimen) for the past 6 months are allowed to participate, provided the antidepressant used is not listed under prohibited medications. Any differential diagnosis of peripheral diabetic neuropathy (PDN) including but not limited to other neuropathies (e.g. vitamin B12 deficiency, Chronic Inflammatory Demyelinating Polyneuropathy), polyradiculopathies, central disorders (e.g. demyelinating disease), or rheumatological disease (e.g. foot arthritis, plantar fasciitis). Concurrent malignancy or history of cancer (exception of basal cell or squamous cell carcinoma of the skin) within the last 5 years prior to screening. Any other diseases or conditions that according to the investigator can compromise the function of the body systems and could result in altered absorption, excessive accumulation, impaired metabolism, or altered excretion of the study intervention (e.g. chronic bowel disease, Crohn's disease, and ulcerative colitis). Any serious or unstable diseases or conditions including psychiatric disorders that might interfere with the conduct of the study or the interpretation of the results. Major surgery or radiological procedures (e.g. Percutaneous transluminal angioplasty (PTA) and stenting of peripheral vascular lesions in lower extremities) within 3 months before screening visit or scheduled during the study period, which might interfere pain response evaluation. Symptomatic peripheral arterial disease in lower or upper extremities, including diabetic ulcers. Use of live, attenuated, replication-competent vaccines. Previous use of strong opioids (e.g. oxymorphone, oxycodone) for neuropathic pain anytime, or topical use of capsaicin within 3 months prior to the screening visit. History or current diagnosis of electrocardiogram (ECG) abnormalities indicating significant risk of safety for study participants. Moderate-to-severe hepatic impairment defined as Child-Pugh Class B or C. Have platelets ≤ 100 x 109/L, or neutrophil count < 1.2 x 109/L (or equivalent), hemoglobin ≤ 100 g/L for women or hemoglobin ≤ 110 g/L for men at screening. Glycemic control unstable (hemoglobin HbA1c ≥11% or 97 mmol/mol) within 3 months prior to screening (e.g. ketoacidosis requiring hospitalization, any recent episode of hypoglycemia requiring assistance through medical intervention, uncontrolled hyperglycemia). ALT >2xULN, or AST >2xULN, or total bilirubin greater than ULN, or alkaline phosphatase (AP) >2x ULN, or INR greater than ULN (unless related to anticoagulation treatment) at screening. Positive hepatitis B virus surface antigen (HBsAg) or positive hepatitis C virus antibodies (anti-HCV) and detection of mRNA (HCV-mRNA tested only if hepatitis C virus antibodies detected). Estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m^2 calculated by Modification of Diet in Renal Disease (MDRD) formula. Uncontrolled hypertension despite optimal treatment with antihypertensive(s), indicated by a sitting systolic blood pressure ≥ 180 mmHg and/or diastolic blood pressure ≥ 110 mmHg.
Facility Information:
Facility Name
NEUROHK s.r.o
City
Chocen
ZIP/Postal Code
565 01
Country
Czechia
Facility Name
Interni a diabetologicka ambulance - Krnov
City
Krnov
ZIP/Postal Code
794 01
Country
Czechia
Facility Name
Fakultni nemocnice Ostrava
City
Ostrava
ZIP/Postal Code
708 52
Country
Czechia
Facility Name
Vseobecna fakultni nemocnice v Praze
City
Praha 2
ZIP/Postal Code
128 08
Country
Czechia
Facility Name
Praglandia
City
Praha 5
ZIP/Postal Code
150 00
Country
Czechia
Facility Name
Vestra Clinics s.r.o.
City
Rychnov nad Kneznou
ZIP/Postal Code
516 01
Country
Czechia
Facility Name
Diabetologicka ambulance Vlasim
City
Vlasim
ZIP/Postal Code
258 01
Country
Czechia
Facility Name
Klinische Forschung Karlsruhe GmbH
City
Karlsruhe
State/Province
Baden-Württemberg
ZIP/Postal Code
76137
Country
Germany
Facility Name
Klinische Forschung Schwerin GmbH
City
Schwerin
State/Province
Mecklenburg-Vorpommern
ZIP/Postal Code
19055
Country
Germany
Facility Name
Klinische Forschung Hannover-Mitte GmbH
City
Hannover
State/Province
Niedersachsen
ZIP/Postal Code
30159
Country
Germany
Facility Name
Herz- und Diabeteszentrum Nordrhein-Westfalen (HDZ NRW)
City
Bad Oeynhausen
State/Province
Nordrhein-Westfalen
ZIP/Postal Code
32545
Country
Germany
Facility Name
InnoDiab Forschung GmbH
City
Essen
State/Province
Nordrhein-Westfalen
ZIP/Postal Code
45136
Country
Germany
Facility Name
Klinische Forschung Berlin GbR
City
Berlin
ZIP/Postal Code
10787
Country
Germany
Facility Name
DRC Gyogyszervizsgalo Kozpont Kft.
City
Balatonfured
ZIP/Postal Code
8230
Country
Hungary
Facility Name
Clinexpert Kft.
City
Budapest
ZIP/Postal Code
1033
Country
Hungary
Facility Name
Coromed Smo Kft
City
Pecs
ZIP/Postal Code
7623
Country
Hungary
Facility Name
ALIAN s.r.o.
City
Bardejov
ZIP/Postal Code
085 01
Country
Slovakia
Facility Name
NEUROPOINT sro, Neurologicka ambulancia
City
Bratislava
ZIP/Postal Code
851 01
Country
Slovakia
Facility Name
Internal and Diabetes Clinic - IN-DIA s.r.o. | Lucenec, Slovakia
City
Lucenec
ZIP/Postal Code
984 01
Country
Slovakia
Facility Name
Svet zdravia, a.s. Vseobecna nemocnica v Ziari nad Hronom
City
Ziar nad Hronom
ZIP/Postal Code
965 37
Country
Slovakia
Facility Name
Neuron - D.T. sro, Neurologicka ambulancia
City
Zilina
ZIP/Postal Code
010 01
Country
Slovakia
Facility Name
Medivasa s.r.o.
City
Zilina
ZIP/Postal Code
01001
Country
Slovakia
Facility Name
Complexo HU Ferrol | Endocrinología y Nutrición
City
Ferrol
State/Province
A Coruña
ZIP/Postal Code
15405
Country
Spain
Facility Name
Hospital Univ. Bellvitge | Anestesiología y Unidad del Dolor
City
L'Hospitalet de Llobregat
State/Province
Barcelona
ZIP/Postal Code
08907
Country
Spain
Facility Name
Complejo Hospitalario Universitario A Coruña
City
A Coruña
ZIP/Postal Code
15006
Country
Spain
Facility Name
Hospital General Universitario de Alicante
City
Alicante
ZIP/Postal Code
03010
Country
Spain
Facility Name
Hospital General Universitario Gregorio Marañón | Endo
City
Madrid
ZIP/Postal Code
28007
Country
Spain
Facility Name
MAC Clinical Research - Teesside
City
Teesside
State/Province
Stockton-on-Tees
ZIP/Postal Code
TS17 6EW
Country
United Kingdom
Facility Name
King's College Hospital - NHS Foundation Trust
City
London
ZIP/Postal Code
SE5 9RS
Country
United Kingdom
Facility Name
MAC Research Centre - Manchester
City
Manchester
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Availability of this study's data will later be determined according to Bayer's commitment to the EFPIA/PhRMA "Principles for responsible clinical trial data sharing". This pertains to scope, timepoint and process of data access. As such, Bayer commits to sharing upon request from qualified researchers patient-level clinical trial data, study-level clinical trial data, and protocols from clinical trials in patients for medicines and indications approved in the US and EU as necessary for conducting legitimate research. This applies to data on new medicines and indications that have been approved by the EU and US regulatory agencies on or after January 01, 2014. Interested researchers can use www.vivli.org to request access to anonymized patient-level data and supporting documents from clinical studies to conduct research. Information on the Bayer criteria for listing studies and other relevant information is provided in the member section of the portal.
Links:
URL
http://clinicaltrials.bayer.com
Description
Click here to find information for studies related to Bayer products. To find this study enter the ClinicalTrials.gov identifier (NCT) number or Bayer Study Identifier (ID) in the search field.

Learn more about this trial

A Study to Learn How Safe BAY2395840 is and How Well it Works in Participants Who Have Diabetic Nerve Pain

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