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Effect of NRD135S.E1 in Peripheral Neuropathic Pain in Diabetic Patients

Primary Purpose

Diabetic Peripheral Neuropathic Pain

Status
Completed
Phase
Phase 2
Locations
Israel
Study Type
Interventional
Intervention
NRD135S.E1
Placebo to match NRD135S.E1
Sponsored by
Novaremed Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Diabetic Peripheral Neuropathic Pain

Eligibility Criteria

18 Years - 99 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. -Males agree to use condoms throughout treatment and follow up study periods.

    • Females must not be of childbearing potential as evidenced by at least one of the following:

      ≥ 62 years old and amenorrheic for ≥ 1 year

    • Amenorrheic ≥ 12 consecutive months and a documented serum follicle stimulating hormone (FSH) level > 35 mIU/mL
    • Irregular menstrual periods and a documented FSH level > 35 mIU/mL
    • On hormone replacement therapy and prior clinical evidence of menopause based on any of the criteria above
    • Surgically sterile
  2. Known stable diabetes mellitus for the last 3 months. (No oral hypoglycemic medications change allowed. Maximum insulin change allowed is ± 20%).
  3. Evidence of peripheral neuropathy associated with diabetes mellitus diagnosed by DN4 criteria.
  4. Presence of ongoing pain due to DPN for at least 3 months.
  5. Mean DPN pain intensity of 4 to 9 on the NPS at screening.
  6. HbA1c ≤ 9% of total hemoglobin at screening.
  7. Willing to stop pain medications for DPN (except for limited use of paracetamol).
  8. Signed written informed consent.

    • Subjects must have signed and dated an Institutional Review Board / Independent Ethics Committee approved written informed consent form in accordance with regulatory and institutional guidelines. This must be obtained before the performance of any protocol related procedures that are not part of normal subject care.
    • Subjects must be willing and able to comply with scheduled visits, treatment schedule, laboratory testing, and other requirements of the study.

Exclusion Criteria

  1. Female of childbearing potential.
  2. Neurologic disorders unrelated to DPN that may interfere with the assessment of DPN.
  3. Known allergy or intolerance to paracetamol.
  4. Evidence of non-DPN polyneuropathy.
  5. The presence of severe pain associated with conditions other than DPN (e.g., peripheral vascular disease, phantom pain, etc.) that could confound the self-evaluation of pain due to DPN.
  6. Any anti-epileptic or anti-depressive treatment. Amityptiline (Elatrol/Elatrolet) or duloxetine (Cymbalta) are permitted at screening but not later.
  7. Constant use of non-steroidal anti-inflammatory drugs or opiates that cannot be withdrawn during the washout period and the whole study duration.
  8. Participation in another clinical trial in the last 3 months.
  9. Poor compliance with prescribed medication or alcohol or drug abuse within 2 years before screening.
  10. Hypersensitivity to paracetamol or any of the inactive ingredients in NRD135S.E1 capsules.
  11. Any serious medical condition, including the presence of laboratory abnormalities, that places the patient at an unacceptable risk if he or she participates in this study or confounds the ability to interpret data from the study.
  12. Patients with any hematological disorder.
  13. Prisoners or subjects who are involuntarily incarcerated.
  14. Subjects who are compulsorily detained for treatment of either a psychiatric or physical (e.g. infectious disease) illness.
  15. Patients whose judgment has been impaired by their physical ir mental condition

Sites / Locations

  • Diabetes and Endocrinology clinic, Bat-Yamon Medical center, Clalit health services
  • Diabetes clinic, Lin Medical Center
  • Rambam Medical Center, Diabetic Endocrine unit
  • Wolfson Medical Center
  • Diabetic and Endocrinology clinic, Clalit health services
  • Meir Medical Center, Endocrynology, diabetes and metabolism Unit
  • Diabetes Department Migdal Hamea Clalit health services
  • DMC Medical Center
  • Sorasky Medical Center, Diabetic unit
  • Ziv Medical Center, Endocrinology Unit

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Placebo Comparator

Arm Label

NRD135S.E1 A

NRD135S.E1 B

NRD135S.E1 C

Placebo to match NRD135S.E1 D

Arm Description

A = 10 mg NRD135S.E1 once daily PO for 21 days

B = 40 mg NRD135S.E1 once daily PO for 21 days

C = 150 mg NRD135S.E1 once daily PO for 21 days

D = Placebo once daily PO for 21 days

Outcomes

Primary Outcome Measures

• Change from the baseline week to Week 3 in the weekly average daily pain intensity as measured on an 11-point numerical pain scale (NPS)

Secondary Outcome Measures

Change from the baseline week to Week 3 in the weekly maximum daily pain intensity as measured on the NPS
Change from the baseline week to Week 3 in the weekly consumption of rescue analgesic (i.e., number of paracetamol 500 mg tablets taken per week)
• Change from Day 8 (end of baseline week) to Day 29 (24 h after last study drug administration) in Short-Form McGill Pain Questionnaire (SF-MPQ) score
Clinician's Global Impression of Change from the baseline week at Day 29 (24 h after last study drug administration)
Patient's Global Impression of Change from the baseline week at Day 29 (24 h after last study drug administration)
Change from the baseline week to Week 3 in the weekly Daily Sleep Interference Score
Incidence of treatment-emergent AEs (TEAEs)

Full Information

First Posted
January 19, 2015
Last Updated
September 21, 2016
Sponsor
Novaremed Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT02345291
Brief Title
Effect of NRD135S.E1 in Peripheral Neuropathic Pain in Diabetic Patients
Official Title
A Phase 2a, Randomized, Double-blind, Placebo (Vehicle)-Controlled, Dose Finding Trial to Assess the Safety, Tolerability and Efficacy of NRD135S.E1 in Patients With Neuropathic Pain Associated With Diabetes Mellitus
Study Type
Interventional

2. Study Status

Record Verification Date
July 2016
Overall Recruitment Status
Completed
Study Start Date
April 2015 (undefined)
Primary Completion Date
July 2016 (Actual)
Study Completion Date
July 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Novaremed Ltd.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
A multicenter, Phase 2a, randomized, double-blind, placebo (vehicle)-controlled, parallel-group, dose-finding study designed to evaluate the efficacy, safety and tolerability of NRD135S.E1 in adult patients with diabetes mellitus type 1 or 2 with neuropathic pain. Potential study patients will sign informed consent prior to undergoing any study-related procedure.
Detailed Description
Following screening, eligible patients will be enrolled and go through a week of washout of analgesic treatment. Patients who are still eligible following the washout will be randomized to one of four treatment groups: NRD135S.E1 at 10, 40, or 150 mg per day or placebo (vehicle). All four treatment groups will start study treatment with 1 week of single blind placebo (baseline week) followed by 3 weeks of the allocated double blind treatment (Weeks 1, 2, and 3). All patients will be followed for 30 days after the last study drug administration. The total study duration per patient is 9 to10 weeks. Visit schedule: Screening (Days minus 14 to minus 8, Visit 1). Washout visit (Day minus 7, Visit 2). Randomization and start of placebo treatment (Day 1, Visit 3). Double blind treatment visits on Days 8 (Visit 4), 15 (Visit 5) and 29 (Visit 6). Follow up visit by telephone (Day 59, Visit 7).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Diabetic Peripheral Neuropathic Pain

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
88 (Actual)

8. Arms, Groups, and Interventions

Arm Title
NRD135S.E1 A
Arm Type
Experimental
Arm Description
A = 10 mg NRD135S.E1 once daily PO for 21 days
Arm Title
NRD135S.E1 B
Arm Type
Experimental
Arm Description
B = 40 mg NRD135S.E1 once daily PO for 21 days
Arm Title
NRD135S.E1 C
Arm Type
Experimental
Arm Description
C = 150 mg NRD135S.E1 once daily PO for 21 days
Arm Title
Placebo to match NRD135S.E1 D
Arm Type
Placebo Comparator
Arm Description
D = Placebo once daily PO for 21 days
Intervention Type
Drug
Intervention Name(s)
NRD135S.E1
Other Intervention Name(s)
E1
Intervention Description
A small chemical entity for treatment of neuropathic pain NRD135S.E1
Intervention Type
Drug
Intervention Name(s)
Placebo to match NRD135S.E1
Other Intervention Name(s)
Placebo for E1
Intervention Description
Placebo capsule to match NRD135S.E1 capsules
Primary Outcome Measure Information:
Title
• Change from the baseline week to Week 3 in the weekly average daily pain intensity as measured on an 11-point numerical pain scale (NPS)
Time Frame
three weeks
Secondary Outcome Measure Information:
Title
Change from the baseline week to Week 3 in the weekly maximum daily pain intensity as measured on the NPS
Time Frame
three weeks
Title
Change from the baseline week to Week 3 in the weekly consumption of rescue analgesic (i.e., number of paracetamol 500 mg tablets taken per week)
Time Frame
three weeks
Title
• Change from Day 8 (end of baseline week) to Day 29 (24 h after last study drug administration) in Short-Form McGill Pain Questionnaire (SF-MPQ) score
Time Frame
three
Title
Clinician's Global Impression of Change from the baseline week at Day 29 (24 h after last study drug administration)
Time Frame
three weeks
Title
Patient's Global Impression of Change from the baseline week at Day 29 (24 h after last study drug administration)
Time Frame
three weeks
Title
Change from the baseline week to Week 3 in the weekly Daily Sleep Interference Score
Time Frame
three weeks
Title
Incidence of treatment-emergent AEs (TEAEs)
Time Frame
three weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
99 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: -Males agree to use condoms throughout treatment and follow up study periods. Females must not be of childbearing potential as evidenced by at least one of the following: ≥ 62 years old and amenorrheic for ≥ 1 year Amenorrheic ≥ 12 consecutive months and a documented serum follicle stimulating hormone (FSH) level > 35 mIU/mL Irregular menstrual periods and a documented FSH level > 35 mIU/mL On hormone replacement therapy and prior clinical evidence of menopause based on any of the criteria above Surgically sterile Known stable diabetes mellitus for the last 3 months. (No oral hypoglycemic medications change allowed. Maximum insulin change allowed is ± 20%). Evidence of peripheral neuropathy associated with diabetes mellitus diagnosed by DN4 criteria. Presence of ongoing pain due to DPN for at least 3 months. Mean DPN pain intensity of 4 to 9 on the NPS at screening. HbA1c ≤ 9% of total hemoglobin at screening. Willing to stop pain medications for DPN (except for limited use of paracetamol). Signed written informed consent. Subjects must have signed and dated an Institutional Review Board / Independent Ethics Committee approved written informed consent form in accordance with regulatory and institutional guidelines. This must be obtained before the performance of any protocol related procedures that are not part of normal subject care. Subjects must be willing and able to comply with scheduled visits, treatment schedule, laboratory testing, and other requirements of the study. Exclusion Criteria Female of childbearing potential. Neurologic disorders unrelated to DPN that may interfere with the assessment of DPN. Known allergy or intolerance to paracetamol. Evidence of non-DPN polyneuropathy. The presence of severe pain associated with conditions other than DPN (e.g., peripheral vascular disease, phantom pain, etc.) that could confound the self-evaluation of pain due to DPN. Any anti-epileptic or anti-depressive treatment. Amityptiline (Elatrol/Elatrolet) or duloxetine (Cymbalta) are permitted at screening but not later. Constant use of non-steroidal anti-inflammatory drugs or opiates that cannot be withdrawn during the washout period and the whole study duration. Participation in another clinical trial in the last 3 months. Poor compliance with prescribed medication or alcohol or drug abuse within 2 years before screening. Hypersensitivity to paracetamol or any of the inactive ingredients in NRD135S.E1 capsules. Any serious medical condition, including the presence of laboratory abnormalities, that places the patient at an unacceptable risk if he or she participates in this study or confounds the ability to interpret data from the study. Patients with any hematological disorder. Prisoners or subjects who are involuntarily incarcerated. Subjects who are compulsorily detained for treatment of either a psychiatric or physical (e.g. infectious disease) illness. Patients whose judgment has been impaired by their physical ir mental condition
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Eli Kaplan, MD
Organizational Affiliation
Novaremed Ltd.
Official's Role
Study Director
Facility Information:
Facility Name
Diabetes and Endocrinology clinic, Bat-Yamon Medical center, Clalit health services
City
Bat-Yam
Country
Israel
Facility Name
Diabetes clinic, Lin Medical Center
City
Haifa
ZIP/Postal Code
35152
Country
Israel
Facility Name
Rambam Medical Center, Diabetic Endocrine unit
City
Haifa
Country
Israel
Facility Name
Wolfson Medical Center
City
Holon
Country
Israel
Facility Name
Diabetic and Endocrinology clinic, Clalit health services
City
Jerusalem
ZIP/Postal Code
9310609
Country
Israel
Facility Name
Meir Medical Center, Endocrynology, diabetes and metabolism Unit
City
Kfar-Saba
ZIP/Postal Code
44821
Country
Israel
Facility Name
Diabetes Department Migdal Hamea Clalit health services
City
Tel Aviv
ZIP/Postal Code
62038
Country
Israel
Facility Name
DMC Medical Center
City
Tel-Aviv
ZIP/Postal Code
6937947
Country
Israel
Facility Name
Sorasky Medical Center, Diabetic unit
City
Tel-Aviv
Country
Israel
Facility Name
Ziv Medical Center, Endocrinology Unit
City
Zefat
Country
Israel

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Effect of NRD135S.E1 in Peripheral Neuropathic Pain in Diabetic Patients

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