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Gabapentin and Donepezil Combination on Experimental Human Pain Models

Primary Purpose

Pain, Neuropathic

Status
Completed
Phase
Phase 1
Locations
United Kingdom
Study Type
Interventional
Intervention
Gabapentin lower dose
Donepezil
Placebo (Dop)
Placebo (Gaba)
Gabapentin higher dose
Sponsored by
GlaxoSmithKline
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional basic science trial for Pain, Neuropathic focused on measuring Donepezil, allodynia, Gabapentin, Sural nerve stimulation, Electrical hyperalgesia

Eligibility Criteria

18 Years - 55 Years (Adult)MaleAccepts Healthy Volunteers

Inclusion Criteria:

  1. Male between 18 and 55 years of age inclusive, at the time of signing the informed consent.
  2. Body weight ≥ 50 Kilogram (kg) and BMI within the range 18.5-29.9 Killogram per square meter (kg/m2) (inclusive).
  3. Healthy as determined by a responsible and experienced physician, based on a medical evaluation including medical history, physical examination, psychiatric history, psychiatric evaluation, laboratory tests and cardiac monitoring.
  4. Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), alkaline phosphatase and bilirubin ≤ 1.5x Upper Limit of Normal (ULN)
  5. QT duration corrected for heart rate by Bazett's formula (QTcB) or QT duration corrected for heart rate by Fridericia's formula (QTcF) < 450 milli second (msec).

Exclusion Criteria:

  1. The subject has either a previous disease or current medical condition, which as judged by the Investigator, may compromise safety or affect the interpretation of efficacy data.
  2. History of known or suspected seizures, including infantile febrile, unexplained significant and recent loss of consciousness or history of significant head trauma with loss of consciousness or a family history (first degree relative) of epilepsy or seizures (fits).
  3. Abnormalities in 12-lead Electrocardiogram (ECG)
  4. Systolic blood pressure (BP) below 90 or above 160mm Hg, or diastolic blood pressure below 50 or above 100 millimeters of mercury (mmHg).
  5. History of sensitivity to any of the study medications
  6. History of regular alcohol consumption within 6 months of the study defined as: an average weekly intake of >21 units. One unit is equivalent to 8 g of alcohol: a half-pint (~240 millil litre [ml]) of beer, 1 glass (125 ml) of wine or 1 (25 ml) measure of spirits.
  7. A positive pre-study drug/alcohol screen at the screening visit.
  8. Excessive caffeine drinkers (~5 or more cups a day) .
  9. Excessive smokers (>5 /day)
  10. Use of prescription or non-prescription drugs, including vitamins, herbal and dietary supplements (including St John's Wort) within 7 days (or 14 days if the drug is a potential enzyme inducer) or 5 half-lives (whichever is longer) prior to screening, unless in the opinion of the Investigator and GSK Medical Monitor the medication will not interfere with the study procedures or compromise subject safety.
  11. Use of any topical steroid or capsaicin preparations in the previous 30 days to screening, unless in the opinion of the Investigator and GSK Medical Monitor the medication will not interfere with the study procedures or compromise subject safety.
  12. The subject is needle phobic
  13. The subject is unable to tolerate the electrical hyperalgesia model or nerve stimulation, including anxiety or atypical response to the stimulation on the training at the screening visit.
  14. The subject does not produce an area of allodynia or hyperalgesia to the electrical hyperalgesia model during the screening session.
  15. Subject who, in the investigator/designee's judgement, poses a significant suicide risk. Evidence of serious suicide risk may include any history of suicidal behaviour and/or any evidence of suicidal ideation on any questionnaires e.g. type 4 or 5 on the C-SSRS in the last 6 months.
  16. The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the baseline session in the current study: 90 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer).
  17. Where participation in the study would result in donation of blood or blood products in excess of 500 mL within a 84 day period.
  18. A positive pre-study Hepatitis B surface antigen or positive Hepatitis C antibody result within 3 months of screening
  19. Unwillingness or inability to follow the procedures outlined in the protocol.

Sites / Locations

  • GSK Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Active Comparator

Experimental

Placebo Comparator

Arm Label

Gabapentin lower dose alone

Gabapentin higher dose alone

Gabapentin in combination with donepezil

Placebo

Arm Description

low dose

higher dose

Gabapentin lower dose and donepezil

Placebo

Outcomes

Primary Outcome Measures

Area of pin-prick hyperalgesia
Change in Area between treatment arms (compared to baseline), measured during the electrical hyperalgesia model using 26 Milli Neuton(mN) von Frey filament
Area of touch-evoked allodynia
Change in Area between treatment arms (compared to baseline), measured during the electrical hyperalgesia model using a cotton bud

Secondary Outcome Measures

Pain threshold
Change in threshold between treatment arms (compared to baseline), measured from single electrical stimulation of sural nerve
Ongoing pain intensity rating
Change in intensity between treatment arms (compared to baseline), measured from 11-point numeric rating scale (NRS) where 0=no pain, 10=maximum pain imaginable
Pain Tolerance
Change in tolerance between treatment arms(compared to baseline), measured from single electrical stimulation of sural nerve
Pain Temporal Summation
Change in temporal summation between treatment arms (compared to baseline), measured from repetitive electrical stimulation of sural nerve
Intensity of flare
Change in intensity between treatment arms (compared to baseline), measured from Laser Doppler imaging evoked by electrical hyperalgesia model

Full Information

First Posted
September 29, 2011
Last Updated
June 9, 2017
Sponsor
GlaxoSmithKline
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1. Study Identification

Unique Protocol Identification Number
NCT01485185
Brief Title
Gabapentin and Donepezil Combination on Experimental Human Pain Models
Official Title
A Randomized, Double Blind, Placebo Controlled Study to Investigate the Effect of Donepezil and Gabapentin Combination on an Experimental Pain Model in Healthy Subjects
Study Type
Interventional

2. Study Status

Record Verification Date
June 2017
Overall Recruitment Status
Completed
Study Start Date
October 11, 2011 (Actual)
Primary Completion Date
July 3, 2012 (Actual)
Study Completion Date
July 3, 2012 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study will compare the effects of gabapentin alone, and gabapentin + donepezil given together in two types of experimental electrical pain tests in up to 48 healthy male subjects (after 24 recruited in the first cohort an interim analysis will be performed). The study is a randomized, double blind, placebo controlled, 3 was cross-over design study with incomplete block design and 4 treatment options. Placebo, gabapentin alone (lower dose and higher dose) or gabapentin (lower dose) with donepezil.
Detailed Description
This study will compare the effects of gabapentin alone, and gabapentin + donepezil given together in two types of experimental electrical pain tests which will be conducted on the forearm and the lower leg, in 24 healthy male subjects initially. Gabapentin (a drug for treatment of seizure disorders) is one of the drugs being used for the treatment of pain caused by the damage to the nerves. Donepezil is a treatment to improve memory in patients with Alzheimer's disease. 24 more subjects may be recruited following a formal analysis during the trial (called interim analysis), if required for optimal scientific value. The study consists of 1 screening visit,1 visit to establish the baseline pain recordings before any treatment is given, then 3 treatment sessions, followed by a followup visit. Each treatment session consists of 12 days of dosing at home and 2 inpatient days for dosing and pain tests. Each volunteer takes part in 3 treatment sessions. In total, the study will last 15 weeks for each volunteer. There will be 4 treatment options: placebo, higher dose of gabapentin, low dose of gabapentin, low dose of gabapentin + donepezil. All subjects will receive the last two options and one out of the first two options, in a random order selected by a computer before the study starts; neither the volunteers nor the persons conducting the pain assessments nor the study team will know which treatment the volunteers receive during the visits (known as a randomised, double-blind study). The study will be conducted in a specialist clinical research unit with adequate facilities with regard to safety and compliance. The results of the tests in the study will help to understand the effects of gabapentin and donepezil together to design future clinical trials.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Pain, Neuropathic
Keywords
Donepezil, allodynia, Gabapentin, Sural nerve stimulation, Electrical hyperalgesia

7. Study Design

Primary Purpose
Basic Science
Study Phase
Phase 1
Interventional Study Model
Crossover Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
48 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Gabapentin lower dose alone
Arm Type
Experimental
Arm Description
low dose
Arm Title
Gabapentin higher dose alone
Arm Type
Active Comparator
Arm Description
higher dose
Arm Title
Gabapentin in combination with donepezil
Arm Type
Experimental
Arm Description
Gabapentin lower dose and donepezil
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Placebo
Intervention Type
Drug
Intervention Name(s)
Gabapentin lower dose
Intervention Description
Repeat, oral dose
Intervention Type
Drug
Intervention Name(s)
Donepezil
Intervention Description
Repeat, oral dose
Intervention Type
Other
Intervention Name(s)
Placebo (Dop)
Intervention Description
Placebo to donepezil, Repeat, oral dose
Intervention Type
Other
Intervention Name(s)
Placebo (Gaba)
Intervention Description
Placebo to gabapentin, Repeat, oral dose
Intervention Type
Drug
Intervention Name(s)
Gabapentin higher dose
Intervention Description
Repeat, oral dose
Primary Outcome Measure Information:
Title
Area of pin-prick hyperalgesia
Description
Change in Area between treatment arms (compared to baseline), measured during the electrical hyperalgesia model using 26 Milli Neuton(mN) von Frey filament
Time Frame
Change from baseline visit to day 14 of treatment sessions
Title
Area of touch-evoked allodynia
Description
Change in Area between treatment arms (compared to baseline), measured during the electrical hyperalgesia model using a cotton bud
Time Frame
Change from baseline visit to day 14 of treatment sessions
Secondary Outcome Measure Information:
Title
Pain threshold
Description
Change in threshold between treatment arms (compared to baseline), measured from single electrical stimulation of sural nerve
Time Frame
Change from baseline visit to day 14 of treatment sessions
Title
Ongoing pain intensity rating
Description
Change in intensity between treatment arms (compared to baseline), measured from 11-point numeric rating scale (NRS) where 0=no pain, 10=maximum pain imaginable
Time Frame
Change from baseline visit to day 14 of treatment sessions
Title
Pain Tolerance
Description
Change in tolerance between treatment arms(compared to baseline), measured from single electrical stimulation of sural nerve
Time Frame
Change from baseline visit to day 14 of treatment sessions
Title
Pain Temporal Summation
Description
Change in temporal summation between treatment arms (compared to baseline), measured from repetitive electrical stimulation of sural nerve
Time Frame
Change from baseline visit to day 14 of treatment sessions
Title
Intensity of flare
Description
Change in intensity between treatment arms (compared to baseline), measured from Laser Doppler imaging evoked by electrical hyperalgesia model
Time Frame
Change from baseline visit to day 14 of treatment sessions

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
55 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Male between 18 and 55 years of age inclusive, at the time of signing the informed consent. Body weight ≥ 50 Kilogram (kg) and BMI within the range 18.5-29.9 Killogram per square meter (kg/m2) (inclusive). Healthy as determined by a responsible and experienced physician, based on a medical evaluation including medical history, physical examination, psychiatric history, psychiatric evaluation, laboratory tests and cardiac monitoring. Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), alkaline phosphatase and bilirubin ≤ 1.5x Upper Limit of Normal (ULN) QT duration corrected for heart rate by Bazett's formula (QTcB) or QT duration corrected for heart rate by Fridericia's formula (QTcF) < 450 milli second (msec). Exclusion Criteria: The subject has either a previous disease or current medical condition, which as judged by the Investigator, may compromise safety or affect the interpretation of efficacy data. History of known or suspected seizures, including infantile febrile, unexplained significant and recent loss of consciousness or history of significant head trauma with loss of consciousness or a family history (first degree relative) of epilepsy or seizures (fits). Abnormalities in 12-lead Electrocardiogram (ECG) Systolic blood pressure (BP) below 90 or above 160mm Hg, or diastolic blood pressure below 50 or above 100 millimeters of mercury (mmHg). History of sensitivity to any of the study medications History of regular alcohol consumption within 6 months of the study defined as: an average weekly intake of >21 units. One unit is equivalent to 8 g of alcohol: a half-pint (~240 millil litre [ml]) of beer, 1 glass (125 ml) of wine or 1 (25 ml) measure of spirits. A positive pre-study drug/alcohol screen at the screening visit. Excessive caffeine drinkers (~5 or more cups a day) . Excessive smokers (>5 /day) Use of prescription or non-prescription drugs, including vitamins, herbal and dietary supplements (including St John's Wort) within 7 days (or 14 days if the drug is a potential enzyme inducer) or 5 half-lives (whichever is longer) prior to screening, unless in the opinion of the Investigator and GSK Medical Monitor the medication will not interfere with the study procedures or compromise subject safety. Use of any topical steroid or capsaicin preparations in the previous 30 days to screening, unless in the opinion of the Investigator and GSK Medical Monitor the medication will not interfere with the study procedures or compromise subject safety. The subject is needle phobic The subject is unable to tolerate the electrical hyperalgesia model or nerve stimulation, including anxiety or atypical response to the stimulation on the training at the screening visit. The subject does not produce an area of allodynia or hyperalgesia to the electrical hyperalgesia model during the screening session. Subject who, in the investigator/designee's judgement, poses a significant suicide risk. Evidence of serious suicide risk may include any history of suicidal behaviour and/or any evidence of suicidal ideation on any questionnaires e.g. type 4 or 5 on the C-SSRS in the last 6 months. The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the baseline session in the current study: 90 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer). Where participation in the study would result in donation of blood or blood products in excess of 500 mL within a 84 day period. A positive pre-study Hepatitis B surface antigen or positive Hepatitis C antibody result within 3 months of screening Unwillingness or inability to follow the procedures outlined in the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
GSK Clinical Trials
Organizational Affiliation
GlaxoSmithKline
Official's Role
Study Director
Facility Information:
Facility Name
GSK Investigational Site
City
Cambridge
ZIP/Postal Code
CB2 2GG
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
25218827
Citation
Boyle Y, Fernando D, Kurz H, Miller SR, Zucchetto M, Storey J. The effect of a combination of gabapentin and donepezil in an experimental pain model in healthy volunteers: Results of a randomized controlled trial. Pain. 2014 Dec;155(12):2510-2516. doi: 10.1016/j.pain.2014.09.003. Epub 2014 Sep 10.
Results Reference
derived

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Gabapentin and Donepezil Combination on Experimental Human Pain Models

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