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NPC-06 to Pain Associated With Acute Herpes Zoster

Primary Purpose

Acute Pain in Herpes Zoster

Status
Completed
Phase
Phase 3
Locations
Japan
Study Type
Interventional
Intervention
NPC-06
Placebo
Sponsored by
Nobelpharma
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Acute Pain in Herpes Zoster focused on measuring Herpes zoster, fosphenytoin, adjuvant analgesic, acute pain, NPC-06

Eligibility Criteria

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

Inclusion Criteria:

  1. Patients aged 18 years or older at the time of informed consent.
  2. Patients who are male or female.
  3. Patients who are inpatient or outpatient.
  4. Patients who are diagnosed with herpes zoster and have acute pain.
  5. Patients who are within 28 days after the onset of herpes zoster.
  6. Patients whose mean NRS pain score is 4 or higher despite the use of the following drugs during the period between 24 hours and 120 minutes before the study drug administration. During this period, one or two of the following drugs should have been used, and the same drug should have been used at least twice.

    • Non-opioid analgesics (excluding its sustained release formulations and topical drugs used for other sites than the target site for efficacy)
    • Ca2+ channels α2δ ligands (excluding gabapentin)
    • Tramadol (excluding its sustained release formulations)
    • An extract from inflammatory rabbit skin inoculated by vaccinia virus
    • Patients whose NRS pain score immediately before the study drug administration is 4 or higher.

(8) Patients who are able to perform NRS self-assessment appropriately. (9) Patients who gave written informed consent based on their own free will after receiving adequate explanation and fully understanding the details of the explanation in participating in the study.

Exclusion Criteria:

  1. Patients who are suspected to be increased intracranial pressure.
  2. Patients who are complicated with epilepsy, serious mental or neuropsychiatric disorders (including dementia, Parkinson's disease, or schizophrenia) or consciousness disturbance.
  3. Patients who are being treated for malignancy. However, those who do not interfere with daily life and have good general condition may be included in the study.
  4. Patients who are being treated for HIV infection or those who are receiving immunosuppressant (including biologics). However, those who do not interfere with daily life and have good general condition may be included in the study.
  5. Patients who are being treated for idiopathic trigeminal neuralgia.
  6. Patients who have other severe pain that may affect the assessment of pain associated with acute herpes zoster.
  7. Patients who have received non-opioid analgesics (excluding its sustained release formulations and topical drugs used for other sites than the target site for efficacy), Ca2+ channel-α2δ ligands (excluding gabapentin), tramadol (excluding its sustained release formulations), or an extract from inflammatory rabbit skin inoculated by vaccinia virus during the period from 120 minutes before the study drug administration to the start of study drug administration.
  8. Patients who have received the following drugs during the period from 24 hours before the study drug administration to immediately before the study drug administration.

    • Non-opioid analgesics (its sustained release formulations)
    • Gabapentin
    • Tramadol (its sustained release formulations)
    • Opioid analgesics
    • Steroidal anti-inflammatory drugs (systemic) for treatment of herpes zoster and pain associated with acute herpes zoster.
    • Antidepressants, antiarrhythmics (excluding those in Vaughan Williams class Ⅱ), NMDA receptor antagonists, centrally acting muscle relaxants, and anesthetics (excluding topical drugs used for other sites than the target site for efficacy).
  9. Patients who have sinus bradycardia or advanced conduction disturbance.
  10. Patients who have a history of hypersensitivity to hydantoin.
  11. Patients who are receiving drugs that are contraindicated in the package insert for fosphenytoin.
  12. Patients who have received amenamevir during the period from 24 hours before the study drug administration to immediately before the study drug administration.
  13. Patients who are complicated with meningitis or have symptoms of meningeal irritation.
  14. Patients who have serious cardiac disease, respiratory disorder, or hepatic or renal dysfunction (as a guide, seriousness corresponding to Grade 3 of "Standards for Classification of Seriousness of Adverse Drug Reactions (Notification No. 80 of the Pharmaceutical Safety Notification ").
  15. Patients who are receiving fosphenytoin, phenytoin, ethotoin, or a combination of these drugs or have received these drugs as adjuvant analgesics.
  16. Patients who have participated in other clinical study within 3 months of the date of the screening test.
  17. Pregnant women, lactating women or patients of childbearing potential during the study period.
  18. Patients who are unable to give appropriate contraception in accordance with the instructions of the investigator or sub-investigator (hereafter, the investigators) during the period from after obtaining informed consent to the end of the follow-up period.
  19. Other patients who are deemed inappropriate for participation in the study by the investigators.

Sites / Locations

  • Akemi Dermatology Clinic
  • Fukuoka Tokushukai Hospital
  • Chugoku Rosai Hospital
  • Hakodate Central General Hospital
  • Japanese Red Cross Society Himeji Hospital
  • Koga General Hospital
  • Shonan Fujisawa Tokushukai Hospital
  • Toyama Dermatologic Clinic
  • Yoshikawa Skin Clinic
  • Juntendo University Hospital
  • Sumi Clinic Dermatology Allergology
  • Kurobe City Hospital
  • University of Yamanashi Hospital
  • Fukuoka Kinen Hospital
  • Hakata Pain Clinic
  • Matsuda Tomoko Dermatological Clinic
  • National Hospital Organization Kanazawa Medical Center
  • University Hospital Kyoto Prefectural University of Medicine
  • Kawasaki Medical School General Medical Center
  • Shizuoka City Shizuoka Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

NPC-06

Placebo

Arm Description

Outcomes

Primary Outcome Measures

The change of NRS (Numeric Rating Scale:Max10, Min0, higher scores mean a worse outcome) score
Change in the NRS pain score from baseline at 120 minutes after the study drug administration.

Secondary Outcome Measures

Full Information

First Posted
July 27, 2022
Last Updated
September 27, 2023
Sponsor
Nobelpharma
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1. Study Identification

Unique Protocol Identification Number
NCT05480553
Brief Title
NPC-06 to Pain Associated With Acute Herpes Zoster
Official Title
A Phase 3, Placebo-Controlled, Double-Blind Controlled Study of NPC-06 in Patients With Pain Associated With Acute Herpes Zoster
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Completed
Study Start Date
August 5, 2022 (Actual)
Primary Completion Date
May 29, 2023 (Actual)
Study Completion Date
August 23, 2023 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

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

5. Study Description

Brief Summary
To confirm the pain relief effect and the safety of NPC-06 (fosphenytoin sodium hydrate) in patients with pain associated with acute herpes zoster in a placebo-controlled, double-blind, parallel-group, comparative manner.
Detailed Description
The eligible patients will be randomized into two groups, and will receive NPC-06 or placebo.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Acute Pain in Herpes Zoster
Keywords
Herpes zoster, fosphenytoin, adjuvant analgesic, acute pain, NPC-06

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
NPC-06
Arm Type
Experimental
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
NPC-06
Intervention Description
Initial dose (Day 1) <Dose> An 18 mg/kg of NPC-06 will be injected by intravenous drip infusion once daily. The maximum dose of the test drug should not exceed 1,200 mg as fosphenytoin sodium. <Administration method> Dilute the study drug 3 to 4-fold using physiological saline for intravenous infusion and then administer the solution over 18 minutes. Maintenance dose(Day 2~7) Maintenance dose on the next day (Day 2) after the initial dose will be mandatory, and will be dosed up to 6 days. Maintenance dose on Day 3 and thereafter will follow the transition criteria for maintenance dose. <Dose> A 7.5 mg/kg of NPC-06 will be injected as needed by intravenous drip infusion once daily. The maximum dose of NPC-06 should not exceed 500 mg as fosphenytoin sodium. <Administration method> Dilute the study drug 3-to 4-fold using physiological saline for intravenous infusion and then administer the solution over 7 minutes and 30 seconds.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Initial dose (Day 1) <Dose> A placebo will be injected by intravenous drip infusion once daily. <Administration method> Dilute the study drug 3 to 4-fold using physiological saline for intravenous infusion and then administer the solution over 18 minutes. Maintenance dose(Day 2~7) Maintenance dose on the next day (Day 2) after the initial dose will be mandatory, and will be dosed up to 6 days. Maintenance dose on Day 3 and thereafter will follow the transition criteria for maintenance dose. <Dose> A placebo will be injected as needed by intravenous drip infusion once daily. Dilute the study drug 3-to 4-fold using physiological saline for intravenous infusion and then administer the solution over 7 minutes and 30 seconds.
Primary Outcome Measure Information:
Title
The change of NRS (Numeric Rating Scale:Max10, Min0, higher scores mean a worse outcome) score
Description
Change in the NRS pain score from baseline at 120 minutes after the study drug administration.
Time Frame
120 minutes after first administration

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients aged 18 years or older at the time of informed consent. Patients who are male or female. Patients who are inpatient or outpatient. Patients who are diagnosed with herpes zoster and have acute pain. Patients who are within 28 days after the onset of herpes zoster. Patients whose mean NRS pain score is 4 or higher despite the use of the following drugs during the period between 24 hours and 120 minutes before the study drug administration. During this period, one or two of the following drugs should have been used, and the same drug should have been used at least twice. Non-opioid analgesics (excluding its sustained release formulations and topical drugs used for other sites than the target site for efficacy) Ca2+ channels α2δ ligands (excluding gabapentin) Tramadol (excluding its sustained release formulations) An extract from inflammatory rabbit skin inoculated by vaccinia virus Patients whose NRS pain score immediately before the study drug administration is 4 or higher. (8) Patients who are able to perform NRS self-assessment appropriately. (9) Patients who gave written informed consent based on their own free will after receiving adequate explanation and fully understanding the details of the explanation in participating in the study. Exclusion Criteria: Patients who are suspected to be increased intracranial pressure. Patients who are complicated with epilepsy, serious mental or neuropsychiatric disorders (including dementia, Parkinson's disease, or schizophrenia) or consciousness disturbance. Patients who are being treated for malignancy. However, those who do not interfere with daily life and have good general condition may be included in the study. Patients who are being treated for HIV infection or those who are receiving immunosuppressant (including biologics). However, those who do not interfere with daily life and have good general condition may be included in the study. Patients who are being treated for idiopathic trigeminal neuralgia. Patients who have other severe pain that may affect the assessment of pain associated with acute herpes zoster. Patients who have received non-opioid analgesics (excluding its sustained release formulations and topical drugs used for other sites than the target site for efficacy), Ca2+ channel-α2δ ligands (excluding gabapentin), tramadol (excluding its sustained release formulations), or an extract from inflammatory rabbit skin inoculated by vaccinia virus during the period from 120 minutes before the study drug administration to the start of study drug administration. Patients who have received the following drugs during the period from 24 hours before the study drug administration to immediately before the study drug administration. Non-opioid analgesics (its sustained release formulations) Gabapentin Tramadol (its sustained release formulations) Opioid analgesics Steroidal anti-inflammatory drugs (systemic) for treatment of herpes zoster and pain associated with acute herpes zoster. Antidepressants, antiarrhythmics (excluding those in Vaughan Williams class Ⅱ), NMDA receptor antagonists, centrally acting muscle relaxants, and anesthetics (excluding topical drugs used for other sites than the target site for efficacy). Patients who have sinus bradycardia or advanced conduction disturbance. Patients who have a history of hypersensitivity to hydantoin. Patients who are receiving drugs that are contraindicated in the package insert for fosphenytoin. Patients who have received amenamevir during the period from 24 hours before the study drug administration to immediately before the study drug administration. Patients who are complicated with meningitis or have symptoms of meningeal irritation. Patients who have serious cardiac disease, respiratory disorder, or hepatic or renal dysfunction (as a guide, seriousness corresponding to Grade 3 of "Standards for Classification of Seriousness of Adverse Drug Reactions (Notification No. 80 of the Pharmaceutical Safety Notification "). Patients who are receiving fosphenytoin, phenytoin, ethotoin, or a combination of these drugs or have received these drugs as adjuvant analgesics. Patients who have participated in other clinical study within 3 months of the date of the screening test. Pregnant women, lactating women or patients of childbearing potential during the study period. Patients who are unable to give appropriate contraception in accordance with the instructions of the investigator or sub-investigator (hereafter, the investigators) during the period from after obtaining informed consent to the end of the follow-up period. Other patients who are deemed inappropriate for participation in the study by the investigators.
Facility Information:
Facility Name
Akemi Dermatology Clinic
City
Urayasu
State/Province
Chiba
Country
Japan
Facility Name
Fukuoka Tokushukai Hospital
City
Kasuga
State/Province
Fukuoka
Country
Japan
Facility Name
Chugoku Rosai Hospital
City
Kure
State/Province
Hiroshima
Country
Japan
Facility Name
Hakodate Central General Hospital
City
Hakodate
State/Province
Hokkaido
Country
Japan
Facility Name
Japanese Red Cross Society Himeji Hospital
City
Himeji
State/Province
Hyogo
Country
Japan
Facility Name
Koga General Hospital
City
Koga
State/Province
Ibaraki
Country
Japan
Facility Name
Shonan Fujisawa Tokushukai Hospital
City
Fujisawa
State/Province
Kanagawa
Country
Japan
Facility Name
Toyama Dermatologic Clinic
City
Nichinan
State/Province
Miyazaki
Country
Japan
Facility Name
Yoshikawa Skin Clinic
City
Takatsuki
State/Province
Osaka
Country
Japan
Facility Name
Juntendo University Hospital
City
Bunkyo-ku
State/Province
Tokyo
Country
Japan
Facility Name
Sumi Clinic Dermatology Allergology
City
Meguro
State/Province
Tokyo
Country
Japan
Facility Name
Kurobe City Hospital
City
Kurobe
State/Province
Toyama
Country
Japan
Facility Name
University of Yamanashi Hospital
City
Chuo
State/Province
Yamanashi
Country
Japan
Facility Name
Fukuoka Kinen Hospital
City
Fukuoka
Country
Japan
Facility Name
Hakata Pain Clinic
City
Fukuoka
Country
Japan
Facility Name
Matsuda Tomoko Dermatological Clinic
City
Fukuoka
Country
Japan
Facility Name
National Hospital Organization Kanazawa Medical Center
City
Kanazawa
Country
Japan
Facility Name
University Hospital Kyoto Prefectural University of Medicine
City
Kyoto
Country
Japan
Facility Name
Kawasaki Medical School General Medical Center
City
Okayama
Country
Japan
Facility Name
Shizuoka City Shizuoka Hospital
City
Shizuoka
Country
Japan

12. IPD Sharing Statement

Plan to Share IPD
No

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NPC-06 to Pain Associated With Acute Herpes Zoster

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