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Pregabalin for the Treatment and Prevention of Spinal Cord Injury Neuropathic Pain

Primary Purpose

Neuropathic Pain, Spinal Cord Injuries

Status
Unknown status
Phase
Phase 4
Locations
Spain
Study Type
Interventional
Intervention
Pregabalin
Placebo
Sponsored by
Julian Taylor Green
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Neuropathic Pain focused on measuring Pregabalin, Neuropathic pain, At-level neuropathic pain, Non-evoked neuropathic pain, Evoked neuropathic pain, Sub-acute spinal cord injury

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Comprehension of clinical trial and signed informed consent before initiation.
  • Male or female adults, age 18 to 70.
  • Clinical history of neuropathic pain secondary to SCI
  • Patients with an AIS of A, B, C or D according to the American Spinal Cord Injury Association (ASIA) Impairment Scale.
  • Persistent neuropathic pain from 1 month up to 6 months after spinal cord injury.
  • Non-evoked at-level pain with ≥ 2 intensity measured with the numerical rating scale (0-10).
  • Non-evoked/evoked at-level pain corresponding to the area of sensory alteration, and within the three dermatomes below the neurological level of the spinal cord injury.
  • Formal acceptance of disponibility for all programmed clinical trial visits and other protocol requisites.
  • Females of child bearing age must demonstrate a negative pregnancy test (performed on screening and subsequent follow up visits) and use a reliable birth control method including abstinence of sexual activity throughout the duration of the study and for at last 28 days after termination of the clinical trial.

Exclusion Criteria:

  • Previous or actual use of gabapentin.
  • Creatinine clearance level <60 ml/min.
  • Neuropathic pain unrelated to spinal cord injury.
  • Lactose intolerance, Lapp lactase insufficiency or glucose malabsorption
  • Platelet count < 100x103/µl.
  • White blood cell count <2.5 x103/µl.
  • Neutrophil count <1.5 x103/µl.
  • Planned surgery during the clinical trial.
  • Patients with peripheral neuropathic pain.
  • Previous history of malignant melanoma.
  • History of malignant tumors, except for in situ uterine cervix carcinoma, in situ basocellular or spinocellular cutaneous carcinomas, superficial bladder tumors (Ta and Tis) with a complete treatment response up to 10 years. Patients with history of lymphoma or breast cancer will be allowed to participate in the trial if a complete treatment response has been observed up to 20 years.
  • Chronic or active infection requiring a systemic therapy, chronic kidney infections, chronic lung infections with bronchiectasias, Mycobacterium tuberculosis infection, active Hepatitis B or C. Diagnosis of latent TB confection should be performed according to the local guidelines.
  • Severe heart diseases such as unstable angina, cardiopathy during the first 6 months after a myocardial infarction, grade III or IV of the New York Heart Association scale for congestive heart failure.
  • Unknown kidney, liver, gastrointestinal, endocrine, lung, hematological, neurological or psychiatric comorbidities.
  • Subjects administered with an experimental or non-commercial drug during the 4 weeks prior to the trial.
  • Patients participating in other clinical studies.
  • Patients that are not competent for completing required tasks (eg. alcohol or drug related problems or psychiatric disorders).
  • Subjects unable to be examined with radiological MRI exploration due to contraindications.
  • Pregnancy or breastfeeding.
  • Any other patient condition that is deemed unsuitable for subject inclusion in the trial according to the research team.

Sites / Locations

  • Hospital Nacional de Parapléjicos de Toledo

Arms of the Study

Arm 1

Arm 2

Arm Type

Placebo Comparator

Active Comparator

Arm Label

Placebo

Pregabalin

Arm Description

Study subjects wil be randomized to the Placebo arm following a stratification procedure based on AIS scale (A-E), neurological level of injury (cervical or thoracic), and presence of at-level neuropathic pain before or after 3 months from the time of spinal cord injury.

Study subjects wil be randomized to the Pregabalin arm following a stratification procedure based on AIS scale (A-E), neurological level of injury (cervical or thoracic), and presence of at-level neuropathic pain before or after 3 months from the time of spinal cord injury.

Outcomes

Primary Outcome Measures

Daily at-level non-evoked pain intensity measured with the numerical rating scale (0-10) expressed as the mean 7-day pain intensity

Secondary Outcome Measures

Weekly below-level non-evoked pain intensity measured with the numerical rating scale (0-10)
Weekly evaluation of at-level neuropathic pain symptoms using the "Neuropathic Pain Symptoms Inventory" (NPSI)
Weekly evaluation of at-level neuropathic pain intensity and interference using the "Brief Pain Inventory" (BPI)
Weekly evaluation of the change in at-level non-evoked neuropathic pain using the "Patient Global Impression Change" (PGIC)
Weekly evaluation of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS)
Weekly evaluation of spasm frequency below the spinal cord injury using the Penn questionnaire
Measurement of the amplitude of cold and heat sensory evoked potentials (Cz-Fz) studied above (C4) and at-level of the SCI
Serum TNF-R1 level
Weekly at-level non-evoked pain intensity measured with the numerical rating scale (0-10) 28 days after the termination of the clinical trial
Number of Paracetamol tablets used as rescue medication during the week
Prevalence and type of adverse events in patients treated with pregabalin
Unblinding testing: patient and investigator will be asked for the treatment they think to have received. Reasons for their judgement (efficacy and safety) will also be asked.

Full Information

First Posted
November 17, 2011
Last Updated
November 22, 2011
Sponsor
Julian Taylor Green
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1. Study Identification

Unique Protocol Identification Number
NCT01479556
Brief Title
Pregabalin for the Treatment and Prevention of Spinal Cord Injury Neuropathic Pain
Official Title
Assessment of Pregabalin Efficacy for the Treatment and Prevention of At-level Non-evoked and Evoked Spinal Cord Injury Neuropathic Pain
Study Type
Interventional

2. Study Status

Record Verification Date
November 2011
Overall Recruitment Status
Unknown status
Study Start Date
December 2011 (undefined)
Primary Completion Date
May 2014 (Anticipated)
Study Completion Date
October 2014 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor-Investigator
Name of the Sponsor
Julian Taylor Green

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study is a phase IV clinical trial with the objective of evaluating whether pain relief associated with pregabalin for at-level non-evoked and evoked neuropathic pain is more efficient during the early rather than late subacute phase of spinal cord injury.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neuropathic Pain, Spinal Cord Injuries
Keywords
Pregabalin, Neuropathic pain, At-level neuropathic pain, Non-evoked neuropathic pain, Evoked neuropathic pain, Sub-acute spinal cord injury

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
82 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
Study subjects wil be randomized to the Placebo arm following a stratification procedure based on AIS scale (A-E), neurological level of injury (cervical or thoracic), and presence of at-level neuropathic pain before or after 3 months from the time of spinal cord injury.
Arm Title
Pregabalin
Arm Type
Active Comparator
Arm Description
Study subjects wil be randomized to the Pregabalin arm following a stratification procedure based on AIS scale (A-E), neurological level of injury (cervical or thoracic), and presence of at-level neuropathic pain before or after 3 months from the time of spinal cord injury.
Intervention Type
Drug
Intervention Name(s)
Pregabalin
Other Intervention Name(s)
Lyrica
Intervention Description
Pregabalin Alpha2-delta calcium channel blocker. 150mg BID p.o.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
150mg BID p.o.
Primary Outcome Measure Information:
Title
Daily at-level non-evoked pain intensity measured with the numerical rating scale (0-10) expressed as the mean 7-day pain intensity
Secondary Outcome Measure Information:
Title
Weekly below-level non-evoked pain intensity measured with the numerical rating scale (0-10)
Title
Weekly evaluation of at-level neuropathic pain symptoms using the "Neuropathic Pain Symptoms Inventory" (NPSI)
Title
Weekly evaluation of at-level neuropathic pain intensity and interference using the "Brief Pain Inventory" (BPI)
Title
Weekly evaluation of the change in at-level non-evoked neuropathic pain using the "Patient Global Impression Change" (PGIC)
Title
Weekly evaluation of anxiety and depression using the Hospital Anxiety and Depression Scale (HADS)
Title
Weekly evaluation of spasm frequency below the spinal cord injury using the Penn questionnaire
Title
Measurement of the amplitude of cold and heat sensory evoked potentials (Cz-Fz) studied above (C4) and at-level of the SCI
Title
Serum TNF-R1 level
Title
Weekly at-level non-evoked pain intensity measured with the numerical rating scale (0-10) 28 days after the termination of the clinical trial
Title
Number of Paracetamol tablets used as rescue medication during the week
Title
Prevalence and type of adverse events in patients treated with pregabalin
Title
Unblinding testing: patient and investigator will be asked for the treatment they think to have received. Reasons for their judgement (efficacy and safety) will also be asked.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Comprehension of clinical trial and signed informed consent before initiation. Male or female adults, age 18 to 70. Clinical history of neuropathic pain secondary to SCI Patients with an AIS of A, B, C or D according to the American Spinal Cord Injury Association (ASIA) Impairment Scale. Persistent neuropathic pain from 1 month up to 6 months after spinal cord injury. Non-evoked at-level pain with ≥ 2 intensity measured with the numerical rating scale (0-10). Non-evoked/evoked at-level pain corresponding to the area of sensory alteration, and within the three dermatomes below the neurological level of the spinal cord injury. Formal acceptance of disponibility for all programmed clinical trial visits and other protocol requisites. Females of child bearing age must demonstrate a negative pregnancy test (performed on screening and subsequent follow up visits) and use a reliable birth control method including abstinence of sexual activity throughout the duration of the study and for at last 28 days after termination of the clinical trial. Exclusion Criteria: Previous or actual use of gabapentin. Creatinine clearance level <60 ml/min. Neuropathic pain unrelated to spinal cord injury. Lactose intolerance, Lapp lactase insufficiency or glucose malabsorption Platelet count < 100x103/µl. White blood cell count <2.5 x103/µl. Neutrophil count <1.5 x103/µl. Planned surgery during the clinical trial. Patients with peripheral neuropathic pain. Previous history of malignant melanoma. History of malignant tumors, except for in situ uterine cervix carcinoma, in situ basocellular or spinocellular cutaneous carcinomas, superficial bladder tumors (Ta and Tis) with a complete treatment response up to 10 years. Patients with history of lymphoma or breast cancer will be allowed to participate in the trial if a complete treatment response has been observed up to 20 years. Chronic or active infection requiring a systemic therapy, chronic kidney infections, chronic lung infections with bronchiectasias, Mycobacterium tuberculosis infection, active Hepatitis B or C. Diagnosis of latent TB confection should be performed according to the local guidelines. Severe heart diseases such as unstable angina, cardiopathy during the first 6 months after a myocardial infarction, grade III or IV of the New York Heart Association scale for congestive heart failure. Unknown kidney, liver, gastrointestinal, endocrine, lung, hematological, neurological or psychiatric comorbidities. Subjects administered with an experimental or non-commercial drug during the 4 weeks prior to the trial. Patients participating in other clinical studies. Patients that are not competent for completing required tasks (eg. alcohol or drug related problems or psychiatric disorders). Subjects unable to be examined with radiological MRI exploration due to contraindications. Pregnancy or breastfeeding. Any other patient condition that is deemed unsuitable for subject inclusion in the trial according to the research team.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Julian Taylor Green
Phone
(34) 925 247 700
Ext
109
Email
jscott@sescam.org
Facility Information:
Facility Name
Hospital Nacional de Parapléjicos de Toledo
City
Toledo
ZIP/Postal Code
45071
Country
Spain

12. IPD Sharing Statement

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Pregabalin for the Treatment and Prevention of Spinal Cord Injury Neuropathic Pain

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