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Study of NGX-1998 for the Treatment of Postherpetic Neuralgia

Primary Purpose

Postherpetic Neuralgia, Pain

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
NGX-1998
Placebo Liquid
Sponsored by
NeurogesX
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Postherpetic Neuralgia focused on measuring postherpetic neuralgia, PHN, capsaicin, herpes zoster, shingles, analgesics, neuropathy

Eligibility Criteria

18 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Between 18 and 90 years of age, inclusive.
  • Diagnosis of PHN with at least six (6) months of pain since shingles vesicle crusting.
  • Average NPRS scores for PHN-associated pain during Days -14 to -4 of 4 to 9, inclusive.
  • Intact, unbroken skin over the painful area(s) to be treated.
  • If taking chronic pain medications, be on a stable (not PRN) regimen for at least 21 days prior to Test Article Application Visit and willing to maintain medications at same stable dose(s) and schedule throughout the study.
  • Female subjects with child-bearing potential must have a negative serum beta human chorionic gonadotropin (hCG) pregnancy test, to be performed within 7 days of the Test Article Application Visit.
  • All subjects must be willing to use effective methods of birth control and/or refrain from participating in a conception process during the study.
  • If breastfeeding, the subject should agree not to breastfeed their child after treatment on the treatment day.
  • Be willing and able to comply with protocol requirements for the duration of study participation.
  • Subjects must sign an informed consent form for this study approved by the Investigator's Institutional Review Board/Independent Ethics Committee (IRB/IEC).

Exclusion Criteria:

  • Concomitant opioid medication, unless orally or transdermally administered and not exceeding a total daily dose of morphine 60 mg/day, or equivalent. Parenteral opioid use is excluded.
  • Unavailability of an effective medication for treatment related discomfort for the subject, such as unwillingness to use opioid analgesics during study treatment, or high tolerance to opioids precluding the ability to relieve treatment-associated discomfort.
  • Active substance abuse or history of chronic substance abuse within the past year, or prior chronic substance abuse judged likely to recur during the study period.
  • Recent use (within 21 days preceding the Test Article Application Visit [Day 0]) of any topically applied pain medication on the painful areas.
  • Receipt of Qutenza® within 12 months of the Test Article Application Visit (Day 0). Subjects who have received Qutenza® 12 months or more before Test Article Application Visit (Day 0), and who did not respond should also be excluded.
  • Participation in another drug research study within 30 days preceding the Test Article Application Visit (Day 0).
  • Current use of any Class I anti-arrhythmic drugs or III anti-arrhythmic drugs.
  • Diabetes mellitus, unless well-controlled as evidenced by an HBA1c level less than or equal to nine percent (9%).
  • A recent history of cardiovascular or cerebrovascular events or unstable hypertension, unless adequately controlled by medication.
  • Significant pain of an etiology other than PHN, for example, compression-related neuropathies, fibromyalgia or arthritis.
  • Painful PHN areas located on the face, above the hairline of the scalp, and/or in proximity to mucous membranes.
  • Any implanted medical device for the treatment of neuropathic pain.
  • History of hypersensitivity to capsaicin, local anesthetics or any components of the CTLs, Cleansing Gel or the lidocaine (2.5%) / prilocaine (2.5%) topical anesthetic cream.
  • Patients with glucose-6 phosphate dehydrogenase deficiencies.
  • Significant ongoing or untreated abnormalities or conditions, including active malignancy defined as treatment required in the last five (5) years, that in the opinion of the Investigator would interfere with the ability to complete the study or the evaluation of AEs.
  • Patients with congenital or idiopathic methemoglobinemia.
  • Recent history of a significant medical-surgical intervention in the judgment of the Investigator; examples include but are not limited to major surgery or percutaneous angioplasty/coronary artery stent placement within the past 3 months, and receipt of immunosuppressive therapy within 3 months, prior to the Test Article Application Visit [Day 0].
  • Evidence of cognitive impairment including dementia that may interfere with subject's ability to complete daily pain diaries requiring subject's recall of average PHN pain level in the past 24 hours.

Sites / Locations

  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site
  • NeurogesX Investigational Site

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Placebo Comparator

Arm Label

NGX-1998, 10% w/w capsaicin

NGX-1998, 20% w/w capsaicin

Placebo liquid

Arm Description

Outcomes

Primary Outcome Measures

Percent change from baseline in the "average pain for the past 24 hours" NPRS score during Weeks 2-8.

Secondary Outcome Measures

Absolute change and percent change from baseline in the "average pain for the past 24 hours" NPRS score at Week 8 and 12
Absolute change and percent change from baseline in the "average pain for the past 24 hours" NPRS score during Weeks 2-12.
Proportion of subjects with at least a 30% decrease from baseline in their "average pain for the past 24 hours" NPRS during Weeks 2-8, Weeks 2-12, at Week 8 and Week 12.
Proportion of subjects with at least a 2 unit decrease from baseline in their "average pain for the past 24 hours" NPRS during Weeks 2-8, Weeks 2-12, at Week 8 and Week 12.

Full Information

First Posted
October 25, 2010
Last Updated
September 6, 2012
Sponsor
NeurogesX
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1. Study Identification

Unique Protocol Identification Number
NCT01228838
Brief Title
Study of NGX-1998 for the Treatment of Postherpetic Neuralgia
Official Title
A Multicenter Randomized, Double-Blind, Controlled Study to Evaluate Safety, Tolerability and Preliminary Efficacy of Two Capsaicin Concentration Variations of NGX-1998 (10% or 20% w/w) in Subjects With Postherpetic Neuralgia (PHN)
Study Type
Interventional

2. Study Status

Record Verification Date
May 2011
Overall Recruitment Status
Completed
Study Start Date
October 2010 (undefined)
Primary Completion Date
September 2011 (Actual)
Study Completion Date
September 2011 (Actual)

3. Sponsor/Collaborators

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

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess the efficacy, safety and tolerability of NGX-1998 applied for 5 minutes for the treatment of postherpetic neuralgia (PHN).
Detailed Description
This study is a 12-week multicenter randomized, double-blind, controlled evaluation of the efficacy, safety and tolerability of NGX-1998 for the treatment of postherpetic neuralgia (PHN). Eligible subjects will have pain from PHN, with average numeric pain rating scale (NPRS) scores during screening of 4 to 9 (inclusive). Painful areas of up to 1500 cm2 will be treated during a single Test Article application. Subjects will be randomly assigned to receive NGX-1998 (10% or 20% w/w) or placebo according to an unequal allocation scheme of 2:2:1. Subjects will also be stratified by gender.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Postherpetic Neuralgia, Pain
Keywords
postherpetic neuralgia, PHN, capsaicin, herpes zoster, shingles, analgesics, neuropathy

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
NGX-1998, 10% w/w capsaicin
Arm Type
Experimental
Arm Title
NGX-1998, 20% w/w capsaicin
Arm Type
Experimental
Arm Title
Placebo liquid
Arm Type
Placebo Comparator
Intervention Type
Drug
Intervention Name(s)
NGX-1998
Intervention Description
Capsaicin topical liquid to be applied for 5 minutes one time only.
Intervention Type
Drug
Intervention Name(s)
Placebo Liquid
Intervention Description
Placebo topical liquid to be applied for 5 minutes one time only.
Primary Outcome Measure Information:
Title
Percent change from baseline in the "average pain for the past 24 hours" NPRS score during Weeks 2-8.
Time Frame
Weeks 2-8
Secondary Outcome Measure Information:
Title
Absolute change and percent change from baseline in the "average pain for the past 24 hours" NPRS score at Week 8 and 12
Time Frame
Week 8 and Week 12
Title
Absolute change and percent change from baseline in the "average pain for the past 24 hours" NPRS score during Weeks 2-12.
Time Frame
Weeks 2-12
Title
Proportion of subjects with at least a 30% decrease from baseline in their "average pain for the past 24 hours" NPRS during Weeks 2-8, Weeks 2-12, at Week 8 and Week 12.
Time Frame
Weeks 2-12
Title
Proportion of subjects with at least a 2 unit decrease from baseline in their "average pain for the past 24 hours" NPRS during Weeks 2-8, Weeks 2-12, at Week 8 and Week 12.
Time Frame
Week 8 and Week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Between 18 and 90 years of age, inclusive. Diagnosis of PHN with at least six (6) months of pain since shingles vesicle crusting. Average NPRS scores for PHN-associated pain during Days -14 to -4 of 4 to 9, inclusive. Intact, unbroken skin over the painful area(s) to be treated. If taking chronic pain medications, be on a stable (not PRN) regimen for at least 21 days prior to Test Article Application Visit and willing to maintain medications at same stable dose(s) and schedule throughout the study. Female subjects with child-bearing potential must have a negative serum beta human chorionic gonadotropin (hCG) pregnancy test, to be performed within 7 days of the Test Article Application Visit. All subjects must be willing to use effective methods of birth control and/or refrain from participating in a conception process during the study. If breastfeeding, the subject should agree not to breastfeed their child after treatment on the treatment day. Be willing and able to comply with protocol requirements for the duration of study participation. Subjects must sign an informed consent form for this study approved by the Investigator's Institutional Review Board/Independent Ethics Committee (IRB/IEC). Exclusion Criteria: Concomitant opioid medication, unless orally or transdermally administered and not exceeding a total daily dose of morphine 60 mg/day, or equivalent. Parenteral opioid use is excluded. Unavailability of an effective medication for treatment related discomfort for the subject, such as unwillingness to use opioid analgesics during study treatment, or high tolerance to opioids precluding the ability to relieve treatment-associated discomfort. Active substance abuse or history of chronic substance abuse within the past year, or prior chronic substance abuse judged likely to recur during the study period. Recent use (within 21 days preceding the Test Article Application Visit [Day 0]) of any topically applied pain medication on the painful areas. Receipt of Qutenza® within 12 months of the Test Article Application Visit (Day 0). Subjects who have received Qutenza® 12 months or more before Test Article Application Visit (Day 0), and who did not respond should also be excluded. Participation in another drug research study within 30 days preceding the Test Article Application Visit (Day 0). Current use of any Class I anti-arrhythmic drugs or III anti-arrhythmic drugs. Diabetes mellitus, unless well-controlled as evidenced by an HBA1c level less than or equal to nine percent (9%). A recent history of cardiovascular or cerebrovascular events or unstable hypertension, unless adequately controlled by medication. Significant pain of an etiology other than PHN, for example, compression-related neuropathies, fibromyalgia or arthritis. Painful PHN areas located on the face, above the hairline of the scalp, and/or in proximity to mucous membranes. Any implanted medical device for the treatment of neuropathic pain. History of hypersensitivity to capsaicin, local anesthetics or any components of the CTLs, Cleansing Gel or the lidocaine (2.5%) / prilocaine (2.5%) topical anesthetic cream. Patients with glucose-6 phosphate dehydrogenase deficiencies. Significant ongoing or untreated abnormalities or conditions, including active malignancy defined as treatment required in the last five (5) years, that in the opinion of the Investigator would interfere with the ability to complete the study or the evaluation of AEs. Patients with congenital or idiopathic methemoglobinemia. Recent history of a significant medical-surgical intervention in the judgment of the Investigator; examples include but are not limited to major surgery or percutaneous angioplasty/coronary artery stent placement within the past 3 months, and receipt of immunosuppressive therapy within 3 months, prior to the Test Article Application Visit [Day 0]. Evidence of cognitive impairment including dementia that may interfere with subject's ability to complete daily pain diaries requiring subject's recall of average PHN pain level in the past 24 hours.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Trudy Vanhove, MD, PhD, MBA
Organizational Affiliation
NeurogesX
Official's Role
Study Director
Facility Information:
Facility Name
NeurogesX Investigational Site
City
Huntsville
State/Province
Alabama
Country
United States
Facility Name
NeurogesX Investigational Site
City
Tucson
State/Province
Arizona
Country
United States
Facility Name
NeurogesX Investigational Site
City
Irvine
State/Province
California
Country
United States
Facility Name
NeurogesX Investigational Site
City
La Jolla
State/Province
California
Country
United States
Facility Name
NeurogesX Investigational Site
City
Napa
State/Province
California
Country
United States
Facility Name
NeurogesX Investigational Site
City
San Francisco
State/Province
California
Country
United States
Facility Name
NeurogesX Investigational Site
City
Santa Monica
State/Province
California
Country
United States
Facility Name
NeurogesX Investigational Site
City
New Port Richey
State/Province
Florida
Country
United States
Facility Name
NeurogesX Investigational Site
City
North Palm Beach
State/Province
Florida
Country
United States
Facility Name
NeurogesX Investigational Site
City
Sarasota
State/Province
Florida
Country
United States
Facility Name
NeurogesX Investigational Site
City
St. Petersburg
State/Province
Florida
Country
United States
Facility Name
NeurogesX Investigational Site
City
Marietta
State/Province
Georgia
Country
United States
Facility Name
NeurogesX Investigational Site
City
Boise
State/Province
Idaho
Country
United States
Facility Name
NeurogesX Investigational Site
City
Bloomington
State/Province
Illinois
Country
United States
Facility Name
NeurogesX Investigational Site
City
West Des Moines
State/Province
Iowa
Country
United States
Facility Name
NeurogesX Investigational Site
City
Kansas City
State/Province
Kansas
Country
United States
Facility Name
NeurogesX Investigational Site
City
Lexington
State/Province
Kentucky
Country
United States
Facility Name
NeurogesX Investigational Site
City
Shreveport
State/Province
Louisiana
Country
United States
Facility Name
NeurogesX Investigational Site
City
Hyannis
State/Province
Massachusetts
Country
United States
Facility Name
NeurogesX Investigational Site
City
Ann Arbor
State/Province
Michigan
Country
United States
Facility Name
NeurogesX Investigational Site
City
Minneapolis
State/Province
Minnesota
Country
United States
Facility Name
NeurogesX Investigational Site
City
Hattiesburg
State/Province
Mississippi
Country
United States
Facility Name
NeurogesX Investigational Site
City
Albany
State/Province
New York
Country
United States
Facility Name
NeurogesX Investigational Site
City
Rochester
State/Province
New York
Country
United States
Facility Name
NeurogesX Investigational Site
City
Hickory
State/Province
North Carolina
Country
United States
Facility Name
NeurogesX Investigational Site
City
Winston-Salem
State/Province
North Carolina
Country
United States
Facility Name
NeurogesX Investigational Site
City
Portland
State/Province
Oregon
Country
United States
Facility Name
NeurogesX Investigational Site
City
Altoona
State/Province
Pennsylvania
Country
United States
Facility Name
NeurogesX Investigational Site
City
San Antonio
State/Province
Texas
Country
United States
Facility Name
NeurogesX Investigational Site
City
Webster
State/Province
Texas
Country
United States
Facility Name
NeurogesX Investigational Site
City
Salt Lake City
State/Province
Utah
Country
United States
Facility Name
NeurogesX Investigational Site
City
Richmond
State/Province
Virginia
Country
United States
Facility Name
NeurogesX Investigational Site
City
Seattle
State/Province
Washington
Country
United States
Facility Name
NeurogesX Investigational Site
City
Wenatchee
State/Province
Washington
Country
United States
Facility Name
NeurogesX Investigational Site
City
Madison
State/Province
Wisconsin
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Study of NGX-1998 for the Treatment of Postherpetic Neuralgia

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