Study to Evaluate the Efficacy and Safety of Lenalidomide in the Treatment of Complex Regional Pain Syndrome Type 1 (CRPS-002)
Complex Regional Pain Syndrome, Type I
About this trial
This is an interventional treatment trial for Complex Regional Pain Syndrome, Type I focused on measuring CRPS, RSDS, Pain, CC-5013, Revlimid, Complex Regional Pain Syndrome, Reflex Sympathy Dystrophy Syndrome, Lenalidomide, CRPS Type I, Celgene
Eligibility Criteria
Inclusion Criteria: Age >= 18 years at the time of signing the informed consent form Understand and voluntarily sign an informed consent form A diagnosis of CRPS Type 1, as defined by modified International Association for the Study of Pain criteria for at least a one-year duration. Unilateral involvement of a distal limb (hand or foot) with or without proximal spread must be present. In the presence of upper and lower limb involvement, the most severely affected limb will be designated the CRPS-affected limb. Screening: CRPS pain intensity score in the CRPS-affected limb must be at least 4 on an 11-point (0-10) Pain Intensity Numerical Rating Scale (PI-NRS). Randomization: Average PI-NRS score for randomization purposes will be based on AM and PM assessments made during the 7 days prior to randomization. At least eight PI-NRS scores during this 7-day period are required and the Average PI-NRS score in the CRPS-affected limb during this period must be at least 4 on an 11-point (0-10) PI-NRS. Measurable (by electrophysiology methods) sural, median sensory, median motor and peroneal motor nerves at the screening nerve conduction study. Opioid analgesics, non-opioid analgesics, non-steroidal anti-inflammatory drugs, anticonvulsants, antidepressant drugs and other non-drug therapies may be continued provided that the subject is on stable doses/regimens for at least four weeks prior to the start of the Treatment Phase (Visit 2). Able to adhere to the study visit schedule and other protocol requirements. Women of childbearing potential (WCBP) must agree to practice complete abstinence from heterosexual intercourse or to use two methods of contraception beginning 4 weeks prior to the start of study drug (Day 1) while on study drug (including dose interruptions) and 4 weeks after the last dose of study drug. The two methods of contraception must include one highly effective method (i.e. intrauterine device [IUD], hormonal [birth control pills, injections, or implants only if used in conjunction with a low-dose (81 mg/day) aspirin regimen], tubal ligation, partner's vasectomy) and one additional effective (barrier) method (i.e. latex condom, diaphragm, cervical cap). If a hormonal method (birth control pills, injections, or implants) or IUD is not medically possible for the subject, two of the barrier methods will be acceptable. Women of childbearing potential (WCBP) must have two negative pregnancy tests (sensitivity of at least 50 mlU/mL) prior to starting study drug treatment. The first test should be performed within 10-14 days and the second within 24 hours of starting study drug. Once treatment has started, it is recommended that subjects have weekly pregnancy test during the first 4 weeks of treatment. Thereafter, subjects are required to have pregnancy testing every 4 weeks in females with regular menstrual cycles and every 2 weeks in females with irregular cycles. Males (including those who have had a vasectomy) must use barrier contraception (latex condoms) when engaging in reproductive sexual activity with WCBP while on study drug and for 4 weeks after the last dose of study drug. Exclusion Criteria: The presence of any of the following will exclude a subject from study enrollment: History of deep vein thrombosis (DVT) or stroke in the past 5 years. Documented peripheral neuropathies to include diabetic neuropathy and other metabolic or toxic neuropathies. Current signs or symptoms of severe, progressive or uncontrolled renal, hepatic, hematological, endocrine, pulmonary, cardiac, neurological or cerebral disease. Any other serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form. White blood cell count (WBC) < 3.5*10^9/L at screening. Bilirubin, alanine transaminase (ALT), aspartate transaminase (AST) or alkaline phosphatase levels more than two times the upper limit of the normal range at screening. Abnormal thyroid function test values at screening. Any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study. Use of concomitant medication(s), which could increase the risk for developing DVT, except for steroid-based contraceptives (oral injectable, implantable) and hormone replacement therapies only if used in conjunction with a low-dose (81 mg/day) aspirin regimen. Concurrent use of thalidomide. Prior development of an allergic reaction/hypersensitivity while taking thalidomide. Prior development of a moderate or severe rash or any desquamation while taking thalidomide. Prior treatment with lenalidomide.
Sites / Locations
- Pivotal Research Centers
- UCSD Center for Pain and Palliative Medicine
- Loma Linda Institution
- Space Coast Neurology
- Northwestern University
- Rehab Institute of Chicago
- University of Iowa
- Johns Hopkins Hospital
- Beth Israel Deaconess Medical Center
- Baystate Medical Center
- Mayo Clinic
- Washington University Pain Mgmt Ctr
- Hospital for Joint Disease
- University of Rochester Medical Center
- UNC Hospitals University of North Carolina
- Duke University Medical Center
- Womack Army Medical Center
- Carolinas Pain Institute, P.A. & the Center for Clinical Research, LLC
- Research Institute of Greater Dayton
- Oregon Health & Science University
- Lehigh Valley Hospital
- Knobler Institute of Neurologic Disease
- Drexel University College of Medicine Department of Neurology Rm 7102
- University of Texas Southwestern Medical Center
- Texas Tech Medical Center Department of Anesthesiology
- University of Virginia Pain Management Center
- Swedish Pain Services
Arms of the Study
Arm 1
Arm 2
Experimental
Placebo Comparator
lenalidomide
Placebo
10 mg/day lenalidomide orally for up to 12 weeks in the double-blind treatment period. Participants who completed double-blind treatment had the option of continuing on lenalidomide in the open-label extension period for as long as benefit was derived from the drug or until study closure.
Placebo orally for up to 12 weeks in the double-blind treatment period. Participants who completed double-blind treatment had the option of crossing over to lenalidomide 10mg in the open-label extension period for as long as benefit was derived from the drug or until study closure.