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Clinical Trial Details — Status: Terminated

Administrative data

NCT number NCT01049217
Other study ID # A0081244
Secondary ID
Status Terminated
Phase Phase 3
First received
Last updated
Start date April 2010
Est. completion date May 2012

Study information

Verified date August 2013
Source Pfizer
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of this study is to evaluate the efficacy of pregabalin compared to placebo in reducing neuropathic pain associated with HIV neuropathy.


Description:

Based on DMC interim efficacy analysis results indicating a low probability for success the study was terminated on April 2, 2012; the termination was unrelated to any safety findings that could impact patient health.


Recruitment information / eligibility

Status Terminated
Enrollment 377
Est. completion date May 2012
Est. primary completion date May 2012
Accepts healthy volunteers No
Gender All
Age group 18 Years and older
Eligibility Inclusion Criteria: - Men and women, ages of 18 or greater - Documented evidence of HIV-1 infection - Documented diagnosis of HIV-associated Distal Symmetrical Polyneuropathy (DSP) with subjective sensory symptom of pain - Pain starts in the feet Exclusion Criteria: - Subject has untreated vitamin B12 deficiency (serum B12 level <200 pg/ml) or if treated B12 deficiency -treatment is less than 6 months of B12 supplementation (injection or intranasal B12) prior to screening - Diabetes mellitus requiring regular medical treatment (other than diet and exercise) or HbA1C >6.9 - Subjects with peripheral neuropathic pain that is not associated with HIV infection; including subjects with conditions such as: Post Herpetic Neuralgia (PHN), Diabetic Peripheral Neuropathy (DPN), familial neuropathies; compression related neuropathy, radicular pain, other infection related neuropathies (eg, leprosy); neuropathy related to: metabolic abnormalities; nutritional factors; vascular insults; inflammation; autoimmune disease; and malignancy

Study Design


Related Conditions & MeSH terms


Intervention

Drug:
pregabalin
Pregabalin 75 mg-300mg twice daily during the course of the study.
placebo
Subjects may be assigned to placebo during this study. The study duration is approximately 19 weeks.

Locations

Country Name City State
Colombia Asistencia Cientifica de Alta Complejidad Bogota Cundinamarca
Colombia Centro Instituto de Investigaciones Fundación Universitaria Sanitas Bogota Cundinamarca
Colombia Riesgo de Fractura S.A Bogotá Cundinamarca
Colombia Instituto Colombiano para el Avance de la Medicina- Santander S.A.S. - ICAMEDIC Santander S.A.S Bucaramanga Santander
Dominican Republic Instituto Dominicano de Estudios Virológicos - IDEV Santo Domingo
India Infectious Disease Clinic Ahmedabad Gujarat
India YR Gaitonde Centre for AIDS Research and Education Chennai Tamil Nadu
India Mahavir Hospital and Research Centre Hyderabad Andhra Pradesh
India Surakshaka Multispeciality Hospital Hyderabad Andhra Pradesh
India Jaslok Hospital & Research Centre Mumbai Maharashtra
India Deenanath Mangeshkar Hospital and Research Centre Pune Maharashtra
Peru Hospital Nacional Dos de Mayo Lima
Peru Hospital Nacional Guillermo Almenara Irigoyen Lima
Poland Katedra Chorob Zakaznych i Hepatologii UMK w Toruniu CM w Bydgoszczy Bydgoszcz
Poland Oddzial Diagnostyki i Terapii AIDS Chorzow
Puerto Rico Ponce School of Medicine - Practice Group Ponce
Puerto Rico Ponce School of Medicine-CAIMED Center Ponce
Puerto Rico Puerto Rico Clinical and Translational Research Consortium Rio Piedras
South Africa Worthwhile Clinical Trials Benoni Gauteng
South Africa University of Cape Town Cape Town Western Cape
South Africa Synapta Clinical Research Centre Durban
South Africa Border Diabetic Centre East London Eastern Cape
South Africa Innovir Institute Gauteng
South Africa Drs Essack and Mitha Johannesburg Gauteng
South Africa Toga Laboratory Johannesburg Gauteng
South Africa University of Witwatersrand-Clinical HIV Research Unit (CHRU) Johannesburg Gauteng
South Africa Mzansi Ethical Research Centre Middelburg
South Africa Be Part Yoluntu Centre Paarl
South Africa Paarl Research Center Paarl
South Africa MediSynergy Port Elizabeth Eastern Cape
South Africa Clinical Research Unit, University of Pretoria Pretoria
South Africa Synexus SA Stanza Bopape Clinical Research Centre Pretoria Gauteng
South Africa Pretoria West Hospital Pretoria West Gauteng
South Africa Chris Hani Baragwanath Hospital, The Palliative Care Centre Soweto Gauteng
South Africa Dr J. Reddy's Surgery Stanger KwaZulu Natal
South Africa Department of Neurology Tygerberg
Thailand Neurology unit, Department of Medicine, Bangkok
Thailand South East Asia Research Collaboration with Hawaii Bangkok
United States AIDS Research Consortium of Atlanta Atlanta Georgia
United States Midtown Neurology, PC Atlanta Georgia
United States Neuroscience Consultants, LLC. Aventura Florida
United States South Florida Medical Research Aventura Florida
United States University of Texas Physicians Bellaire Texas
United States Rehabilitation Institute of Chicago Chicago Illinois
United States Amelia Court HIV Research Clinic Dallas Texas
United States Neurology Specialists of Decatur Research Center Decatur Georgia
United States The University of Texas Medical School at Houston Houston Texas
United States AIDS Research Alliance of America Los Angeles California
United States Anthony Mills, MD, Inc. Los Angeles California
United States David Geffen School of Medicine at UCLA c/o NNAB Los Angeles California
United States The Kinder Medical Group Miami Florida
United States Wohlfeiler, Piperato & Associates, LLC Miami Beach Florida
United States Mount Sinai School of Medicine New York New York
United States Providence Clinical Research North Hollywood California
United States Desert Medical Group, Inc. dba Desert Oasis Healthcare Medical Group Palm Springs California
United States Arizona Research Center Phoenix Arizona
United States Southwest Center for HIV/AIDS Phoenix Arizona
United States SW Center for HIV/AIDS Phoenix Arizona
United States University of California San Diego San Diego California
United States Stanford University Medical Center Stanford California
United States Meridien Research Tampa Florida
United States University of Toledo Toledo Ohio
United States University of Toledo Medical Center Toledo Ohio

Sponsors (1)

Lead Sponsor Collaborator
Pfizer's Upjohn has merged with Mylan to form Viatris Inc.

Countries where clinical trial is conducted

United States,  Colombia,  Dominican Republic,  India,  Peru,  Poland,  Puerto Rico,  South Africa,  Thailand, 

Outcome

Type Measure Description Time frame Safety issue
Other Number of Participants With Treatment-Emergent (TE) Adverse Events (AEs) or Serious Adverse Events (SAEs) An AE was any untoward medical occurrence attributed to study drug in a participant who received study drug. An SAE was an AE resulting in any of the following outcomes or deemed significant for any other reason: death; initial or prolonged inpatient hospitalization; life-threatening experience (immediate risk of dying); persistent or significant disability/incapacity; congenital anomaly. Treatment-emergent are events between first dose of study drug and up to 28 days after last dose that were absent before treatment or that worsened relative to pretreatment state. Baseline up to 28 days after last dose
Other Number of Participants With Abnormal Laboratory Test Findings Laboratory tests included hematology, chemistry, cluster of differentiation 4 (CD4) count and cluster of differentiation 8 (CD8) count, HIV plasma viral load, B12, Venereal Disease Research Laboratory (VDRL), toxic screens for drugs and alcohol, reflex thyroid-stimulating hormone (TSH), urinalysis. Number of participants with a laboratory abnormality meeting specified criteria while on study treatment or during lag time was reported. Screening up to Week 17
Other Number of Participants With Positive Serum and Urine Pregnancy Serum pregnancy test (regardless of childbearing potential) and urine pregnancy test for all female participants were performed. Screening for serum pregnancy test, Week 1 for urine pregnancy test
Other Number of Participants With Abnormal Physical Examination Findings A physical examination included an examination of the general appearance, skin, chest, pulses, pulmonary, cardiovascular, head, eyes, ears, nose, throat, abdominal, and extremities. Screening, Week 8, 17
Other Body Weight Screening, Week 1, 4, 8, 12, 16, 17
Other Sitting Systolic and Diastolic Blood Pressure Systolic Blood Pressure (SBP) is the blood pressure (pressure exerted by circulating blood on the walls of blood vessels) when heart is contracting; it is the maximum arterial pressure during contraction of left ventricle of heart. Diastolic Blood Pressure (DBP) is the blood pressure (pressure exerted by circulating blood on the walls of blood vessels) when heart is relaxing; it is the minimum arterial pressure during relaxation and dilation of ventricles of heart. Screening, Week 1, 4, 8, 12, 16, 17
Other Sitting Heart Rate Screening, Week 1, 4, 8, 12, 16, 17
Other Number of Participants With Neurological Examination Findings A neurological examination consisted of examination of the mental state, cranial nerve function, motor function (reflexes of patellar, achilles, biceps, babinski and coordination) and sensory function (sharp sensation of dorsal surface of right and left great toe, light touch of lower extremities [LE], right and left first metatarsal joint position sense, and vibration sensation [vibration is felt for < 6 seconds = markedly diminished, 6 to 10 seconds = mild loss, > 10 seconds = normal]). Screening
Other Number of Participants Who Met Mini-International Neuropsychiatric Interview (MINI) Criteria MINI: short structured clinical interview to make diagnoses of psychiatric disorders according to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) or International Classifications of Disease-10 (ICD-10). In the MINI Modules, participants were asked a series of Yes/No questions. Screening
Other Number of Participants With Response to Sheehan-Suicidality Tracking Scale (S-STS) Mapped to the Columbia Classification Algorithm of Suicide Assessment (C-CASA) Categories S-STS:8-item clinician/participant administered prospective rating scale to assess TE suicidal(Su) ideation(ID),behavior(BHV).Items 1a,2-6,7a,8 scored on 5-point Likert scale 0(not at all) to 4(extremely). Items 1,1b,7 require yes/no response. S-STS total score range 0-30. Lower score=reduced Su tendency. Responses on S-STS were mapped to Columbia Classification Algorithm of Suicide Assessment(C-CASA) as 1:Completed Su; 2: Su attempt; 3: Preparatory acts; 4: Su ID; 5: Self-injurious (SI) BHV, intent unknown; 6: Not enough information; 7: SI BHV, no Su intent; 8: Other, no deliberate self harm. Screening, Post-Baseline (Week 4 up to Week 17)
Other Number of Participants With Response to Patient Health Questionnaire-8 (PHQ-8) PHQ-8: 8-item self-administered validated subset of PHQ-9, which comprises first 8 items of measure. Participant rated "Over past 2 weeks, how often bothered by any of following problems?": little interest in doing things(1); feeling down(2); trouble falling or staying asleep/sleeping too much(3); feeling tired(4); poor appetite/overeating(5); feeling bad about self(6); trouble concentrating(7); moving or speaking slowly or being so fidgety/moving around more than usual (8). Each item scored on scale of 0(not at all)-3(nearly every day). Total score range: 0-24, higher score=greater severity. Screening
Primary Change From Baseline in Mean Pain Score at Endpoint (up to Week 16) Mean pain score was defined as the mean of the last 7 daily diary pain ratings. Participants rated their Human Immunodeficiency Virus (HIV) neuropathy pain over the past 24 hours on an 11-point numeric rating scale ranging from 0 = no pain to 10 = worst possible pain. A rating of 1-3 was considered as mild pain; 4-6 = moderate pain; and 7-10 = severe pain. Endpoint was the last observation for a participant assessed using specified imputation method, modified Baseline Observation Carried Forward (mBOCF). Baseline, Endpoint (up to Week 16)
Secondary Number of Participants With Categorical Scores on Patient Global Impression of Change (PGIC) PGIC: participant rated instrument to measure participant's change in overall status on a 7-point scale; range from 1 (very much improved) to 7 (very much worse). Number of participants in each category is reported. Week 16
Secondary Number of Participants With Categorical Scores on Clinician Global Impression of Change (CGIC) The CGIC scale measures a physician's global impression of a participant's clinical condition at final visit in terms of change relative to the start of treatment (CGIC). At final visit, the participants CGIC will be categorized into a three point scale as: improvement: CGI response of very much improved, much improved or minimally improved; no change: CGI response of no change; worsening: CGI response of very much worse, much worse or minimally worse. Number of participants in each category is reported. Week 16
Secondary Change From Baseline in Numeric Rating Scale (NRS)-Sleep Interference Score at Week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 and Endpoint (up to Week 16) Weekly mean sleep interference score was defined as the mean of the daily sleep interference diary ratings split into 7 day intervals. Participants rated how HIV neuropathy pain has interfered with their sleep during the past 24 hours on an 11-point NRS ranging from 0 = does not interfere with sleep to 10 = completely interferes (unable to sleep due to pain). Endpoint was the last observation for a participant assessed using specified imputation method. Baseline, Week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, Endpoint (up to Week 16)
Secondary Change From Baseline in Numeric Rating Scale (NRS)-Current Pain Score at Week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 and Endpoint (up to Week 16) Weekly current pain score was defined as the mean of the daily current pain diary ratings split into 7 day intervals. Participants rated current ("right now") HIV neuropathy pain an 11-point NRS ranging from 0 = no pain to 10 = worst possible pain. A rating of 1-3 was considered as mild pain; 4-6 = moderate pain; and 7-10 = severe pain. Endpoint was the last observation for a participant assessed using specified imputation method. Baseline, Week 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, Endpoint (up to Week 16)
Secondary Change From Baseline in Brief Pain Inventory-Short Form (BPI-sf) Score at Week 4, 8, 12, 16 and Endpoint (up to Week 16) BPI-sf:5-item self-administered questionnaire to assess severity,impact of pain on daily functions. Pain Severity Index (PSI):average of Question 1-4 each measured severity of pain over past 24-hours on 11-point scale (0=no pain to 10=worst possible pain). Pain Interference Index (PII):average of 7 pain interference items of Question 5 that measured level of interference of pain on daily function on 11-point scale (0=does not interfere to 10=completely interferes). For PSI, PII range:0-10 higher score=higher pain/interference. Endpoint=last observation for participant as per imputation method. Baseline, Week 4, 8, 12, 16, Endpoint (up to Week 16)
Secondary Change From Baseline in Neuropathic Pain Symptom Inventory (NPSI) Item Scores at Endpoint (up to Week 16) NPSI: participant-rated questionnaire to evaluate different symptoms of neuropathic pain. It includes 10 descriptors and 2 temporal items. Results reported for the 10 descriptors (burning, squeezing, pressure, electric shocks, stabbing, light touching of area, pressure of area, cold of area, pins and needles, tingling) quantified on a 0 (no symptoms) to 10 (worst symptoms imaginable) scale. Endpoint was the last observation for a participant assessed using specified imputation method. Baseline, Endpoint (up to Week 16)
Secondary Neuropathic Pain Symptom Inventory (NPSI): Change From Baseline in Number of Participants With Duration of Spontaneous Pain and Number of Pain Attacks at Endpoint (up to Week 16) NPSI: participant-rated questionnaire to evaluate different symptoms of neuropathic pain. It includes 10 descriptors, and 2 temporal items. Results reported for categorical change in temporal items assessed on 5-point scale for duration of spontaneous pain (1=continuously, 2=8-12 hours [hrs], 3=4-7 hrs, 4=1-3 hrs, 5=less than 1 hr), numbers of pain attacks (1=more than 20, 2=11-20 attacks, 3=6-10 attacks, 4=1-5 attacks, 5=no attack). Change data categorized as worsened (negative change), unchanged (no change), and improved (positive change). Endpoint=last observation as per imputation method. Baseline, Endpoint (up to Week 16)
Secondary Change From Baseline in Neuropathic Pain Symptom Inventory (NPSI) Subscales and Total Intensity Score at Endpoint (up to Week 16) NPSI: participant rated questionnaire to evaluate different symptoms of neuropathic pain (subscales: burning [superficial] spontaneous pain, pressing [deep] spontaneous pain, paroxysmal pain, evoked pain, and paresthesia/dyesthesia [P/D]). Includes 10 descriptors quantified on a 0 (no symptoms) to 10 (worst symptoms imaginable) and 2 temporal items assessing duration of spontaneous ongoing and paroxysmal pain. The relevant subscales and total score were transformed to 0-1, higher score indicates a greater intensity of pain. Endpoint=last observation for participant as per imputation method. Baseline, Endpoint (up to Week 16)
Secondary Total Sleep Time (TST) and Minutes of Interrupted Sleep (MIS) Total sleep time is the number of minutes asleep between time of sleep onset to morning awakening and MIS is the number of minutes spent awake after sleep onset to final awakening. TST and MIS were determined by actigraphy. Actigraphy was performed with an accelerometer that was worn on the wrist like a watch. It was programmed to record movements while the device was being worn. Endpoint was the last observation for a participant assessed using specified imputation method. Baseline (Day -14 to 1), Week 1 through Week 4, Week 12 through Week 16, Endpoint (up to Week 16)
Secondary Sleep Fragmentation Index (SFI) SFI is a measure to quantify sleep restlessness. SFI calculated from analysis of the periods that participant was not moving (immobile bouts). It is number of immobile bouts that were exactly 1 minute long divided by total number of immobile bouts. Value ranges from 0-100 percent, with low number representing more restful sleep. SFI determined by actigraphy. Actigraphy was performed with an accelerometer that was worn on wrist like a watch. It was programmed to record movements while device was being worn. Endpoint was the last observation for a participant assessed using imputation method. Baseline (Day -14 to 1), Week 1 through Week 4, Week 12 through Week 16, Endpoint (up to Week 16)
Secondary Sleep Efficiency Sleep efficiency is the time spent asleep divided by total time between sleep onset and sleep end, multiplied by 100. Sleep efficiency was determined by actigraphy. Actigraphy was performed with an accelerometer that was worn on the wrist like a watch. It was programmed to record movements while the device was being worn. Endpoint was the last observation for a participant assessed using specified imputation method. Baseline (Day -14 to 1), Week 1 through Week 4, Week 12 through Week 16, Endpoint (up to Week 16)
Secondary Total Activity Counts Activity counts are the units of motion. It is equal to the sum of peak accelerations each second during the epoch (60 seconds). Total activity counts per day is the sum of the activity counts for each epoch (60 seconds) during the "day" (non sleep period). A total activity count was determined by actigraphy. Actigraphy was performed with an accelerometer that was worn on the wrist like a watch. It was programmed to record movements while the device was being worn. Endpoint was the last observation for a participant assessed using specified imputation method. Baseline (Day -14 to 1), Week 1 through Week 4, Week 12 through Week 16, Endpoint (up to Week 16)
Secondary Percentage Day Time Above Sedentary Level Percentage of time above sedentary level is number of epochs (60 seconds) with greater than (>) 200 activity counts per minute divided by total number of epochs during the "day" (non sleep period) multiplied by 100. This was determined by actigraphy. Actigraphy was performed with an accelerometer that was worn on the wrist like a watch. It was programmed to record movements while the device was being worn. Endpoint was the last observation for a participant assessed using specified imputation method. Baseline (Day -14 to 1), Week 1 through Week 4, Week 12 through Week 16, Endpoint (up to Week 16)
Secondary Change From Baseline in Medical Outcomes Study-Sleep Scale (MOS-SS) at Endpoint (up to Week 16) Participant-rated 12-item questionnaire to assess constructs of sleep over past week; 7 subscales: sleep disturbance (range 0-100), snoring (range 0-100), awaken short of breath (SOB) or with headache (range 0-100), sleep adequacy (range 0-100), somnolence (range: 0-100); sleep quantity (range: 0-24), optimal sleep (yes/no), and 9 item index measures of sleep disturbance provide composite scores: sleep problems index (range 0-100). Except adequacy, optimal sleep and quantity, higher scores=more impairment. Endpoint was the last observation for a participant assessed using imputation method. Baseline, Endpoint (up to Week 16)
Secondary Medical Outcomes Study-Sleep Scale (MOS-SS): Number of Participants With Optimal Sleep MOS-SS: participant-rated 12 item questionnaire to assess constructs of sleep over past week. It included 7 subscales: sleep disturbance, snoring, awaken short of breath or with headache, sleep adequacy, somnolence, sleep quantity, optimal sleep, and 9 item index measures of sleep disturbance provide composite scores: sleep problems index. Participants responded whether their sleep was optimal or not optimal by choosing yes or no. Endpoint was the last observation for a participant assessed using imputation method. Baseline, Endpoint (up to Week 16)
Secondary Change From Baseline in Hospital Anxiety and Depression Scales (HADS) at Endpoint (up to Week 16) HADS: participant rated questionnaire with 2 subscales. HADS-A assesses state of generalized anxiety (anxious mood, restlessness, anxious thoughts, panic attacks); HADS-D assesses state of lost interest and diminished pleasure response (lowering of hedonic tone). Each subscale comprised of 7 items with range 0 (no presence of anxiety or depression) to 3 (severe feeling of anxiety or depression). Total score 0 to 21 for each subscale; higher score indicates greater severity of anxiety and depression symptoms. Endpoint was the last observation for a participant assessed using imputation method. Baseline, Endpoint (up to Week 16)
Secondary Change From Baseline in 36-Item Short-Form Health Survey (SF-36) at Endpoint (up to Week 16) SF-36 is a standardized survey evaluating 8 domains of functional health and well being: physical and social (So) functioning (Fn), physical and emotional role (role-physical [R-P], role-emotional [R-E]) limitations, bodily pain (BP), general health (GH), vitality (Vit), mental health (MnH). Two summary scores include Physical Component (Ph C) and Mental Component (Mn C). The score for a section is an average of the individual question scores. Score range for domain scores and summary scores: 0-100 (100=highest level of functioning). Baseline, Endpoint (up to Week 16)
Secondary Number of Participants Who Were Employed or Unemployed Assessed by Work Productivity and Activity Impairment: Specific Health Problem (WPAI: SHP) Questionnaire WPAI: 6-question participant rated questionnaire to determine the degree to which specific health problem (SHP) affected work productivity while at work and affected activities outside of work. It assesses amount of absenteeism, presenteeism and daily activity impairment attributable to a HIV neuropathy pain. Number of participants who responded "Yes/No" to Question 1: Are you currently employed (working for pay)? are reported. Baseline, Week 16, 17
Secondary Absenteeism and Presenteeism Assessed by Work Productivity and Activity Impairment: Specific Health Problem (WPAI: SHP) Questionnaire WPAI: 6-question participant rated questionnaire to determine the degree to which SHP affected work productivity while at work and affected activities outside of work. It assesses amount of absenteeism, presenteeism and daily activity impairment attributable to a HIV neuropathy pain. Question 2 and 3 assesses absenteeism as: Hours of work missed in past 7 days due to leg/foot pain or other reason, respectively. Question 4 assesses presenteeism as: Hours of work performed in past 7 days. A participant who had responded 'no' to question 1 regarding employment status reported hours of work and as this was a self-reported questionnaire the source data were included. Baseline, Week 16, 17
Secondary Productivity and Activity Impairment Assessed by Work Productivity and Activity Impairment: Specific Health Problem (WPAI: SHP) Questionnaire WPAI: 6-question participant rated questionnaire to determine the degree to which SHP affected work productivity while at work and affected activities outside of work. It assesses amount of absenteeism, presenteeism and daily activity impairment attributable to a HIV neuropathy pain. Question 5 and 6 assesses: How much leg/foot pain affect productivity and daily activity, respectively in past 7 days? on 11-point scale, where 0 (not affected/no impairment) to 10 (completely affected/impaired). Baseline, Week 16, 17
Secondary Diagnostic Neuropathy Assessment Screening
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