Parkinson's Disease With Severe Pain Clinical Trial
To demonstrate superiority of OXN PR compared to placebo with respect to analgesic efficacy in subjects with chronic severe pain associated with Parkinson's disease (PD), as assessed by averaged 24 hour pain scores collected for 7 days prior to the clinic visits
Pain management in PD is a recognised unmet need. Estimates of incidence vary in the
literature from 29% to 83%. The types and sources of pain experienced by PD patients vary
and include: musculoskeletal pain, PD related chronic pain, fluctuation-related pain,
nocturnal pain, coat-hanger pain, oro-facial pain and peripheral limb or abdominal pain
(also including drug-induced pain). Whilst modifications to dosing of dopaminergic therapy
represents the most common method of controlling some of these pain symptoms, this must be
balanced against the worsening of side effects of increased doses of this treatment type.
Oxycodone hydrochloride and naloxone hydrochloride dihydrate combined oral prolonged release
tablets (OXN PR), is the investigational product to be used in this study. OXN PR is a
prolonged release tablet consisting of oxycodone and naloxone in a 2:1 ratio. Due to the
local competitive antagonism of the opioid receptor-mediated oxycodone effect by naloxone in
the gut, naloxone reduces opioid-associated bowel dysfunction.
The purpose of this study is to investigate whether effective pain control for the treatment
of PD associated pain may be achieved with OXN PR. The secondary considerations for this
study are to examine whether OXN PR may offer any additional benefits to the patients
Quality of Life or symptoms of PD. If effective pain relief can be achieved with an
analgesic without the side effects described in above, this could reduce the need to
increase the dose of dopaminergic medications to manage pain, and therefore reduce the
negative side effects of dopaminergic therapy described above. Given the prevalence of
constipation in this patient population the bowel sparing effects of the OXN PR combination
treatment may provide an ethical rationale for its use over that of other opioids.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double-Blind, Primary Purpose: Treatment