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Clinical Trial Details — Status: Recruiting

Administrative data

NCT number NCT04759703
Other study ID # 2020P002928
Secondary ID
Status Recruiting
Phase Phase 2/Phase 3
First received
Last updated
Start date January 24, 2022
Est. completion date June 1, 2025

Study information

Verified date March 2024
Source Massachusetts General Hospital
Contact Benjamin W Wipper
Phone 617-643-6026
Email bwipper@mgh.harvard.edu
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The investigators propose to test the use of pramipexole in patients being treated for Opioid Use Disorder to test its ability to reduce symptoms of both Restless Legs Syndrome and protracted opioid withdrawal and thereby promote initiation, engagement, and retention in treatment.


Description:

This is a parallel, two-arm, double-blind, randomized placebo-controlled 2-week trial investigating the effects of pramipexole 0.25-0.5 mg on Restless Legs Syndrome (RLS) symptoms in patients suffering from opioid withdrawal. The investigators hypothesize that pramipexole is an effective treatment for RLS symptoms in Opioid Use Disorder (OUD) patients during post-detox clinical stabilization. Further, the investigators hypothesize that treatment of RLS in this context will also improve overall symptoms of opioid withdrawal. RLS is a sensory-motor neurological disorder characterized by an irresistible urge to move the legs. The investigators have recently confirmed anecdotal reports that RLS is common among patients with OUD experiencing opioid withdrawal. Dopamine agonists such as pramipexole are efficacious and first-line FDA-approved treatments in low doses for RLS. Recruitment and enrollment will occur at the Gavin Foundation Clinical Stabilization Services (CSS) in Quincy, Massachusetts. Eligible patients will be randomized to two weeks of pramipexole or placebo after an initial 3-day screening period and will be asked to complete 5 remote study visits over video or phone. Participants will be asked to complete sleep diaries and questionnaires at various points throughout the study.


Recruitment information / eligibility

Status Recruiting
Enrollment 80
Est. completion date June 1, 2025
Est. primary completion date February 1, 2025
Accepts healthy volunteers No
Gender All
Age group 18 Years to 75 Years
Eligibility Inclusion Criteria: 1. Men or women of any ethnic origin. 2. Written informed consent is obtained 3. Speaks and writes in English 4. A willingness and ability to comply with study procedures. 5. Age 18-75 years 6. Patients with diagnosed OUD who have undergone primary detoxification for their OUD in the Gavin Acute Treatment Service (ATS), have been transferred to the Gavin Clinical Stabilization Service (CSS), and have some persistent opioid withdrawal as indicated by a Subjective Opiate Withdrawal Scale (SOWS) >1 on Day 1 7. Diagnosis of RLS from the Hening Telephone Diagnostic Interview (HTDI) with subsequent confirmation by clinical interview conducted by a study physician 8. International Restless Legs Syndrome Severity Scale (IRLS) Symptoms subscale score of >15 for three consecutive days prior to randomization Exclusion Criteria: 1. Receiving opioid-agonist medications at transfer to the CSS 2. Pregnant 3. Participants with active or unstable major psychiatric disorder other than OUD, who, in the investigators' judgment, require further treatment 4. Use of dopaminergic agonists or antagonists within the last 30 days 5. Alcohol use disorder within the last 30 days 6. History of being treated for RLS, specifically with dopamine agonist medications 7. Methamphetamine or benzodiazepine dependence in the last 30 days 8. Neurological disorder or cardiovascular disease raising safety concerns about use of pramipexole and/or judged to interfere with ability to assess efficacy of the treatment 9. Medical instability considered to interfere with study procedures 10. Stage 3, 4, or 5 renal insufficiency 11. Participation in this study on a previous admission to the CSS

Study Design


Intervention

Drug:
Pramipexole
0.25 mg pramipexole tablets
Placebo
Matching placebo tablets

Locations

Country Name City State
United States Massachusetts General Hospital Boston Massachusetts
United States Gavin Foundation Clinical Stabilization Services Quincy Massachusetts

Sponsors (1)

Lead Sponsor Collaborator
Massachusetts General Hospital

Country where clinical trial is conducted

United States, 

References & Publications (3)

Handelsman L, Cochrane KJ, Aronson MJ, Ness R, Rubinstein KJ, Kanof PD. Two new rating scales for opiate withdrawal. Am J Drug Alcohol Abuse. 1987;13(3):293-308. doi: 10.3109/00952998709001515. — View Citation

Hening WA, Allen RP, Washburn M, Lesage S, Earley CJ. Validation of the Hopkins telephone diagnostic interview for restless legs syndrome. Sleep Med. 2008 Mar;9(3):283-9. doi: 10.1016/j.sleep.2007.04.021. Epub 2007 Jul 17. — View Citation

Walters AS, LeBrocq C, Dhar A, Hening W, Rosen R, Allen RP, Trenkwalder C; International Restless Legs Syndrome Study Group. Validation of the International Restless Legs Syndrome Study Group rating scale for restless legs syndrome. Sleep Med. 2003 Mar;4(2):121-32. doi: 10.1016/s1389-9457(02)00258-7. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Change from Baseline International Restless Legs Syndrome Study Group Scale (IRLS) at 2 weeks A validated tool to measure restless legs syndrome severity, on a scale of 0-40, with a higher score representing greater restless legs syndrome severity 2 weeks
Secondary Change from Baseline Subjective Opiate Withdrawal Scale (SOWS) at 2 weeks The Subjective Opiate Withdrawal Scale (SOWS) is a 16-item self-administered instrument. One of the items queries for presence of 'restlessness'. 2 weeks
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