Comparison of the Effects of Tapentadol and Oxycodone on Gastrointestinal and Colonic Transit in Humans

NCT ID: NCT01500317

Last Updated: 2012-12-17

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

38 participants

Study Classification

INTERVENTIONAL

Study Start Date

2011-05-31

Study Completion Date

2011-12-31

Brief Summary

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Tapentadol is FDA approved for the treatment of moderate to severe acute pain. Due to the dual mechanism of action as an opioid agonist and norepinephrine reuptake inhibitor, there is potential for off label use in chronic pain.

Tapentadol is a new molecular entity that is structurally similar to tramadol. Tapentadol is a centrally-acting analgesic with a dual mode of action as an agonist at the mu-opioid receptor and as a norepinephrine reuptake inhibitor. These two actions are synergistic in pain relief. While its action reflects aspects of tramadol and morphine, its ability to control pain is more on the order of hydrocodone and oxycodone.

Its dual mode of action provides analgesia at similar levels of more potent narcotic analgesics such as hydrocodone, oxycodone, and meperidine with a more tolerable side effect profile. Clinical studies showed that tapentadol effectively relieves moderate to severe pain in various pain care settings. In addition, it was reported to be associated with significantly fewer treatment discontinuations due to a significantly lower incidence of gastrointestinal-related adverse events compared with equivalent doses of oxycodone. The combination of these reduced treatment discontinuation rates and tapentadol efficacy for the relief of moderate to severe nociceptive and neuropathic pain may offer an improvement in pain therapy by increasing patient compliance with their treatment regimen.

Detailed Description

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Single center, parallel group, randomized controlled trial of tapentadol, oxycodone and placebo effects on gastrointestinal and colonic transit in healthy human volunteers

Conditions

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Effects of 2 Mu-opiates on Gastrointestinal Transit

Keywords

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tapentadol oxycodone mu-opiate stomach small intestine colon motility nausea constipation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Tapentadol

75 mg tapentadol tid

Group Type ACTIVE_COMPARATOR

Tapentadol

Intervention Type DRUG

Subjects received tapentadol immediate release formulation, 75 mg three times per day (tid) for 48 hours.

Oxycodone

5 mg oxycodone tid

Group Type ACTIVE_COMPARATOR

Oxycodone

Intervention Type DRUG

Subjects received oxycodone immediate release formulation, 5 mg three times per day (tid) for 48 hours.

Placebo

Placebo tid

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Subjects received placebo three times per day (tid) for 48 hours.

Interventions

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Tapentadol

Subjects received tapentadol immediate release formulation, 75 mg three times per day (tid) for 48 hours.

Intervention Type DRUG

Oxycodone

Subjects received oxycodone immediate release formulation, 5 mg three times per day (tid) for 48 hours.

Intervention Type DRUG

Placebo

Subjects received placebo three times per day (tid) for 48 hours.

Intervention Type DRUG

Other Intervention Names

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Tapentadol brand name: Nucynta Dazidox ETH-Oxydose Endocodone Oxecta Oxy IR Oxycontin Oxyfast Percolone Roxicodone

Eligibility Criteria

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Inclusion Criteria

1. Males and non-pregnant, non-breastfeeding females
2. 18-65 years old

Exclusion Criteria

1. Use of any mu-opioid agent in the last 3 months
2. Structural or metabolic diseases/conditions that affect the gastrointestinal system, or functional gastrointestinal disorders. For screening the shortened screening version of the Bowel Disease Questionnaire (Appendix) will be used to exclude subjects with dyspepsia, irritable bowel syndrome or significant gastrointestinal symptoms. Of 19 questions, participants have to have three or less positives to be eligible to participate.
3. Unable to withdraw medications 48 hours prior to the study :

* Alter GI transit including laxatives, magnesium or aluminum-containing antacids, prokinetics, erythromycin, narcotics, anticholinergics, tricyclic antidepressants, selective serotonin re-uptake inhibitors (SSRIs) and newer antidepressants.
* Analgesic drugs including opiates, nonsteroidal anti-inflammatory drugs (NSAIDs), COX 2 inhibitors
* SSRI NOTE: Low stable doses of thyroid replacement, estrogen replacement, low dose aspirin for cardioprotection and birth control pills or depot injections are permissible.
4. Female subjects who are pregnant or breast feeding.
5. Clinical evidence (including physical exam, ECG, hemoglobin level and review of the medical history) of significant cardiovascular, respiratory, renal, hepatic, gastrointestinal, hematological, neurological, psychiatric, or other disease that interfere with the objectives of the study.
6. Subjects who are considered by the investigator to be alcoholics not in remission or known substance abusers.
7. Subjects who have participated in another clinical study within the past 30 days
8. History of porphyria, renal (creatinine \> 1.5mg/dL) or significant liver impairment (transaminases, alkaline phosphatase of gamma-glutamyl transpeptidase (GGT) \>2 times upper limit of normal)
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Center for Research Resources (NCRR)

NIH

Sponsor Role collaborator

Mayo Clinic

OTHER

Sponsor Role lead

Responsible Party

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Michael Camilleri

MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Michael Camilleri, MD

Role: PRINCIPAL_INVESTIGATOR

Mayo Clinic

Locations

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Mayo Clinic in Rochester

Rochester, Minnesota, United States

Site Status

Countries

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United States

Other Identifiers

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Pharmacodynamic study

Identifier Type: OTHER

Identifier Source: secondary_id

UL1RR024150

Identifier Type: NIH

Identifier Source: secondary_id

View Link

11-002334

Identifier Type: -

Identifier Source: org_study_id