Study to Compare Gabapentin to Tramadol in Children With Chronic Neuropathic or Mixed Pain

NCT ID: NCT02722603

Last Updated: 2019-10-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

TERMINATED

Clinical Phase

PHASE3

Total Enrollment

2 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-09-12

Study Completion Date

2019-06-18

Brief Summary

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This study evaluates the efficacy and safety of gabapentin relative to tramadol for the treatment of chronic, neuropathic or mixed pain in the paediatric population. Children from 3 months to less than 18 years of age experiencing moderate to severe chronic pain will receive either gabapentin or tramadol for 15 weeks. The difference in average pain scores between treatment arms at the end of the treatment period will be assessed.

Detailed Description

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Gabapentin is indicated for the treatment of peripheral neuropathic pain in adults. In the absence of specific paediatric studies, it is not approved for the same condition in children.

The paediatric use of gabapentin is hampered by a) the lack of a suitable paediatric formulation, b) the significant variability of gabapentin pharmacokinetics profile and c) efficacy and safety data in this specific population.

The GABA-1 study is designed to demonstrate the efficacy of gabapentin oral solution relative to tramadol and to document the Pharmacokinetic and safety profile of gabapentin in this indication.

GABA-1 is a non-inferiority trial because gabapentin is expected to be equally effective but better tolerated than tramadol, thus providing a clinical benefit to affected children.

Conditions

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Chronic Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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gabapentin / placebo tramadol

gabapentin 75 mg/ml syrup / placebo tramadol, 3 times/day for 15 weeks.

Group Type EXPERIMENTAL

gabapentin

Intervention Type DRUG

75 mg/ml gabapentin syrup

placebo tramadol

Intervention Type OTHER

placebo tramadol oral drops

tramadol / placebo gabapentin

tramadol oral drops 100 mg/ml / placebo gabapentin, 3 times/day for 15 weeks.

Group Type ACTIVE_COMPARATOR

tramadol

Intervention Type DRUG

100 mg/ml tramadol oral drops

placebo gabapentin

Intervention Type OTHER

placebo gabapentin syrup

Interventions

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gabapentin

75 mg/ml gabapentin syrup

Intervention Type DRUG

tramadol

100 mg/ml tramadol oral drops

Intervention Type DRUG

placebo tramadol

placebo tramadol oral drops

Intervention Type OTHER

placebo gabapentin

placebo gabapentin syrup

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

1. Male or female, aged 3 months to less than 18 years at screening.
2. Informed consent by parent(s) and/or legal guardian according to each country legal requirement.
3. Assent by the patient, where applicable, according to each country legal requirement.
4. Subjects that meet the diagnostic criteria for neuropathic or mixed pain.
5. Subjects that present with chronic pain defined as the recurrent or continuous pain persisting more than 3 months. Duration of pain will be determined from the date of the first pain experienced.
6. Subjects that present with at least moderate pain as defined by average pain intensity of ≥4/10 as assessed during a 3-day screening period
7. Stable underlying disease condition and treatment.
8. In presence of malignant diseases, subjects in clinical remission and/or no expected changes in their therapeutic protocol during participation to the present study.

Exclusion Criteria

1. Pain duration of more than 5 years.
2. Current use of gabapentin or tramadol.
3. History of failure to respond to adequate treatment by gabapentin or tramadol/opioids for neuropathic pain.
4. History of epileptic condition except febrile seizure disorder.
5. Subjects with sleeping apnoea syndrome of any origin or subjects with history of severe respiratory impairment.
6. Subjects with diagnosis of sickle cell disease.
7. Subjects that present significant cognitive impairment.
8. Subjects that present current, controlled or uncontrolled, co-morbid psychiatric diagnosis that can impair pain diagnosis and assessment such as severe depressive conditions or psychosis.
9. Subjects with history of suicidal ideation or behaviour.
10. History of substance abuse in particular opioids.
11. Subjects under prohibited concomitant medication
12. Subjects in need for corticosteroid oral treatment or corticosteroid infiltrations to treat pain caused by infiltration or compression of neural structures, e.g. peripheral nerves or spinal cord.
13. Subjects born prematurely at ≤ 36 weeks gestational age, if recruited during the first year of age.
14. Subjects with a body mass index (BMI) for age and gender of \< 5th percentile or \> 95th percentile.
15. Subjects with glomerular filtration rate \< 90 mL/min/1.73 m2 (Schwarz equation).
16. Subjects with significant hepatic impairment or with Aspartate Transaminase (AST) or Alanine Transaminase (ALT) enzymes 3 times the upper limit of the age-specific reference range.
17. Subjects with known allergy, hypersensitivity or clinically significant intolerance to gabapentin or tramadol or any component found in the study drugs.
18. Subjects with fructose intolerance, diabetes, glucose-galactose malabsorption or lactase-isomaltase deficiency.
19. Subjects with clinically relevant abnormal ECG at the screening visit in the discretion of the Investigator/cardiologist.
20. Subjects participating in another clinical interventional trial.
21. Subjects scheduled for surgery or in recovery from surgery occurring within 3 months of baseline assessment.
22. Female subjects who are pregnant or currently lactating.
23. Subjects that failed screening or were previously enrolled in this study.
Minimum Eligible Age

3 Months

Maximum Eligible Age

17 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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European Commission

OTHER

Sponsor Role collaborator

Pharmaceutical Research Management srl

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Florentia Kaguelidou

Role: PRINCIPAL_INVESTIGATOR

Center Clin Investig INSERM CIC 1426 H. R Debré APH de Paris

Locations

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Universitaets klinikum Erlangen

Erlangen, , Germany

Site Status

Erasmus Universitair Medisch Centrum Rotterdam

Rotterdam, , Netherlands

Site Status

Countries

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Germany Netherlands

References

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Finnerup NB, Sindrup SH, Jensen TS. Recent advances in pharmacological treatment of neuropathic pain. F1000 Med Rep. 2010 Jul 14;2:52. doi: 10.3410/M2-52.

Reference Type BACKGROUND
PMID: 21170362 (View on PubMed)

Mellegers MA, Furlan AD, Mailis A. Gabapentin for neuropathic pain: systematic review of controlled and uncontrolled literature. Clin J Pain. 2001 Dec;17(4):284-95. doi: 10.1097/00002508-200112000-00002.

Reference Type BACKGROUND
PMID: 11783808 (View on PubMed)

Kaguelidou F, Le Roux E, Mangiarini L, Lundin R, de Leeuw TG, Della Pasqua O, Felisi M, Bonifazi D, Tibboel D, Ceci A, de Wildt SN, Alberti C; GAPP consortium. Non-inferiority double-blind randomised controlled trial comparing gabapentin versus tramadol for the treatment of chronic neuropathic or mixed pain in children and adolescents: the GABA-1 trial-a study protocol. BMJ Open. 2019 Feb 20;9(2):e023296. doi: 10.1136/bmjopen-2018-023296.

Reference Type DERIVED
PMID: 30787078 (View on PubMed)

Other Identifiers

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2014-004851-30

Identifier Type: -

Identifier Source: org_study_id

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