The Effect of Lacosamide in Peripheral Neuropathic Pain

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

PHASE2

Total Enrollment

63 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-01-15

Study Completion Date

2022-06-03

Brief Summary

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The main purpose of this study is to compare the change in pain intensity during treatment with a sodium-channel blocker (lacosamide) in patients with peripheral neuropathic pain with and without the irritable nociceptor phenotype.

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Detailed Description

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The main purpose of this study is to compare the change in pain intensity during treatment with a sodium-channel blocker (lacosamide) in patients with peripheral neuropathic pain with and without the irritable nociceptor phenotype. As this is a mechanistic study, the main purpose is to compare the change in pain intensity in patients who receive an expected sufficiently effective dose of lacosamide. As supportive evidence for a drug-specific predictive biomarker, the purpose is also to compare the change in pain intensity during lacosamide vs. placebo for the two phenotypes.

We hypothesize that the sodium-channel blocker lacosamide will be more effective in patients with the irritable nociceptor than those without the non-irritable nociceptor phenotype, and that lacosamide is more effective than placebo in patients with the irritable nociceptor phenotype.

Conditions

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Neuropathic Pain Neuropathy;Peripheral Neuropathy, Painful Neuropathy, Diabetic Neuropathy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Lacosamide

Lacosamide (50 mg) are given as capsules and taken orally twice a day, up to 200 mg b.i.d.

Group Type ACTIVE_COMPARATOR

Lacosamide

Intervention Type DRUG

Lacosamide (50 mg) and identical placebo are given as capsules and taken orally twice a day, up to 200 mg b.i.d.

Placebo

Placebo are given as capsules, same as lacosamide, and taken orally twice a day, without active ingredient.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

Identical placebo are given as capsules and taken orally twice a day.

Interventions

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Lacosamide

Lacosamide (50 mg) and identical placebo are given as capsules and taken orally twice a day, up to 200 mg b.i.d.

Intervention Type DRUG

Placebo

Identical placebo are given as capsules and taken orally twice a day.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Age ≥ 18 years.
2. Probable or definite peripheral neuropathic pain for at least 3 months (Finnerup et al. 2016)
3. Average pain intensity of at least 4 and not above 9 on a 0-10 NRS during the 7-day baseline week (Dworkin et al. 2012).
4. Written informed consent.

Exclusion Criteria

1. Other causes of pain in the same area, or other concomitant pain that cannot be distinguished from the neuropathic pain
2. Patient who cannot cooperate or are unable to complete the project and patients who do not speak Danish.
3. Known and current cardiac conduction disturbance (2⁰ or 3⁰ atrioventricular (AV) block, prolonged QTc interval \> 450 ms, heart rate \<50 or \>110 bpm, a QRS interval \>120ms (ECG required)), significant cardiac, renal or liver disease or other severe illness. In patients treated with pregabalin also PQ interval \> 0,2s and cardiac disease. Sitting diastolic blood pressure below 50 mmHg or above 105 mmHg.
4. Major depressive episode within 6 months, recurrent depressive disorder or other significant psychiatric disease, alcohol, illicit drug or drug abuse.
5. Pregnancy or lactation
6. Woman of childbearing potential, unless they use and acceptable effective contraception measure as defined in the Clinical Trials Facilitation Group (CTFG) during the study and at least 2 weeks after, or if their male partner is vasectomized and their sole partners. Negative pregnancy test is required.
7. Known allergy to lacosamide or excipients.
8. Concomitant pain treatment with tricyclic antidepressants, topical analgesics (lidocaine, capsaicin), lamotrigine, oxcarbazepine, cannabinoids or strong opioids that cannot be discontinued. Other treatment for neuropathic pain are allowed in a stable dose (from 14 days before randomization to completion of the trial), if they cannot be tapered off completely.
9. Concomitant treatment with products known to be associated with PQ (PR) prolongation other than pregabalin.
10. Patients inappropriate for placebo
11. Planned surgery
12. Use of sodium channel blockers within at least five half-lives and investigational drugs within 30 days.
13. Patients on controlled sodium diet, unless the amount of sodium in the capsules is acceptable for their diet.
14. The score "yes" on item 4 or item 5 of the Suicidal Ideation section of the Columbia Suicide Severity Rating Scale (C-SSRS), if the ideation occurred in the past 6 months, or "yes on any item of the Suicidal Behaviour section, except for the "Non-suicidal Self Injurious Behaviour" if this behaviour occurred in the past 2 years.

Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No