Oral Ketamine Administration in Patients With Peripheral Neuropathic Pain (KETACLUD)

This study is ongoing, but not recruiting participants.
Sponsor:
Information provided by (Responsible Party):
University Hospital, Toulouse
ClinicalTrials.gov Identifier:
NCT00961194
First received: August 17, 2009
Last updated: September 27, 2013
Last verified: September 2013
  Purpose

Nowadays, available drugs cannot always produce pain relief in patients with neuropathic pain disease.

It is believed that drugs acting as antagonists of the N-methyl-D-aspartic acid (NMDA) receptor may have been efficient in the treatment of neuropathic pain disorders.

Ketamine is the only NMDA receptor antagonist commercially available in France. Ketamine is usually administered intravenously for surgical anesthesia.

The intravenous administration of ketamine will be difficult to manage in the treatment of chronic neuropathic pain.

Some trials using oral ketamine for the treatment of neuropathic pain were conducted but results were heterogeneous. This may be explained by the different range of ketamine doses tested.

The aim of this clinical trial is to identify a safe and an efficient dose of orally administrated ketamine for the treatment of peripheral neuropathic pain.

The clinical trial will be conducted in Toulouse Hospital, France. This study is a randomized, double-blind, placebo-controlled trial. The study will be conducted using 4 parallel groups (three doses of ketamine versus placebo).


Condition Intervention Phase
Neuropathic Pain
Drug: Ketamine
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor)
Primary Purpose: Supportive Care
Official Title: Evaluation of the Analgesic Effect of Orally Administrated Ketamine in Peripheral Neuropathic Pain Disease: Comparison of Three Doses Versus Placebo.

Resource links provided by NLM:


Further study details as provided by University Hospital, Toulouse:

Primary Outcome Measures:
  • Evaluation of pain intensity using a 10 cm visual analogue scale (VAS) (0 = no pain; 10 = worst possible pain) before and after 7 days of oral administration of one of the three doses of ketamine or placebo. [ Time Frame: V1 (14 days before ketamine treatment), at V2 (before oral administration of one of the three doses of ketamine or placebo), at V3 (after 7 days of oral administration), and at V4 (after 7 days of the end of treatment) ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Pain intensity will be evaluated by measuring thermal sensibility. A thermode will be used to determine the heat and cold pain thresholds (thermotest) and by measuring hyperalgesia [ Time Frame: Thermotest and hyperalgesia will be assessed at T0 and T1 hour, at visit 2 and visit 3 ] [ Designated as safety issue: Yes ]

Estimated Enrollment: 30
Study Start Date: March 2009
Estimated Study Completion Date: March 2014
Primary Completion Date: September 2013 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Placebo Comparator: placebo

The study will be conducted using 4 parallel groups (three doses of ketamine versus placebo).Each patient will receive the indicated dose of oral ketamine or placebo once and if there are not adverse events, he will be able to continue the treatment three times a day, during 7 days (between visit 2 and 3).

The oral ketamine will be administered in form of syrup.

Drug: Ketamine

Initial dosage: 250 mg/5 ml

Three doses of ketamine will be tested:

  • 0.35 mg/kg
  • 0.7 mg/kg
  • 1.4 mg/kg Each patient will receive the indicated dose of oral ketamine or placebo once and if there are not adverse events, he will be able to continue the treatment three times a day, during 7 days (between visit 2 and 3).

The oral ketamine will be administered in form of syrup.

Other Name: Ketamine PANPHARMA
Experimental: dose of ketamine tested = 0.35 mg/kg

The study will be conducted using 4 parallel groups (three doses of ketamine versus placebo).Each patient will receive the indicated dose of oral ketamine or placebo once and if there are not adverse events, he will be able to continue the treatment three times a day, during 7 days (between visit 2 and 3).

The oral ketamine will be administered in form of syrup.

Drug: Ketamine

Initial dosage: 250 mg/5 ml

Three doses of ketamine will be tested:

  • 0.35 mg/kg
  • 0.7 mg/kg
  • 1.4 mg/kg Each patient will receive the indicated dose of oral ketamine or placebo once and if there are not adverse events, he will be able to continue the treatment three times a day, during 7 days (between visit 2 and 3).

The oral ketamine will be administered in form of syrup.

Other Name: Ketamine PANPHARMA
Active Comparator: dose of ketamine tested = 0.7 mg/kg

The study will be conducted using 4 parallel groups (three doses of ketamine versus placebo).Each patient will receive the indicated dose of oral ketamine or placebo once and if there are not adverse events, he will be able to continue the treatment three times a day, during 7 days (between visit 2 and 3).

The oral ketamine will be administered in form of syrup.

Drug: Ketamine

Initial dosage: 250 mg/5 ml

Three doses of ketamine will be tested:

  • 0.35 mg/kg
  • 0.7 mg/kg
  • 1.4 mg/kg Each patient will receive the indicated dose of oral ketamine or placebo once and if there are not adverse events, he will be able to continue the treatment three times a day, during 7 days (between visit 2 and 3).

The oral ketamine will be administered in form of syrup.

Other Name: Ketamine PANPHARMA
Active Comparator: dose of ketamine tested = 1.4 mg/kg

The study will be conducted using 4 parallel groups (three doses of ketamine versus placebo).Each patient will receive the indicated dose of oral ketamine or placebo once and if there are not adverse events, he will be able to continue the treatment three times a day, during 7 days (between visit 2 and 3).

The oral ketamine will be administered in form of syrup.

Drug: Ketamine

Initial dosage: 250 mg/5 ml

Three doses of ketamine will be tested:

  • 0.35 mg/kg
  • 0.7 mg/kg
  • 1.4 mg/kg Each patient will receive the indicated dose of oral ketamine or placebo once and if there are not adverse events, he will be able to continue the treatment three times a day, during 7 days (between visit 2 and 3).

The oral ketamine will be administered in form of syrup.

Other Name: Ketamine PANPHARMA

Detailed Description:

In previous studies, it was shown that when ketamine was administrated by the intravenous route, its analgesic action was rapid. In one study, when oral ketamine was administrated to patients suffering from neuropathic pain, in six out of nine patients, pain was relieved after 24 hours post-administration.

In this study, ketamine will be administrated during seven days, which will allow us to evaluate ketamine efficiency and safety.

The effect of ketamine on pain intensity will be mainly studied using a visual analogue scale (VAS) but also taking into account the score assigned by the patient to his pain. This score will be noted down by patients before, during and after ketamine treatment.

Evaluation of benefit/risk for ketamine administration during this trial, shows that even if adverse events are not excluded, the benefit for the patients may be neuropathic pain relief.

Because clinical current knowledge regarding oral administration of ketamine is limited, this trial intends to enlarge information about ketamine efficiency and safety, more particularly in neuropathic pain disorders.

  Eligibility

Ages Eligible for Study:   30 Years to 90 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must suffer from peripheral neuropathic chronic pain.
  • Pain score must be at least 40 mm in a VAS (reflecting pain intensity during the 7 days and the day before visit 1).
  • Patients in which pain is not satisfactory relieved by level 1, 2 or 3 analgesic drugs (associated or not with antidepressants or antiepileptic drugs). Patients treated with level 2 or 3 analgesic drugs must stop these treatments one week before and during ketamine treatment.
  • Patients must benefit from the French Social security system.
  • Patients must be able to complete the tests.
  • Patients must give a written informed consent.
  • Patients must be aged from 30 to 90 years.
  • Female fertile patients must use an efficient method of contraception.

Exclusion Criteria:

  • Patients not suffering from peripheral neuropathic chronic pain.
  • Pain score is less than 40 mm in a VAS (reflecting pain intensity during the 7 days and the day before visit 1).
  • Patients not able to complete the tests.
  • Patients not able to stop level 2 or 3 analgesic drugs.
  • Patients in which ketamine is contraindicated:

    • Hypersensibility to one of the compounds of the ketamine syrup
    • Uncontrolled arterial hypertension
    • Recent cardio vascular accident
    • Severe cardiac problems
    • Drug abuse
    • Psychosis
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00961194

Locations
France
Service de Neurochirurgie
Toulouse, France, 31059
Sponsors and Collaborators
University Hospital, Toulouse
Investigators
Principal Investigator: Nathalie Cantagrel, MD University Hospital, Toulouse
  More Information

No publications provided

Responsible Party: University Hospital, Toulouse
ClinicalTrials.gov Identifier: NCT00961194     History of Changes
Other Study ID Numbers: 0730102, AOL 2007
Study First Received: August 17, 2009
Last Updated: September 27, 2013
Health Authority: France: Afssaps - Agence française de sécurité sanitaire des produits de santé (Saint-Denis)

Keywords provided by University Hospital, Toulouse:
Ketamine
pain
neuropathic pain
chronic

Additional relevant MeSH terms:
Neuralgia
Pain
Neurologic Manifestations
Nervous System Diseases
Peripheral Nervous System Diseases
Neuromuscular Diseases
Signs and Symptoms
Ketamine
Analgesics
Sensory System Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Pharmacologic Actions
Central Nervous System Agents
Therapeutic Uses
Anesthetics, Dissociative
Anesthetics, Intravenous
Anesthetics, General
Anesthetics
Central Nervous System Depressants
Excitatory Amino Acid Antagonists
Excitatory Amino Acid Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action

ClinicalTrials.gov processed this record on September 30, 2014