Gabapentin and Donepezil Combination on Experimental Human Pain Models
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Purpose
This study will compare the effects of gabapentin alone, and gabapentin + donepezil given together in two types of experimental electrical pain tests in up to 48 healthy male subjects (after 24 recruited in the first cohort an interim analysis will be performed).
The study is a randomized, double blind, placebo controlled, 3 was cross-over design study with incomplete block design and 4 treatment options. Placebo, gabapentin alone (lower dose and higher dose) or gabapentin (lower dose) with donepezil.
| Condition | Intervention | Phase |
|---|---|---|
|
Pain, Neuropathic |
Drug: Gabapentin lower dose Drug: Donepezil Other: Placebo (Dop) Other: Placebo (Gaba) Drug: Gabapentin higher dose |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Pharmacodynamics Study Intervention Model: Crossover Assignment Masking: Double Blind (Subject, Investigator) Primary Purpose: Basic Science |
| Official Title: | A Randomized, Double Blind, Placebo Controlled Study to Investigate the Effect of Donepezil and Gabapentin Combination on an Experimental Pain Model in Healthy Subjects |
- Area of pin-prick hyperalgesia [ Time Frame: Change from baseline visit to day 14 of treatment sessions ] [ Designated as safety issue: No ]Change in Area between treatment arms (compared to baseline), measured during the electrical hyperalgesia model using 26 Milli Neuton(mN) von Frey filament
- Area of touch-evoked allodynia [ Time Frame: Change from baseline visit to day 14 of treatment sessions ] [ Designated as safety issue: No ]Change in Area between treatment arms (compared to baseline), measured during the electrical hyperalgesia model using a cotton bud
- Pain threshold [ Time Frame: Change from baseline visit to day 14 of treatment sessions ] [ Designated as safety issue: No ]Change in threshold between treatment arms (compared to baseline), measured from single electrical stimulation of sural nerve
- Ongoing pain intensity rating [ Time Frame: Change from baseline visit to day 14 of treatment sessions ] [ Designated as safety issue: No ]Change in intensity between treatment arms (compared to baseline), measured from 11-point numeric rating scale (NRS) where 0=no pain, 10=maximum pain imaginable
- Pain Tolerance [ Time Frame: Change from baseline visit to day 14 of treatment sessions ] [ Designated as safety issue: No ]Change in tolerance between treatment arms(compared to baseline), measured from single electrical stimulation of sural nerve
- Pain Temporal Summation [ Time Frame: Change from baseline visit to day 14 of treatment sessions ] [ Designated as safety issue: No ]Change in temporal summation between treatment arms (compared to baseline), measured from repetitive electrical stimulation of sural nerve
- Intensity of flare [ Time Frame: Change from baseline visit to day 14 of treatment sessions ] [ Designated as safety issue: No ]Change in intensity between treatment arms (compared to baseline), measured from Laser Doppler imaging evoked by electrical hyperalgesia model
| Enrollment: | 48 |
| Study Start Date: | October 2011 |
| Study Completion Date: | June 2012 |
| Primary Completion Date: | June 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Experimental: Gabapentin lower dose alone
low dose
|
Drug: Gabapentin lower dose
Repeat, oral dose
|
|
Active Comparator: Gabapentin higher dose alone
higher dose
|
Other: Placebo (Dop)
Placebo to donepezil, Repeat, oral dose
|
|
Experimental: Gabapentin in combination with donepezil
Gabapentin lower dose and donepezil
|
Drug: Donepezil
Repeat, oral dose
Drug: Gabapentin higher dose
Repeat, oral dose
|
|
Placebo Comparator: Placebo
Placebo
|
Other: Placebo (Gaba)
Placebo to gabapentin, Repeat, oral dose
|
Detailed Description:
This study will compare the effects of gabapentin alone, and gabapentin + donepezil given together in two types of experimental electrical pain tests which will be conducted on the forearm and the lower leg, in 24 healthy male subjects initially. Gabapentin (a drug for treatment of seizure disorders) is one of the drugs being used for the treatment of pain caused by the damage to the nerves. Donepezil is a treatment to improve memory in patients with Alzheimer's disease. 24 more subjects may be recruited following a formal analysis during the trial (called interim analysis), if required for optimal scientific value. The study consists of 1 screening visit,1 visit to establish the baseline pain recordings before any treatment is given, then 3 treatment sessions, followed by a followup visit. Each treatment session consists of 12 days of dosing at home and 2 inpatient days for dosing and pain tests. Each volunteer takes part in 3 treatment sessions. In total, the study will last 15 weeks for each volunteer. There will be 4 treatment options: placebo, higher dose of gabapentin, low dose of gabapentin, low dose of gabapentin + donepezil. All subjects will receive the last two options and one out of the first two options, in a random order selected by a computer before the study starts; neither the volunteers nor the persons conducting the pain assessments nor the study team will know which treatment the volunteers receive during the visits (known as a randomised, double−blind study). The study will be conducted in a specialist clinical research unit with adequate facilities with regard to safety and compliance. The results of the tests in the study will help to understand the effects of gabapentin and donepezil together to design future clinical trials.
Eligibility| Ages Eligible for Study: | 18 Years to 55 Years |
| Genders Eligible for Study: | Male |
| Accepts Healthy Volunteers: | Yes |
Inclusion Criteria:
- Male between 18 and 55 years of age inclusive, at the time of signing the informed consent.
- Body weight ≥ 50 Kilogram (kg) and BMI within the range 18.5-29.9 Killogram per square meter (kg/m2) (inclusive).
- Healthy as determined by a responsible and experienced physician, based on a medical evaluation including medical history, physical examination, psychiatric history, psychiatric evaluation, laboratory tests and cardiac monitoring.
- Aspartate aminotransferase (AST), Alanine aminotransferase (ALT), alkaline phosphatase and bilirubin ≤ 1.5x Upper Limit of Normal (ULN)
- QT duration corrected for heart rate by Bazett's formula (QTcB) or QT duration corrected for heart rate by Fridericia's formula (QTcF) < 450 milli second (msec).
Exclusion Criteria:
- The subject has either a previous disease or current medical condition, which as judged by the Investigator, may compromise safety or affect the interpretation of efficacy data.
- History of known or suspected seizures, including infantile febrile, unexplained significant and recent loss of consciousness or history of significant head trauma with loss of consciousness or a family history (first degree relative) of epilepsy or seizures (fits).
- Abnormalities in 12-lead Electrocardiogram (ECG)
- Systolic blood pressure (BP) below 90 or above 160mm Hg, or diastolic blood pressure below 50 or above 100 millimeters of mercury (mmHg).
- History of sensitivity to any of the study medications
- History of regular alcohol consumption within 6 months of the study defined as: an average weekly intake of >21 units. One unit is equivalent to 8 g of alcohol: a half-pint (~240 millil litre [ml]) of beer, 1 glass (125 ml) of wine or 1 (25 ml) measure of spirits.
- A positive pre-study drug/alcohol screen at the screening visit.
- Excessive caffeine drinkers (~5 or more cups a day) .
- Excessive smokers (>5 /day)
- Use of prescription or non-prescription drugs, including vitamins, herbal and dietary supplements (including St John's Wort) within 7 days (or 14 days if the drug is a potential enzyme inducer) or 5 half-lives (whichever is longer) prior to screening, unless in the opinion of the Investigator and GSK Medical Monitor the medication will not interfere with the study procedures or compromise subject safety.
- Use of any topical steroid or capsaicin preparations in the previous 30 days to screening, unless in the opinion of the Investigator and GSK Medical Monitor the medication will not interfere with the study procedures or compromise subject safety.
- The subject is needle phobic
- The subject is unable to tolerate the electrical hyperalgesia model or nerve stimulation, including anxiety or atypical response to the stimulation on the training at the screening visit.
- The subject does not produce an area of allodynia or hyperalgesia to the electrical hyperalgesia model during the screening session.
- Subject who, in the investigator/designee's judgement, poses a significant suicide risk. Evidence of serious suicide risk may include any history of suicidal behaviour and/or any evidence of suicidal ideation on any questionnaires e.g. type 4 or 5 on the C-SSRS in the last 6 months.
- The subject has participated in a clinical trial and has received an investigational product within the following time period prior to the baseline session in the current study: 90 days, 5 half-lives or twice the duration of the biological effect of the investigational product (whichever is longer).
- Where participation in the study would result in donation of blood or blood products in excess of 500 mL within a 84 day period.
- A positive pre-study Hepatitis B surface antigen or positive Hepatitis C antibody result within 3 months of screening
- Unwillingness or inability to follow the procedures outlined in the protocol.
Contacts and Locations More Information
No publications provided
| Responsible Party: | GlaxoSmithKline |
| ClinicalTrials.gov Identifier: | NCT01485185 History of Changes |
| Other Study ID Numbers: | 115484 |
| Study First Received: | September 29, 2011 |
| Last Updated: | December 6, 2012 |
| Health Authority: | United Kingdon: No Health Authority United States: Food and Drug Administration United Kingdom: Research Ethics Committee United Kingdom: Medicines and Healthcare Products Regulatory Agency |
Keywords provided by GlaxoSmithKline:
|
Donepezil allodynia Gabapentin Sural nerve stimulation Electrical hyperalgesia |
Additional relevant MeSH terms:
|
Neuralgia Pain Neurologic Manifestations Nervous System Diseases Peripheral Nervous System Diseases Neuromuscular Diseases Signs and Symptoms Gabapentin Donepezil Gamma-Aminobutyric Acid Analgesics Sensory System Agents Peripheral Nervous System Agents Physiological Effects of Drugs Pharmacologic Actions |
Central Nervous System Agents Therapeutic Uses Anticonvulsants Antiparkinson Agents Anti-Dyskinesia Agents Calcium Channel Blockers Membrane Transport Modulators Molecular Mechanisms of Pharmacological Action Cardiovascular Agents Anti-Anxiety Agents Tranquilizing Agents Central Nervous System Depressants Psychotropic Drugs Excitatory Amino Acid Antagonists Excitatory Amino Acid Agents |
ClinicalTrials.gov processed this record on May 23, 2013