Evaluate the Efficacy and Safety of NYX-2925 in Subjects With Fibromyalgia

• ClinicalTrials.gov Identifier: NCT03249103
• Recruitment Status: Completed
• First Posted: August 15, 2017
• Results First Posted: September 16, 2022
• Last Update Posted: September 16, 2022
• Sponsor: Aptinyx
• Collaborator: inVentiv Health Clinical
• Information provided by (Responsible Party): Aptinyx

Study Description

Brief Summary:

The primary objective is to determine whether daily dosing with NYX-2925 changes markers of central pain processing in subjects with fibromyalgia by evaluating changes in evoked pain, and visual stimulation, functional magnetic resonance imaging (fMRI), resting state function connectivity magnetic resonance imaging (rs-fcMRI) and proton magnetic resonance spectroscopy (H-MRS) in fibromyalgia subjects on active drug versus placebo.

Condition or disease	Intervention/treatment	Phase
Fibromyalgia	Drug: NYX-2925; Drug: Placebo oral capsule	Phase 2

Detailed Description:

This is a single-blind, exploratory, placebo-controlled, pilot study to assess the efficacy and safety of daily oral NYX-2925 in fibromyalgia subjects. The study will include a screening period (up to 30 days), a placebo period, an active treatment period with, and a follow-up period as follows:

• Placebo PO Every Day (QD) for 2 weeks
• NYX-2925 PO QD for 2 weeks (2x)
• Follow-up for 1 week

Eligible subjects will receive MRIs during the screening period, during the placebo period, during the NYX-2925 PO QD period. Safety assessments will be conducted and adverse events will be collected during the study. Daily pain scores and other fibromyalgia scales will be collected during the study. Daily pain scores and other fibromyalgia scales will be collected for exploratory analysis. During the follow-up period, an optional MRI will be completed for consenting subjects in order to evaluate duration of effect.

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 22 participants
• Allocation: N/A
• Intervention Model: Single Group Assignment
• Intervention Model Description: All subjects will receive placebo, NYX-2925 20 mg QD, NYX-2925 200 mg QD for sequential 2 week treatment periods, then go into Follow-up for 1 week.
• Masking: None (Open Label)
• Masking Description: Subjects are masked to the sequence in which they are taking placebo QD, NYX-2925 20 mg QD, NYX-2925 200 mg QD.
• Primary Purpose: Treatment
• Official Title: A Phase 2, Single-Blind, Exploratory, Placebo-controlled, Pilot Study to Assess the Efficacy and Safety of Daily Oral NYX-2925 in Subjects With Fibromyalgia
• Actual Study Start Date: August 14, 2017
• Actual Primary Completion Date: April 18, 2019
• Actual Study Completion Date: April 18, 2019

Arms and Interventions

Arm	Intervention/treatment
Experimental: All subjects; Up to 24 subjects will receive placebo, NYX-2925 20 mg QD, and NYX-2925 200 mg QD for sequential 2 week treatment periods, then go into Follow-up for 1 week.	Drug: NYX-2925; NYX-2925 is a novel small molecule that modulates the N-methyl-D-aspartate receptor (NMDAR).; Drug: Placebo oral capsule; Matching placebo capsules.

Outcome Measures

Primary Outcome Measures :

1. Mean (SD) Glx/Total Creatine Levels in Dorsal Anterior Cingulate Cortex (dACC): NYX-2925 20 mg and 200 mg PO QD at Week 4 and Week 6, Respectively. [ Time Frame: Week 2, Week 4, Week 6 ]
2. Mean (SD) Changes in Posterior Insula (pINS) Glx/Total Creatine Levels Before and After Acute Painful Pressure Stimulation: NYX-2925 20 mg and 200 mg PO QD at Week 4 and Week 6, Respectively. [ Time Frame: Week 2, Week 4, and Week 6 ]

Other Outcome Measures:

1. Mean Change in Numeric Pain Rating Scale (NPRS) Score Assessing Average Pain in the Past 24 Hours [ Time Frame: Change from Baseline, Week 2 (Placebo), Week 4, and Week 6 (NYX-2925) ]
   Numeric pain rating scale is a unidimensional segmented numeric version of the visual analog scale. A subject selects a whole number (0 to 10) that best indicates the intensity of their pain, where 0 represents no pain and 10 the worst pain imaginable.

Eligibility Criteria

• Ages Eligible for Study: 18 Years to 70 Years (Adult, Older Adult)
• Sexes Eligible for Study: Female
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

1. Subjects meets the 2010 American College of Rheumatology (ACR) criteria for fibromyalgia.
2. Self-reported clinical pain ≥ 4 and on the Numeric Pain Rating Scale (NPRS) at screening and baseline.
3. Subject receives and agrees to remain on their stable fibromyalgia treatment plan established at least 14 days prior to dosing.
4. Subject agrees to use only non-steroidal anti-inflammatory (NSAID) or acetaminophen treatment as needed for breakthrough pain, and/or, zopiclone, zolpidem, zaleplon, or eszopiclone for sleep (if needed).
5. Right handed.
6. Calculates creatinine clearance ≥ 60 mL/minute.
7. Female subjects of child bearing potential with a negative serum pregnancy test prior to entry into the study and who are practicing an adequate method of birth control (e.g., surgical sterilization, oral or parenteral contraceptives, intrauterine device that is considered safe for MRI procedures, barrier [condom with spermicide]) and who do not plan to become pregnant, breastfeed, or donate ova during the course of the study and for 28 days after the final administration of investigational product.
8. Ability to understand the requirements of the study, provide written informed consent, abide by the study restrictions, and agree to return for the required assessments.

Exclusion Criteria:

1. Current or expected use of opioid or narcotic analgesics, monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, gabapentins, topiramate, anticonvulsants, benzodiazepines, and sedatives, or hypnotics.
2. Unstable doses of allowed antidepressants or muscle relaxants. Use of NSAIDs or acetaminophen 24 hours prior to imaging procedures is prohibited.
3. Pain due to concurrent disease such as rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, or other chronic widespread pain condition(s) that may confound fibromyalgia pain.
4. Untreated endocrine disorder that may confound fibromyalgia assessments.
5. Psychiatric or cognitive disorder (e.g., current schizophrenia, severe depression, suicidal ideation, dementia, etc.).
6. Clinically significant alcohol or other substance abuse within the last 2 years.
7. Positive screen for medically inappropriate or illegal use of drugs of abuse.
8. Current treatment with medications such as ketamine, amantadine, dextromethorphan, memantine, methadone, dextropropoxyphene, or ketobemidone.
9. History of allergy, sensitivity, or intolerance to medications such as ketamine, amantadine, dextromethorphan, memantine, methadone, dextropropoxyphene, or ketobemidone.
10. Women, who are pregnant, breast feeding, or planning to become pregnant or donate ova during the course of the study and for 28 days after the final administration of investigational product.
11. Huntington's, Parkinson's, Alzheimer's, Multiple Sclerosis, or history of seizures, epilepsy, or strokes.
12. Contraindications to fMRI procedures. These may include but are not limited to: surgical clips, surgical staples, metal implants, and certain metallic dental material.
13. Current or habitual use (within the last 12 months) of artificial nails, nails enhancements, or nail extensions that cover any portion of either thumbnail.
14. Abnormal laboratory results, medical history, or concurrent conditions that would preclude safe study participation, or interfere with study procedures/assessments.
15. Impaired liver function.
16. Known history of significant heart condition or high blood pressure.
17. Current evidence of dysplasia or history of cancer malignancy (including lymphoma and leukemia) in the last 5 years.
18. Human immunodeficiency virus (HIV) infection, hepatitis, or other ongoing infectious disease.
19. History of severe kidney or liver impairment.
20. History of migraine.
21. History of lower limb vascular surgery or current lower limb vascular dysfunction.
22. Received an investigational drug or device within 30 days of dosing.
23. Previous treatment with NYX-2925.
24. Resting heart rate < 45 or ≥ 95 beats per minute.

Contacts and Locations

Locations

United States, Michigan

Aptinyx Clinical Site

Ann Arbor, Michigan, United States, 48109

United States, Ohio

Aptinyx Clinical Site

Cincinnati, Ohio, United States, 45220

Sponsors and Collaborators

Aptinyx

inVentiv Health Clinical

  Study Documents (Full-Text)

Documents provided by Aptinyx:

Study Protocol  [PDF] March 7, 2018

Statistical Analysis Plan  [PDF] November 26, 2018

More Information

• Responsible Party: Aptinyx
• ClinicalTrials.gov Identifier: NCT03249103
• Other Study ID Numbers: NYX-2925-2002
• First Posted: August 15, 2017
• Results First Posted: September 16, 2022
• Last Update Posted: September 16, 2022
• Last Verified: August 2022

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: Yes

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Aptinyx:

Fibromyalgia

Additional relevant MeSH terms:

Fibromyalgia; Myofascial Pain Syndromes; Muscular Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Neuromuscular Diseases; Nervous System Diseases