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A Study to Evaluate the Effectiveness and Safety of Tapentadol (CG5503) Extended Release (ER) in Patients With Moderate to Severe Chronic Low Back Pain

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ClinicalTrials.gov Identifier: NCT00449176
Recruitment Status : Completed
First Posted : March 20, 2007
Results First Posted : June 24, 2010
Last Update Posted : April 30, 2012
Sponsor:
Collaborator:
Information provided by:

Study Description
Brief Summary:
The purpose of this trial is to evaluate the effectiveness (level of pain control) and safety of orally administrated tapentadol (CG5503) Extended Release (ER) (base) at doses of 100-250 mg twice daily in patients with moderate to severe chronic pain of the lower back, in comparison with placebo and Oxycodone Controlled Release (CR).

Condition or disease Intervention/treatment Phase
Low Back Pain Drug: tapentadol (CG5503) ER Drug: oxycodone CR Drug: placebo Phase 3

Detailed Description:
The primary objective of this randomized (study medication assigned to patients by chance), double-blind (neither patient nor investigator knows the study medication), phase III, placebo and active controlled trial is to evaluate the efficacy and safety of orally administered tapentadol (CG5503) Extended Release (ER) (base) at doses 100-250 mg twice daily in patients with moderate to severe chronic pain of the lower back. The study is being conducted for registration and approval of tapentadol (CG5503) in the US and outside US. The trial will consist of five periods: screening (to assess eligibility), washout (3-7 days with determination of baseline pain intensity), titration (of dose over 3 weeks to the optimal individual level), maintenance (investigational drug intake for 12 weeks with adjustments allowed), and follow-up (2 weeks post treatment discontinuation). The study hypothesis is that the study drug will be more effective than placebo in reducing patients' pain intensity. The Secondary objectives include the collection of pharmacokinetic (related to how the body uses the drug) information for dose verification. The trial objectives will be assessed by comparing the baseline pain level to the level of week 12 of the maintenance phase. This will be done by looking at the patient's pain diary information. Titrate tapentadol (CG5503) ER (extended release) in 50 mg steps to patient's optimal dose ranging between 100mg and 250mg twice a day; Oxycodone CR (controlled release) 20mg to 50mg twice a day; Placebo (no active ingredients). All doses of trial treatment will be taken orally with or without food, for a maximum timeframe of 15 weeks.

Study Design

Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 981 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomized Double-Blind, Placebo- and Active-Control, Parallel-arm, Phase III Trial With Controlled Adjustment of Dose to Evaluate the Efficacy and Safety of CG5503 Extended-Release (ER) in Subjects With Moderate to Severe Chronic Low Back Pain
Study Start Date : February 2007
Primary Completion Date : May 2008
Study Completion Date : May 2008

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Back Pain
U.S. FDA Resources

Arms and Interventions

Arm Intervention/treatment
Experimental: 001
tapentadol (CG5503) ER 50 100 150 200 250 mg twice daily for 15 weeks
Drug: tapentadol (CG5503) ER
50, 100, 150, 200, 250 mg twice daily for 15 weeks
Active Comparator: 002
oxycodone CR 10 20 30 40 50 mg twice daily for 15 weeks
Drug: oxycodone CR
10, 20, 30, 40, 50 mg twice daily for 15 weeks
Placebo Comparator: 003
placebo matching placebo twice daily for 15 weeks
Drug: placebo
matching placebo twice daily for 15 weeks


Outcome Measures

Primary Outcome Measures :
  1. Change From Baseline of the Average Pain Intensity Based on a 11-point Numerical Rating Scale (NRS) Over the Last Week of the Maintenance Period at Week 12. [ Time Frame: Baseline and 12 weeks ]
    For this twice daily pain assessment, the subjects were to indicate the level of pain experienced over the previous 12 hours on an 11-point Numerical Rating Scale (NRS) where a score of 0 indicated "no pain" and a score of 10 indicated "pain as bad as you can imagine".


Secondary Outcome Measures :
  1. Change From Baseline in Brief Pain Inventory (BPI) Total Pain Score Over the Last Week of the Maintenance Period at Week 12. [ Time Frame: Baseline and 12 week endpoint ]
    Total pain score where zero equals "no pain" to ten equals "pain as bad as you can imagine" from 12 week endpoint vs baseline.

  2. Change From Baseline in Sleep Latency Time in Hours Over the Last Week of the Maintenance Period at Week 12. [ Time Frame: Baseline and 12 week endpoint ]
    A Sleep Questionnaire addressed the following question: "How long after bedtime/lights out did you fall asleep last night (hours)?" 12 week endpoint-mean changes from baseline at endpoint for sleep latency. Decrease in time(hours) indicates improvement.

  3. Percentage of Patients Who Reported Very Much Improved or Much Improved From Baseline in Patient Global Impression of Change Over the Last Week of the Maintenance Period at Week 12 [ Time Frame: Baseline and 12 week endpoint ]
    Ordinal measure indicating change from start of treatment (On a scale of 7 = Very much Worse to 1 = very much improved)

  4. Number of Participants With Treatment Discontinuation Due to Lack of Efficacy [ Time Frame: Baseline and 12 weeks ]
    The number of participants who discontinued due to lack of efficacy from baseline to endpoint

  5. Change From Baseline in EuroQol-5® (EQ-5D) Health Status Index to Week 12 [ Time Frame: Baseline and 12 week endpoint ]
    Change from baseline to end point in EuroQol-5 Dimension Questionnaire. A higher score indicates an improvement in health in the Health Status Index. The EuroQol-5 is a five dimensional health state classification. Each dimension is assessed on a 3-point ordinal scale (1=no problems, 2=some problems, 3=extreme problems). The responses to the five EQ-5D dimensions were scored using a utility-weighted algorithm to derive an EQ-5D health status index score between 0 to 1, with 1.00 indicating "full health" and 0 representing dead.

  6. Responder Analysis 50% Improvement [ Time Frame: Baseline and Week 12 ]
    Defined by the proportion of subjects achieving at least 50% improvement from baseline in the primary endpoint of change from baseline of the average pain intensity based on the 11-point Numerical Rating Scale (NRS) at week 12. The subjects were to indicate the level of pain experienced over the previous 12 hours on an 11-point NRS where a score of 0 indicated "no pain" and a score of 10 indicated "pain as bad as you can imagine".


Eligibility Criteria

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Senior)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Men and non-pregnant, non-lactating women having a diagnosis of Lower Back Pain (LBP) of non-malignant origin present for at least 3 months
  • Patients taking analgesic medications for at least 3 months prior to screening and/or dissatisfied with their current therapy
  • Patients requiring opioid treatment must be taking daily doses of opioid-based analgesic, equivalent to < 160 mg of oral morphine
  • Baseline score of =5 on an 11-point numerical rater scale, calculated as the average pain intensity during the last 3 days prior to randomization.

Exclusion Criteria:

  • History of alcohol and/or drug abuse in Investigator's judgement
  • History of significant liver insufficiency
  • chronic hepatitis B or C, or HIV, presence of active hepatitis B or C within the past 3 months
  • Life-long history of seizure disorder or epilepsy
  • History of malignancy within past 2 years, with exception of basal cell carcinoma that has been successfully treated
  • Uncontrolled hypertension
  • Patients with severely impaired renal function
  • Patients with moderate to severly impaired hepatic function or with laboratory values reflecting inadequate hepatic function
Contacts and Locations

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT00449176


Sponsors and Collaborators
Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
Grünenthal GmbH
Investigators
Study Director: Johnson & Johnson Pharmaceutical Research & Development, L.L. C. Clinical Trial Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
More Information

Additional Information:
Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Vice President, Compound Developmen Team Leader, Johnson & Johnson Pharmaceutical Research & Development, L.L.C.
ClinicalTrials.gov Identifier: NCT00449176     History of Changes
Other Study ID Numbers: CR013399
R331333PAI3011 ( Other Identifier: Johnson & Johnson Pharmaceutical Research & Development, L.L.C. )
First Posted: March 20, 2007    Key Record Dates
Results First Posted: June 24, 2010
Last Update Posted: April 30, 2012
Last Verified: April 2012

Keywords provided by Johnson & Johnson Pharmaceutical Research & Development, L.L.C.:
Low Back Pain
Chronic Pain
Pain Assessment
Tapentadol

Additional relevant MeSH terms:
Back Pain
Low Back Pain
Pain
Neurologic Manifestations
Nervous System Diseases
Signs and Symptoms
Oxycodone
Analgesics, Opioid
Narcotics
Central Nervous System Depressants
Physiological Effects of Drugs
Analgesics
Sensory System Agents
Peripheral Nervous System Agents