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Chronic PainPhase 3NCT00982280

Evaluation of Effectiveness and Tolerability of Tapentadol Hydrochloride in Subjects With Severe Pain Due to Osteoarthritis Taking WHO Step III Analgesics But Showing a Lack of Tolerability.

A Phase 3 study testing Tapentadol PR in people with Chronic Pain and Osteoarthritis, run by Grünenthal GmbH at 24 sites in 6 countries.

Terminated

Stopped early. The study ended before it was planned to and will not resume.

Official record
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Trial summary

The main objective of the study is to evaluate the effectiveness, tolerability, and safety of tapentadol hydrochloride prolonged release (PR) in participants suffering from severe chronic pain due to osteoarthritis of the knee who are taking WHO Step III analgesics and show lack of tolerability. Read more about this study

Who is it for?
Ages 40 years and older
Conditions the study is for
Chronic Pain, Osteoarthritis
What is being tested?
Tapentadol PR
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
82 participants
Where
24 sitesin 6 countries
Study dates
Sep 2009to Aug 2010
Phase
Phase 3
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 40 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Participants must have signed an Informed Consent Form indicating that they understand the purpose of and procedures required for the trial and are willing to participate in it.
  • Participants are men or non-pregnant, non-lactating women. Sexually active women must be postmenopausal, surgically sterile, or practicing an effective method of birth control (e.g., prescription oral contraceptives, contraceptive injections, intrauterine device, double barrier method, contraceptive patch, male partner sterilization) before entry and throughout the trial. Women of childbearing potential must have a negative pregnancy test at screening.
  • Participants must be appropriately communicative to verbalize and to differentiate with regard to location and intensity of the pain.
  • Participants must be at least 40 years of age.
  • Participants must have a diagnosis of osteoarthritis of the knee based on the American College of Rheumatology (ACR) Classification criteria:
  • Knee pain and
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  • Radiographic osteophytes or
  • Knee pain and aged 40 years or above and
  • Morning stiffness of less than 30 minutes of duration and
  • Crepitus on motion.
  • Participants must have pain at the reference joint which has been present for at least 3 months.
  • Participant's pain must require a strong analgesic (defined as WHO Step III) as judged by the Investigator
  • Participant must be taking a WHO Step III analgesic on a daily basis for at least 2 weeks prior to the Screening Visit.
  • Participant must have responded to the WHO Step III analgesic, i.e., participant must have a confirmed average pain intensity score (NRS 3) of smaller or equal to 5 points during the last 3 days prior to the Screening Visit.
  • Participant must report opioid-related side effects as the reason to change their analgesic
  • Participant must report a rate of satisfaction with their previous analgesic regimen not exceeding "fair" on a subject satisfaction with treatment scale (5-point VRS).

Who cannot join

  • Presence of a clinically significant disease or laboratory findings that in the Investigator's opinion may affect efficacy or safety assessments.
  • Presence of active systemic or local infection that may, in the opinion of the Investigator, affect the efficacy, quality of life/function or safety assessments.
  • History of alcohol or drug abuse, or suspicion thereof in Investigator's judgement.
  • Presence of concomitant autoimmune inflammatory conditions.
  • Known history of or laboratory values reflecting severe renal impairment.
  • Known history of moderately or severely impaired hepatic function.
Show all 24Show fewer
  • History of or active hepatitis B or C within the past 3 months or history of HIV infection.
  • History of seizure disorder or epilepsy.
  • Any of the following within 1 year: mild/moderate traumatic brain injury, stroke, transient ischemic attack, or brain neoplasm. Severe traumatic brain injury within 15 years (consisting of 1 or more of the following: brain contusion, intracranial hematoma, either unconsciousness or post traumatic amnesia lasting more than 24 h) or residual sequelae suggesting transient changes in consciousness.
  • Pregnant or breast-feeding.
  • History of allergy to, or hypersensitivity to tapentadol hydrochloride or its excipients, or contraindications related to tapentadol hydrochloride including:
  • participants with acute or severe bronchial asthma or hypercapnia.
  • participants who have or are suspected of having paralytic ileus.
  • Employees of the Investigator or trial site, with direct involvement in this trial or other trials under the direction of the Investigator or trial site, as well as family members of employees of the Investigator.
  • Participation in another trial concurrently or within 4 weeks prior to the Screening Visit.
  • Known to or suspected of not being able to comply with the protocol and the use of the investigational medicinal product.
  • Use of monoamine oxidase inhibitors within 14 days before the Screening Visit.
  • Non-stable dosing of selective serotonin reuptake inhibitors within 30 days before the Screening Visit (the doses must remain stable during the trial).
  • Osteoarthritis in a flare state.
  • Use of intra-articular injections of hyaluronic acid in the reference joint within 3 months before the Screening Visit.
  • Presence of conditions other than OA of the reference joint that could confound the assessment or self-evaluation of pain, e.g., anatomical deformities, significant skin conditions such as abscess or syndromes with widespread pain such as fibromyalgia. Subjects with OA at joints other than the reference joint will not be excluded as long as the reference joint is the source of main pain and disability.
  • History and clinical signs at the reference joint of crystal-induced (e.g., gout, pseudo-gout), metabolic, infectious and autoimmune disease.
  • Any painful procedures during the trial (e.g., major surgery including the reference joint) that may, in the opinion of the Investigator, affect the efficacy or safety assessments.
  • Pending litigation due to chronic pain or disability.

Trial locations and contacts

24 sites in 6 countries.

24 sites in 6 countries

United Kingdom7 sites
  • Site 3

    Birmingham

  • Site 6

    Carmarthen

  • Site 1

    Leeds

  • Site 2

    London

  • Site 8

    Middlesbrough

  • Site 9

    Oxford

  • Site 10

    York

Other trials in United Kingdom

Denmark5 sites
  • Site 4

    Aalborg

  • Site 7

    Hvidovre

  • Site 6

    Kolding

  • Site 2

    Odense

  • Site 3

    Vejle

Other trials in Denmark

Germany5 sites
  • Site 1

    Berlin

  • Site 7

    Katzhütte

  • Site 2

    Leer

  • Site 8

    Leipzig

  • Site 9

    Zerbst

Other trials in Germany

Poland3 sites
  • Site 4

    Lublin

  • Site 5

    Ostrów Mazowiecka

  • Site 2

    Tychy

Other trials in Poland

Australia2 sites
  • Site 4

    Melbourne

  • Site 2

    Perth

Other trials in Australia

Spain2 sites
  • Site 4

    Madrid

  • Site 1

    Valencia

Other trials in Spain

About this study

Official title: An Evaluation of the Effectiveness and Tolerability of Tapentadol Hydrochloride Prolonged Release, and Tapentadol Hydrochloride Immediate Release on Demand, in Subjects With Severe Chronic Pain Due to Osteoarthritis of the Knee Taking WHO Step III Analgesics But Showing a Lack of Tolerability.

The main objective of the study is to evaluate the effectiveness, tolerability, and safety of tapentadol hydrochloride prolonged release (PR) in participants suffering from severe chronic pain due to osteoarthritis of the knee who are taking WHO Step III analgesics and show lack of tolerability. This is a clinical effectiveness trial designed to establish a link between anticipated clinical outcomes and the clinical practice by means of selected measures of clinical and subject-reported outcome. The trial will compare the effectiveness of previous analgesic treatment (WHO Step III) with that of tapentadol hydrochloride PR treatment during defined periods of evaluation.

Read the detailed description

The trial will last up to 13 weeks for each subject and includes:

  • One week of observation under previous analgesic treatment.
  • Twelve weeks of treatment with tapentadol hydrochloride PR.
Being tested
Tapentadol PR
Keywords
Osteoarthritis, pain assessment, tapentadol, centrally acting analgesic
Medical subject headings
Chronic Pain, Osteoarthritis

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Tapentadol PRDrug

    Also called Nucynta, Palexia

    Tapentadol Prolonged Release (PR) Titration and Optimal Dose Period: Starting at 50 mg, 100 mg or 150 mg Tapentadol PR twice daily, adjusting at 50 mg PR steps (upwards or downwards) as necessary to achieve a balance between pain relief and a satisfactory level of tolerability. Participants were not permitted to exceed 500 mg of Tapentadol per day.

    Maintenance Period: Participants continuing on the dose established in the previous period.

Study groups in NCT00982280
Study groupRoleWhat they receive
TapentadolExperimentalTapentadol PR was given orally twice a day. A maximum of 2 oral Tapentadol IR tablets per day, with a minimum of a 4 hour interval between doses, were taken if there were acute pain episodes. The total daily dose of Tapentadol PR and IR were not permitted to exceed 500 mg per day.
Receives: Drug: Tapentadol PR

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Responder Rate

    Participants were considered responders if they reported the same or less average pain intensity over a 3 day period after 6 weeks of tapentadol PR treatment as with their previous analgesic treatment.

    Measured: 6 weeks

Secondary outcomes (19)
  1. Average Pain Intensity Before the Start of Tapentadol Treatment

    For this pain assessment, the participant was to indicate the level of average pain experienced over the previous 3 days 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".

    Measured: Baseline

  2. Change in Average Pain Intensity After 6 Weeks of Tapentadol PR Treatment.

    For this pain assessment, the participant was to indicate the level of average pain experienced over the previous 3 days 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". The value indicates the change from the baseline value on the 0 to 10 scale. A Negative value indicates a reduction in pain intensity from the baseline average pain intensity.

    Measured: Baseline; Week 6 (6 weeks)

  3. Change in Average Pain Intensity After 12 Weeks of Tapentadol PR Treatment.

    For this pain assessment, the participant was to indicate the level of average pain experienced over the previous 3 days 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". The value indicates the change from the baseline value on the 0 to 10 scale. A Negative value indicates a reduction in pain intensity from the baseline average pain intensity.

    Measured: Baseline; Week 12 (12 weeks)

  4. Baseline Western Ontario McMaster Questionnaire (WOMAC) Global Score Assessing Pain, Disability and Joint Stiffness of the Knee

    Western Ontario McMaster Questionnaire (WOMAC) Global Score: WOMAC is measured with a Likert ordinal scale (the participant gives one of 5 possible answers) A higher score indicate that a symptom is bothersome or disabling. The WOMAC is a self-administered questionnaire and has 24 questions: Pain, Stiffness and Physical Function. The possible scores range from 0-20 for pain, 0-8 for stiffness, 0-68 for physical function and these are then summed 0-96 for the global score. A lower score indicates a lower level of symptoms and or disability.

    Measured: Baseline

  5. Change From Baseline in the Western Ontario McMaster Questionnaire (WOMAC) Global Score Assessing Pain, Disability and Joint Stiffness of the Knee Over the Last Week at Week 6

    The WOMAC is a self-administered questionnaire and has 24 questions: Pain, Stiffness and Physical Function. The possible scores range from 0-20 for pain, 0-8 for stiffness, 0-68 for physical function and these are then summed 0-96 for the global score. The negative value indicates that there has been an improvement since baseline, the higher the value the greater the change since baseline.

    Measured: 6 weeks

  6. Change From Baseline in the Western Ontario McMaster Questionnaire (WOMAC) Global Score Assessing Pain, Disability and Joint Stiffness of the Knee Over the Last Week at Week 12

    The WOMAC is a self-administered questionnaire and has 24 questions: Pain, Stiffness and Physical Function. The possible scores range from 0-20 for pain, 0-8 for stiffness, 0-68 for physical function and these are then summed 0-96 for the global score. The negative value indicates that there has been an improvement since baseline, the higher the value the greater the change since baseline.

    Measured: 12 weeks

  7. EuroQol-5 (EQ-5D) Health Status Index Outcome Over Time

    The participant scored the EuroQol-5. This 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. The positive values indicate that during the study the health status improved.

    Measured: 6 weeks

  8. EuroQol-5 (EQ-5D) Health Status Index Outcome Over Time

    The participant scored the EuroQol-5. This 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. The positive values indicate that during the study the health status improved.

    Measured: 12 weeks

  9. Change in Health Related Quality of Life: EuroQol-5D Health State Visual Analog Scale (VAS)

    EuroQoL-5D Health State Visual Analog Scale (VAS) is a participant rated questionnaire to assess health-related quality of life in terms of a single index value. The VAS component rates current health state on a scale from 0 (worst imaginable health state) to 100 (best imaginable health state); higher scores indicate a better health state. The values indicated represent the change from the baseline, a positive value indicates an improvement.

    Measured: 6 Weeks

  10. Change in Health Related Quality of Life: EuroQol-5D Health State Visual Analog Scale (VAS)

    EuroQoL-5D Health State Visual Analog Scale (VAS) is a participant rated questionnaire to assess health-related quality of life in terms of a single index value. The VAS component rates current health state on a scale from 0 (worst imaginable health state) to 100 (best imaginable health state); higher scores indicate a better health state. The values indicated represent the change from the baseline, a positive value indicates an improvement.

    Measured: 12 Weeks

  11. Clinical Global Impression of Change

    In the Clinical Global Impression of Change (CGIC) the clinician indicates the perceived change over the treatment period. The clinician is requested to choose one of seven categories. Scores range from very much improved to very much worse.

    Measured: Baseline; End of Week 6 (6 Weeks)

  12. Clinical Global Impression of Change

    In the Clinical Global Impression of Change (CGIC) the clinician indicates the perceived change over the treatment period. The clinician is requested to choose one of seven categories. Scores range from very much improved to very much worse.

    Measured: Baseline; End of Week 12 (12 Weeks)

  13. Patient Global Impression of Change

    In the Patient Global Impression of Change (PGIC) the participant indicates the perceived change over the treatment period. The participant is requested to choose one of seven categories. Scores range from very much improved to very much worse.

    Measured: Baseline; End of Week 6 (6 Weeks)

  14. Patient Global Impression of Change

    In the Patient Global Impression of Change (PGIC) the participant indicates the perceived change over the treatment period. The participant is requested to choose one of seven categories. Scores range from very much improved to very much worse.

    Measured: Baseline; End of Week 12 (12 Weeks)

  15. Participant's Satisfaction With Previous Analgesic Treatment.

    Participants were requested to rate their previous analgesic medication on a 5-point scale. Previous medication was rated as excellent, very good, good, fair and poor.

    Measured: Baseline

  16. Participant's Satisfaction With New Analgesic Treatment, i.e Tapentadol.

    Participants were requested to rate their tapentadol (new) analgesic medication on a 5-point scale. The medication was rated as excellent, very good, good, fair and poor.

    Measured: After 6 weeks

  17. Participant's Satisfaction With New Analgesic Treatment, i.e Tapentadol.

    Participants were requested to rate their tapentadol (new) analgesic medication on a 5-point scale. The medication was rated as excellent, very good, good, fair and poor.

    Measured: After 12 weeks

  18. Mean Equipotency Ratio of Tapentadol Compared to Buprenorphine

    Tapentadol was compared to Transdermal Buprenorphine with Buprenorphine set to 1. The average total daily dose of Tapentadol at which a pain score equivalent or below to the pain score at the end of observation period under Transdermal Buprenorphine was reached was documented as the equipotent or equianalgesic dose to the total daily dose of the previously used Transdermal Buprenorphine.

    Measured: Baseline; End of Week 6 (6 Weeks)

  19. Mean Equipotency Ratio of Tapentadol Compared to Oxycodone

    Tapentadol was compared to Oxycodone with Oxycodone set to 1. The average total daily dose of Tapentadol at which a pain score equivalent or below to the pain score at the end of observation period under Oxycodone was reached was documented as the equipotent or equianalgesic dose to the total daily dose of the previously used Oxycodone.

    Measured: Baseline; End of Week 6 (6 Weeks)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Sep 2009 (estimated)
  2. Study startSep 2009
  3. Primary completionMay 2010
  4. Study completionAug 2010

Why it stopped: Slow Recruitment and supply of Investigational Medicinal Product Issues

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
82 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00982280
Sponsor's protocol ID
847022
Other IDs
2009-010425-39, 2009
Status last verified
Oct 2019
First submitted
22 Sep 2009
Last updated
18 Oct 2019
Data monitoring committee
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Tapentadol PR in people with Chronic Pain and Osteoarthritis, run by Grünenthal GmbH at 24 sites in 6 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 16 inclusion and 24 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: stopped early, as of the sponsor's last update on 18 Oct 2019. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 24 sites in United Kingdom, Denmark, Germany, Poland, Australia and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 14 Dec 2011). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Responder Rate (time frame: 6 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Oct 2019.

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Clinical Trial NCT00982280 | AzTrials