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Uremic PruritusPhase 2NCT01660243

Efficacy and Safety of MT-9938 for Treatment of Uremic Pruritus in Subjects With End-stage Renal Disease Receiving Hemodialysis

A Phase 2 study testing Nalfurafine hydrochloride(MT-9938) 2.5μg, Nalfurafine hydrochloride(MT-9938) 5μg and Nalfurafine hydrochloride(MT-9938) 10μg in people with Uremic Pruritus, run by Toray Industries, Inc at 4 sites in United States.

Terminated

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

Official record
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Trial summary

This study is being conducted to investigate the efficacy of MT-9938 compared with placebo after 2 weeks, to continue to evaluate efficacy for an additional 6 weeks, and to explore the effect of a reduction in itching intensity on health-related Quality of Life(QoL) domains, especially those which recent research… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Uremic Pruritus
What is being tested?
Nalfurafine hydrochloride(MT-9938) 2.5μg, Nalfurafine hydrochloride(MT-9938) 5μg and Nalfurafine hydrochloride(MT-9938) 10μg
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
45 participants
Where
4 sitesUnited States
Study dates
Sep 2012to Mar 2014
Phase
Phase 2
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 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • On stable hemodialysis for at least 3 months
  • Has stable functioning arteriovenous fistula, graft or other venous access
  • Has continued (uncontrolled) uremic pruritus despite standard of care in the institution
  • Has severe pruritus, as determined by a qualifying score of ≥3 on the Itch Severity Score Scale (0 to 4) either day or night during the week prior to Screening Visit
  • Has no known drug addiction to any prescription, nonprescription, herbal or natural drugs, and successfully passes a drug screen test
  • Women and men whose partners are of childbearing potential agree to practice the medically acceptable methods of birth control and agree to continue with the regimen throughout the duration of the study
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  • Capable of understanding and responding to the subject questionnaires, understands the purpose and risks of the study, and has given written informed consent
  • Has rated his/her NRS score each day for at least 5 days out of the 7 days of the Run-in Phase
  • Has severe pruritus, as determined by qualifying mean worst NRS score in a day of ≥5 (on 11 point NRS) at the end of the 1-week Run-in Phase

Who cannot join

  • Current, clinically significant medical comorbidities
  • Abnormal liver dysfunction
  • Pruritus attributed mainly to any disease unrelated to kidney disease
  • Calcium x phosphorus product >80 mg2/dL2 or hemoglobin <7 g/dL or parathyroid hormone levels >1000 pg/mL at Screening
  • Received ultraviolet B treatment within 30 days prior to Screening
  • Started or changed psychotropic medication within 14 days prior to Screening
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  • Is receiving opioid antagonists or opioid agonists within 7 days prior to Screening and not willing to abstain from these medications during the study.
  • Started or changed medications, creams or emollients including over-the-counter oil bath treatment for relief of pruritus within 7 days prior to Screening
  • Has known hypersensitivity to opioids or the study drug ingredients
  • Is currently participating in an investigational drug or device clinical study or was participating in such a study within 30 days prior to the start of Screening
  • Female subject who is known to be pregnant or nursing
  • Is considered not suitable for inclusion in the study in the opinion of Investigator
  • Has current suicidal ideation with some intent to act or with specific plan and intent or had suicidal behavior at any time in subject's life

Trial locations and contacts

4 sites in 1 country.

United States4 sites
  • Study site

    Los Angeles, California

  • Study site

    New York, New York

  • Study site

    Rosedale, New York

  • Study site

    San Antonio, Texas

Other trials in United States

About this study

Official title: A Phase 2, Randomized, Double-blind, Placebo-controlled, Fixed-dose, Parallel-group, Multicenter, Efficacy, and Safety Study of MT-9938 for Treatment of Uremic Pruritus in Subjects With End-stage Renal Disease Receiving Hemodialysis

This study is being conducted to investigate the efficacy of MT-9938 compared with placebo after 2 weeks, to continue to evaluate efficacy for an additional 6 weeks, and to explore the effect of a reduction in itching intensity on health-related Quality of Life(QoL) domains, especially those which recent research suggests have a positive correlation with overall survival for this patient group. The study will consist of the following phases: Screening (1 to 2 weeks), Run in (1 week), double-blind Treatment (8 weeks), Washout (1 week) culminating in a Follow-up Visit (1 week after the last dose).

Read the detailed description

This study has been terminated because of insufficient patient recruitment. There were no safety concerns.

Conditions
Uremic Pruritus
Being tested
Nalfurafine hydrochloride(MT-9938) 2.5μg, Nalfurafine hydrochloride(MT-9938) 5μg, Nalfurafine hydrochloride(MT-9938) 10μg, Placebo
Keywords
Pruritus, Renal dialysis, Receptors, Opioid, kappa, Sleep Disorders, Quality of Life
Medical subject headings
Pruritus, Sleep Wake Disorders

What participants receive

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

  • Nalfurafine hydrochloride(MT-9938) 2.5μgDrug

    2.5 μg (2capsules) once daily for 8 weeks

  • Nalfurafine hydrochloride(MT-9938) 5μgDrug

    5 μg (2capsules) once daily for 8 weeks

  • Nalfurafine hydrochloride(MT-9938) 10μgDrug

    10 μg (2capsules) once daily for 8 weeks

  • PlaceboDrug

    Placebo (2capsules) once daily for 8 weeks

Study groups in NCT01660243
Study groupRoleWhat they receive
MT-9938 2.5μgActive comparatorNot described
Receives: Drug: Nalfurafine hydrochloride(MT-9938) 2.5μg
MT-9938 5μgActive comparatorNot described
Receives: Drug: Nalfurafine hydrochloride(MT-9938) 5μg
MT-9938 10μgActive comparatorNot described
Receives: Drug: Nalfurafine hydrochloride(MT-9938) 10μg
PlaceboPlacebo comparatorNot described
Receives: Drug: Placebo

What is being measured

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

  1. Change From Baseline in Worst-itching 11-point Numerical Rating Scale (NRS)

    The subject indicated the number on the line from left (0:no itching) to right (10:worst itch I have ever experienced). Assessments was made twice daily using an electronic Patient Reported Outcomes (ePRO) device from the Screening Visit to the Follow-up Visit (Week 9). The 2 daily assessments was separated by 12 h, at approximately 8 am and at approximately 8 pm. Subjects selected the number that best described the worst itch during the day (assessed at approximately 8 pm) or during the night (assessed at approximately 8 am). The day or night score, whichever was greater, was used to calculate the weekly average score and changes from baseline (average over the Run-in Phase [Days -7 to -1]) score in weekly average at 2, 4 and 8 weeks as specified in the protocol are reported. Amount of change score of plus indicates worsening, and minus indicates improvement.

    Measured: 2 weeks, 4 weeks and 8 week

  2. Change From Baseline in Worst-itching Visual Analog Scale (VAS)

    The subject placed a single vertical mark on the line of a VAS corresponding to degree of itching intensity from left (no itching) to right (worst itch I have ever experienced). The VAS represents a 100 mm line. It consists of 101 selectable regions and the subject's score on the VAS will correspond to the region (0 to 100) selected on the line. Assessments was made twice daily using an ePRO device from the Screening Visit to the Follow-up Visit (Week 9). The 2 daily assessments was separated by 12 h, in the morning at approximately 8 am and in the night at approximately 8 pm. Subjects put a single vertical mark on the line to show the intensity of your worst itching during the day or during the night. The day or night score, whichever was greater, was used to calculate the weekly average score and changes from baseline in weekly average at 2, 4 and 8 weeks as specified in the protocol are reported. Amount of change score of plus indicates worsening, and minus indicates improvement.

    Measured: 2 weeks, 4 weeks and 8 weeks

  3. Change From Baseline in Itch Severity Score

    The subject performed an assessment on day and nighttime symptoms of itch and effect of itch on sleep using a 5-point ordinal scale of itchiness (0 = none, 1 = mild, 2 = Moderate, 3=Severe, 4 = very severe). Assessments was made during each dialysis treatment (3x/week) and recorded on paper from the Screening Visit to the Follow-up Visit (Week 9). Change from Baseline (average over the Run-in Phase [Days -7 to -1]) in Weekly Averages of Itch Severity Score were assessed and score at 2, 4 and 8 weeks as specified in the protocol are reported. Amount of change score of plus indicates worsening, and minus indicates improvement.

    Measured: 2 weeks, 4 weeks and 8 weeks

  4. Change From Baseline in Sleep Quality Assessment

    The PSQI has a minimum possible score of 0 (better sleep quality) and a maximum possible score of 10 (worse sleep quality). Subjects was asked to rate their sleep experience during the previous week. Pittsburgh Sleep Quality Index (PSQI) modified assessment was made during the dialysis treatment 1x/week every week and recorded on paper from the Screening Visit to the Follow-up Visit (Week 9).Change from Baseline (the Run-in Phase [Days -7 to -1]) were assessed and score at 2, 4 and 8 weeks as specified in the protocol are reported. Amount of change score of plus indicates worsening, and minus indicates improvement.

    Measured: 2 weeks, 4 weeks and 8 weeks

  5. Change From Baseline in QoL Assessment (Skindex-10)

    The Skindex-10 has a minimum possible score of 0 (itching not bothersome) and a maximum possible score of 60 (itching very bothersome). The Skindex-10 is a self-administered questionnaire used to evaluate the health-related QoL in UP. It is comprised of 10 questions, adopted for pruritus from the Skindex-16, a widely used instrument for a variety of skin disease. Subjects was asked to identify on paper at Baseline and Weeks 2, 4, and 8 (EOT) what has bothered them most during the past week by marking along a scale 0 to 6 boxes from "never bothered" to "always bothered. Change from Baseline (the Run-in Phase [Days -7 to -1]) were assessed. Amount of change score of plus indicates worsening, and minus indicates improvement.

    Measured: 2 weeks, 4 weeks and 8 weeks

  6. The Mean Value in Treatment Satisfaction (Patient's Global Impression of Change )

    The PGIC has a minimum possible score of 1 (very much improved) and a maximum possible score of 7 (very much worse). Subjects was asked to use a categorical scale with 7 categories to describe their global impression of change (PGIC) with study drug treatment. Subjects recorded their impression of change on paper at Weeks 2, 4, and 8 (EOT).

    Although the change from baseline (run-in phase [Days -7 to -1]) was specified as an outcome in this study, it was not calculated because the target enrollment was not met and no meaningful statistical analysis could be expected. Therefore, the mean value of patients at each point is shown instead.

    Measured: 2 weeks, 4 weeks and 8 weeks

  7. Change From Baseline in QoL Assessment (5-D-Itch Scale)

    The 5-D-Itch scale has a minimum possible score of 5 (better) and a maximum possible score of 25 (worse). Subjects was asked to assess QoL by means of the 5D-Itch-Scale at Baseline, Weeks 2, 4, and 8 (EOT). The 5D-Itch Scale is a 5-item (duration, degree, direction, disability, and distribution) multidimensional measure of pruritus itch. Change from Baseline (the Run-in Phase [Days -7 to -1]) were assessed. Amount of change score of plus indicates worsening, and minus indicates improvement.

    Measured: 2 weeks, 4 weeks and 8 weeks

  8. The Number of Patients in Excoriation

    Investigator and/or the designated medically qualified staff assessed the subject's excoriation at Baseline, and weekly thereafter, by completing the subject's answers to the following questions:

    Excoriation present? Yes/No If yes, please rate the severity: Mild/Moderate/Severe

    Although the change from baseline (run-in phase [Days -7 to -1]) was specified as an outcome in this study, it was not calculated because the target enrollment was not met and no meaningful statistical analysis could be expected. Therefore, the number of patients at each point is shown instead.

    Measured: 2 weeks, 4 weeks and 8 weeks

Secondary outcomes (1)
  1. Number of Participants With Adverse Events as a Measure of Safety and Tolerability

    The number of subjects with at least 1 treatment-emergent adverse event (TEAE). Please see the adverse event table for specific.

    Measured: 8 weeks

Timeline

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

  1. First posted8 Aug 2012 (estimated)
  2. Study startSep 2012
  3. Primary completionMar 2014
  4. Study completionMar 2014

Why it stopped: This study has been terminated because of insufficient patient recruitment.

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 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
45 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01660243
Sponsor's protocol ID
MT-9938-A01
Status last verified
Nov 2021
First submitted
2 Aug 2012
Last updated
9 Feb 2022
Data monitoring committee
No

Publications

  • Hercz D, Jiang SH, Webster AC. Interventions for itch in people with advanced chronic kidney disease. Cochrane Database Syst Rev. 2020 Dec 7;12(12):CD011393. doi: 10.1002/14651858.CD011393.pub2.

    PubMed 33283264

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Nalfurafine hydrochloride(MT-9938) 2.5μg, Nalfurafine hydrochloride(MT-9938) 5μg and Nalfurafine hydrochloride(MT-9938) 10μg in people with Uremic Pruritus, run by Toray Industries, Inc at 4 sites in United States.

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 9 inclusion and 13 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 9 Feb 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in United States. 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. Some participants in this study may receive a placebo. 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 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 9 Feb 2022). 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?

Change From Baseline in Worst-itching 11-point Numerical Rating Scale (NRS) (time frame: 2 weeks, 4 weeks and 8 week). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01660243, which also lists 1 linked publication.

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 9 Feb 2022.

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