A Randomized, Controlled Trial of Gabapentin Enacarbil in Subjects with Neuropathic Pain Associated with Diabetic Peripheral Neuropathy.

Background Gabapentin enacarbil ( GEn), a transported prodrug of gabapentin, provides sustained, dose-proportional gabapentin exposure. The purpose of this study was to investigate the dose response of GEn to select the optimal dose(s) for clinical use in subsequent diabetic peripheral neuropathy (...

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Publicado en:Pain Practice Vol. 13; no. 6; pp. 485 - 497
Autores principales: Rauck, Richard, Makumi, Clare W., Schwartz, Sherwyn, Graff, Ole, Meno-Tetang, Guy, Bell, Christopher F., Kavanagh, Sarah T., McClung, Carrie L.
Formato: research tables/charts randomized controlled trial Journal Article
Publicado: Wiley-Blackwell Jul2013
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
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        atl: A Randomized, Controlled Trial of Gabapentin Enacarbil in Subjects with Neuropathic Pain Associated with Diabetic Peripheral Neuropathy.
      aug:
        au:
          Rauck, Richard
          Makumi, Clare W.
          Schwartz, Sherwyn
          Graff, Ole
          Meno-Tetang, Guy
          Bell, Christopher F.
          Kavanagh, Sarah T.
          McClung, Carrie L.
        affil: Carolinas Pain Institute
      sug:
        subj:
          Diabetic Neuropathies Drug Therapy
          Peripheral Nervous System Diseases Drug Therapy
          Gabapentin Administration and Dosage
          Treatment Outcomes
          Chronic Pain Drug Therapy
          Dose-Response Relationship, Drug
          Randomized Controlled Trials
          Multicenter Studies
          Double-Blind Studies
          Human
          Male
          Female
          Descriptive Statistics
          Pretest-Posttest Design
          Short Form-36 Health Survey (SF-36)
          Scales
          Questionnaires
          Clinical Assessment Tools
          Funding Source
          Models, Statistical
          Repeated Measures
          Multimethod Studies
          Sensitivity and Specificity
          Analysis of Covariance
          Logistic Regression
          Middle Age
          Adult
          Aged
          Aged, 80 and Over
          Parametric Statistics
          Confidence Intervals
          Gabapentin Adverse Effects
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background Gabapentin enacarbil ( GEn), a transported prodrug of gabapentin, provides sustained, dose-proportional gabapentin exposure. The purpose of this study was to investigate the dose response of GEn to select the optimal dose(s) for clinical use in subsequent diabetic peripheral neuropathy ( DPN) trials. Methods This was a multicenter, randomized, double-blind, double-dummy, parallel group, placebo-controlled trial with a study duration of approximately 20 weeks (Clinicaltrials.gov database, Identifier ! NCT00643760). Pregabalin ( PGB) (Lyrica®; Pfizer Inc.) was used as an active control to provide assay sensitivity of the trial. A total of 421 adult subjects with DPN were randomized in a ratio of 2:1:1:1:2 to receive oral GEn 3,600 mg/day, GEn 2,400 mg/day, GEn 1,200 mg/day, PGB 300 mg/day, or matching placebo, respectively. The primary efficacy endpoint was change from baseline to end of maintenance treatment with respect to the mean 24-hour average pain intensity score based on an 11-point Pain Intensity Numerical Rating Scale ( PI- NRS). Safety and tolerability assessments included treatment-emergent adverse events ( TEAEs), laboratory evaluations, vital signs, electrocardiograms ( ECG), neurological examination, and pedal edema. Results The adjusted mean difference vs. placebo at the end of maintenance treatment with respect to the mean 24-hour average PI- NRS pain intensity score for GEn 1,200 mg (−0.35; [95% CI: −1.02, 0.31]; P = 0.295), GEn 2,400 mg (−0.02; [95% CI: −0.71, 0.66]; P = 0.946), and GEn 3,600 mg (−0.55; [95% CI: −1.10, 0.01]; P = 0.105) was not statistically significant. The active control, PGB (300 mg/day), did not differentiate from placebo. Conclusion Overall, none of the GEn treatment groups differentiated from placebo. Analyses of the secondary endpoints showed comparable results across treatment groups. However, the majority of the endpoints, including all of the pain endpoints, showed the largest numerical treatment difference was between GEn 3,600 mg and placebo. The active control, PGB (300 mg/day), did not differentiate from placebo.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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