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| ID | Type | Description | Link |
|---|---|---|---|
| KF5503/41 |
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| Name | Class |
|---|---|
| Grünenthal GmbH | INDUSTRY |
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The purpose of this study is to compare bowel function/constipation that occurs during tapentadol treatment with that occuring during oxycodone treatment, as measured by the frequency of spontaneous bowel movements per week. The frequency of spontaneous bowel movements will be determined from a Bowel Function Patient Diary completed by the enrolled sujbects.
Chronic pain from end-stage degenerative joint disease is often moderate to severe in intensity and results in a relatively constant level of pain requiring continuous pain relief medication. Despite available pain relief medications, 60% to 80% of subjects suffering from chronic pain are currently inadequately treated. Opioid pain medications are central to the effective treatment of moderate to severe pain. However, opioid therapy is frequently complicated by side effects. Constipation is one of the most commonly reported side effects and most debilitating. An opioid medication that provides pain relief with a reduced incidence of constipation symptoms would improve the capability of subjects to stay on medication to achieve the long-term relief they need. This is a randomized, double-blind, placebo- and active-controlled, parallel-arm, multicenter study with 4 treatment groups of subjects who have moderate to severe chronic pain from end-stage degenerative joint disease of the hip or knee and who are candidates for primary total or partial joint replacement. The study consists of 3 periods: a pretreatment period (a 14-day screening for study eligibility and a 7-day washout of any previously taken opioid medication), a double-blind treatment period (a 14-day IR treatment phase followed by a 28-day ER treatment phase), and a follow-up period (1 study-site visit within 4 days after the last dose of study drug is taken and 1 telephone contact within 10 to 14 days after the last dose of study drug is taken). On Day 1 of the IR treatment phase, patients will be randomly assigned to 1 of 4 possible treatment groups to receive 50 mg CG5503 IR, 75 mg CG5503 IR, 10 mg oxycodone IR, or placebo daily every 4 to 6 hours. At the beginning of the ER treatment phase, patients' study drugs will be transitioned to the ER form (by conversion from the IR to approximate equivalent total daily doses of the ER form) of their randomly assigned study drug of tapentadol ER, oxycodone CR, or placebo. The ER study drugs will be taken every 12 hours b.i.d. Dosages will be adjustable, with the study site personnel oversight, to ensure adequate pain relief is provided. Beginning with the washout period, patients will be given hand-held computer diaries in which to record their pain intensity, pain relief, bowel movement information, and answer questions on any nausea or vomiting that may occur. In addition, patients will write down the times and dosages of all medications they take during the study in a medication diary. Safety and tolerability will be assessed using physical examination, monitoring of adverse events, clinical and laboratory measures, and 12 lead ECG results. The first study hypothesis is that both tapentadol IR dosages are more effective than placebo in relieving pain based on the SPID score recorded by the patients over the first 5 days of the study. The second study hypothesis is that the Bowel Function Patient Diary results for both tapentadol IR dosages demonstrate improved tolerability compared to oxycodone IR 10 mg, based on the number of spontaneous bowel movements per week over the first 2 weeks of the study. In the IR treatment phase, each patient will take CG5503 IR 50 mg, CG5503 IR 75 mg, oxycodone IR 10 mg, or placebo orally every 4 to 6 hours for 14 days. In the ER treatment phase, dosages of the IR treatment groups will be converted to approximately equivalent dosages of the ER form of the assigned study drug: tapentadol ER, oxycodone CR, or placebo. Dosages may range from 100 to 500 mg/day of tapentadol ER and 20 to 60 mg/day of oxycodone CR taken orally 2x daily for 28 days.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 001 | Experimental | Tapentadol IR (CG5503) 50mg for 14 days |
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| 002 | Experimental | Tapentadol IR (CG5503) 75mg for 14 days |
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| 003 | Active Comparator | oxycodone IR 10mg for 14 days |
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| 004 | Placebo Comparator | placebo 1 capsule for 14 days |
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| 005 | Experimental | Tapentadol ER (CG5503) flexible dose tablets and capsules 2 x a day for 28 days (100-500mg/day) |
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| 006 | Active Comparator | oxycodone CR flexible dose tablets and capsules 2 x a day for 28 days (20-60mg/day) |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| oxycodone CR | Drug | flexible dose tablets and capsules 2 x a day for 28 days (20-60mg/day) |
| |
| Measure | Description | Time Frame |
|---|---|---|
| 5-Day Sum of Pain Intensity Difference (SPID5) | SPID5 was calculated as the weighted (weights is taken as the number of hours elapsed since the previous measurement) sum of the PID collected up to 5 days. Pain intensity (PI) score is calculated as the average PI over the past 12 hours using an 11-point (0 to 10) numerical rating scale (NRS) where "0" is no pain and "10" is pain as bad as you can imagine. The difference between baseline PI at the qualifying period and current PI is pain intensity difference (PID). | Day 1 to Day 5 |
| Spontaneous Bowel Movements Per Week (SBMs/Week) | The number of SBM over the 14-day IR treatment phase was determined from the Bowel Function Patient Diary and factored to enable a per week value to be used. An SBM is defined as any BM that has occurred without the use of a laxative, enema, suppository, or manual manipulation within the previous 24 hours. | Week 1 to Week 2 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Johnson & Johnson Pharmaceutical Research & Development, L.L. C. Clinical Trial | Johnson & Johnson Pharmaceutical Research & Development, L.L.C. | Study Director |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 21494892 | Derived | Etropolski M, Kelly K, Okamoto A, Rauschkolb C. Comparable efficacy and superior gastrointestinal tolerability (nausea, vomiting, constipation) of tapentadol compared with oxycodone hydrochloride. Adv Ther. 2011 May;28(5):401-17. doi: 10.1007/s12325-011-0018-0. Epub 2011 Apr 13. |
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A total of 1000 participants were screened, 598 were randomized, 596 participants received medication in the first part of the double-blind treatment period (IR treatment phase). A total of 463 participants received medication in the second part of the double-blind treatment period (ER treatment phase).
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| ID | Title | Description |
|---|---|---|
| FG000 | Placebo | IR Treatment : 1 capsule for 14 days |
| FG001 | Tapentadol 50 mg | IR Treatment : 50mg for 14 days |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| IR Treatment |
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| 007 | Placebo Comparator | placebo Tablets and capsules 2 x a day for 28 days |
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| oxycodone IR |
| Drug |
10mg for 14 days |
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| Tapentadol ER (CG5503) | Drug | flexible dose tablets and capsules 2 x a day for 28 days (100-500mg/day) |
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| Tapentadol IR (CG5503) | Drug | 50mg for 14 days |
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| Tapentadol IR (CG5503) | Drug | 75mg for 14 days |
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| placebo | Drug | 1 capsule for 14 days |
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| placebo | Drug | Tablets and capsules 2 x a day for 28 days |
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| FG002 |
| Tapentadol 75 mg |
IR Treatment : 75mg for 14 days |
| FG003 | Oxycodone | IR Treatment : 10mg for 14 days |
| FG004 | Placebo ER | ER Treatment : Tablets and capsules 2 x a day for 28 days |
| FG005 | Tapentadol ER | ER Treatment : flexible dose tablets and capsules 2 x a day for 28 days (100-500mg/day) |
| FG006 | Oxycodone CR | ER Treatment : flexible dose tablets and capsules 2 x a day for 28 days (20-60mg/day) |
| COMPLETED |
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| NOT COMPLETED |
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| ER Treatment |
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| ID | Title | Description |
|---|---|---|
| BG000 | Placebo | IR Treatment : 1 capsule for 14 days |
| BG001 | Tapentadol 50 mg | IR Treatment : 50mg capsule for 14 days |
| BG002 | Tapentadol 75 mg | IR Treatment : 75mg capsule for 14 days |
| BG003 | Oxycodone | IR Treatment : 10mg capsule for 14 days |
| BG004 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants | Participants |
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| Age Continuous | Mean | Standard Deviation | years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region Enroll | Number | Participants |
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| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Primary | 5-Day Sum of Pain Intensity Difference (SPID5) | SPID5 was calculated as the weighted (weights is taken as the number of hours elapsed since the previous measurement) sum of the PID collected up to 5 days. Pain intensity (PI) score is calculated as the average PI over the past 12 hours using an 11-point (0 to 10) numerical rating scale (NRS) where "0" is no pain and "10" is pain as bad as you can imagine. The difference between baseline PI at the qualifying period and current PI is pain intensity difference (PID). | Intention To Treat (ITT) population : One participant who has been treated is not included in the ITT population as no baseline pain assessment was available (Arm: Tapentadol 50 mg). | Posted | Mean | Standard Deviation | Units on a scale | Day 1 to Day 5 |
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| Primary | Spontaneous Bowel Movements Per Week (SBMs/Week) | The number of SBM over the 14-day IR treatment phase was determined from the Bowel Function Patient Diary and factored to enable a per week value to be used. An SBM is defined as any BM that has occurred without the use of a laxative, enema, suppository, or manual manipulation within the previous 24 hours. | Intention To Treat (ITT) population : One participant who has been treated is not included in the ITT population as no baseline pain assessment was available (Arm: Tapentadol 50 mg). | Posted | Mean | Standard Deviation | number of stools/week | Week 1 to Week 2 |
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Only participants who had at least one of the TEAEs listed in the Other (non Serious) AE table are included in the Total no. participants with Non-Serious Adverse Events.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Placebo | IR Treatment : 1 capsule for 14 days | 1 | 148 | 48 | 148 | ||
| EG001 | Tapentadol 50 mg | IR Treatment : 50mg for 14 days | 1 | 151 | 65 | 151 | ||
| EG002 | Tapentadol 75 mg | IR Treatment : 75mg for 14 days | 0 | 154 | 88 | 154 | ||
| EG003 | Oxycodone | IR Treatment : 10mg for 14 days | 1 | 143 | 98 | 143 | ||
| EG004 | Placebo ER | ER Treatment : Tablets and capsules 2 x a day for 28 days | 0 | 122 | 23 | 122 | ||
| EG005 | Tapentadol ER | ER Treatment : flexible dose tablets and capsules 2 x a day for 28 days (100-500mg/day) | 1 | 250 | 80 | 250 | ||
| EG006 | Oxycodone CR | ER Treatment : flexible dose tablets and capsules 2 x a day for 28 days (20-60mg/day) | 0 | 91 | 36 | 91 |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Kidney infection | Infections and infestations | MedDRA 11.0 | Non-systematic Assessment |
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| Arteriosclerosis coronary artery | Cardiac disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Myocardial infarction | Cardiac disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Pulmonary embolism | Respiratory, thoracic and mediastinal disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Deep vein thrombosis | Vascular disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nausea | Gastrointestinal disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Constipation | Gastrointestinal disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Dry mouth | Gastrointestinal disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Somnolence | Nervous system disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Dizziness | Nervous system disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Headache | Nervous system disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Pruritus | Skin and subcutaneous tissue disorders | MedDRA 11.0 | Non-systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Senior Director, Clinical Leader | Johnson & Johnson Pharmaceutical Research & Development, L.L.C. | 609-730-4537 |
| ID | Term |
|---|---|
| D007592 | Joint Diseases |
| D001168 | Arthritis |
| D010003 | Osteoarthritis |
| D018771 | Arthralgia |
| D000377 | Agnosia |
| ID | Term |
|---|---|
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010468 | Perceptual Disorders |
| D019954 | Neurobehavioral Manifestations |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D000077432 | Tapentadol |
| ID | Term |
|---|---|
| D010636 | Phenols |
| D001555 | Benzene Derivatives |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
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| Lack of Efficacy |
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| Lost to Follow-up |
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| Withdrawal by Subject |
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| Study Medication Non-Compliant |
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| Other |
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| Between 18 and 65 years |
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| >=65 years |
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| Male |
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| USA |
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| ANCOVA | The model includes treatment and pooled center as factors and baseline pain intensity score as covariate. | 0.004 | P-value is adjusted for multiplicity for comparison against placebo using Hochberg's test. | Difference in Least-Squares Means | 63.4 | Standard Error of the Mean | 20.23 | 95 | 23.67 | 103.13 | The 95% confidence interval is unadjusted for multiplicity. | No | Superiority or Other |
| Units | Counts |
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| Participants |
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