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This was a double-blind, randomised, placebo-controlled, parallel-group, multicentre, multinational, Phase II study in 528 subjects with pain due to Fibromyalgia syndrome(FMS). Subjects were randomised in a 1:1:1:1 ratio to receive placebo, Eslicarbazepine acetate (ESL) 400 mg once daily (QD), ESL 800 mg QD or ESL 1200 mg QD. The study was carried out as follows.
This was a double-blind, randomised, placebo-controlled, parallel-group, multicentre, multinational, Phase II study in 528 subjects with pain due to FMS. Subjects were randomised in a 1:1:1:1 ratio to receive placebo, ESL 400 mg once daily (QD), ESL 800 mg QD or ESL 1200 mg QD. The study was carried out as follows:
Screening Visit (Visit [V] 1): After completing screening procedures at V1, eligible subjects began the 2 week Baseline Period.
Baseline Period (2 weeks): Subjects discontinued taking prohibited medications on V1 (beginning of washout period). Subjects were tapered off of discontinued medications. Washout was completed by Day -7 (7 days before V2). Subjects refrained from taking any pain medications and other prohibited medications (except rescue medication) throughout the study. During the Baseline Period, subjects used the subject diary to complete the diary pain assessment on a 0-10 numeric pain rating scale (NPRS) and to record information on rescue medication daily on awakening.
Titration Period (1 week): Upon completing the Baseline Period, subjects returned to the study centre for V2 (Randomisation Visit, Day 1). At V2, subjects, who had completed at least 4 subject diary pain assessments satisfactorily within the past 7 days, had an average pain score that was ≥4 and ≤9 and continued to meet all study entry criteria, were randomly assigned to 1 of the 4 treatment groups. During the 1-week Titration Period, subjects randomised to the ESL 400 mg QD and the ESL 800 mg QD treatment groups received ESL 400 mg QD; and subjects randomised to the ESL 1200 mg QD treatment group received ESL 600 mg QD; subjects assigned to placebo treatment received placebo QD.
Maintenance Period (12 weeks): Starting at V3, subjects assigned to treatment with ESL received their full dosage regimens QD; subjects assigned to placebo treatment received placebo QD. During the Maintenance Period, subjects had visits every 4 weeks.
Follow-up Period (2 weeks): Approximately 2 weeks after taking the last dose of study medication, subjects returned to the study centre for the Follow-up Visit and underwent the end-of-study evaluations.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Placebo | Placebo Comparator | Tablets |
|
| ESL 400 mg | Active Comparator | Eslicarbazepine acetate (BIA 2-093) tablets |
|
| ESL 800 mg | Active Comparator | Eslicarbazepine acetate (BIA 2-093) tablets |
|
| ESL 1200 mg | Active Comparator | Eslicarbazepine acetate (BIA 2-093) tablets |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Placebo | Drug | Tablets |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Absolute Change From Baseline to Endpoint in Mean Pain | The primary efficacy variable was the absolute change from baseline to endpoint in mean pain. Pain intensity was assessed on an 11-point (0-10) Numeric pain rating scale (NPRS), where 0 = no pain and 10 = worst possible pain and was recorded in a subject's diary. The subject was instructed to complete the assessment daily on awakening.Primary analyses were conducted on the full analysis set (FAS) which consisted of all randomised subjects who received at least 1 dose of study medication and with at least 1 post-randomisation rating of 24-h-average pain. The primary efficacy variable was the absolute change from baseline to endpoint in mean pain recorded in a subject's diary upon awakening each morning. An ANCOVA on the FAS revealed no statistically significant differences between the 3 ESL groups and the placebo group after 13 weeks of treatment. | Baseline and 13 Weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Patricio Soares-da-Silva, MD, PhD | BIAL - Portela & Cª, S.A. | Study Director |
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After completing procedures at V1, subjects returned to the study centre for V2. At V2, subjects, who had completed at least 4 subject diary pain assessments satisfactorily within the past 7 days, had an average pain score that was ≥4 and ≤9 and continued to meet all study entry criteria, were randomly assigned to 1 of the 4 treatment groups.
Subjects were screened in 84 centres in 16 European countries (Austria, Bulgaria, Czech Republic, France, Germany, Hungary, Italy, Netherlands, Poland, Portugal, Romania, Serbia, Slovakia, Spain, Ukraine and United Kingdom).
Study initiation date: 21 Apr 2009 Study completion date: 03 Sep 2010;
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| ID | Title | Description |
|---|---|---|
| FG000 | Placebo | Placebo tablets matching the 400-mg and 600-mg tablets were administered Once daily (QD) by oral route. |
| FG001 | ESL 400 mg | Eslicarbazepine acetate (ESL) 400 mg : ESL was supplied in 400-mg tablets and was administered QD by oral route. |
| FG002 | ESL 800 mg | ESL 800 mg : ESL was supplied in 400-mg tablets and was administered QD by oral route |
| FG003 | ESL 1200 mg | ESL was supplied in 400-mg and 600-mg tablets and was administered QD by oral route. |
| Title | Milestones | Reasons Not Completed | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Placebo | Tablets Placebo : Tablets |
| BG001 | ESL 400 mg | Eslicarbazepine acetate (BIA 2-093) tablets ESL 400 mg : Eslicarbazepine acetate (BIA 2-093) tablets |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Customized | Number |
| 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 | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Absolute Change From Baseline to Endpoint in Mean Pain | The primary efficacy variable was the absolute change from baseline to endpoint in mean pain. Pain intensity was assessed on an 11-point (0-10) Numeric pain rating scale (NPRS), where 0 = no pain and 10 = worst possible pain and was recorded in a subject's diary. The subject was instructed to complete the assessment daily on awakening.Primary analyses were conducted on the full analysis set (FAS) which consisted of all randomised subjects who received at least 1 dose of study medication and with at least 1 post-randomisation rating of 24-h-average pain. The primary efficacy variable was the absolute change from baseline to endpoint in mean pain recorded in a subject's diary upon awakening each morning. An ANCOVA on the FAS revealed no statistically significant differences between the 3 ESL groups and the placebo group after 13 weeks of treatment. | Posted | Least Squares Mean | Standard Error | units on a scale | Baseline and 13 Weeks |
|
Adverse events (AEs) were evaluated throughout the study that consisted of a 2-week Baseline Period, a 1-week Titration Period (active treatment or placebo) and a 12- week Maintenance Period (active treatment or placebo).
Safety was evaluated based on adverse events (AEs)
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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 | Tablets Placebo : Tablets |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Abdominal pain | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Headache | Nervous system disorders | MedDRA (Unspecified) | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Head of Clinical Research Section | Bial - Portela & Cª, S.A. | + 351 22 986 61 00 | clinical.trials@bial.com |
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| ID | Term |
|---|---|
| D005356 | Fibromyalgia |
| ID | Term |
|---|---|
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
| D009468 | Neuromuscular Diseases |
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| ID | Term |
|---|---|
| C416835 | eslicarbazepine acetate |
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| ESL 400 mg |
| Drug |
tablets |
|
|
| ESL 800 mg | Drug | tablets |
|
|
| ESL 1200 mg | Drug | tablets |
|
|
| Lack of Efficacy |
|
| Withdrawal by Subject |
|
| Lost to Follow-up |
|
| Protocol Violation |
|
| Subject non-compliance |
|
| at sponsor request |
|
| Pregnancy |
|
| BG002 | ESL 800 mg | Eslicarbazepine acetate (BIA 2-093) tablets ESL 800 mg : Eslicarbazepine acetate (BIA 2-093) tablets |
| BG003 | ESL 1200 mg | Eslicarbazepine acetate (BIA 2-093) tablets ESL 1200 mg : Eslicarbazepine acetate (BIA 2-093) tablets |
| BG004 | Total | Total of all reporting groups |
| participants |
|
| Sex: Female, Male | Count of Participants | Participants |
|
Tablets Placebo : Tablets |
| OG001 | ESL 400 mg | Eslicarbazepine acetate (BIA 2-093) tablets ESL 400 mg : Eslicarbazepine acetate (BIA 2-093) tablets |
| OG002 | ESL 800 mg | Eslicarbazepine acetate (BIA 2-093) tablets ESL 800 mg : Eslicarbazepine acetate (BIA 2-093) tablets |
| OG003 | ESL 1200 mg | Eslicarbazepine acetate (BIA 2-093) tablets ESL 1200 mg : Eslicarbazepine acetate (BIA 2-093) tablets |
|
|
| 3 |
| 131 |
| 75 |
| 131 |
| EG001 | ESL 400 mg | Eslicarbazepine acetate (BIA 2-093) tablets ESL 400 mg : Eslicarbazepine acetate (BIA 2-093) tablets | 5 | 130 | 86 | 130 |
| EG002 | ESL 800 mg | Eslicarbazepine acetate (BIA 2-093) tablets ESL 800 mg : Eslicarbazepine acetate (BIA 2-093) tablets | 6 | 135 | 92 | 135 |
| EG003 | ESL 1200 mg | Eslicarbazepine acetate (BIA 2-093) tablets ESL 1200 mg : Eslicarbazepine acetate (BIA 2-093) tablets | 1 | 132 | 93 | 132 |
| Abortion induced | Surgical and medical procedures | MedDRA (Unspecified) | Systematic Assessment |
|
| Arthropod bite | Injury, poisoning and procedural complications | MedDRA (Unspecified) | Systematic Assessment |
|
| Blood creatine phosphokinase increased | Investigations | MedDRA (Unspecified) | Systematic Assessment |
|
| Breast cancer in situ | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | MedDRA (Unspecified) | Systematic Assessment |
|
| Completed suicide | Psychiatric disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Fall | Injury, poisoning and procedural complications | MedDRA (Unspecified) | Systematic Assessment |
|
| Gastroenteritis | Infections and infestations | MedDRA (Unspecified) | Systematic Assessment |
|
| Hyponatraemia | Metabolism and nutrition disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Inguinal hernia | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Intervertebral disc protrusion | Musculoskeletal and connective tissue disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Syncope | Nervous system disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Incisional hernia | Injury, poisoning and procedural complications | MedDRA (Unspecified) | Systematic Assessment |
|
| Multiple injuries | Injury, poisoning and procedural complications | MedDRA (Unspecified) | Systematic Assessment |
|
| Suicidal ideation | Psychiatric disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Nausea | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Fatigue | General disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Gamma-glutamyl transferase increased | Investigations | MedDRA (Unspecified) | Systematic Assessment |
|
| Vertigo | Ear and labyrinth disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Vomiting | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Nasopharyngitis | Infections and infestations | MedDRA (Unspecified) | Systematic Assessment |
|
| Rash | Skin and subcutaneous tissue disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Abdominal pain upper | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Somnolence | Nervous system disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Dyspepsia | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Constipation | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Fibromyalgia | Musculoskeletal and connective tissue disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Back pain | Musculoskeletal and connective tissue disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Alanine aminotransferase increased | Investigations | MedDRA (Unspecified) | Systematic Assessment |
|
| Insomnia | Psychiatric disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Oedema peripheral | General disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Abdominal pain | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Diarrhoea | Gastrointestinal disorders | MedDRA (Unspecified) | Systematic Assessment |
|
| Blood creatine phosphokinase increased | Investigations | MedDRA (Unspecified) | Systematic Assessment |
|
| Pain | General disorders | MedDRA (Unspecified) | Systematic Assessment |
|
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| D009422 |
| Nervous System Diseases |