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Post-herpetic neuralgia (PHN) is pain following acute herpes zoster; defined as pain lasting longer than 3 months. Current first line management consists of tricyclic anti-depressants and anti-convulsants such as gabapentin and pregabalin. There is an unmet medical need for treatments got topical therapies that demonstrate efficacy without serious side effects.
Post-herpetic neuralgia (PHN) is defined as pain following acute herpes zoster (AHZ) lasting >3 months. PHN develops in about 10% of patients following an episode of AHZ. 95% of adults ate seropositive for varicella zoster virus antibodies, and are, therefore, at risk for AHZ and PHN. Wider use of AHZ vaccine approved in 2006 may reduce the incidence of PHN. Nevertheless, PHN may be severe and frequently interferes with daily activities and with sleep.
First line management of PHN pain currently is tricyclic anti-depressants and anti-convulsants such as gabapentin and pregabalin, and use of a 5% lidocaine patch. second line therapies include opioid analgesia and topical capsaicin: combinations of topical and systemic therapies may be used as well. These therapies have common side effects of dry mouth, constipation, sedation, urinary retention, nausea, somnolence, dizziness, weight gain and peripheral edema.
there is an unmet medial need for topical therapies that demonstrate efficacy without the significant side effects o the therapies mentioned above. 3VM cream, a low concentration of copper in a cream vehicle may b such a therapy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 3VM1001 cream | Experimental | Patients will be randomized to self treat with 2 g of VM1001 cream times daily for ten days, have a five day wash out period and then 10 days of self treatment with the comparator. |
|
| Placebo | Placebo Comparator | Patients will be randomized to self treat with either active product or placebo comparator thrice daily for 10 days followed by a 5 day wash out period then 10 days of experimental treatment thrice daily for 20 days. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 3VM1001 | Drug | Self treatment 3 times daily for 10 days |
| |
| Measure | Description | Time Frame |
|---|---|---|
| The time averaged mean in a standard 100 mm visual analog scale (VAS). | The time averaged mean of all patient pain scores over each study period; trend over time for each treatment sill be assessed by day of therapy to evaluate any increase or decrease in effect for each study treatment. | 25 days total |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse Events, serious adverse events, and study discontinuation | Collection of adverse events and the number of subjects discontinuing he study | 25 days total |
| Patient Global Expression of change Scale (PGIC) from baseline (day 0) to the end of each study period. |
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Inclusion Criteria:
Exclusion Criteria:
Subject with systemic disease that would put him/her at an additional risk or limit his/her ability to participate in the study in the opinion of the investigator;
Subject with known history of human immunodeficiency virus, hepatitis C, or hepatitis B;
Malignancy other than basal cell carcinoma and carcinoma in situ within the past 2 years;
Subject who has an active history of alcohol or drug abuse;
Wilson's disease or other known disorder of copper metabolism;
Known hypersensitivity or allergy to any component of the product, or to acetaminophen
Pregnant and breastfeeding women.
Subject with active herpes zoster lesions;
Subject with open skin lesions or skin infections in the target area, or conditions over the target area such as eczema or psoriasis;
Mild pain in the target area, characterized by VAS score of < 40 mm
Pain in any other part of the body that could interfere with the patient's assessment of pain in the target area
Subject who has taken concomitant medications for the treatment of PHN (except acetaminophen or gabapentin) in the last four weeks. If taking gabapentin the dose must have been stable for at least four weeks;
Treatment with local anesthetic or steroids (including lidocaine patch, transcutaneous electrical nerve stimulation, etc.) in the last 2 weeks or nerve blocks within the last 30 days;
Subject who has used capsaicin preparations on a regular basis in the 90 days prior to screening and at all in the past two weeks;
Use of prohibited concomitant medications/therapies;
Subject with history of serious mental illness or psychiatric illness such as dementia, depression, or schizophrenia, that will limit his/her ability to comply with study procedures;
Subject who is unable to apply, or have a care giver apply, study ointment to the area of most painful skin segments, three times daily, once within 2 hours of waking, once mid-afternoon, and once prior to bedtime;
Subject who has participated in any other investigational study within 60 days prior to screening;
Subject who is employed by the Sponsor, study staff, and their families; or
Subject who has any condition that would make him/her, in the opinion of the investigator or Sponsor, unsuitable for the study.
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Medex Healthcare Research, Inc. | Chicago | Illinois | 60602 | United States | ||
| Medex Healthcare Reasearch, Inc. |
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| ID | Term |
|---|---|
| D051474 | Neuralgia, Postherpetic |
| D006562 | Herpes Zoster |
| ID | Term |
|---|---|
| D009437 | Neuralgia |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |
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Double-blind, Placebo-controlled, Crossover study to evaluate treatment and tolerability of the experimental product for treatment of post herpetic pain.
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Subjects will be randomized to receive either treatment wih 3VM1001 cream or the comparator daily for 10 days followed by 5 day wash out period before 10 days of treatment with the comparator or investigational treatment, .
| Placebo |
| Other |
Cream without investigational drug. Self treatment 3 times daily for 10 days |
|
This measure is a single-item rating by participants of their improvement with treatment on a 7-point sale that ranges from "very much improved" to very much worse" with "no change "the mid-midpoint". |
| 25 days total |
| Change in Patient Global Assessment of Treatment Satisfaction from baseline to the end of each study phase. | Patient Global Assessment of Treatment Satisfaction from baseline to the end of each study phase. Patients will rate their overall satisfaction with study treatment using a 5-point categorical scale. | 25 days total |
| Use of Rescue medication | recording of the use of rescue mediation at each phase of the study. | 25 days total |
| New York |
| New York |
| 10036 |
| United States |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D000073618 | Varicella Zoster Virus Infection |
| D006566 | Herpesviridae Infections |
| D004266 | DNA Virus Infections |
| D014777 | Virus Diseases |
| D007239 | Infections |