E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with cancer in palliative stage of their illness. Suffering from fatigue with or without decreased concentration, depression or drowsiness, who feel their fatigue is severe enough to decrease their quality of life. |
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MedDRA Classification |
E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To investigate the actual effects of methylphenidate on these patients. Following up small prospective studies in palliative care or medically unwell patients where methylphenidate has been shown to be effective as a treatment for fatigue, depression or concentration seperately. None has looked at the effects of the more nebulous syndrome of fatigue. a) To identify the main areas of “fatigue” that amphetamine acts upon in different patients. |
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E.2.2 | Secondary objectives of the trial |
b) To explore whether there are any consistent or common patterns of effects between patients, independent of the perceived cause of their fatigue. c) To explore the fatigue experience of patients who fail to respond to amphetamine. d) To obtain scores from 3 Fatigue scales and by comparison to ascertain which of these scales might be more appropriate to use in a later pilot double blind placebo controlled trial of methylphenidate treatment in this group of patients.
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E.2.3 | Trial contains a sub-study | Information not present in EudraCT |
E.3 | Principal inclusion criteria |
• Any patient, known to have cancer, entering the Countess Mountbatten Service who describes drowsiness, fatigue, tiredness, lethargy, decreased concentration or other similar symptom that is interfering with their daily living or quality of life. • With or without symptoms and signs of clinical depression. • Must be capable of understanding the patient leaflet though this may be read for them. • Must be willing to give written consent (unless physical disability prevents this at which time audio recorded verbal consent will be accepted). Audio-recorded verbal consent will be stored as with the rest of the study audio recordings for 15 years on Digital Video Disc. • Aged 18 years or over • Patient aware of diagnosis • Patient well enough to undertake study
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E.4 | Principal exclusion criteria |
As identified by the manufacturers data sheet; • A history of on-going hypertension requiring medical treatment. • A previous history of agitated psychosis whether alone or as part of delirium, depression or other psychiatric illness. • A previous history of anxiety attacks or anxiety disorder.
Study considerations; • Patients GP unwilling to consider continuation of treatment following trial if the patient wishes it. • Involvement in another concurrent research trial. • Use of alternative remedies with unknown side effect profiles and possible interactions with the trial drug. • Patient imminently dying. • No telephone available at their place of residence, as this will make patient follow up much more difficult and may introduce delays in reporting of side effects. • Significant deafness, speech impediment or other disability leading to recording of interviews being impossible. • Patient not able to converse in English.
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E.5 End points |
E.5.1 | Primary end point(s) |
Completion of 5 days of amphetamine treatment with a qualitative interview on the last day of treatment. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | No |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Information not present in EudraCT |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Patients experiences of drug effects. |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description |
Qualitative study - exploratory off licence use |
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E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Information not present in EudraCT |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
Pre and post treatment experience |
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E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial has a data monitoring committee | Information not present in EudraCT |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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Completion of the analysis of each patients in depth interview recording. Applying the concepts of thematic analysis a point will be reached where no further significant themes are being raised from further interviews. It is envisaged that this will occur after approximately 15 patient interviews. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |