Clinical Trial Results:
Prospective Randomised 12-Week Controlled Study of Visual Field Change in Subjects With Partial Seizures Receiving Pregabalin or Placebo
Summary
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EudraCT number |
2009-014269-25 |
Trial protocol |
HU CZ PL BG |
Global end of trial date |
04 Feb 2020
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Results information
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Results version number |
v1(current) |
This version publication date |
17 Feb 2021
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First version publication date |
17 Feb 2021
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Other versions |
Trial Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
Subject Disposition
Baseline Characteristics
End Points
Adverse Events
More Information
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Trial identification
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Sponsor protocol code |
A0081096
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT00351611 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Pfizer Inc.
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Sponsor organisation address |
235 E 42nd Street, New York, United States, NY 10017
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Public contact |
Pfizer ClinicalTrials.gov Call Center, Pfizer Inc., 001 8007181021, ClinicalTrials.gov_Inquiries@pfizer.com
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Scientific contact |
Pfizer ClinicalTrials.gov Call Center, Pfizer Inc., 001 8007181021, ClinicalTrials.gov_Inquiries@pfizer.com
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Paediatric regulatory details
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Is trial part of an agreed paediatric investigation plan (PIP) |
No
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Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial? |
No
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Results analysis stage
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Analysis stage |
Final
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Date of interim/final analysis |
05 Oct 2020
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Is this the analysis of the primary completion data? |
No
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Global end of trial reached? |
Yes
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Global end of trial date |
04 Feb 2020
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Was the trial ended prematurely? |
No
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General information about the trial
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Main objective of the trial |
To evaluate visual fields in subjects with partial epilepsy receiving 12 weeks treatment of
pregabalin compared to placebo.
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Protection of trial subjects |
The study was in compliance with the ethical principles derived from the Declaration of Helsinki and in compliance with all International Conference for Harmonization (ICH) Good Clinical Practice (GCP) Guidelines. All the local regulatory requirements pertinent to safety of trials subjects were followed.
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Background therapy |
- | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
26 Jul 2006
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Long term follow-up planned |
No
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Independent data monitoring committee (IDMC) involvement? |
No
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Population of trial subjects
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Number of subjects enrolled per country |
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Country: Number of subjects enrolled |
Bulgaria: 10
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Country: Number of subjects enrolled |
Hungary: 7
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Country: Number of subjects enrolled |
India: 30
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Country: Number of subjects enrolled |
Korea, Republic of: 33
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Country: Number of subjects enrolled |
Mexico: 3
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Country: Number of subjects enrolled |
Poland: 7
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Country: Number of subjects enrolled |
Thailand: 11
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Country: Number of subjects enrolled |
United States: 86
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Worldwide total number of subjects |
187
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EEA total number of subjects |
24
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Number of subjects enrolled per age group |
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In utero |
0
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Preterm newborn - gestational age < 37 wk |
0
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Newborns (0-27 days) |
0
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Infants and toddlers (28 days-23 months) |
0
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Children (2-11 years) |
0
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Adolescents (12-17 years) |
0
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Adults (18-64 years) |
186
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From 65 to 84 years |
1
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85 years and over |
0
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Recruitment
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Recruitment details |
- | ||||||||||||||||||||||||||||||
Pre-assignment
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Screening details |
This study was conducted in multiple sites from 26-Jul-2006 to 04-Feb-2020. This study used an Internal Review Committee (IRC). | ||||||||||||||||||||||||||||||
Period 1
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Period 1 title |
Overall Study (overall period)
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Is this the baseline period? |
Yes | ||||||||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||||||||||||||||||||
Roles blinded |
Investigator, Carer, Subject | ||||||||||||||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Pregabalin | ||||||||||||||||||||||||||||||
Arm description |
Subjects were randomised to receive pregabalin. In Week 1 (titration), subjects received pregabalin 150 milligram (mg) per day (mg/day) as 75 mg oral capsules twice daily. From Week 2 to 12, subjects received pregabalin 300 mg/day as 150 mg oral capsules twice daily. In Week 13 (tapering), subjects received 150 mg/day as 75 mg oral capsules twice daily. Subjects were followed up from Week 14 to 15. If subjects not tolerated 300 mg/day dose, they were discontinued from the study. | ||||||||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
Pregabalin
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Investigational medicinal product code |
PD-0144723
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Other name |
CI-1008
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Pharmaceutical forms |
Capsule
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Routes of administration |
Oral use
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Dosage and administration details |
In Week 1, subjects received pregabalin 150 mg/day as 75 mg oral capsules twice daily. From Week 2 to 12, subjects received pregabalin 300 mg/day as 150 mg oral capsules twice daily. In Week 13, subjects received 150 mg/day as 75 mg oral capsules twice daily.
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Arm title
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Placebo | ||||||||||||||||||||||||||||||
Arm description |
Subjects with were randomised to receive placebo matched to pregabalin for Week 1 to 13 and were followed up from Week 14 to 15. | ||||||||||||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||||||||||||
Investigational medicinal product name |
Placebo
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Investigational medicinal product code |
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Other name |
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Pharmaceutical forms |
Capsule
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Routes of administration |
Oral use
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Dosage and administration details |
Subjects received placebo matched to pregabalin from Week 1 to 13.
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Baseline characteristics reporting groups
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Reporting group title |
Pregabalin
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Reporting group description |
Subjects were randomised to receive pregabalin. In Week 1 (titration), subjects received pregabalin 150 milligram (mg) per day (mg/day) as 75 mg oral capsules twice daily. From Week 2 to 12, subjects received pregabalin 300 mg/day as 150 mg oral capsules twice daily. In Week 13 (tapering), subjects received 150 mg/day as 75 mg oral capsules twice daily. Subjects were followed up from Week 14 to 15. If subjects not tolerated 300 mg/day dose, they were discontinued from the study. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Subjects with were randomised to receive placebo matched to pregabalin for Week 1 to 13 and were followed up from Week 14 to 15. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Pregabalin
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Reporting group description |
Subjects were randomised to receive pregabalin. In Week 1 (titration), subjects received pregabalin 150 milligram (mg) per day (mg/day) as 75 mg oral capsules twice daily. From Week 2 to 12, subjects received pregabalin 300 mg/day as 150 mg oral capsules twice daily. In Week 13 (tapering), subjects received 150 mg/day as 75 mg oral capsules twice daily. Subjects were followed up from Week 14 to 15. If subjects not tolerated 300 mg/day dose, they were discontinued from the study. | ||
Reporting group title |
Placebo
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Reporting group description |
Subjects with were randomised to receive placebo matched to pregabalin for Week 1 to 13 and were followed up from Week 14 to 15. |
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End point title |
Percentage of Subjects With a Decrease (p<0.05) From Baseline in Threshold Value in any 5 or More Points in Humphrey 24-2 Swedish Interactive Threshold Algorithm (SITA) Standard Testing at Week 12 or Early Termination | ||||||||||||
End point description |
Percentage of subjects is reported, with a decrease in threshold value from baseline to Week 12 or termination in any 5 or more points (in either eye) at the p<0.05 level repeated in same 5 points on subsequent computerized automated perimetry testing. It was derived from Humphrey 24-2 SITA standard visual field analyzer. For each eye there were 52 test points. For each test point, Humphrey analyzer determined threshold value for sensitivity to light by subject. In addition, for each points, test provided probabilities (p<0.05, p<0.02, etc) that a subject with normal vision of same age would have same result, i.e., that measured value at that point was at or below respective percentile of age-specific empiric distribution at that position of field for normal subjects. Per protocol population: all subjects randomized to treatment who received at least 1 dose of study medication and excluded subjects with decrease in at least 5 points at termination but did not return for repeat test.
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End point type |
Primary
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End point timeframe |
Baseline, Week 12 or Early Termination (any time up to Week 12)
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Statistical analysis title |
Pregabalin versus Placebo | ||||||||||||
Statistical analysis description |
A 2-sided 95 percent (%) confidence interval (CI) on the difference in percentage of subjects, between pregabalin and placebo was constructed using unconditional exact methods.
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Comparison groups |
Pregabalin v Placebo
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Number of subjects included in analysis |
168
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Analysis specification |
Pre-specified
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Analysis type |
non-inferiority [1] | ||||||||||||
Method |
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Parameter type |
Difference in percentage of subjects | ||||||||||||
Point estimate |
-1.7094
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-9.1751 | ||||||||||||
upper limit |
5.9784 | ||||||||||||
Notes [1] - Non-inferiority was demonstrated if the upper CI bound was less than 0.10 (10%). |
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End point title |
Change From Baseline in Mean Deviation Score From Humphrey Threshold Test at Week 12 or Early Termination | ||||||||||||
End point description |
Mean Deviation (MD) is a global index of visual field depression. The MD ranges from 0 decibels (dB) (no defect) to about -32 dB (end-stage damage), higher scores indicate worse condition. It is derived from Humphrey 24-2 SITA Standard visual field analyzer. Change in mean deviation from baseline to Week 12 or termination was computed for each subject. As planned, for each subject, the worst eye (eye with the greatest decrease in mean deviation) was used in the analysis and data is reported for same. ITT population included all subjects randomised to treatment, who received at least 1 dose of study medication. Here, “Number of Subjects Analysed” refers to those subjects who were evaluable for this endpoint.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 12 or Early Termination (any time up to Week 12)
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Statistical analysis title |
Pregabalin versus Placebo | ||||||||||||
Statistical analysis description |
Analysis of covariance (ANCOVA) with treatment and center in the model and the baseline mean deviation as the covariate was used to construct a 2-sided 95% CI on the difference in least squares (LS) means between pregabalin and placebo.
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Comparison groups |
Pregabalin v Placebo
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Number of subjects included in analysis |
179
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Analysis specification |
Pre-specified
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Analysis type |
non-inferiority [2] | ||||||||||||
P-value |
= 0.4414 | ||||||||||||
Method |
ANCOVA | ||||||||||||
Parameter type |
Difference in LS mean | ||||||||||||
Point estimate |
-0.125
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-0.443 | ||||||||||||
upper limit |
0.194 | ||||||||||||
Notes [2] - Non-inferiority with respect to mean deviation was demonstrated if the lower bound of the CI is greater than –2.0 decibels. |
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End point title |
Change From Baseline in Visual Acuity at Week 12 or Early Termination | ||||||||||||
End point description |
Visual acuity best-corrected (with glasses or best possible glasses prescription) was measured using early treatment diabetic retinopathy study (ETDRS) charts. There were 2 ETDRS charts. The letters on chart A were read using the right eye and on chart B using the left eye. The subjects started from the top of the chart to down. The subjects read down the chart until they reached a row where a minimum of 3 letters on a line could not be read. The subjects were scored by number of letters identified correctly. Range was from 0 to 70, with higher scores indicate better visual acuity. As planned, for each subject, the worst eye (eye with the greatest decrease in visual acuity) was used in the analysis and data is reported for same. ITT population included all subjects randomised to treatment, who received at least 1 dose of study medication. Here, “Number of Subjects Analysed” refers to those subjects who were evaluable for this endpoint.
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End point type |
Secondary
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End point timeframe |
Baseline, Week 12 or Early Termination (any time up to Week 12)
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Statistical analysis title |
Pregabalin versus Placebo | ||||||||||||
Statistical analysis description |
ANCOVA with treatment and center in the model and the baseline visual acuity as the covariate was used to construct a 2-sided 95% confidence interval on the difference in LS means between pregabalin and placebo.
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Comparison groups |
Pregabalin v Placebo
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Number of subjects included in analysis |
177
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Analysis specification |
Pre-specified
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Analysis type |
other | ||||||||||||
P-value |
= 0.1346 | ||||||||||||
Method |
ANCOVA | ||||||||||||
Parameter type |
Difference in LS mean | ||||||||||||
Point estimate |
-0.9
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-2.083 | ||||||||||||
upper limit |
0.283 |
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Adverse events information
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Timeframe for reporting adverse events |
Baseline up to Week 15
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Adverse event reporting additional description |
Same event may appear as both an adverse event and serious adverse event. However, what is presented are distinct events. An event may be categorised as serious in 1 subject and as non-serious in another, or a subject may have experienced both a serious and non-serious event. Safety was evaluated on safety analysis set.
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Assessment type |
Non-systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
23.1
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Reporting groups
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Reporting group title |
Pregabalin
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Reporting group description |
Subjects were randomised to receive pregabalin. In Week 1 (titration), subjects received pregabalin 150 mg/day as 75 mg oral capsules twice daily. From Week 2 to 12, subjects received target dose of pregabalin, 300 mg/day as 150 mg oral capsules twice. In Week 13 (tapering), subjects again received 150 mg/day as 75 mg oral capsules twice daily. If subjects could not tolerate 300 mg/day dose, they were discontinued from the study. Subjects were followed up from Week 14 to 15. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo
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Reporting group description |
Subjects were randomised to receive placebo matched to pregabalin for Week 1 to 13 and were followed up from Week 14 to 15. | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 4% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Substantial protocol amendments (globally) |
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Were there any global substantial amendments to the protocol? Yes | |||
Date |
Amendment |
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17 Oct 2006 |
Increase in the number of centers participating from 10 to 15.
Eliminate weight restriction enrollment criteria.
Increase the screening period from 1 week to 21 days. |
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12 Aug 2009 |
Protocol template language updated to current SOP protocol template.
Increase in the number of centers participating from 15 to 60.
Removal of exclusion of subjects with prior treatment with pregabalin.
Exclusion of subjects with history of pregabalin intolerance and subjects with a history of intolerability to pregabalin, or with a history of insufficient response in the treatment of epilepsy.
Change of concomitant medication exclusion from exclusion of CNS active medications to exclusion of psychotropic compounds.
Addition of safety assessments using the Sheehan-Suicidality Tracking Scale and the Patient Health Questionnaire-8. |
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12 Dec 2011 |
To add new safety wording.
To allow for rescreening of subjects.
To add clarification around the timing of the visual field testing (VFT) and handling of the primary endpoint as an AE. Also clarification of prohibited and allowed concomitant medications; and documentation of adverse events related to changes from entry in vital signs, weight and on the physical exam.
PASS language added, Subject Selection, Compliance, DMC text added. |
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15 Dec 2015 |
Single Reference Safety Document (SRSD) for this study was changed from the Core Data Sheet (CDS) to the Investigators Brochure (IB).
The following changes were made to comply with FDA and Neuropsychiatric and Abuse Potential Advisory Council (NAPAC) Guidance:
• Suicidality assessment: the Columbia-Suicide Severity Rating Scale (C-SSRS) will be performed instead of the Sheehan-Suicidality Tracking Scale (S-STS) for subjects screened following approval/initiation of Amendment 4. Subjects who are randomized under Amendment 3 will not switch to the C-SSRS.
• Suicidal Behaviors Questionnaire–Revised (SBQ-R) will be performed at screening.
• Scoring instructions for the PHQ8 have been inserted as well as a reference to the Instruction Manual.
The following protocol exclusion has been inserted to increase subject safety:
• Any subject at risk of suicide or self-harm based on investigator judgment and/or details of a mental health risk assessment (MHRA) by a qualified mental health professional.
• The number of sites to participate in the study has been deleted.
The following changes were made to comply with the current protocol template and required language/wording:
• Abbreviation list moved to an Appendix.
• Updated terms study drug and study medication to investigational product for
• consistency.
• Inserted Lifestyle Guidelines which includes template contraception language.
• Inserted Sponsors Medically Qualified Personnel.
• Updated Trial Treatments including insertion of new sections for Investigational Product Storage, Investigational Product Accountability and Destruction of
• Investigational Product Supplies.
• Updated Drug Supplies.
• Updated Investigational Product Storage.
• Updated Quality Control and Quality Assurance.
• Inserted Medication Errors.
• Updated Exposure During Pregnancy.
• Inserted Occupational Exposure.
• Updated Publication of Results. |
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Interruptions (globally) |
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Were there any global interruptions to the trial? No | |||
Limitations and caveats |
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Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data. | |||
None reported |