Clinical Trial Results:
A multicentre, double-blind, randomised, placebo controlled study to determine the efficacy and tolerability of OXN PR for the treatment of severe Parkinson's disease associated pain
Summary
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EudraCT number |
2011-002901-31 |
Trial protocol |
GB ES DE CZ HU |
Global end of trial date |
05 Nov 2013
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Results information
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Results version number |
v1(current) |
This version publication date |
31 Mar 2016
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First version publication date |
31 Mar 2016
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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 |
OXN2504
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
NCT01439100 | ||
WHO universal trial number (UTN) |
- | ||
Sponsors
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Sponsor organisation name |
Mundipharma Research GmbH & Co. KG
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Sponsor organisation address |
Höhenstraße 10, Limburg, Germany, D-65549
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Public contact |
European Medical Operations, Mundipharma Research Limited, +44 122342490, info@contact-clinical-trials.com
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Scientific contact |
European Medical Operations, Mundipharma Research Limited, +44 122342490, info@contact-clinical-trials.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 Nov 2013
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
05 Nov 2013
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Global end of trial reached? |
Yes
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Global end of trial date |
05 Nov 2013
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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 demonstrate superiority of OXN PR compared to placebo with respect to analgesic efficacy in subjects with chronic severe pain associated with Parkinson's disease (PD), as assessed by averaged 24 hour pain scores collected for 7 days prior to the clinic visits.
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Protection of trial subjects |
All subjects were provided with oral and written information describing the nature and duration of the study, its purpose, the procedures to be performed, the potential risks and benefits involved, and any potential discomfort. Each subject was given a copy of the patient information sheet (PIS) and informed consent form (ICF). The subject was asked to sign and date an ICF prior to any study-specific procedures being performed. Under a separate informed consent process, subjects were invited to consent to blood sampling for pharmacogenomic testing. The collected blood samples were anonymised and stored for future analysis. The consent to pharmacogenomic sampling was completely separate from the main study and subjects were able to take part in the main study without consenting to pharmacogenomic blood sampling. Blood sampling took place prior to receiving any dose of study medication.
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Background therapy |
In the Double Blind period, Levodopa and benserazide hydrochloride combination Tablets, 100/25 mg, PRN, oral were provided as rescue medication. In the Open Label period, Oxycodone immediate release (OxyIR) Capsules, 5 mg, PRN, oral were provided as rescue medication | ||
Evidence for comparator |
The comparator product was placebo oxycodone hydrochloride and naloxone hydrochloride dihydrate combined oral prolonged release tablets, OXN PR. Placebo was chosen as comparator in order to measure the pain relief provided by the investigational medicinal product. Rescue medication (described above) was provided. | ||
Actual start date of recruitment |
31 Oct 2011
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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 |
Romania: 21
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Country: Number of subjects enrolled |
Spain: 15
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Country: Number of subjects enrolled |
United Kingdom: 21
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Country: Number of subjects enrolled |
Czech Republic: 33
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Country: Number of subjects enrolled |
Germany: 43
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Country: Number of subjects enrolled |
Hungary: 34
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Country: Number of subjects enrolled |
Poland: 35
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Worldwide total number of subjects |
202
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EEA total number of subjects |
202
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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) |
79
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From 65 to 84 years |
123
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85 years and over |
0
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Recruitment
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Recruitment details |
Subjects were recruited from 47 active centres in 7 countries: Czech Republic: 6 centres; Germany: 10 centres; Poland: 8 centres; Hungary: 7 centres; Romania: 3 centres; Spain: 7 centres; United Kingdom: 6 centres . | ||||||||||||||||||||||||
Pre-assignment
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Screening details |
A total of 252 subjects provided written informed consent and were screened, 202 were randomized. | ||||||||||||||||||||||||
Period 1
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Period 1 title |
Double-blind
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Is this the baseline period? |
Yes | ||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Double blind | ||||||||||||||||||||||||
Roles blinded |
Subject, Investigator, Monitor, Data analyst, Carer, Assessor | ||||||||||||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Oxycodone Naloxone | ||||||||||||||||||||||||
Arm description |
Oxycodone Naloxone Prolonged Release Tablets | ||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||
Investigational medicinal product name |
Oxycodone hydrochloride and naloxone hydrochloride dihydrate combined oral prolonged release tablets OXN PR-
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Investigational medicinal product code |
OXN
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
OXN 5/2.5 mg PR; OXN 10/5 mg PR ; OXN 15/7.5 mg PR ; OXN 20/10 mg PR all taken q12h, Oral
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Arm title
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Placebo Oxycodone Naloxone | ||||||||||||||||||||||||
Arm description |
Placebo Oxycodone Naloxone Prolonged Release Tablets | ||||||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||||||
Investigational medicinal product name |
Placebo Oxycodone hydrochloride and naloxone hydrochloride dihydrate combined oral prolonged release tablets OXN PR-
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Investigational medicinal product code |
Placebo OXN
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Placebo OXN 5/2.5 mg PR; Placebo OXN 10/5 mg PR ; Placebo OXN 15/7.5 mg PR ; Placebo OXN 20/10 mg PR all taken q12h, Oral
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Period 2
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Period 2 title |
Open Label
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Is this the baseline period? |
No | ||||||||||||||||||||||||
Allocation method |
Randomised - controlled
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Blinding used |
Not blinded | ||||||||||||||||||||||||
Blinding implementation details |
Open label
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Arms
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Are arms mutually exclusive |
No
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Arm title
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Oxycodone Naloxone | ||||||||||||||||||||||||
Arm description |
Oxycodone Naloxone Prolonged Release Tablets | ||||||||||||||||||||||||
Arm type |
Experimental | ||||||||||||||||||||||||
Investigational medicinal product name |
Oxycodone hydrochloride and naloxone hydrochloride dihydrate combined oral prolonged release tablets OXN PR-
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Investigational medicinal product code |
OXN
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
OXN 5/2.5 mg PR; OXN 10/5 mg PR ; OXN 15/7.5 mg PR ; OXN 20/10 mg PR all taken q12h, Oral
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Arm title
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Placebo Oxycodone Naloxone | ||||||||||||||||||||||||
Arm description |
Placebo Oxycodone Naloxone Prolonged Release Tablets | ||||||||||||||||||||||||
Arm type |
Placebo | ||||||||||||||||||||||||
Investigational medicinal product name |
Placebo Oxycodone hydrochloride and naloxone hydrochloride dihydrate combined oral prolonged release tablets OXN PR-
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Investigational medicinal product code |
Placebo OXN
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Other name |
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Pharmaceutical forms |
Tablet
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Routes of administration |
Oral use
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Dosage and administration details |
Placebo OXN 5/2.5 mg PR; Placebo OXN 10/5 mg PR ; Placebo OXN 15/7.5 mg PR ; Placebo OXN 20/10 mg PR all taken q12h, Oral
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Baseline characteristics reporting groups
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Reporting group title |
Oxycodone Naloxone
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Reporting group description |
Oxycodone Naloxone Prolonged Release Tablets | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo Oxycodone Naloxone
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Reporting group description |
Placebo Oxycodone Naloxone Prolonged Release Tablets | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Oxycodone Naloxone
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Reporting group description |
Oxycodone Naloxone Prolonged Release Tablets | ||
Reporting group title |
Placebo Oxycodone Naloxone
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Reporting group description |
Placebo Oxycodone Naloxone Prolonged Release Tablets | ||
Reporting group title |
Oxycodone Naloxone
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Reporting group description |
Oxycodone Naloxone Prolonged Release Tablets | ||
Reporting group title |
Placebo Oxycodone Naloxone
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Reporting group description |
Placebo Oxycodone Naloxone Prolonged Release Tablets |
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End point title |
To demonstrate superiority of OXN PR compared to placebo with respect to analgesic efficacy in subjects with chronic severe pain associated with Parkinson’s disease (PD), as assessed by averaged 24 hour pain scores collected for 7 days prior to the clinic | ||||||||||||
End point description |
There were no plans to make adjustments for multiplicity for the primary endpoint. There was only one primary endpoint for this study, the averaged 24 hour pain scores collected for 7 days prior to the study clinical visit at Week 16. All other analyses on the primary endpoint for different populations and methods of handling missing data are conducted as sensitivity analyses.
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End point type |
Primary
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End point timeframe |
The averaged 24 hour pain scores collected for 7 days prior to the study clinical visit at Week 16
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Statistical analysis title |
Superiority of OXN PR vs Placebo (ave 24h pain) | ||||||||||||
Statistical analysis description |
The primary analysis to assess the statistical hypothesis was via a Mixed Model for Repeated Measures (MMRM) analysis. The comparison was used to test, in a confirmatory manner, the hypothesis that OXN PR was superior to placebo with respect to the averaged 24 hour pain scores following at Week 16 i.e. to test the following 2-sided hypothesis:
Null hypothesis: OXN PR = Placebo in averaged 24 hour pain scores at Week 16
Alternative: OXN PR ≠ Placebo in averaged 24 hour pain scores at Week 16
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Comparison groups |
Oxycodone Naloxone v Placebo Oxycodone Naloxone
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Number of subjects included in analysis |
134
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Analysis specification |
Pre-specified
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Analysis type |
superiority [1] | ||||||||||||
P-value |
= 0.058 | ||||||||||||
Method |
Mixed Model for Repeated Measure | ||||||||||||
Parameter type |
Mean difference (final values) | ||||||||||||
Point estimate |
-0.6
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
-1.26 | ||||||||||||
upper limit |
0.02 | ||||||||||||
Variability estimate |
Standard error of the mean
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Dispersion value |
0.33
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Notes [1] - Superiority was demonstrated if the primary comparison of OXN PR versus Placebo was significant at the 5% level. |
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Adverse events information
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Timeframe for reporting adverse events |
In the Double-blind period the OXN PR group mean exposure was 90.8 days, as compared with 93.1 days in the placebo group. In the Open Label period the mean exposure was 28.7 days
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Assessment type |
Non-systematic | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
15.0
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Reporting groups
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Reporting group title |
Oxycodone Naloxone
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Reporting group description |
Oxycodone Naloxone Prolonged Release Tablets - Double Blind Period | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Reporting group title |
Placebo Oxycodone Naloxone
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Reporting group description |
Placebo Oxycodone Naloxone Prolonged Release Tablets - Double blind period | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 5% | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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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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13 Jan 2012 |
In Section 8.3.2 ‘Secondary Efficacy Variable(s)’ a bullet point was added between bullet 1 and 3 that the percentage of responders (defined as a ≥30% reduction from baseline) in averaged 24 hour pain scores collected for 7 days preceding the study clinic visit at Week 16 was also tested in a hierarchical testing strategy. In Section 14.2 ‘Statistical Considerations’, the percentage of responders in averaged 24 hour pain scores at Week 16 was added to the key secondary endpoints which were tested for confirmatory statistical significance under a hierarchical testing strategy. In Section 14.7 ‘Secondary Outcome/Efficacy Variables, it was added that in the case the analyses described before in this section yielded statistically significant differences at each time point, the percentage of responders in averaged 24 hour pain scores at Week 16 were analysed in a formal, confirmatory manner to test for superiority. Logistic regression analysis was used to determine the odds ratio and 95% confidence interval of OXN PR relative to placebo. The statistical model included terms for treatment and centre as factors, and baseline averaged pain score as a covariate. LOCF was used for this analysis. A supportive analysis was performed on the PP Population. A sensitivity analysis on the FAP was also applied to the analysis of the key secondary endpoint of the percentage of responders in averaged 24 hour pain scores, implementing the same logistic regression model, using OC data at the 16-week time point. The analysis of the key secondary endpoint, CGI-I (as assessed by the Investigator), were conducted in a formal manner in the event that the hierarchical testing structure yielded statistically significant differences at each time point. A statistically significant difference in the percentage of responders in averaged 24 hour pain scores at Week 16 was added as a criterion. |
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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 |