Clinical Trial Results:
Investigation of dose response relationships when using low dose naltrexone (LDN) for the treatment of fibromyalgia
Summary
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EudraCT number |
2016-002081-31 |
Trial protocol |
DK |
Global end of trial date |
10 Sep 2018
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Results information
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Results version number |
v1(current) |
This version publication date |
18 Dec 2019
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First version publication date |
18 Dec 2019
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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 |
16008
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Additional study identifiers
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ISRCTN number |
- | ||
US NCT number |
- | ||
WHO universal trial number (UTN) |
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Sponsors
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Sponsor organisation name |
Odense University Hospital
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Sponsor organisation address |
Sdr. Boulevard, Odense C, Denmark, 5000
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Public contact |
Karin Plesner, Anæstesiologisk-intensiv afd V, Odense Universitets Hospital, karin.bruun.plesner@rsyd.dk
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Scientific contact |
Karin Plesner, Anæstesiologisk-intensiv afd V, Odense Universitets Hospital, karin.bruun.plesner@rsyd.dk
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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 |
31 Jan 2019
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Is this the analysis of the primary completion data? |
Yes
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Primary completion date |
10 Sep 2018
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Global end of trial reached? |
Yes
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Global end of trial date |
10 Sep 2018
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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 test different doses of low dosis naltrexone (LDN) in patients with fibromyalgia and to estimate effective dose in 50% and 95% of cases.
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Protection of trial subjects |
No specific measures
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Background therapy |
Subjects were allowed to continue their usual pain medication. Opioids was not allowed during the trial and 8 weeks before inclusion. | ||
Evidence for comparator |
- | ||
Actual start date of recruitment |
28 Dec 2016
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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 |
Denmark: 54
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Worldwide total number of subjects |
54
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EEA total number of subjects |
54
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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) |
54
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From 65 to 84 years |
0
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85 years and over |
0
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Recruitment
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Recruitment details |
Subjects were recruited in 2 periods: Pre-period: December 12th 2016 to April 26th 2017. (8 subjects included) Trial was interrupted and an amendment was made to the protocol. Study was restarted. Period 1: June 7th 2017 to September 10th 2018. (27 subjects included) | |||||||||||||||
Pre-assignment
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Screening details |
Period 1: 28 subjects screened, 27 subjects included. | |||||||||||||||
Pre-assignment period milestones
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Number of subjects started |
56 [1] | |||||||||||||||
Number of subjects completed |
54 | |||||||||||||||
Pre-assignment subject non-completion reasons
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Reason: Number of subjects |
Protocol deviation: 2 | |||||||||||||||
Notes [1] - The number of subjects reported to have started the pre-assignment period are not the same as the worldwide number enrolled in the trial. It is expected that these numbers will be the same. Justification: This i a study with 1 arm only. Currently the system cannot accommodate this specific scenario. Hence we had to workaround this by adding a baseline arm that is considered one group and the end data another group. An equal number of subjects were added to the arms, giving a deviation in number of enrolled subjects. This is done to be able to use the statistical analysis set to report analysis for a single arm. |
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Period 1
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Period 1 title |
Treatment (overall period)
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Is this the baseline period? |
Yes | |||||||||||||||
Allocation method |
Not applicable
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Blinding used |
Not blinded | |||||||||||||||
Arms
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Are arms mutually exclusive |
Yes
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Arm title
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Baseline | |||||||||||||||
Arm description |
Baseline | |||||||||||||||
Arm type |
No intervention | |||||||||||||||
Investigational medicinal product name |
No investigational medicinal product assigned in this arm
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Arm title
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Treatment LDN | |||||||||||||||
Arm description |
LDN | |||||||||||||||
Arm type |
Experimental | |||||||||||||||
Investigational medicinal product name |
Naltrexone hydrochloride
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Investigational medicinal product code |
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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 |
One daily dosage in the evening.
Doses between 0,75 mg and 6 mg.
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Baseline characteristics reporting groups
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Reporting group title |
Treatment
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Reporting group description |
- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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End points reporting groups
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Reporting group title |
Baseline
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Reporting group description |
Baseline | ||
Reporting group title |
Treatment LDN
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Reporting group description |
LDN |
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End point title |
Effective dose in 50% | ||||||||||||
End point description |
The end point is estimated based on the effect of different doses in the 25 subjects who completed the treatment period of 3 weeks, calculated based on the Up-and-down method.
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End point type |
Primary
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End point timeframe |
From restart of the study after amendment to the protocol was made: From June 7th 2017 to September 10th 2018
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Statistical analysis title |
Up-and-Down method | ||||||||||||
Comparison groups |
Baseline v Treatment LDN
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Number of subjects included in analysis |
50
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Analysis specification |
Pre-specified
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Analysis type |
other [1] | ||||||||||||
Method |
Up-and-down method | ||||||||||||
Parameter type |
PAVA estimate | ||||||||||||
Point estimate |
3.88
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
3.39 | ||||||||||||
upper limit |
4.35 | ||||||||||||
Variability estimate |
Standard deviation
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Notes [1] - Up-and-down method |
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End point title |
Effective dose in 95 % | ||||||||||||
End point description |
The end point is estimated based on the effect of different doses in the 25 subjects who completed the treatment period of 3 weeks, calculated based on the Up-and-down method.
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End point type |
Primary
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End point timeframe |
From restart of the study after amendment to the protocol was made: From June 7th 2017 to September 10th 2018
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Statistical analysis title |
Up-and-Down method | ||||||||||||
Comparison groups |
Baseline v Treatment LDN
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Number of subjects included in analysis |
50
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Analysis specification |
Pre-specified
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Analysis type |
other [2] | ||||||||||||
Method |
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Parameter type |
PAVA estimate | ||||||||||||
Point estimate |
5.4
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Confidence interval |
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level |
95% | ||||||||||||
sides |
2-sided
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lower limit |
4.66 | ||||||||||||
upper limit |
6.13 | ||||||||||||
Variability estimate |
Standard deviation
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Notes [2] - Up-and-down method |
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Adverse events information
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Timeframe for reporting adverse events |
Adverse events reported at: Baseline, 2 weeks, 4 weeks.
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Adverse event reporting additional description |
Regular interviews.
Questionnaire about symptoms.
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Assessment type |
Systematic | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary used for adverse event reporting
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Dictionary name |
MedDRA | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Dictionary version |
V22.1
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Reporting groups
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Reporting group title |
Overall group
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Reporting group description |
- | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Frequency threshold for reporting non-serious adverse events: 0% | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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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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06 Jun 2017 |
Change of primary endpoint.
Positive effect of treatment assessed by Patient Global Impression of Improvement on a 7-point Likert scale with the ancors: Very much worse, worse, little worse, no change, little better, better, very much better.
Positive effect if: Little better, better, very much better.
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Interruptions (globally) |
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Were there any global interruptions to the trial? Yes | |||||||
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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. | |||||||
Given the sequential method we had to evaluate effect of the treatment after a relatively short period of time, and 2 weeks was chosen based on time-response curves from previous trials. |