E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients suffering from pain due to knee osteoarthritis |
Pacientes con dolor por artrosis de rodilla |
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E.1.1.1 | Medical condition in easily understood language |
Patients suffering from pain due to knee osteoarthritis |
Pacientes con dolor por artrosis de rodilla |
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E.1.1.2 | Therapeutic area | Diseases [C] - Musculoskeletal Diseases [C05] |
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 |
This study aimed at demonstrating, by means of functional MRI (fMRI), the effect of Tapentadol on brain response to knee painful stimulation in knee osteoarthritis patients with clinical evidence of central sensitization. |
El objetivo de este estudio es demostrar, mediante fMRI, el efecto de tapentadol en la respuesta cerebral al dolor en la rodilla mediante estimulación dolorosa debido a artrosis de rodilla en pacientes con evidencia clínica de sensibilización central. |
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E.2.2 | Secondary objectives of the trial |
• To investigate Tapentadol effects on functional connectivity during brain resting-state in centrally sensitized patients. This is a methodologically new exploratory approach under development in the MRI Research Unit of Hospital del Mar in Barcelona. The team has achieved relevant recent results (Pujol et al 2014a,b,c, 2015, 2016; Lopez-Sola et al. 2104, Contreras-Rodríguez et al. 2014, Blanco-Hinojo 2016).
• To assess the relationships between Tapentadol effects on brain response to painful stimulation and Tapentadol effects on clinical parameters. |
• Investigador los efectos de tapentadol en la conectividad funcional durante el estado de reposo del cerebro en pacientes con sensibilización central. Esto es un abordaje metodológicamente nuevo en desarrollo por el Servicio de Radiología del Hospital del mar de Barcelona. Este equipo ha logrado resultados relevantes recientemente en este área (Pujol et al 2014a,b,c, 2015, 2016; Lopez-Sola et al. 2104, Contreras-Rodríguez et al. 2014, Blanco-Hinojo 2016).
• Evaluar la relación entre el efecto de tapentadol en la respuesta cerebral a la estimulación dolorosa y los efectos de tapentadol en parámetros clínicos. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. A diagnosis of knee OA and suitable for the study as determined by a responsible physician, based on a medical evaluation including medical history, physical examination, laboratory tests and cardiac monitoring. 2. Have a radiological and clinical diagnosis of knee OA based upon American College of Rheumatology (ACR) criteria (1986) affecting at least one knee of a minimum of 3 months in symptom duration prior to screening. 3. Central sensitization as defined by a positive clinical evidence of pain central sensitization affecting the knee combined with a minimum of 2 tender points around the affected knee experimentally verified using pain thresholds (Arendt-Nielsen et al. 2010, Graven-Nielsen et al. 2010, Woolf 2011, Imamura et al. 2008, Nijs et al. 2010). 4. Patients with Brief Pain Inventory (BPI) item 5 score of 6-10 points 5. Subject is either male or female and at least 45 years of age. 6. Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the consent form. 7. Patients capable to be treated according to the technical specifications of summary of product characteristics (SmPC). |
1. Presentar el paciente un diagnóstico de artrosis de rodilla y ser adecuado para el studio según el investigador responsable, basado en la evaluación médica incluyendo historial médico, examen físico, test de laboratorio y monitorización cardiaca. 2. Tener un diagnóstico clínico y radiológico de artrosis de rodilla basado en los criterios del Colegio Americano de Reumatología [American College of Rheumatology (ACR) (1986) con un mínimo de 3 meses con síntomas previos a la selección. 3. Sensibilización central definida por una evidencia positive de dolor por sensibilización central afectando a la rodilla, combinado con al menos dos puntos de sensibilidad alrededor de la rodilla afectada, verificado experimentalmente utilizando umbrales de dolor (Arendt-Nielsen et al. 2010, Graven-Nielsen et al. 2010, Woolf 2011, Imamura et al. 2008, Nijs et al. 2010). 4. Pacientes con una puntuación de 5 ítems sobre 6-10 puntos en el Inventario Breve del Dolor [Brief Pain Inventory (BPI)] 5. Sujetos mujeres o varones con al menos una edad de 45 años. 6. Ser capaz de dar su consentimiento informado, que incluye la adherencia a los requerimientos y a lista de restricciones indicadas en el consentimiento informado. 7. Pacientes indicados para el tratamiento con las características técnica de la Ficha Técnica. |
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E.4 | Principal exclusion criteria |
1. A female subject is eligible to participate if she is of non-childbearing potential. 2. Body weight >120kg. 3. Severe or non-stable medical conditions. |
1. Mujeres elegibles a participar si presentan un potencial de edad fértil. 2. Peso corporal >120kg. 3. Condición médica grave y no estable |
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E.5 End points |
E.5.1 | Primary end point(s) |
Brain response to knee painful stimulation (endpoint) will be obtained by applying direct pulsed pressure stimulation on the painful knee and pulsed pressure stimulation on a non-arthritic hyperalgesic area (i.e., the anterior tibial surface of the leg). |
La respuesta cerebral a la estimulación dolorosa en la rodilla (variable primaria) será obtenida aplicando directamente estimulación por presión pulsada en la rodilla dolorosa y estimulación por presión pulsada en el área hiperalgésica no artrósica (por ejemplo, en la superficie de la tibia anterior de la pierna). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Each patient will participate in a total of 3 treatment conditions: tapentadol, placebo and no treatment, after which an MRI exam will be administered in each case (14-21 days after each treatment condition ends). |
Cada paciente participará en 3 condiciones de tratamiento: tapentadol, placebo y sin tratamiento, después de cada una, se realizará una MRI (14-21 días después de la finalización de cada condición) |
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E.5.2 | Secondary end point(s) |
Pain threshold Temporal summation Brief Pain Inventory (BPI) Hospital Anxiety and Depression (HADS) PainDETECT WOMAC |
Umbral del Dolor Sumación temporal Brief Pain Inventory (BPI) Hospital Anxiety and Depression (HADS) PainDETECT WOMAC |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
14-21 days after each treatment condition ends |
14-21 días después de la finalización de cada condición |
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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 | No |
E.6.4 | Safety | No |
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 | No |
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 |
brain response to the treatment |
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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 | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | Yes |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 3 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
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 | No |
E.8.7 | Trial has a data monitoring committee | No |
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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The duration of each treatment phase will be 14 days and the time between treatments will be 14-21 days, with a total duration of the study of 112 days. A subject may terminate participation in the trial at any time without providing a reason and without any personal disadvantage. Additionally, the investigators can stop the participation of a subject after consideration of the benefit/risk ratio. |
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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 | 0 |
E.8.9.1 | In the Member State concerned months | 9 |
E.8.9.1 | In the Member State concerned days | 0 |