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    Clinical Trial Results:
    Efficacy and safety of Fixed-Dose Combination (FDC) products containing trazodone and gabapentin in patients affected by painful diabetic neuropathy: randomized, controlled, dose finding study.

    Summary
    EudraCT number
    2018-000133-12
    Trial protocol
    CZ   GB   PL  
    Global end of trial date
    06 Jun 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    22 Jun 2021
    First version publication date
    22 Jun 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    039(1)PO16357
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT03749642
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Angelini Pharma S.p.A
    Sponsor organisation address
    Viale Amelia, 70, Rome, Italy, 00181
    Public contact
    Study Manager, Angelini Pharma S.p.A, +39 0691045349, paola.lipone@angelinipharma.com
    Scientific contact
    Study Manager, Angelini Pharma S.p.A, +39 0691045349, paola.lipone@angelinipharma.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    06 Jun 2020
    Is this the analysis of the primary completion data?
    Yes
    Primary completion date
    06 Jun 2020
    Global end of trial reached?
    Yes
    Global end of trial date
    06 Jun 2020
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    The primary objective of the study was to collect preliminary information on the effect of three doses of trazodone/gabapentin FDC products on pain intensity in patients with painful diabetic neuropathy after 8-week treatment period.
    Protection of trial subjects
    During the study the following treatment were allowed: paracetamol (acetaminophen) in case of need for analgesics and aspirin for prophylaxis for myocardial infarction or transient ischemic attacks.
    Background therapy
    Not Applicable
    Evidence for comparator
    Gabapentin, recommended as first line drug in PDN, was used in this study as active comparator of known effectiveness to give context to the measured differences from placebo and to facilitate an evaluation of the clinical relevance of those differences.
    Actual start date of recruitment
    22 Nov 2018
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Poland: 153
    Country: Number of subjects enrolled
    United Kingdom: 9
    Country: Number of subjects enrolled
    Czechia: 72
    Country: Number of subjects enrolled
    France: 6
    Worldwide total number of subjects
    240
    EEA total number of subjects
    231
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    125
    From 65 to 84 years
    115
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Before entering the study, patients were fully informed about the purposes of the research, possible benefits, any potential personal reasonable risk or discomfort, the expected duration of their participation, as well as procedures and laboratory tests to undergo. A copy of the ICF including the information sheet was given to the patient.

    Pre-assignment
    Screening details
    At Screening Visit (10-15 days before Visit -1) potentially eligible patients were selected for the enrolment in the trial.

    Period 1
    Period 1 title
    PERIOD 1 (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Double blind
    Roles blinded
    Subject, Investigator
    Blinding implementation details
    In case of medical emergency, the Investigator was able to unblind the treatment code through the blinded labels provided by the Sponsor. The reason for unblinding was properly documented and notified to the Sponsor. In order to maintain the study double-blind conditions, the double-dummy technique was used. Thus, patients randomized in Arms 1, 2, 3 and 5 were co-administered with placebo capsules, in order to balance the number of capsules taken by the patient each time during.

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Trazo/Gaba 2.5/25 mg
    Arm description
    Trazodone/gabapentin FDC (Fixed-Dose Combination) 2.5/25 mg, capsules. One capsule, three times a day, for 8 weeks. The total daily dose of trazodone/gabapentin administered was 7.5/75 mg. Capsules contained trazodone hydrochloride, gabapentin, lactose anhydrous, talc, magnesium stearate vegetal.
    Arm type
    Experimental

    Investigational medicinal product name
    Trazo/Gaba 2.5/25 mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    One capsule, three times a day, for 8 weeks. The total daily dose of trazodone/gabapentin administered was 7.5/75 mg.

    Arm title
    Trazo/Gaba 5/50 mg
    Arm description
    Trazodone/gabapentin FDC 5/50 mg, capsules. One capsule, three times a day, for 8 weeks. The total daily dose of trazodone/gabapentin administered was 15/150 mg. Capsules contained trazodone hydrochloride, gabapentin, lactose anhydrous, talc, magnesium stearate vegetal.
    Arm type
    Experimental

    Investigational medicinal product name
    Trazo/Gaba 5/50 mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    One capsule, three times a day, for 8 weeks. The total daily dose of trazodone/gabapentin administered was 15/150 mg.

    Arm title
    Trazo/Gaba 10/100 mg
    Arm description
    Trazodone/gabapentin FDC 10/100 mg, capsules. One capsule, three times a day, for 8 weeks. The total daily dose of trazodone/gabapentin administered was 30/300 mg. Capsules contained trazodone hydrochloride, gabapentin, lactose anhydrous, talc, magnesium stearate vegetal.
    Arm type
    Experimental

    Investigational medicinal product name
    Trazo/Gaba 10/100 mg
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    One capsule, three times a day, for 8 weeks. The total daily dose of trazodone/gabapentin administered was 30/300 mg.

    Arm title
    Placebo
    Arm description
    Placebo, capsules. Two capsules, three times a day, for 8 weeks. Capsules contained lactose anhydrous, talc, magnesium stearate vegetal.
    Arm type
    Placebo

    Investigational medicinal product name
    Placebo
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Two capsules, three times a day, for 8 weeks.

    Arm title
    Gabapentin
    Arm description
    Gabapentin, capsules (Neurontin®, Pfizer), according to the following scheduling dosage regimen:
    Arm type
    Active comparator

    Investigational medicinal product name
    Gabapentin
    Investigational medicinal product code
    Other name
    Neurontin® (Pfizer)
    Pharmaceutical forms
    Capsule
    Routes of administration
    Oral use
    Dosage and administration details
    Gabapentin 100 mg 2 capsules 3 times a day from day 0 to day 6 (±1).Total daily dosage: 600 mg Gabapentin 300 mg 1 capsule 3 times a dayfrom day 7 (±1) to day 13 (±1). Total daily dosage: 900 mg Gabapentin 400 mg 1 capsule 3 times a day from day 14 (±1) to day 20 (±1). Total daily dosage:1200 mg Gabapentin 300 mg 2 capsules 3 times a day from day 21 (±1) to day 56 (±2) . Total daily dosage:1800 mg

    Number of subjects in period 1
    Trazo/Gaba 2.5/25 mg Trazo/Gaba 5/50 mg Trazo/Gaba 10/100 mg Placebo Gabapentin
    Started
    39
    38
    37
    83
    43
    Completed
    35
    35
    32
    62
    35
    Not completed
    4
    3
    5
    21
    8
         Consent withdrawn by subject
    1
    1
    1
    8
    2
         PT showing QTcF prolongation
    2
    2
    4
    8
    3
         Adverse event, non-fatal
    -
    -
    -
    1
    2
         PT erroneously enrolled
    -
    -
    -
    2
    1
         Prohibited medication
    -
    -
    -
    1
    -
         Other reasons
    1
    -
    -
    1
    -

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Trazo/Gaba 2.5/25 mg
    Reporting group description
    Trazodone/gabapentin FDC (Fixed-Dose Combination) 2.5/25 mg, capsules. One capsule, three times a day, for 8 weeks. The total daily dose of trazodone/gabapentin administered was 7.5/75 mg. Capsules contained trazodone hydrochloride, gabapentin, lactose anhydrous, talc, magnesium stearate vegetal.

    Reporting group title
    Trazo/Gaba 5/50 mg
    Reporting group description
    Trazodone/gabapentin FDC 5/50 mg, capsules. One capsule, three times a day, for 8 weeks. The total daily dose of trazodone/gabapentin administered was 15/150 mg. Capsules contained trazodone hydrochloride, gabapentin, lactose anhydrous, talc, magnesium stearate vegetal.

    Reporting group title
    Trazo/Gaba 10/100 mg
    Reporting group description
    Trazodone/gabapentin FDC 10/100 mg, capsules. One capsule, three times a day, for 8 weeks. The total daily dose of trazodone/gabapentin administered was 30/300 mg. Capsules contained trazodone hydrochloride, gabapentin, lactose anhydrous, talc, magnesium stearate vegetal.

    Reporting group title
    Placebo
    Reporting group description
    Placebo, capsules. Two capsules, three times a day, for 8 weeks. Capsules contained lactose anhydrous, talc, magnesium stearate vegetal.

    Reporting group title
    Gabapentin
    Reporting group description
    Gabapentin, capsules (Neurontin®, Pfizer), according to the following scheduling dosage regimen:

    Reporting group values
    Trazo/Gaba 2.5/25 mg Trazo/Gaba 5/50 mg Trazo/Gaba 10/100 mg Placebo Gabapentin Total
    Number of subjects
    39 38 37 83 43 240
    Age categorical
    Units: Subjects
        Adults 18-64 years
    24 23 21 39 18 125
        Adults 65-84 years
    15 15 16 44 25 115
    Age continuous
    Demographic data - Age (years) in Safety Population
    Units: years
        arithmetic mean (standard deviation)
    61.74 ( 8.54 ) 61.29 ( 8.53 ) 61.62 ( 9.17 ) 63.02 ( 8.84 ) 63.74 ( 8.38 ) -
    Gender categorical
    Units: Subjects
        Female
    15 18 19 40 21 113
        Male
    24 20 18 43 22 127
    Subject analysis sets

    Subject analysis set title
    m-ITT population
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    All randomized patients who took at least one dose of the study medication, having a baseline and at least one post-baselineNumeric Rating Scale (NRS) evaluation.

    Subject analysis set title
    PP population
    Subject analysis set type
    Per protocol
    Subject analysis set description
    All randomized patients with at least 80% of compliance to the treatment, having no major protocol violations, and having Numering Rating Scale (NRS) baseline and Visit 6 evaluations.

    Subject analysis set title
    Safety population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All randomized patients who took at least one dose of the study medication;

    Subject analysis sets values
    m-ITT population PP population Safety population
    Number of subjects
    236
    201
    240
    Age categorical
    Units: Subjects
        Adults 18-64 years
        Adults 65-84 years
    Age continuous
    Demographic data - Age (years) in Safety Population
    Units: years
        arithmetic mean (standard deviation)
    ( )
    ( )
    ( )
    Gender categorical
    Units: Subjects
        Female
    101
    98
    113
        Male
    125
    103
    127

    End points

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    End points reporting groups
    Reporting group title
    Trazo/Gaba 2.5/25 mg
    Reporting group description
    Trazodone/gabapentin FDC (Fixed-Dose Combination) 2.5/25 mg, capsules. One capsule, three times a day, for 8 weeks. The total daily dose of trazodone/gabapentin administered was 7.5/75 mg. Capsules contained trazodone hydrochloride, gabapentin, lactose anhydrous, talc, magnesium stearate vegetal.

    Reporting group title
    Trazo/Gaba 5/50 mg
    Reporting group description
    Trazodone/gabapentin FDC 5/50 mg, capsules. One capsule, three times a day, for 8 weeks. The total daily dose of trazodone/gabapentin administered was 15/150 mg. Capsules contained trazodone hydrochloride, gabapentin, lactose anhydrous, talc, magnesium stearate vegetal.

    Reporting group title
    Trazo/Gaba 10/100 mg
    Reporting group description
    Trazodone/gabapentin FDC 10/100 mg, capsules. One capsule, three times a day, for 8 weeks. The total daily dose of trazodone/gabapentin administered was 30/300 mg. Capsules contained trazodone hydrochloride, gabapentin, lactose anhydrous, talc, magnesium stearate vegetal.

    Reporting group title
    Placebo
    Reporting group description
    Placebo, capsules. Two capsules, three times a day, for 8 weeks. Capsules contained lactose anhydrous, talc, magnesium stearate vegetal.

    Reporting group title
    Gabapentin
    Reporting group description
    Gabapentin, capsules (Neurontin®, Pfizer), according to the following scheduling dosage regimen:

    Subject analysis set title
    m-ITT population
    Subject analysis set type
    Modified intention-to-treat
    Subject analysis set description
    All randomized patients who took at least one dose of the study medication, having a baseline and at least one post-baselineNumeric Rating Scale (NRS) evaluation.

    Subject analysis set title
    PP population
    Subject analysis set type
    Per protocol
    Subject analysis set description
    All randomized patients with at least 80% of compliance to the treatment, having no major protocol violations, and having Numering Rating Scale (NRS) baseline and Visit 6 evaluations.

    Subject analysis set title
    Safety population
    Subject analysis set type
    Safety analysis
    Subject analysis set description
    All randomized patients who took at least one dose of the study medication;

    Primary: Change from baseline of the average daily pain score - V6

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    End point title
    Change from baseline of the average daily pain score - V6 [1]
    End point description
    The primary endpoint of the study was the change from baseline of the average daily pain score based on the 11-point NRS to Visit 6 (Day 56 ±2) in the m-ITT with LOCF population. At the end-point time, scores were averaged from the last seven on-treatment entries in subjects’ daily electronic device, calculated from a minimum of four pain ratings in daily electronic device entries.
    End point type
    Primary
    End point timeframe
    Visit 6 (Day 56 ±2)
    Notes
    [1] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This study is a Phase II dose-finding study. Primary endpoint was evaluated on the 3 trazo-gaba doses combo versus placebo, excluding the active treatment (Gabapentin).
    End point values
    Trazo/Gaba 2.5/25 mg Trazo/Gaba 5/50 mg Trazo/Gaba 10/100 mg Placebo
    Number of subjects analysed
    39
    38
    37
    80
    Units: mean change
    arithmetic mean (standard deviation)
        Mean change from baseline
    -2.52 ( 2.31 )
    -2.24 ( 1.96 )
    -2.46 ( 2.12 )
    -2.02 ( 1.95 )
    Statistical analysis title
    Analysis of covariance (ANCOVA)
    Statistical analysis description
    Primary endpoint was evaluated using an analysis of covariance (ANCOVA), including treatment and center as factors and baseline as covariate and applying linear contrast test, excluding the active treatment (Gabapentin). Only if the linear contrast test was significant (p<0.05), the step down Dunnett test is used to determine the Minimum Effective Dose (MED). If linearity was not verified (p>0.05) an ANCOVA model is performed (m-ITT with LOCF and PP).
    Comparison groups
    Placebo v Trazo/Gaba 2.5/25 mg
    Number of subjects included in analysis
    119
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.3729
    Method
    ANCOVA
    Parameter type
    Mean difference (final values)
    Point estimate
    -0.5356
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.274
         upper limit
    0.2026
    Variability estimate
    Standard deviation
    Statistical analysis title
    Analysis of covariance (ANCOVA)
    Statistical analysis description
    Primary endpoint was evaluated using an analysis of covariance (ANCOVA), including treatment and center as factors and baseline as covariate and applying linear contrast test, excluding the active treatment (Gabapentin). Only if the linear contrast test was significant (p<0.05), the step down Dunnett test is used to determine the Minimum Effective Dose (MED). If linearity was not verified (p>0.05) an ANCOVA model is performed (m-ITT with LOCF and PP).
    Comparison groups
    Trazo/Gaba 5/50 mg v Placebo
    Number of subjects included in analysis
    118
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.9239
    Method
    ANCOVA
    Parameter type
    Mean difference (final values)
    Point estimate
    -0.2005
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -0.9401
         upper limit
    0.539
    Variability estimate
    Standard deviation
    Statistical analysis title
    Analysis of covariance (ANCOVA)
    Statistical analysis description
    Primary endpoint was evaluated using an analysis of covariance (ANCOVA), including treatment and center as factors and baseline as covariate and applying linear contrast test, excluding the active treatment (Gabapentin). Only if the linear contrast test was significant (p<0.05), the step down Dunnett test is used to determine the Minimum Effective Dose (MED). If linearity was not verified (p>0.05) an ANCOVA model is performed (m-ITT with LOCF and PP).
    Comparison groups
    Trazo/Gaba 10/100 mg v Placebo
    Number of subjects included in analysis
    117
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.8135
    Method
    ANCOVA
    Parameter type
    Mean difference (final values)
    Point estimate
    -0.288
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.0342
         upper limit
    0.4582
    Variability estimate
    Standard deviation

    Secondary: Change from baseline of the average daily pain score - V5

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    End point title
    Change from baseline of the average daily pain score - V5 [2]
    End point description
    Change from baseline of the average daily pain score based on the 11-point NRS to V5. At the end-point times, scores were averaged from the last seven on-treatment entries in subjects’ daily electronic device, calculated from a minimum of four pain ratings in daily electronic device entries.
    End point type
    Secondary
    End point timeframe
    V5
    Notes
    [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This study is a Phase II dose-finding study. This endpoint was evaluated on the 3 trazo-gaba doses combo versus placebo, excluding the active treatment (Gabapentin).
    End point values
    Trazo/Gaba 2.5/25 mg Trazo/Gaba 5/50 mg Trazo/Gaba 10/100 mg Placebo
    Number of subjects analysed
    39
    38
    37
    80
    Units: mean change form baseline
        arithmetic mean (standard deviation)
    -2.55 ( 2.33 )
    -2.09 ( 1.81 )
    -2.23 ( 1.93 )
    -1.67 ( 1.73 )
    Statistical analysis title
    Analysis of covariance (ANCOVA)
    Statistical analysis description
    Analysis of variance between the Trazo/gaba_2.5/25mg and Placebo.
    Comparison groups
    Trazo/Gaba 2.5/25 mg v Placebo
    Number of subjects included in analysis
    119
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.0116
    Method
    ANCOVA
    Parameter type
    Mean difference (final values)
    Point estimate
    -0.9387
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.665
         upper limit
    -0.213
    Variability estimate
    Standard deviation
    Statistical analysis title
    Analysis of covariance (ANCOVA)
    Statistical analysis description
    Analysis of variance between the Trazo/gaba_5/50 mg and Placebo.
    Comparison groups
    Trazo/Gaba 5/50 mg v Placebo
    Number of subjects included in analysis
    118
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.22
    Method
    ANCOVA
    Parameter type
    Mean difference (final values)
    Point estimate
    -0.4564
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.1882
         upper limit
    0.2753
    Variability estimate
    Standard deviation
    Statistical analysis title
    Analysis of covariance (ANCOVA)
    Statistical analysis description
    Analysis of variance between the Trazo/gaba_10/100 mg and Placebo.
    Comparison groups
    Trazo/Gaba 10/100 mg v Placebo
    Number of subjects included in analysis
    117
    Analysis specification
    Pre-specified
    Analysis type
    superiority
    P-value
    = 0.1046
    Method
    ANCOVA
    Parameter type
    Mean difference (final values)
    Point estimate
    -0.6108
    Confidence interval
         level
    95%
         sides
    2-sided
         lower limit
    -1.3496
         upper limit
    0.1281
    Variability estimate
    Standard deviation

    Secondary: Percentage of responder patients at Visit 6 (30%)

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    End point title
    Percentage of responder patients at Visit 6 (30%)
    End point description
    The proportions of responder patients was defined as subjects who achieved at least 30% of reduction in the 11-point NRS pain score from baseline to Visit 6 evaluated in m-ITT population.
    End point type
    Secondary
    End point timeframe
    Visit 6
    End point values
    Trazo/Gaba 2.5/25 mg Trazo/Gaba 5/50 mg Trazo/Gaba 10/100 mg Placebo Gabapentin
    Number of subjects analysed
    39
    38
    37
    80
    42
    Units: Percentage
    number (not applicable)
        Percentage
    51.3
    47.4
    51.4
    42.5
    33.3
    No statistical analyses for this end point

    Secondary: Change from baseline of the average daily pain score as assay sensitivity

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    End point title
    Change from baseline of the average daily pain score as assay sensitivity [3]
    End point description
    Change from baseline of the average daily pain score based on the 11-point NRS to V6 between Gabapentin and Placeb as assay sensitivity.
    End point type
    Secondary
    End point timeframe
    Visit 6
    Notes
    [3] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: This study is a Phase II dose-finding study. This endpoint was evaluated on the 3 trazo-gaba doses combo versus placebo, excluding the active treatment (Gabapentin).
    End point values
    Placebo Gabapentin
    Number of subjects analysed
    80
    42
    Units: Mean change from baseline
    arithmetic mean (standard deviation)
        Mean change from baseline
    -2.02 ( 1.95 )
    -1.92 ( 2.21 )
    No statistical analyses for this end point

    Secondary: Change from baseline to Visit 4 of NPSI

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    End point title
    Change from baseline to Visit 4 of NPSI
    End point description
    Change from baseline to Visit 4 of NPSI Total score in m-ITT. The Neuropathic Pain Symptom Inventory (NPSI) questionnaire evaluates the several symptoms of neuropathic pain.
    End point type
    Secondary
    End point timeframe
    Visit 4
    End point values
    Trazo/Gaba 2.5/25 mg Trazo/Gaba 5/50 mg Trazo/Gaba 10/100 mg Placebo Gabapentin
    Number of subjects analysed
    38
    38
    36
    78
    42
    Units: mean change from baseline
    arithmetic mean (standard deviation)
        Mean change from baseline
    -27.39 ( 18.85 )
    -19.24 ( 19.63 )
    -23.42 ( 20.99 )
    -19.26 ( 22.54 )
    -20.02 ( 23.45 )
    No statistical analyses for this end point

    Secondary: BDI-II score change V6-V0

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    End point title
    BDI-II score change V6-V0
    End point description
    Change in BDI-II total score from baseline were evaluated at Visit 6. The Beck Depression Inventory-II (BDI-II) questionnaire specifically evaluates the intensity of depression.
    End point type
    Secondary
    End point timeframe
    Visit 6
    End point values
    Trazo/Gaba 2.5/25 mg Trazo/Gaba 5/50 mg Trazo/Gaba 10/100 mg Placebo Gabapentin
    Number of subjects analysed
    38
    38
    36
    78
    42
    Units: mean change from baseline
    arithmetic mean (standard deviation)
        Mean change from baseline
    -2.79 ( 4.76 )
    -1.82 ( 3.78 )
    -1.06 ( 3.67 )
    -0.78 ( 3.84 )
    0.36 ( 8.10 )
    No statistical analyses for this end point

    Secondary: Change from baseline to Visit 6 of ISI Total score

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    End point title
    Change from baseline to Visit 6 of ISI Total score
    End point description
    Change from baseline to Visit 6 of Insomnia Severity Index (ISI) - Total score
    End point type
    Secondary
    End point timeframe
    Visit 6
    End point values
    Trazo/Gaba 2.5/25 mg Trazo/Gaba 5/50 mg Trazo/Gaba 10/100 mg Placebo Gabapentin
    Number of subjects analysed
    38
    38
    36
    78
    42
    Units: mean change from baseline
    arithmetic mean (standard deviation)
        Mean change from baseline
    -2.97 ( 4.72 )
    -2.82 ( 4.16 )
    -1.92 ( 5.76 )
    -2.44 ( 4.80 )
    -2.64 ( 5.15 )
    No statistical analyses for this end point

    Secondary: Change from baseline to Visit 6 of EQ-5D-5L Health Today score

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    End point title
    Change from baseline to Visit 6 of EQ-5D-5L Health Today score
    End point description
    Change from baseline to Visit 6 of EQ-5D-5L Health Today score. The EQEuroQol 5 Dimension 5 Level ( EQ-5D-5L) questionnaire specifically evaluates 5 dimensions of patient’s quality of life, like mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. This scale also assesses the patient’s self-rated health.
    End point type
    Secondary
    End point timeframe
    Visit 6
    End point values
    Trazo/Gaba 2.5/25 mg Trazo/Gaba 5/50 mg Trazo/Gaba 10/100 mg Placebo Gabapentin
    Number of subjects analysed
    38
    38
    36
    78
    42
    Units: Mean change from baseline
    arithmetic mean (standard deviation)
        Mean change from baseline
    12.76 ( 16.22 )
    7.63 ( 18.84 )
    7.00 ( 19.07 )
    5.76 ( 23.12 )
    4.79 ( 27.94 )
    No statistical analyses for this end point

    Secondary: Percentage of responder patients at Visit 6 (50%)

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    End point title
    Percentage of responder patients at Visit 6 (50%)
    End point description
    The proportions of responder patients was defined as subjects who achieved at least 50% of reduction in the 11-point NRS pain score from baseline to Visit 6 evaluated in m-ITT population.
    End point type
    Secondary
    End point timeframe
    Visit 6
    End point values
    Trazo/Gaba 2.5/25 mg Trazo/Gaba 5/50 mg Trazo/Gaba 10/100 mg Placebo Gabapentin
    Number of subjects analysed
    39
    38
    37
    80
    42
    Units: Percentage
    number (not applicable)
        Percentage of responsers
    35.9
    26.3
    35.1
    28.8
    19.0
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    The timeframe for reporting adverse events was from Informed Consent signature to last visit as per protocol.
    Adverse event reporting additional description
    One hundred ninety-two (192) AEs were reported during the study. Four SAEs recorded in 4 patients in the study did not report a fatal outcome, but only 2 events occurred after the start of the investigational treatment (1 in Trazo/Gaba 5/50 mg group and 1 in placebo group).
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    ver. 21.1
    Reporting groups
    Reporting group title
    Trazo/Gaba 2.5/25 mg
    Reporting group description
    Patient allocated to Trazodone/gabapentin FDC 2.5/25 mg capsules

    Reporting group title
    Trazo/Gaba 5/50 mg
    Reporting group description
    Patient allocated to Trazodone/gabapentin FDC 5/50 mg capsules.

    Reporting group title
    Trazo/Gaba 10/100 mg
    Reporting group description
    Patient allocated to Trazodone/gabapentin FDC 10/100 mg capsules.

    Reporting group title
    Placebo
    Reporting group description
    Patient allocated to Placebo capsules.

    Reporting group title
    Gabapentin
    Reporting group description
    Patient allocated to Gabapentin capsules.

    Serious adverse events
    Trazo/Gaba 2.5/25 mg Trazo/Gaba 5/50 mg Trazo/Gaba 10/100 mg Placebo Gabapentin
    Total subjects affected by serious adverse events
         subjects affected / exposed
    0 / 39 (0.00%)
    1 / 38 (2.63%)
    0 / 37 (0.00%)
    1 / 83 (1.20%)
    0 / 43 (0.00%)
         number of deaths (all causes)
    0
    0
    0
    0
    0
         number of deaths resulting from adverse events
    0
    0
    0
    0
    0
    Injury, poisoning and procedural complications
    PT inflammation wound
         subjects affected / exposed
    0 / 39 (0.00%)
    1 / 38 (2.63%)
    0 / 37 (0.00%)
    0 / 83 (0.00%)
    0 / 43 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cardiac disorders
    Acute myocardial infarction
         subjects affected / exposed
    0 / 39 (0.00%)
    0 / 38 (0.00%)
    0 / 37 (0.00%)
    1 / 83 (1.20%)
    0 / 43 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Trazo/Gaba 2.5/25 mg Trazo/Gaba 5/50 mg Trazo/Gaba 10/100 mg Placebo Gabapentin
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    6 / 39 (15.38%)
    13 / 38 (34.21%)
    5 / 37 (13.51%)
    12 / 83 (14.46%)
    5 / 43 (11.63%)
    Investigations
    Electrocardiogram QT prolonged
         subjects affected / exposed
    2 / 39 (5.13%)
    3 / 38 (7.89%)
    4 / 37 (10.81%)
    9 / 83 (10.84%)
    3 / 43 (6.98%)
         occurrences all number
    2
    3
    4
    9
    3
    Injury, poisoning and procedural complications
    Overdose
         subjects affected / exposed
    0 / 39 (0.00%)
    2 / 38 (5.26%)
    0 / 37 (0.00%)
    1 / 83 (1.20%)
    0 / 43 (0.00%)
         occurrences all number
    0
    2
    0
    2
    0
    Nervous system disorders
    Headache
         subjects affected / exposed
    3 / 39 (7.69%)
    2 / 38 (5.26%)
    0 / 37 (0.00%)
    1 / 83 (1.20%)
    0 / 43 (0.00%)
         occurrences all number
    3
    2
    0
    1
    0
    General disorders and administration site conditions
    Peripheral swelling
         subjects affected / exposed
    0 / 39 (0.00%)
    2 / 38 (5.26%)
    0 / 37 (0.00%)
    0 / 83 (0.00%)
    0 / 43 (0.00%)
         occurrences all number
    0
    2
    0
    0
    0
    Infections and infestations
    Upper respiratory tract infection
         subjects affected / exposed
    0 / 39 (0.00%)
    2 / 38 (5.26%)
    0 / 37 (0.00%)
    0 / 83 (0.00%)
    0 / 43 (0.00%)
         occurrences all number
    0
    2
    0
    0
    0
    Metabolism and nutrition disorders
    Nasopharyngitis
         subjects affected / exposed
    0 / 39 (0.00%)
    2 / 38 (5.26%)
    1 / 37 (2.70%)
    1 / 83 (1.20%)
    2 / 43 (4.65%)
         occurrences all number
    0
    2
    1
    1
    2
    Hypoglycaemia
         subjects affected / exposed
    1 / 39 (2.56%)
    2 / 38 (5.26%)
    0 / 37 (0.00%)
    0 / 83 (0.00%)
    0 / 43 (0.00%)
         occurrences all number
    1
    2
    0
    0
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    04 Apr 2019
    The substantial Study Amendment no. 1 dated April 04th, 2019 proposed an update of the Investigational Medicinal Product Dossier (IMPD) of the present clinical trial. The new version of the IMPD was prepared in order to include the long term positive stability data reached at 24 months for placebo capsules; the long term positive stability data reached at 24 months for gabapentin 100 mg, 300 mg, 400 mg capsules; a new water content analytical method developed and validated by Angelini S.p.A; and to declare Angelini S.p.A. as the company responsible for performing the water content analysis. The Study Amendment no. 1 was approved by the applicable Ethics Committees and Competent Authorities in accordance with the local regulations.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Not applicable
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