A Study to Compare Safety and Efficacy of Tramadol Hydrochloride/Acetaminophen With Gabapentin in Participants With Diabetic Neuropathy

Overview[ - collapse ][ - ]

Purpose The purpose of this study is to evaluate the effectiveness and safety of tramadol hydrochloride (HCl) 37.5 miligram (mg)/acetaminophen 325 mg compared to gabapentin in participants with diabetic neuropathic (nerve disorder caused by diabetes mellitus) pain.
ConditionDiabetic Neuropathy
InterventionDrug: Tramadol hydrochloride/ Acetaminophen
Drug: Gabapentin
PhasePhase 4
SponsorJanssen Korea, Ltd., Korea
Responsible PartyJanssen Korea, Ltd., Korea
ClinicalTrials.gov IdentifierNCT00634543
First ReceivedMarch 6, 2008
Last UpdatedJuly 26, 2013
Last verifiedJuly 2013

Tracking Information[ + expand ][ + ]

First Received DateMarch 6, 2008
Last Updated DateJuly 26, 2013
Start DateDecember 2006
Estimated Primary Completion DateOctober 2008
Current Primary Outcome MeasuresChange From Baseline in Pain Intensity Score at Day 43 [Time Frame: Baseline and Day 43] [Designated as safety issue: No]Pain intensity was assessed on 11-point numerical rating scale ranging from 0=no pain to 10=pain as bad as you can imagine.
Current Secondary Outcome Measures
  • Percentage of Participants With Pain Relief [Time Frame: Day 15, Day 29 and Day 43] [Designated as safety issue: No]Pain relief was assessed on a scale ranging from -1 to 4, where -1=became worse, 0=no change, 1=relieved a little, 2=relieved moderately, 3=relieved a lot and 4=completely resolved.
  • Overall Assessment of Study Medication by Participants [Time Frame: Day 43] [Designated as safety issue: No]Overall assessment of study medication was done by participants. Assessment was made on a scale of -2 to 2 where, -2=very bad, -1=bad, 0=no change, 1= good and 2=very good.
  • Overall Assessment of Study Medication by Investigator [Time Frame: Day 43] [Designated as safety issue: No]Overall assessment of study medication was done by Investigator. Assessment was made on a scale of -2 to 2 where, -2=very bad, -1=bad, 0=no change, 1= good and 2=very good.
  • Change From Baseline in Brief Pain Inventory (BPI) Score at Day 43 [Time Frame: Baseline and Day 43] [Designated as safety issue: No]The BPI is a questionnaire designed to assess the severity and impact of pain on quality of life. Pain severity score is caculated by sum of all severity items (pain worst, pain least, pain average and pain now) divided by pain now. Total score for pain severity ranges from 0=no pain to 10=extreme pain. Pain interference score was calculated by sum of all interference items (general activity, mood, walking ability, normal work, relations with other people, sleep, and enjoyment of life) score. Total score for pain interference ranges from 0=no interference to 70= interferes completely.
  • Change From Baseline in Short Form-36 (SF-36) Score at Day 43 [Time Frame: Baseline and Day 43] [Designated as safety issue: No]The SF-36 is designed to assess the health status of participants. The SF-36 includes 1 multi-item scale measuring physical health and mental health. Physical health includes physical functioning, role limitations due to physical health, pain and general health. Mantal health includes role limitations due to emotional problems, energy/fatigue, emotional well being and social functioning. Each item is scored on a 0-100 range so that the lowest and highest possible scores are set at 0 and 100, respectively. All items are scored so that a high score defines a more favorable health state.

Descriptive Information[ + expand ][ + ]

Brief TitleA Study to Compare Safety and Efficacy of Tramadol Hydrochloride/Acetaminophen With Gabapentin in Participants With Diabetic Neuropathy
Official TitleComparison of the Effectiveness and Safety Between Tramadol 37.5 Mg/Acetaminophen 325mg And Gabapentin for The Treatment of Painful Diabetic Neuropathy: Multicenter, Randomized, Open Comparative Study
Brief Summary
The purpose of this study is to evaluate the effectiveness and safety of tramadol
hydrochloride (HCl) 37.5 miligram (mg)/acetaminophen 325 mg compared to gabapentin in
participants with diabetic neuropathic (nerve disorder caused by diabetes mellitus) pain.
Detailed Description
This is an open-label (a medical research study in which participants and researchers are
told which treatments the participants are receiving, "unblinded"), multi-center and
randomized (study drug is assigned by chance) study to compare the effectiveness and safety
of tramadol HCl 37.5 mg/acetaminophen 325 mg with gabapentin in participants with diabetic
neuropathy. The study will consist of 4 periods: Screening period (up to Day -14),
Randomization period (Day 1), Dosage adjustment period (Day 15) and Maintenance period (Day
43). The participants will be randomly assigned to 1 of the 2 treatment groups: tramadol HCl
37.5 mg/acetaminophen 325 mg or gabapentin. Tramadol Hcl/acetaminophen group will receive 1
tablet for 3 days, then 1 tablet twice daily for 4 days followed by 1 tablet thrice daily
for next 7 days. If there is no pain relief, the dosage can be increased up to 8 tablets per
day for Day 15 to 28, and then the increased dosage will be maintained for Day 29 to 42.
Gabapentin group will receive 300 mg on Day 1, 300 mg twice daily on Day 2, and 300 mg
thrice daily for Day 3 to 7. Then for Day 8 to 14, participants will receive 300 mg in the
morning, 300 mg in the midday and 600 mg in the evening. If there is no pain relief,
gabapentin can be increased up to 3600 mg per day for Day 15 to 28, and then the increased
dosage will be maintained for Day 29 to 42. Primarily, efficacy will be evaluated by pain
intensity using numeric rating scale (NRS). Participants' safety will be monitored
throughout the study.
Study TypeInterventional
Study PhasePhase 4
Study DesignAllocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
ConditionDiabetic Neuropathy
InterventionDrug: Tramadol hydrochloride/ Acetaminophen
Participants will receive 1 tablet containing tramadol HCl 37.5 milligram (mg) and acetaminophen 325 mg once daily, at bed time on Days 1 to 3,. 1 tablet twice daily on Days 4 to 7 and 1 tablet thrice daily on Day 8 to 14. If there is no pain relief, the dosage can be increased up to 8 tablets per day for Days 15 to 28. The increased dose will be maintained for Days 29 to 42.
Other Names:
UltracetDrug: Gabapentin
Participants will receive Gabapentin 300 mg once daily at bed time on Day 1, 300 mg twice daily on Day 2 and 300 mg thrice daily on Day 3. Gabapentin 300 mg will be administered twice daily (in the morning and midday) and gabapentin 600 mg in the evening on Day 8 to 14. If there is no pain relief, the dosage can be increased up to 3600 mg per day for Days 15 to 28. The increased dose will be maintained for Days 29 to 42.
Study Arm (s)
  • Experimental: Tramadol hydrochloride (HCl)/ Acetaminophen
    Participants will receive 1 tablet containing tramadol HCl 37.5 milligram (mg) and acetaminophen 325 mg once daily, at bed time on Days 1 to 3, 1 tablet twice daily on Days 4 to 7 and 1 tablet thrice daily on Day 8 to 14. If there is no pain relief, the dosage can be increased up to 8 tablets per day for Days 15 to 28. The increased dose will be maintained for Days 29 to 42.
  • Active Comparator: Gabapentin
    Participants will receive Gabapentin 300 mg once daily at bed time on Day 1, 300 mg twice daily on Day 2 and 300 mg thrice daily on Day 3. Gabapentin 300 mg will be administered twice daily (in the morning and midday) and gabapentin 600 mg in the evening on Day 8 to 14. If there is no pain relief, the dosage can be increased up to 3600 mg per day for Days 15 to 28. The increased dose will be maintained for Days 29 to 42.

Recruitment Information[ + expand ][ + ]

Recruitment StatusCompleted
Estimated Enrollment162
Estimated Completion DateOctober 2008
Estimated Primary Completion DateOctober 2008
Eligibility Criteria
Inclusion Criteria:

- Participants having painful symmetric neuropathy (a disturbance in the function of
the brain or spinal cord that may affect the nerves and muscles of the body) in the
lower limbs applicable to both of the following conditions: decreased sensation of
leg to monofilament, none or decreased ankle reflexes or decreased vibratory
sensation and pain symptoms such as numbness (loss of sensation), tingling,
paresthesia (a skin sensation, such as burning, prickling, itching, or tingling, with
no apparent physical cause), burning, shooting pain, stabbing or lancinating
(characterized by a sensation of cutting, piercing, or stabbing) pain

- Participants having painful diabetic neuropathy in the lower limbs for 3 months
before randomization

- Participants diagnosed with Type ll diabetes and stable blood sugar level controlled
with an oral medication, insulin or diet therapy for 3 months before randomization

- Participants with glycated hemoglobin (HbA1c) less than or equal to 10 percent

- Participants with pain intensity score of greater than or equal to 4 on numeric
rating scale (NRS) for the last 48 hours

Exclusion Criteria:

- Participants who have previously experienced failure of tramadol treatment or have
discontinued tramadol administration due to adverse event

- Participants who have received the prohibited medication before randomization (e.g.,
capsaicin, use of systemic steroids, steroid or local anesthetic injections, tramadol
HCl or tramadol combination, gabapentin, opioid analgesics, antidepressants,
anticonvulsants, alpha-lipoic acid, acupuncture, COX-2 selective inhibitors,
long-acting NSAIDs, opioid analgesics, sedative-hypnotics, muscle relaxants,
anxiolytics, antipsychotics, TENS, short-acting non-opioid analgesics)

- Participants with neuropathic pain caused by other reasons (e.g., alcohol abuse,
connective tissue disease, toxic exposure, infection, neoplasm, ischemia)

- Participants suffering from painful diabetic neuropathy over 10 years

- Participants with physical damage or disease which may cause abnormal absorption,
excessive accumulation, metabolism or excretion disorder of the study medication
GenderBoth
Ages18 Years
Accepts Healthy VolunteersNo
ContactsNot Provided
Location CountriesNot Provided

Administrative Information[ + expand ][ + ]

NCT Number NCT00634543
Other Study ID NumbersCR012967
Has Data Monitoring CommitteeNo
Information Provided ByJanssen Korea, Ltd., Korea
Study SponsorJanssen Korea, Ltd., Korea
CollaboratorsNot Provided
Investigators Study Director: Janssen Korea, Ltd. Clinical Trial Janssen Korea, Ltd.
Verification DateJuly 2013