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Trial registered on ANZCTR
Registration number
ACTRN12611000822987
Ethics application status
Approved
Date submitted
4/08/2011
Date registered
4/08/2011
Date last updated
4/08/2015
Type of registration
Prospectively registered
Titles & IDs
Public title
A study of oral EMA401 in the treatment of pain following shingles to see if EMA401 can reduce the level of pain.
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Scientific title
A double-blind, placebo-controlled, randomised trial to prove the therapeutic concept and to determine the safety, tolerability and pharmacokinetic profile of EMA401 (angiotensin II type 2 receptor antagonist) administered orally in patients with postherpetic neuralgia.
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Secondary ID [1]
262632
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Postherpetic Neuralgia
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Condition category
Condition code
Neurological
268468
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
EMA401 sodium salt capsules (2 x 50 mg) will be administered at a dose of 100 mg twice daily, taken on an empty stomach at least 1 hour before a meal (total 200 mg daily dose).
The two capsules on each dosing occasion should be taken orally with a minimum of 200 mL of water. The Treatment Period will be 29 days consisting of 28 days of twice daily dosing and a single dose on the morning of Day 29, to give a total of 57 doses, followed by 13 days (+/- 3 days) without treatment.
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Intervention code [1]
266980
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Treatment: Drugs
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Comparator / control treatment
Patients will be randomised in a 1:1 ratio to receive EMA401 or placebo.
Placebo capsules, identical to the active drug in appearance and contain the same excipients but not containing EMA401 sodium salt.
Two Placebo capsules will be administered twice daily, taken on an empty stomach at least 1 hour before a meal. The two capsules on each dosing occasion should be taken orally with a minimum of 200 mL of water.
The Treatment Period will be 29 days consisting of 28 days of twice daily dosing and a single dose on the morning of Day 29, to give a total of 57 doses, followed by 13 days (+/- 3 days) without treatment.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Change in mean pain intensity score (using an 11-point numerical rating scale/Likert scale) between baseline and the last week of dosing (Day 22 to 28).
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Assessment method [1]
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Timepoint [1]
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At Baseline (consists of daily pain scores recorded over 7 consecutive days during the Screening Period (week 0)) and at week 4 from intervention commencement.
The daily pain intensity score is averaged over 7 days to obtain the mean pain intensity score for a week.
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Secondary outcome [1]
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Onset and maintenance of effect as defined by pattern of change in the mean pain intensity score over the entire Treatment Period.
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Assessment method [1]
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Timepoint [1]
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At Baseline (week 0) and at 1 week, 2 weeks, 3 weeks and 4 weeks after intervention commencement.
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Secondary outcome [2]
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Proportion of patients achieving a greater than or equal to 30% reduction in mean pain intensity score compared to baseline
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Assessment method [2]
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Timepoint [2]
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At Baseline (week 0) and at week 4 from intervention commencement.
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Eligibility
Key inclusion criteria
Patients will be entered into this study only if they meet all of the following criteria;
be able to give voluntary written informed consent to participate in the study;
be over eighteen years of age;
be diagnosed as suffering from post herpetic neuralgia defined as pain persisting for more than six months after onset of herpes zoster rash;
be diagnosed as suffering from moderate to severe pain across the Screening Period;
willing and be able to comply with all study procedures;
for females, have a negative pregnancy test at the Screening Visit (Visit 1) and at Visit 2 (Day 1) prior to administration of study medication;
for females, be of non-child-bearing potential (i.e. either surgically sterilised or one year post-menopausal), or if of child-bearing potential, must have used adequate contraceptive precautions for 30 days prior to screening, and must agree to use two approved methods of contraception for the duration of the study, and for one month after administration of the last dose of study medication;
for males, agree to use two approved methods of contraception for the duration of the study and until 1 month after administration of the last dose of the study medication, where approved methods of contraception include surgical sterilization (vasectomy at least 6 months prior to dosing), condom use by male partners of female patients or by male patients, birth control pills, diaphragm with vaginal spermicide, intra uterine device, contraceptive hormonal patches, implants or injections by female patients or female partners of male patients;
and be fluent in the language of the endpoint scales provided to patients in the study.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients who meet any of the following criteria will be excluded from participating in the study;
be currently receiving any of the listed prohibited medications or have received within 30 days prior to the Screening Visit (Visit 1) or is anticipated to receive after the start of the trial (i.e. on or after Visit 1) any new prescription systemic or topical medication for their post herpetic neuralgia, patients may be enrolled if stable on therapy for their post herpetic neuralgia as specified in the list of permitted medications;
have received an investigational drug within 30 days or 10 half-lives of the drug, whichever is longer, prior to the Screening Visit (Visit 1) or have previously received EMA401; known to be allergic to EMA401 or any of the excipients or who have a history of an allergic reaction to previous medication that required management by a health care professional;
have a clinically significant history of systemic allergic disease (e.g., urticaria, atopic dermatitis);
have a blood pressure, after resting for at least 5 minutes, outside a systolic blood pressure range of 100-150 mmHg or a diastolic blood pressure outside a range of 50-90 mmHg on two consecutive measurements (at least 10 minutes apart and completed within 20 minutes of the initial measurement);
have a pulse rate, after sitting for at least 5 minutes, greater than 100 beats per minute or lower than 50 beats per minute, or 45 beats per minute if on beta blockers, on two consecutive measurements (at least 10 minutes apart and completed within 20 minutes of the initial measurement);
known to be diabetic;
consume more than 4 units of alcohol daily for a man or 3 units of alcohol for a woman (1 unit equals 300 mL beer, one glass of wine, one measure of spirits) or has a history of alcohol abuse/dependence;
have evidence of significant renal insufficiency, indicated by an estimated creatinine clearance using the Cockcroft-Gault formula of less than 50 mL/min at Screening (Visit 1);
have serum aspartate transaminase, gamma glutamyl transaminase or alanine transaminase levels greater than 3 times the upper limit of normal or have total bilirubin concentrations greater than 2 times the upper limit of normal at Screening (Visit 1);
other than pain as a result of postherpetic neuralgia, have an active, uncontrolled medical condition (e.g., neurological, gastrointestinal, renal, hepatic, cardiovascular, pulmonary, metabolic, endocrine, haematological, genitourinary or other major disorder), or psychiatric illness (e.g., depression, schizophrenia), or any other significant clinical disorder or laboratory finding that in the opinion of the investigator, precludes participation in the study or may interfere with the study objectives;
other than pain as a result of postherpetic neuralgia, have had a clinically significant illness or operative procedure within 4 weeks of the Screening Visit (Visit 1) (e.g. influenza, myocardial infarction);
have undergone neurolytic or neurosurgical therapy for postherpetic neuralgia;
have other moderate to severe pain condition that may confound the self-evaluation of pain due to postherpetic neuralgia;
have skin conditions in the affected area that in the investigator's opinion could alter sensation;
have active herpes zoster upon physical examination at Screening (Visit 1) or during the study;
have hepatitis B, hepatitis C or human immunodeficiency virus infection as defined by being seropositive for hepatitis B surface antigen, hepatitis C virus antibodies or human immunodeficiency virus antibodies respectively;
have a history of at least one genital herpes outbreak;
or are pregnant or lactating.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
17/08/2011
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Actual
10/08/2011
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Date of last participant enrolment
Anticipated
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Actual
18/05/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
172
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Accrual to date
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Final
183
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Recruitment outside Australia
Country [1]
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South Africa
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State/province [1]
3724
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Country [2]
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Bulgaria
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State/province [2]
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Country [3]
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Czech Republic
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State/province [3]
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Country [4]
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Serbia and Montenegro
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State/province [4]
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Country [5]
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Ukraine
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State/province [5]
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Country [6]
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Georgia
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State/province [6]
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Spinifex Pharmaceuticals Pty Ltd
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Address [1]
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Corporate One, Suite G5, 84 Hotham St, Preston, VIC, 3072, Australia
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Country [1]
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Australia
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Primary sponsor type
Commercial sector/Industry
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Name
Spinifex Pharmaceuticals Pty Ltd
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Address
Corporate One, Suite G5, 84 Hotham St, Preston, VIC, 3072, Australia
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Pharma-Ethics Pty Ltd
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Ethics committee address [1]
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123 Amcor Road, Lyttelton, Manor, 0157
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Ethics committee country [1]
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South Africa
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Date submitted for ethics approval [1]
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08/04/2011
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Approval date [1]
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26/05/2011
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Ethics approval number [1]
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11054264
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Ethics committee name [2]
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Zvezdara University Medical Center
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Ethics committee address [2]
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Office for Human Research Protections 1, U Clinical Ctr Zvezdara IRB 1 Medical, No IRB0000318, Dimitrija Tucovica 161, 11000 Belgrade
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Ethics committee country [2]
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Serbia and Montenegro
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Date submitted for ethics approval [2]
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14/04/2011
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Approval date [2]
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20/04/2011
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Ethics approval number [2]
269421
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Ethics committee name [3]
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Clinical Centre of Vojvodine
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Ethics committee address [3]
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Hajduk Veljkova 1-9, 21000 Novi Sad, Hajduk Veljka 1
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Ethics committee country [3]
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Serbia and Montenegro
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Date submitted for ethics approval [3]
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15/04/2011
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Approval date [3]
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05/05/2011
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Ethics approval number [3]
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00-01/256
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Ethics committee name [4]
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Ethics Committee The University Hospital and the Faculty Medicine Palacky University in Olomouc
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Ethics committee address [4]
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Building B1, I.P. Pavolva 6, 775 20 Olomouc
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Ethics committee country [4]
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Czech Republic
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Date submitted for ethics approval [4]
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26/04/2011
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Approval date [4]
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16/05/2011
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Ethics approval number [4]
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62/11
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Ethics committee name [5]
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Ethics Committee of the Institute for Clinical and Experimental Medicine and Faculty Thomayer Hospital
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Ethics committee address [5]
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Videnska 800, 140 59, Praha 4
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Ethics committee country [5]
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Czech Republic
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Date submitted for ethics approval [5]
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19/04/2011
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Approval date [5]
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11/05/2011
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Ethics approval number [5]
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745/11 (L 11-32)
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Ethics committee name [6]
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The University Hospital Kralovske Vinohrady
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Ethics committee address [6]
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Srobarova 50, 100 34, Praha 10
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Ethics committee country [6]
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Czech Republic
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Date submitted for ethics approval [6]
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26/04/2011
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Approval date [6]
269425
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04/05/2011
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Ethics approval number [6]
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KH/17/0/2011
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Ethics committee name [7]
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Ethics Committee, Faculty Hospital Hradec Kralove
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Ethics committee address [7]
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Hradeck Ulice 1172, 500 03, Hradec Kralove 3
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Ethics committee country [7]
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Czech Republic
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Date submitted for ethics approval [7]
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19/04/2011
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Approval date [7]
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09/06/2011
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Ethics approval number [7]
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201106 D04M
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Ethics committee name [8]
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Faculty Hospital u sv. Anny v Brne Vystavni
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Ethics committee address [8]
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17/19, 656 91, Brno
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Ethics committee country [8]
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Czech Republic
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Date submitted for ethics approval [8]
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20/04/2011
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Approval date [8]
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08/06/2011
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Ethics approval number [8]
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30L/2011
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Ethics committee name [9]
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Clinical Centre of Serbia Ethics Committee
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Ethics committee address [9]
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Pasterova 2, 11000 Belgrade
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Ethics committee country [9]
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Serbia and Montenegro
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Date submitted for ethics approval [9]
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17/05/2011
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Approval date [9]
269497
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09/06/2011
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Ethics approval number [9]
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1009/24-A and 1009/24-B
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Ethics committee name [10]
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Central Ethics Committee of the Health Ministry of Ukraine
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Ethics committee address [10]
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5, Narodne Opolchennya str., Kyiv, 03680
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Ethics committee country [10]
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Ukraine
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Date submitted for ethics approval [10]
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28/04/2011
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Approval date [10]
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14/06/2011
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Ethics approval number [10]
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5.12-680/KE
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Summary
Brief summary
This is a proof of concept study designed to investigate the efficacy of EMA401 when administered orally, twice daily (200 mg total daily dose) for 28 days in patients with postherpetic neuralgia aged 18 years old and over. The secondary objectives of the study are to determine the safety, tolerability and pharmacokinetic profile of EMA401 and to evaluate the efficacy of EMA401 using a number of alternate endpoints.
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Trial website
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Trial related presentations / publications
The manuscript describing this clinical trial appeared online in The Lancet on 05/02/2014. Reference: doi:10.1016/S0140-6736(13)62337-5.
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Public notes
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Contacts
Principal investigator
Name
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Dr Milton Raff
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Address
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Christiaan Barnard Memorial Hospital
181 Longmarket Street
Cape Town, 8000
South Africa
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Country
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South Africa
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Phone
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+21 4806252
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Tom McCarthy
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Address
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Spinifex Pharmaceuticals Pty Ltd
Corporate One, Suite G5, 84 Hotham St
Preston, VIC, 3072, Australia
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Country
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Australia
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Phone
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+61 3 9863 6820
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Geoff Kitson
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Address
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10, The Courtyard
East Park, Crawley
West Sussex RH10 6AG
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Country
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United Kingdom
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Phone
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+44 1293 425300
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Fax
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+44 1293 415893
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Future drug discovery in renin-angiotensin-aldosterone system intervention.
2017
https://dx.doi.org/10.1080/17460441.2017.1335301
Embase
The Angiotensin AT2 Receptor: Froma Binding Site to a Novel Therapeutic Target.
2022
https://dx.doi.org/10.1124/pharmrev.120.000281
N.B. These documents automatically identified may not have been verified by the study sponsor.
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