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A Dose-ranging Study of the Safety and Effectiveness of JNJ-42160443 as add-on Treatment in Patients With Low Back Pain - NCT00973024-(Clinical Trial 351717)



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City:  Renton
State:  
WA
Zip Code:
Conditions: Low Back Pain - Low Back Pain, Recurrent
Purpose: The purpose of this study is to compare the safety and effectiveness of different doses of JNJ-42160443 with placebo in the treatment of chronic, moderate to severe low back pain patients with a diagnosis of chronic low back pain.
Study summary: Low back pain is a common cause of nonmalignant, chronic pain and represents one of the most significant socioeconomic health-related problems in developed countries. In 1991, an estimated annual incidence of 5% was reported in American adults. Up to 50% of working adults experience back pain every year and 70% of all adults experience it at some time in their lives. Despite the variety of available medications for nonmalignant, chronic pain, many patients with chronic pain do not obtain adequate relief or experience unacceptable side effects from existing medications. Nerve growth factor plays an important role in the generation of pain in several acute and chronic pain states, and anti-NGF therapy was associated with significant improvement in chronic pain from osteoarthritis. Therefore, anti-NGF therapy may be effective in the treatment of pain from chronic osteoarthritis as well as other chronic pain states.This current study is a randomized (study drug assigned by chance), double-blind (neither the physician nor the patient knows the name of the assigned drug) study to evaluate the safety and effectiveness of different doses of JNJ-42160443 compared with placebo in the treatment of men and women 18 to 80 years of age, inclusive, with a diagnosis of chronic low back pain who have moderate to severe, chronic low back pain that is not controlled by standard pain medications. The study has 4 phases: a screening phase of 3 weeks, a treatment phase of 12 weeks, an extension phase of 92 weeks, and a follow-up phase of 26 weeks after the last dose of study medication. Patients who have an average daily pain intensity score of >=5 averaged over the last 3 days before treatment assignment will receive one of four JNJ-42160443 treatments or placebo given once every 4 weeks as an injection under the skin while continuing to take their baseline pain medications for 12 weeks. Patients who complete the 12-week treatment phase will be eligible to enter the 92-week extension phase or will discontinue the study. Final visit evaluations will occur 26 weeks after the last dose of study medication is taken, or at early withdrawal from the study. Assessments of effectiveness include daiy pain intensity assessments, sleep interference assessment, the Oswestry Disability Index (ODI), the Brief Pain Inventory (BPI) Short Form, Patient Global Assessment of Change (PGA), Short Form-36 Health Survey (SF-36), Medical Outcomes Study (MOS) Sleep Scale, the Work Productivity and Impairment Questionnaire, and Safety, Tolerability, and Efficacy Preview (STEP) interview. Safety assessments include monitoring of adverse events, vital signs, physical examinations, neurologic examinations and evaluations, clinical laboratory evaluations, electrocardiograms (ECGs), the Beck Depression Inventory II (BDI-II), and injection site evaluations. The study hypothesis is that JNJ-42160443 is better than placebo as a safe and effective treatment when added to standard pain treatments in patients with moderate to severe, chronic low back pain. JNJ-42160443 (10 milligrams in 0.1 milliliter) or matching placebo given as an injection under the skin once every 4 weeks; one of four JNJ-42160443 doses (0.1 mL [1 mg] every 4 weeks; 0.3 mL [3 mg] every 4 weeks; 0.6 mL (6 mg) loading dose on Day 1 followed by 0.3 mL [3 mg] every 4 weeks; or 1 mL (10 mg) every 4 weeks, or matching placebo.
Criteria: Inclusion Criteria: - Diagnosis of chronic low back pain that must have been present (by history) for at least >=20 days/month, >=3 hours/day, and >=6 months - Have low back pain classified by the Quebec Task Force Classification for Spinal Disorders as either Category 1: pain without radiation to the extremity or Category 2: pain with radiation proximally to the knee and without neurologic signs - have an average pain intensity score of >=5 averaged over the last 3 days of pain scores before random assignment (Day 1) - Must be receiving at least 1 of the following analgesic regimens: stable dose of non-steroidal anti-inflammatory drugs for a minimum of 5 days each week for the 4 weeks before screening, as stable dose of immediate-release opioids for a minimum of 5 days each week for the 4 weeks before screening, but not exceeding 200 mg oral morphine equivalents per day, or a stable dose of long-acting opioids for the 4 weeks before screening, but not exceeding 200 mg oral morphine equivalents per day - A mini mental state examination score of >=26 at screening Exclusion Criteria: - Have low back pain classified by the Quebec Task Force Classification for Spinal Disorders as Category 3: pain with radiation distally beyond the knee and without neurologic signs or Category 4: Pain with radiation to the extremity and with neurologic signs - history within the past year of any of the following: seizure disorder - intrathecal therapy and ventricular shunts, mild or moderate traumatic brain injury, stroke, or transient ischemic attack, meningitis - History of brain injury within the past 15 years consisting of >= 1 of the following, or with residual sequalae suggesting transient changes in consciousness: brain contusion, intracranial hematoma, either unconsciousness or posttraumatic amnesia lasting more than 24 hours - History of epilepsy or multiple sclerosis - Current diagnosis of fibromyalgia, complex regional pain syndrome (including reflex sympathetic dystrophy or causalgia), acute spinal cord compression, bowel or bladder dysfunction as a result of cauda equine compression, back pain caused by secondary infection, or pain caused by confirmed or suspected neoplasm - Any new or unresolved neurologic deficits, including progressive deficits, within 6 months before screening
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Data Source: ClinicalTrials.gov
Date Processed: February 17, 2010
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