Fixed Versus Flexible Dosing of Pregabalin in Patients With Fibromyalgia (Flexdose)
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Purpose
A 9-week randomized double-blind, multi-center study of 172 patients, who after 1 week baseline evaluation are randomized to either fixed dose pregabalin starting at 75 mg BID for one week and increased to 150 mg BID for 7 weeks or flexibly dosed pregabalin given BID (75-300 mg/d) increased gradually over 4 weeks then maintained at that same dosing for 4 weeks.It is proposed that use of flexible dosing combined with nightly dosing would have similar pain relief to fixed dosing, would improve adherence, would have less side effects and would be more likely to improve sleep.
| Condition | Intervention | Phase |
|---|---|---|
|
Fibromyalgia |
Drug: Pregabalin |
Phase 4 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Caregiver, Investigator) Primary Purpose: Treatment |
| Official Title: | Fixed Versus Flexible Dosing of Pregabalin in Patients With Fibromyalgia |
- Pain score evaluation by NRS [ Time Frame: 8 weeks ] [ Designated as safety issue: No ]Least square mean change in Fibromyalgia pain at 8weeks compared to baseline utilizing an 11 point numerical rating scale daily pain diary (0 = no pain to 10 =worst possible pain) performed at daily awakening.
- Patient Global Impression of Change [ Time Frame: At weeks 4 and 8 ] [ Designated as safety issue: No ]
- Discontinuation rate [ Time Frame: 9 weeks ] [ Designated as safety issue: Yes ]Discontinuation rates due to lack of efficacy and discontinuation rates due to adverse event.
- Improvements in Wolfe Symptom Severity Score [ Time Frame: 9 weeks ] [ Designated as safety issue: No ]Wolfe Symptom Severity scales for pain, fatigue, trouble sleeping, trouble with anxiety or depression, trouble thinking or remembering, overall FM severity, problems awaking feeling unrefreshed
| Enrollment: | 174 |
| Study Start Date: | July 2010 |
| Study Completion Date: | July 2012 |
| Primary Completion Date: | July 2012 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: Flexible Dose
flexibly dosed pregabalin given BID (75-300 mg/d) increased gradually over 4 weeks then maintained at that same dosing for 4 weeks
|
Drug: Pregabalin
Fixed dosing of pregabalin: Week 1: 75 mg bid. Weeks 2 - 8: 150 mg bid. Week 9 (Days 57-60 and Days 61-63): 75 mg bid. Flexible dosing of pregabalin: Week 1: placebo in the AM and 75 mg nightly; Week 2: placebo in the AM and 150 mg nightly.; Week 3 placebo in the a.m., 225 mg nightly; Weeks 4 - 8 placebo in the a.m., 300 mg nightly. Week 9 (Days 57-60) placebo in the a.m,, 150 mg bid nightly and Days 61-63: placebo in the a.m., and 75 mg bid nightly. |
|
Active Comparator: Fixed Dosing
75 mg BID for one week and increased to 150 mg BID for 7 weeks
|
Drug: Pregabalin
Fixed dosing of pregabalin: Week 1: 75 mg bid. Weeks 2 - 8: 150 mg bid. Week 9 (Days 57-60 and Days 61-63): 75 mg bid. Flexible dosing of pregabalin: Week 1: placebo in the AM and 75 mg nightly; Week 2: placebo in the AM and 150 mg nightly.; Week 3 placebo in the a.m., 225 mg nightly; Weeks 4 - 8 placebo in the a.m., 300 mg nightly. Week 9 (Days 57-60) placebo in the a.m,, 150 mg bid nightly and Days 61-63: placebo in the a.m., and 75 mg bid nightly. |
Eligibility| Ages Eligible for Study: | 18 Years to 65 Years |
| Genders Eligible for Study: | Female |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- diagnosis of fibromyalgia by ACR criteria
- ambulatory patients
- complete of 5 pain diaries during 1 week evaluation
- other inclusion criteria may apply
Exclusion Criteria:
- pregnant or of childbearing potential not using contraceptives
- use of pregabalin in the past
- concomitant use of opioids or gabapentin
- estimated creatinine clearance less than 60
- other criteria may apply
Contacts and Locations| United States, California | |
| Stuart L Silverman MD Inc. | |
| Beverly Hills, California, United States, 90211 | |
| David Silver MD Inc | |
| Beverly Hills, California, United States, 90211 | |
| Talbert Medical Group | |
| Huntington Beach, California, United States, 92646 | |
| Catalina Pointe Clinial Research | |
| Tucson, California, United States, 85704 | |
| Affilaites in Medical Specialty | |
| West Hills, California, United States, 91307 | |
| Study Director: | Keaton Nasser | Osteoporosis Medical Center |
| Principal Investigator: | Stuart L Silverman, M.D. | Osteoporosis Medical Center |
More Information
No publications provided
| Responsible Party: | Osteoporosis Medical Center, Beverly Hills, CA |
| ClinicalTrials.gov Identifier: | NCT01226667 History of Changes |
| Other Study ID Numbers: | SLS2009001 |
| Study First Received: | October 1, 2010 |
| Last Updated: | July 30, 2012 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by Osteoporosis Medical Center, Beverly Hills, CA:
|
fibromyalgia lyrica pregabalin |
Additional relevant MeSH terms:
|
Fibromyalgia Myofascial Pain Syndromes Muscular Diseases Musculoskeletal Diseases Rheumatic Diseases Neuromuscular Diseases Nervous System Diseases Pregabalin |
Analgesics Sensory System Agents Peripheral Nervous System Agents Physiological Effects of Drugs Pharmacologic Actions Central Nervous System Agents Therapeutic Uses Anticonvulsants |
ClinicalTrials.gov processed this record on May 23, 2013