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Brief Title: A Study to Evaluate Tapentadol (CG5503) in the Treatment of Chronic Tumor-Related Pain Compared With Placebo and Morphine
Official Title: A Randomized Withdrawal, Active- and Placebo-controlled, Double-blind, Multi-center Phase III Trial Assessing Safety and Efficacy of Oral CG5503 (Tapentadol) PR* in Subjects With Moderate to Severe Chronic Malignant Tumor-related Pain
Study ID: NCT00472303
Brief Summary: The purpose of this study will be to determine whether tapentadol (CG5503) is effective and safe in the treatment of chronic tumor related pain compared to placebo. In addition tapentadol (CG5503) will also be compared to morphine controlled release, also referred to as slow release (SR). \*Tapentadol prolonged-release (PR) is the term used in the European Union and is referred to as extended release (ER) in the United States.
Detailed Description: Normally chronic tumor related pain is controlled when participants receive repeated doses of opioid analgesics. However, opioid therapy is commonly associated with side effects such as nausea, vomiting, sedation, constipation, addiction, tolerance, and respiratory depression. Tapentadol (CG5503), a newly synthesized drug with an prolonged release (PR) formulation, also acts as a centrally acting pain reliever but has 2 mechanisms of action. The aim of this trial is to investigate the effectiveness (level of pain control) and safety (side effects) of tapentadol (CG5503) PR compared with no drug (placebo) and corresponding dose of morphine (an opioid commonly used to treat tumor related pain). This trial is a randomized, double-blind (neither investigator nor patient will know which treatment was received), active- and placebo-controlled, parallel-group, randomized withdrawal design, multicenter trial. The trial includes a 2 week titration phase starting with either 40 mg morphine (PR) bid (bid = twice daily dosing, one dose in the morning and one dose in the evening) or 100 mg tapentadol (CG5503) PR bid. Based on effectiveness and side effects subjects can up-titrate in steps of 50 mg tapentadol (CG5503 PR) to a maximal dose of 250 mg tapentadol (CG5503) PR bid or 100 mg morphine PR bid. If participants meet the stabilisation criteria at the end of the titration phase they will be re-randomized to either placebo or active treatment and will continue 4 weeks at the last dose level in the maintenance phase. Only participants on tapentadol in the titration phase will be re-randomized to either matching placebo or to tapentadol. To maintain the blinding nature of the trial participants in the morphine arm during the titration phase will also be re-randomized however they will all remain on morphine controlled release in the maintenance phase. Placebo to match tapentadol tablets, as well as placebo to match morphine capsules, will be used to mask the treatment allocation. Participants will be issued with an electronic diary (eDiary) to capture Numeric Rating Scale (NRS) pain intensities. Assessments of pain relief include the pain intensity numeric rating scale (NRS) and patient global impression of change (PGIC). Safety evaluations include monitoring of adverse events, physical examinations, clinical laboratory tests and electrocardiograms. Venous blood samples will be collected for the determination of serum concentrations of tapentadol (CG5503).
Minimum Age: 18 Years
Eligible Ages: ADULT, OLDER_ADULT
Sex: ALL
Healthy Volunteers: No
Site 043004, Klagenfurt, , Austria
Site 043002, Vienna, , Austria
Site 043001, Vienna, , Austria
Site 043005, Vienna, , Austria
Site 359013, Gabrovo, , Bulgaria
Site 359011, Pleven, , Bulgaria
Site 359014, Plovdiv, , Bulgaria
Site 359004, Shumen, , Bulgaria
Site 359008, Sofia, , Bulgaria
Site 359012, Varna, , Bulgaria
Site 385007, Osijek, , Croatia
Site 385001, Slavonski Brod, , Croatia
Site 385004, Varazdin, , Croatia
Site 385006, Zabok, , Croatia
Site 385002, Zagreb, , Croatia
Site 385003, Zagreb, , Croatia
Site 420005, Brno, , Czechia
Site 420002, Ceske Budejovice, , Czechia
Site 420006, Hradec Kralove, , Czechia
Site 420007, Liberec, , Czechia
Site 420008, Olomouc, , Czechia
Site 420001, Pilsen, , Czechia
Site 420004, Prague, , Czechia
Site 033101, Tarbes, , France
Site 049009, Berlin, , Germany
Site 049014, Essen, , Germany
Site 049012, Köln, , Germany
Site 049007, Löwenstein, , Germany
Site 049020, Potsdam, , Germany
Site 049006, Waldkirch, , Germany
Site 049002, Wiesbaden, , Germany
Site 036001, Debrecen, , Hungary
Site 036005, Komárom, , Hungary
Site 036003, Mátraháza, , Hungary
Site 036002, Nyiregyhaza, , Hungary
Site 036010, Szekszard, , Hungary
Site 036006, Székesfehérvár, , Hungary
Site 036009, Székesfehérvár, , Hungary
Site 039001, Napoli, , Italy
Site 373001, Chisinau, , Moldova, Republic of
Site 373002, Chisinau, , Moldova, Republic of
Site 048004, Bydgoszcz, , Poland
Site 048005, Gdańsk, , Poland
Site 048007, Poznan, , Poland
Site 048001, Warszawa, , Poland
Site 040006, Brasov, , Romania
Site 040002, Bucharest, , Romania
Site 040003, Bucharest, , Romania
Site 040004, Bucharest, , Romania
Site 040005, Cluj-Napoca, , Romania
Site 040001, Iasi, , Romania
Site 040007, Timisoara, , Romania
Site 007010, Arkhangel'sk, , Russian Federation
Site 007003, Moscow, , Russian Federation
Site 007007, Nizhniy Novgorod, , Russian Federation
Site 007012, Vladikavkaz, , Russian Federation
Site 007005, Yaroslavl, , Russian Federation
Site 381003, Belgrade, , Serbia
Site 381004, Belgrade, , Serbia
Site 381005, Belgrade, , Serbia
Site 381002, Nis, , Serbia
Site 381001, Sremska Kamenica, , Serbia
Site 421005, Banska Bystrica, , Slovakia
Site 421001, Kosice, , Slovakia
Site 034009, Barcelona, , Spain
Site 034005, Barcelona, , Spain
Site 034006, Mahón, , Spain
Site 034012, Pamplona, , Spain
Site 034004, Sevilla, , Spain
Site 034002, Valencia, , Spain
Site 046001, Stockholm, , Sweden
Name: Hans Georg Kress, Dr.
Affiliation: Clinic of Anaesthesiology and Pain Management, AKH Vienna
Role: PRINCIPAL_INVESTIGATOR