A Phase 3, Multicenter, Randomized, Double-Blind, Placebo-Controlled 14-Week Study of Mirogabalin in Chinese Patients with Diabetic Peripheral Neuropathic Pain.

IF 4.1 2区 医学 Q1 CLINICAL NEUROLOGY
Pain and Therapy Pub Date : 2024-08-01 Epub Date: 2024-06-19 DOI:10.1007/s40122-024-00617-2
Xiaohui Guo, Yang Yu, Yongbo Zhang, Li Sun, Yufeng Li, Bing Song, Li Hang, Masayuki Baba, Yosuke Wasaki, Kunika Kikumori, Emiko Murayama
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引用次数: 0

Abstract

Introduction: There is no approved effective drug for diabetic peripheral neuropathic pain (DPNP) in China. Gabapentinoids including mirogabalin have shown promise, although data in Chinese patients are scarce.

Methods: This phase 3, multicenter, randomized, double-blind, placebo-controlled trial investigated the efficacy and safety of mirogabalin for treating DPNP in China. Mirogabalin was administered at 5 mg twice daily for the first week and uptitrated to 15 mg twice daily for a total duration of 14 weeks. The primary efficacy endpoint was the change from baseline in weekly average daily pain score (ADPS) at week 14; secondary endpoints included the ADPS responder rate, Short-Form McGill Pain Questionnaire visual analogue scale score, patient global impression of change (PGIC), average daily sleep interference score (ADSIS), EuroQol 5-dimensions 5-levels (EQ-5D-5L), and incidence of treatment-emergent adverse events (TEAEs).

Results: Of 393 patients (mirogabalin, n = 196; placebo n = 197), the mean age was 58.2 years (mirogabalin, 58.7 years; placebo, 57.7 years) and 54.2% were male (mirogabalin, 56.1%; placebo, 52.3%). Mirogabalin elicited a greater change from baseline in the weekly ADPS vs. placebo at week 14: least-squares mean difference (95% confidence interval) vs. placebo - 0.39 (- 0.74, - 0.04), p = 0.0301. PGIC, ADSIS, and EQ-5D-5L data reflected significantly better improvements for patients receiving mirogabalin vs. placebo. The incidence of TEAEs was 75.0% and 75.1% in the mirogabalin and placebo groups, respectively. Most TEAEs were mild or moderate, and the incidence of TEAEs leading to treatment discontinuation was 2.6% in the mirogabalin group and 1.5% in the placebo group.

Conclusions: Although the effect size of mirogabalin was reduced due to the placebo effect, mirogabalin is a safe and effective treatment option for Chinese patients with DPNP.

Trial registration: ClinicalTrials.gov identifier, NCT04094662.

Abstract Image

米罗加滨治疗中国糖尿病周围神经痛患者的 3 期、多中心、随机、双盲、安慰剂对照 14 周研究。
导言:在中国,糖尿病周围神经痛(DPNP)尚无有效的治疗药物。加巴喷丁类药物,包括米罗加巴林,已显示出治疗前景,尽管在中国患者中的数据很少:这项三期多中心、随机、双盲、安慰剂对照试验研究了米罗格列宾治疗中国 DPNP 的疗效和安全性。米罗卡宾的剂量为 5 毫克,每天两次,第一周开始给药,之后逐渐增加至 15 毫克,每天两次,共持续 14 周。主要疗效终点是第14周时每周平均每日疼痛评分(ADPS)与基线相比的变化;次要终点包括ADPS应答率、短式麦吉尔疼痛问卷视觉模拟量表评分、患者总体变化印象(PGIC)、平均每日睡眠干扰评分(ADSIS)、EQ-5D-5L(EuroQol 5-dimensions 5-levels)和治疗突发不良事件(TEAEs)的发生率:在393名患者中(mirogabalin,n = 196;安慰剂,n = 197),平均年龄为58.2岁(mirogabalin,58.7岁;安慰剂,57.7岁),54.2%为男性(mirogabalin,56.1%;安慰剂,52.3%)。与安慰剂相比,米罗卡宾在第 14 周引起的每周 ADPS 与基线相比变化更大:与安慰剂相比,最小二乘平均差(95% 置信区间)为 - 0.39 (- 0.74, - 0.04),P = 0.0301。PGIC、ADSIS和EQ-5D-5L数据显示,与安慰剂相比,接受米罗卡宾治疗的患者病情改善明显。米瑞巴林组和安慰剂组的 TEAEs 发生率分别为 75.0% 和 75.1%。大多数TEAEs为轻度或中度,导致停药的TEAEs发生率在米罗格林组为2.6%,安慰剂组为1.5%:尽管安慰剂效应导致米瑞巴林的疗效降低,但米瑞巴林是中国DPNP患者安全有效的治疗选择:试验注册:ClinicalTrials.gov标识符,NCT04094662。
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来源期刊
Pain and Therapy
Pain and Therapy CLINICAL NEUROLOGY-
CiteScore
6.60
自引率
5.00%
发文量
110
审稿时长
6 weeks
期刊介绍: Pain and Therapy is an international, open access, peer-reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of pain therapies and pain-related devices. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to, acute pain, cancer pain, chronic pain, headache and migraine, neuropathic pain, opioids, palliative care and pain ethics, peri- and post-operative pain as well as rheumatic pain and fibromyalgia. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports, trial protocols, short communications such as commentaries and editorials, and letters. The journal is read by a global audience and receives submissions from around the world. Pain and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.
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