Article ; Online: Efficacy and safety of oral nalbuphine extended release in prurigo nodularis: results of a phase 2 randomized controlled trial with an open-label extension phase.
Journal of the European Academy of Dermatology and Venereology : JEADV
2021 Volume 36, Issue 3, Page(s) 453–461
Abstract: ... randomized, double-blind, placebo-controlled trial with an open-label, 50-week extension phase.: Methods ... and mu opioid antagonist nalbuphine extended release (NAL-ER) tablets in a phase 2, multicentre ... of mild-to-moderate severity. The safety profile did not change with extended open-label treatment ...
| Abstract | Background: Treatment of prurigo nodularis (PN) is challenging and new treatment options are needed. Objective: To evaluate the efficacy and safety of two oral doses of the kappa opioid agonist and mu opioid antagonist nalbuphine extended release (NAL-ER) tablets in a phase 2, multicentre, randomized, double-blind, placebo-controlled trial with an open-label, 50-week extension phase. Methods: Subjects with moderate-to-severe PN were randomized to NAL-ER 81 mg (NAL-ER81) or 162 mg (NAL-ER162) tablets twice-daily or placebo for 8 weeks of stable dosing following a 2-week titration period. Subjects completing Week 10 with a Worst Itch Numerical Rating Scale (WI-NRS) score ≥5 at the time of rollover (or during the observation period) were eligible for open-label treatment. Results: Of 63 randomized subjects, 62 were treated and comprised the modified intent-to-treat population (MITT), 50 completed 10 weeks of treatment. In the MITT analysis, 8 subjects (44.4%) treated with NAL-ER162 (P = 0.32) and 6 (27.3%) treated with NAL-ER81 (P = 0.78) achieved ≥30% reduction from baseline in 7-day WI-NRS at Week 10 (primary efficacy endpoint) vs. 8 (36.4%) in the placebo group. Itch reduction was significant among 8/12 (66.7%) subjects completing Week 10 treated with NAL-ER162 vs. placebo (8/20, 40.0%; P = 0.03). Additionally, 6 subjects (33.3%) treated with NAL-ER162 and 3 (13.6%) treated with NAL-ER81 achieved ≥50% reduction from baseline in 7-day WI-NRS at Week 10 (coprimary endpoint). Extended open-label treatment was associated with further improvements in itch reduction and favourable changes in PN lesion activity as assessed by Prurigo Activity Score. Adverse events occurred predominantly during dose titration and were of mild-to-moderate severity. The safety profile did not change with extended open-label treatment. Conclusion: In adult subjects with PN, oral treatment with NAL-ER 162 mg twice daily provided measurable anti-pruritic efficacy in subjects completing ≥10 weeks of treatment and was well tolerated (ClinicalTrials.gov: NCT02174419). |
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| MeSH term(s) | Adult ; Double-Blind Method ; Gastrointestinal Diseases ; Humans ; Nalbuphine/adverse effects ; Prurigo/complications ; Prurigo/drug therapy ; Pruritus/chemically induced ; Pruritus/complications ; Pruritus/drug therapy ; Treatment Outcome | ||||||||||
| Chemical Substances | Nalbuphine (L2T84IQI2K) | ||||||||||
| Language | English | ||||||||||
| Publishing date | 2021-12-01 | ||||||||||
| Publishing country | England | ||||||||||
| Document type | Clinical Trial, Phase II ; Journal Article ; Multicenter Study ; Randomized Controlled Trial | ||||||||||
| ZDB-ID | 1128828-0 | ||||||||||
| ISSN | 1468-3083 ; 0926-9959 | ||||||||||
| ISSN (online) | 1468-3083 | ||||||||||
| ISSN | 0926-9959 | ||||||||||
| DOI | 10.1111/jdv.17816 | ||||||||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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