메뉴 건너뛰기




Volumn 33, Issue 4, 2012, Pages 689-699

Early phase drug development for treatment of chronic pain - Options for clinical trial and program design

Author keywords

Adaptive dosing; Chronic pain; Clinical trial; Dose titration; Drug development; Enriched enrolment

Indexed keywords

ANALGESIC AGENT; AZD 1386; GABAPENTIN; NONSTEROID ANTIINFLAMMATORY AGENT; PLACEBO; PREGABALIN; UNCLASSIFIED DRUG; VANILLOID RECEPTOR 1 ANTAGONIST;

EID: 84861530688     PISSN: 15517144     EISSN: 15592030     Source Type: Journal    
DOI: 10.1016/j.cct.2012.02.013     Document Type: Review
Times cited : (10)

References (54)
  • 2
    • 77955326429 scopus 로고    scopus 로고
    • Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment
    • Baron R., Binder A., Wasner G. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol 2010, 9:807-819.
    • (2010) Lancet Neurol , vol.9 , pp. 807-819
    • Baron, R.1    Binder, A.2    Wasner, G.3
  • 3
    • 0031742603 scopus 로고    scopus 로고
    • Postherpetic neuralgia: irritable nociceptors and deafferentation
    • Fields H.L., Rowbotham M., Baron R. Postherpetic neuralgia: irritable nociceptors and deafferentation. Neurobiol Dis 1998, 5:209-227.
    • (1998) Neurobiol Dis , vol.5 , pp. 209-227
    • Fields, H.L.1    Rowbotham, M.2    Baron, R.3
  • 4
    • 77955327981 scopus 로고    scopus 로고
    • Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): somatosensory abnormalities in 1236 patients with different neuropathic pain syndromes
    • Maier C., Baron R., Tölle T.R., Binder A., Birbaumer N., Birklein F., et al. Quantitative sensory testing in the German Research Network on Neuropathic Pain (DFNS): somatosensory abnormalities in 1236 patients with different neuropathic pain syndromes. Pain 2010, 150:439-450.
    • (2010) Pain , vol.150 , pp. 439-450
    • Maier, C.1    Baron, R.2    Tölle, T.R.3    Binder, A.4    Birbaumer, N.5    Birklein, F.6
  • 5
    • 0037333776 scopus 로고    scopus 로고
    • Translation of symptoms and signs into mechanisms in neuropathic pain
    • Jensen T.S., Baron R. Translation of symptoms and signs into mechanisms in neuropathic pain. Pain 2003, 102:1-8.
    • (2003) Pain , vol.102 , pp. 1-8
    • Jensen, T.S.1    Baron, R.2
  • 6
    • 34249031812 scopus 로고    scopus 로고
    • Usefulness and limitations of quantitative sensory testing: clinical and research applications in neuropathic pain states
    • Hansson P., Backonja M., Bouhassira D. Usefulness and limitations of quantitative sensory testing: clinical and research applications in neuropathic pain states. Pain 2007, 129:256-259.
    • (2007) Pain , vol.129 , pp. 256-259
    • Hansson, P.1    Backonja, M.2    Bouhassira, D.3
  • 7
    • 77951767278 scopus 로고    scopus 로고
    • Research design considerations for confirmatory chronic pain clinical trials: IMMPACT recommendations
    • Dworkin R.H., Turk D.C., Peirce-Sandner S., Baron R., Bellamy N., Burke L.B., et al. Research design considerations for confirmatory chronic pain clinical trials: IMMPACT recommendations. Pain 2010, 149:177-193.
    • (2010) Pain , vol.149 , pp. 177-193
    • Dworkin, R.H.1    Turk, D.C.2    Peirce-Sandner, S.3    Baron, R.4    Bellamy, N.5    Burke, L.B.6
  • 8
    • 19444384710 scopus 로고    scopus 로고
    • Human surrogate models of neuropathic pain
    • Klein T., Magerl W., Rolke R., Treede R.-D. Human surrogate models of neuropathic pain. Pain 2005, 115:227-233.
    • (2005) Pain , vol.115 , pp. 227-233
    • Klein, T.1    Magerl, W.2    Rolke, R.3    Treede, R.-D.4
  • 9
    • 77955590146 scopus 로고    scopus 로고
    • The evidence for pharmacological treatment of neuropathic pain
    • Finnerup N.B., Sindrup S.H., Jensen T.S. The evidence for pharmacological treatment of neuropathic pain. Pain 2010, 150:573-581.
    • (2010) Pain , vol.150 , pp. 573-581
    • Finnerup, N.B.1    Sindrup, S.H.2    Jensen, T.S.3
  • 11
    • 33751531514 scopus 로고    scopus 로고
    • Short-term efficacy of pharmacotherapeutic interventions in osteoarthritic knee pain: a meta-analysis of randomised placebo-controlled trials
    • Bjordal J.M., Klovning A., Ljunggren A.E., Slordal L. Short-term efficacy of pharmacotherapeutic interventions in osteoarthritic knee pain: a meta-analysis of randomised placebo-controlled trials. Eur J Pain 2007, 11:125-138.
    • (2007) Eur J Pain , vol.11 , pp. 125-138
    • Bjordal, J.M.1    Klovning, A.2    Ljunggren, A.E.3    Slordal, L.4
  • 12
    • 0016801215 scopus 로고
    • A clinical trial design avoiding undue placebo treatment
    • Amery W., Dony J. A clinical trial design avoiding undue placebo treatment. J Clin Pharmacol 1975, 15:674-679.
    • (1975) J Clin Pharmacol , vol.15 , pp. 674-679
    • Amery, W.1    Dony, J.2
  • 13
    • 0027452136 scopus 로고
    • Single-dose, randomized, double-blind, double-dummy, cross-over comparison of extradural and i.v. clonidine in chronic pain
    • Carroll D., Jadad A., King L., Wiffen P., Glynn C., McQuay H. Single-dose, randomized, double-blind, double-dummy, cross-over comparison of extradural and i.v. clonidine in chronic pain. Br J Anaesth 1993, 71:665-669.
    • (1993) Br J Anaesth , vol.71 , pp. 665-669
    • Carroll, D.1    Jadad, A.2    King, L.3    Wiffen, P.4    Glynn, C.5    McQuay, H.6
  • 14
    • 0028943895 scopus 로고
    • Transdermal clonidine compared to placebo in painful diabetic neuropathy using a two-stage "enriched enrollment" design
    • Byas-Smith M.G., Max M.B., Muir J., Kingman A. Transdermal clonidine compared to placebo in painful diabetic neuropathy using a two-stage "enriched enrollment" design. Pain 1995, 60:267-274.
    • (1995) Pain , vol.60 , pp. 267-274
    • Byas-Smith, M.G.1    Max, M.B.2    Muir, J.3    Kingman, A.4
  • 15
    • 40049083562 scopus 로고    scopus 로고
    • Enriched enrolment with randomised withdrawal (EERW): time for a new look at clinical trial design in chronic pain
    • McQuay H.J., Derry S., Moore R.A., Poulain P., Legout V. Enriched enrolment with randomised withdrawal (EERW): time for a new look at clinical trial design in chronic pain. Pain 2008, 135:217-220.
    • (2008) Pain , vol.135 , pp. 217-220
    • McQuay, H.J.1    Derry, S.2    Moore, R.A.3    Poulain, P.4    Legout, V.5
  • 16
    • 0019850758 scopus 로고
    • Methodological problems in studies of depressive disorder: utility of the discontinuation design
    • Quitkin F.M., Rabkin J.G. Methodological problems in studies of depressive disorder: utility of the discontinuation design. J Clin Psychopharmacol 1981, 1:283-288.
    • (1981) J Clin Psychopharmacol , vol.1 , pp. 283-288
    • Quitkin, F.M.1    Rabkin, J.G.2
  • 17
    • 0037112181 scopus 로고    scopus 로고
    • Randomized discontinuation design: application to cytostatic antineoplastic agents
    • Rosner G.L., Stadler W., Ratain M.J. Randomized discontinuation design: application to cytostatic antineoplastic agents. J Clin Oncol 2002, 20:4478-4484.
    • (2002) J Clin Oncol , vol.20 , pp. 4478-4484
    • Rosner, G.L.1    Stadler, W.2    Ratain, M.J.3
  • 18
    • 72249114042 scopus 로고    scopus 로고
    • Two-stage enriched enrolment pain trials: a brief review of designs and opportunities for broader application
    • Quessy S.N. Two-stage enriched enrolment pain trials: a brief review of designs and opportunities for broader application. Pain 2010, 148:8-13.
    • (2010) Pain , vol.148 , pp. 8-13
    • Quessy, S.N.1
  • 19
    • 79951671590 scopus 로고    scopus 로고
    • Pregabalin for peripheral neuropathic pain: a multicenter, enriched enrollment randomized withdrawal placebo-controlled trial
    • Gilron I., Wajsbrot D., Therrien F., Lemay J. Pregabalin for peripheral neuropathic pain: a multicenter, enriched enrollment randomized withdrawal placebo-controlled trial. Clin J Pain 2011, 27:185-193.
    • (2011) Clin J Pain , vol.27 , pp. 185-193
    • Gilron, I.1    Wajsbrot, D.2    Therrien, F.3    Lemay, J.4
  • 20
    • 77954641010 scopus 로고    scopus 로고
    • Pregabalin in the treatment of neuropathic pain: a randomised double-blind trial
    • van Seventer R., Bach F.W., Toth C.C., Serpell M., Temple J., Murphy T.K., et al. Pregabalin in the treatment of neuropathic pain: a randomised double-blind trial. Eur J Neurol 2010, 17:1082-1089.
    • (2010) Eur J Neurol , vol.17 , pp. 1082-1089
    • van Seventer, R.1    Bach, F.W.2    Toth, C.C.3    Serpell, M.4    Temple, J.5    Murphy, T.K.6
  • 21
    • 0032954053 scopus 로고    scopus 로고
    • Topical lidocaine patch relieves postherpetic neuralgia more effectively than a vehicle topical patch: results of an enriched enrollment study
    • Galer B.S., Rowbotham M.C., Perander J., Friedman E. Topical lidocaine patch relieves postherpetic neuralgia more effectively than a vehicle topical patch: results of an enriched enrollment study. Pain 1999, 80:533-538.
    • (1999) Pain , vol.80 , pp. 533-538
    • Galer, B.S.1    Rowbotham, M.C.2    Perander, J.3    Friedman, E.4
  • 22
    • 43549104210 scopus 로고    scopus 로고
    • Fibromyalgia relapse evaluation and efficacy fro durability of meaningful relief (FREEDOM): a 6-month, double-blind, placebo-controlled trial with pregabalin
    • Crofford L.J., Mease P.J., Simpson S.L., Young J.P., Martin S.A., Haig G.M., et al. Fibromyalgia relapse evaluation and efficacy fro durability of meaningful relief (FREEDOM): a 6-month, double-blind, placebo-controlled trial with pregabalin. Pain 2008, 136:419-436.
    • (2008) Pain , vol.136 , pp. 419-436
    • Crofford, L.J.1    Mease, P.J.2    Simpson, S.L.3    Young, J.P.4    Martin, S.A.5    Haig, G.M.6
  • 23
    • 44649161550 scopus 로고    scopus 로고
    • Enriched enrolment: definition of effects of enrichment and dose in trials of pregabalin and gabapentin in neuropathic pain. A systematic review
    • Straube S., Derry S., McQuay H.J., Moore A.M. Enriched enrolment: definition of effects of enrichment and dose in trials of pregabalin and gabapentin in neuropathic pain. A systematic review. BJCP 2008, 66:266-275.
    • (2008) BJCP , vol.66 , pp. 266-275
    • Straube, S.1    Derry, S.2    McQuay, H.J.3    Moore, A.M.4
  • 24
    • 0034940415 scopus 로고    scopus 로고
    • Stratification of flare intensity identifies placebo responders in a treatment efficacy trial of patients with osteoarthritis
    • Scott-Lennox J.A., McLaughlin-Miley C., Lennox R.D., Bohlig A.M., Cutler B.L., Yan C., et al. Stratification of flare intensity identifies placebo responders in a treatment efficacy trial of patients with osteoarthritis. Arthritis Rheum 2001, 44:1599-1607.
    • (2001) Arthritis Rheum , vol.44 , pp. 1599-1607
    • Scott-Lennox, J.A.1    McLaughlin-Miley, C.2    Lennox, R.D.3    Bohlig, A.M.4    Cutler, B.L.5    Yan, C.6
  • 25
    • 0032054226 scopus 로고    scopus 로고
    • Threats to the validity of clinical trials employing enrichment strategies for sample selection
    • Leber P.D., Davis C.S. Threats to the validity of clinical trials employing enrichment strategies for sample selection. Control Clin Trials 1998, 19:178-187.
    • (1998) Control Clin Trials , vol.19 , pp. 178-187
    • Leber, P.D.1    Davis, C.S.2
  • 26
    • 43549113560 scopus 로고    scopus 로고
    • Long-term trials of pregabalin and duloxetine for fibromyalgia symptoms: how study designs can affect placebo factors
    • Staud R., Price D.D. Long-term trials of pregabalin and duloxetine for fibromyalgia symptoms: how study designs can affect placebo factors. Pain 2008, 136:232-234.
    • (2008) Pain , vol.136 , pp. 232-234
    • Staud, R.1    Price, D.D.2
  • 27
    • 50249189344 scopus 로고    scopus 로고
    • Placebo response in neuropathic pain trials
    • Quessy S.N., Rowbotham M.C. Placebo response in neuropathic pain trials. Pain 2008, 138:479-483.
    • (2008) Pain , vol.138 , pp. 479-483
    • Quessy, S.N.1    Rowbotham, M.C.2
  • 30
    • 20644431597 scopus 로고    scopus 로고
    • Efficacy and safety of opioid agonists in the treatment of neuropathic pain of nonmalignant origin: systematic review and meta-analysis of randomized controlled trials
    • Eisenberg E., McNicol E.D., Carr D.B. Efficacy and safety of opioid agonists in the treatment of neuropathic pain of nonmalignant origin: systematic review and meta-analysis of randomized controlled trials. JAMA 2005, 293:3043-3052.
    • (2005) JAMA , vol.293 , pp. 3043-3052
    • Eisenberg, E.1    McNicol, E.D.2    Carr, D.B.3
  • 32
    • 0029033654 scopus 로고
    • Influence of confounding factors on designs for dose-effect relationship estimates
    • Girard P., Boissel J.P. Influence of confounding factors on designs for dose-effect relationship estimates. Stat Med 1995, 14:987-1005.
    • (1995) Stat Med , vol.14 , pp. 987-1005
    • Girard, P.1    Boissel, J.P.2
  • 33
    • 0032477294 scopus 로고    scopus 로고
    • Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus
    • Backonja M., Beydoun A., Edwards K.R., Schwartz S.L., Fonseca V., Hes M., et al. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus. JAMA 1998, 280:1831-1836.
    • (1998) JAMA , vol.280 , pp. 1831-1836
    • Backonja, M.1    Beydoun, A.2    Edwards, K.R.3    Schwartz, S.L.4    Fonseca, V.5    Hes, M.6
  • 34
    • 41749093436 scopus 로고    scopus 로고
    • Pregabalin in patients with central neuropathic pain: a randomized, double-blind, placebo-controlled trial of a flexible-dose regimen
    • Vranken J.H., Dijkgraaf M.G., Kruis M.R., van der Vegt M.H., Hollmann M.W., Heesen M. Pregabalin in patients with central neuropathic pain: a randomized, double-blind, placebo-controlled trial of a flexible-dose regimen. Pain 2008, 136:150-157.
    • (2008) Pain , vol.136 , pp. 150-157
    • Vranken, J.H.1    Dijkgraaf, M.G.2    Kruis, M.R.3    van der Vegt, M.H.4    Hollmann, M.W.5    Heesen, M.6
  • 35
    • 19444362218 scopus 로고    scopus 로고
    • Efficacy of pregabalin in neuropathic pain evaluated in a 12-week, randomised, double-blind, multi-centre, placebo-controlled trial of flexible- and fixed-dose regimens
    • Freynhagen R., Strojek K., Griesing T., Whalen E., Balkenohl M. Efficacy of pregabalin in neuropathic pain evaluated in a 12-week, randomised, double-blind, multi-centre, placebo-controlled trial of flexible- and fixed-dose regimens. Pain 2005, 115:254-263.
    • (2005) Pain , vol.115 , pp. 254-263
    • Freynhagen, R.1    Strojek, K.2    Griesing, T.3    Whalen, E.4    Balkenohl, M.5
  • 37
    • 0026087226 scopus 로고
    • A simulation study comparing designs for dose ranging
    • Sheiner L.B., Hashimoto Y., Beal S. A simulation study comparing designs for dose ranging. Stat Med 1991, 10:303-321.
    • (1991) Stat Med , vol.10 , pp. 303-321
    • Sheiner, L.B.1    Hashimoto, Y.2    Beal, S.3
  • 38
    • 28244484349 scopus 로고    scopus 로고
    • Getting the dose right: Report from the tenth European Federation of Pharmaceutical Sciences (EUFEPS) conference on optimizing drug development
    • Stanski D.R., Rowland M., Sheiner L.B. Getting the dose right: Report from the tenth European Federation of Pharmaceutical Sciences (EUFEPS) conference on optimizing drug development. J Pharmacokinet Pharmacodyn 2005, 32:199-211.
    • (2005) J Pharmacokinet Pharmacodyn , vol.32 , pp. 199-211
    • Stanski, D.R.1    Rowland, M.2    Sheiner, L.B.3
  • 39
    • 0025727995 scopus 로고
    • Population dose-response relationships determined from efficacy trials: the antihypertensive effect of atenonol and betaxolol
    • Sambol N.C., Clementi W.A., Sheiner L.B. Population dose-response relationships determined from efficacy trials: the antihypertensive effect of atenonol and betaxolol. J Pharmacokinet Biopharm 1991, 19(Suppl. 3):79S-91S.
    • (1991) J Pharmacokinet Biopharm , vol.19 , Issue.SUPPL. 3
    • Sambol, N.C.1    Clementi, W.A.2    Sheiner, L.B.3
  • 43
    • 36248961734 scopus 로고    scopus 로고
    • Innovative approaches for designing and analyzing adaptive dose-ranging trials
    • Bornkamp B., Bretz F., Dmitrienko A., Enas G., Gaydos B., Hsu C.H., et al. Innovative approaches for designing and analyzing adaptive dose-ranging trials. J Biopharm Stat 2007, 17:965-995.
    • (2007) J Biopharm Stat , vol.17 , pp. 965-995
    • Bornkamp, B.1    Bretz, F.2    Dmitrienko, A.3    Enas, G.4    Gaydos, B.5    Hsu, C.H.6
  • 45
    • 84861527242 scopus 로고    scopus 로고
    • Adaptive and model-based dose-ranging trials: quantitative evaluation and recommendations
    • and 466-468
    • Pinheiro J., Sax F., Antonijevic Z., Bornkamp B., Bretz F., Chuang-Stein C., et al. Adaptive and model-based dose-ranging trials: quantitative evaluation and recommendations. Stat Biopharm Res 2010, 2:435-454. and 466-468.
    • (2010) Stat Biopharm Res , vol.2 , pp. 435-454
    • Pinheiro, J.1    Sax, F.2    Antonijevic, Z.3    Bornkamp, B.4    Bretz, F.5    Chuang-Stein, C.6
  • 46
    • 84861526783 scopus 로고    scopus 로고
    • Guidance for Industry: Adaptive Design Clinical Trials for Drugs and Biologics
    • Available from URL:, Accessed 2011 Aug 28, US Food and Drug Administration
    • US Food and Drug Administration Guidance for Industry: Adaptive Design Clinical Trials for Drugs and Biologics. Draft Guidance February 2010 [online] February 2010, Available from URL:, Accessed 2011 Aug 28. http://www.fda.gov/downloads/Drugs/guidancecomplianceregulatoryinformation/guidances/ucm201790.pdf.
    • (2010) Draft Guidance February 2010 [online]
  • 47
    • 33644897345 scopus 로고    scopus 로고
    • Implementation of a Bayesian adaptive design in a proof of concept study
    • Smith M.K., Jones I., Morris M.F., Grieve A.P., Tan K. Implementation of a Bayesian adaptive design in a proof of concept study. Pharm Stat 2006, 5:39-50.
    • (2006) Pharm Stat , vol.5 , pp. 39-50
    • Smith, M.K.1    Jones, I.2    Morris, M.F.3    Grieve, A.P.4    Tan, K.5
  • 48
    • 84908120149 scopus 로고    scopus 로고
    • A phase II randomized controlled trial evaluating the efficacy and safety of the TRPV1 antagonist AZD1386 in osteoarthritis of the knee
    • Poster nr. PM379 [online]. Available from URL:, [Accessed 2011 Aug 28]
    • Svensson O., Thorne C., Miller F., Björnsson M., Reimfelt A., Karlsten R. A phase II randomized controlled trial evaluating the efficacy and safety of the TRPV1 antagonist AZD1386 in osteoarthritis of the knee. Abstracts 13th World Congress on Pain, Montreal 2010 2010, Poster nr. PM379 [online]. Available from URL:, [Accessed 2011 Aug 28]. http://iasp.omnibooksonline.com/2010/.
    • (2010) Abstracts 13th World Congress on Pain, Montreal 2010
    • Svensson, O.1    Thorne, C.2    Miller, F.3    Björnsson, M.4    Reimfelt, A.5    Karlsten, R.6
  • 49
    • 36248951724 scopus 로고    scopus 로고
    • Optimal designs for estimating the interesting part of a dose-effect curve
    • Miller F., Guilbaud O., Dette H. Optimal designs for estimating the interesting part of a dose-effect curve. J Biopharm Stat 2007, 17:1097-1115.
    • (2007) J Biopharm Stat , vol.17 , pp. 1097-1115
    • Miller, F.1    Guilbaud, O.2    Dette, H.3
  • 50
    • 54549109142 scopus 로고    scopus 로고
    • A comparison of methods for adaptive treatment selection
    • Friede T., Stallard N. A comparison of methods for adaptive treatment selection. Biom J 2008, 50:767-781.
    • (2008) Biom J , vol.50 , pp. 767-781
    • Friede, T.1    Stallard, N.2
  • 51
    • 42449156446 scopus 로고    scopus 로고
    • Adaptive Dunnett tests for treatment selection
    • Koenig F., Brannath W., Bretz F., Posch M. Adaptive Dunnett tests for treatment selection. Stat Med 2008, 27:1612-1625.
    • (2008) Stat Med , vol.27 , pp. 1612-1625
    • Koenig, F.1    Brannath, W.2    Bretz, F.3    Posch, M.4
  • 52
    • 77958565657 scopus 로고    scopus 로고
    • Adaptive dose-finding: Proof of Concept with type I error control
    • Miller F. Adaptive dose-finding: Proof of Concept with type I error control. Biom J 2010, 52:577-589.
    • (2010) Biom J , vol.52 , pp. 577-589
    • Miller, F.1
  • 53
    • 85018265198 scopus 로고    scopus 로고
    • Committee for Medicinal Products for Human Use
    • Doc. ref. CHMP/EWP/2459/02 [online]. Available from URL:, [Accessed 2011 Aug 28], EuropeanMedicinesAgency
    • EuropeanMedicinesAgency Committee for Medicinal Products for Human Use. Reflection paper on methodological issues in confirmatory clinical trials planned with an adaptive design October 2007, Doc. ref. CHMP/EWP/2459/02 [online]. Available from URL:, [Accessed 2011 Aug 28]. http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_guideline/2009/09/WC500003616.pdf.
    • (2007) Reflection paper on methodological issues in confirmatory clinical trials planned with an adaptive design


* 이 정보는 Elsevier사의 SCOPUS DB에서 KISTI가 분석하여 추출한 것입니다.