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A Study of Sativex® for Pain Relief in Patients With Advanced Malignancy (SPRAY)

This study has been completed.

Sponsored by: GW Pharmaceuticals Ltd.
Information provided by: GW Pharmaceuticals Ltd.
ClinicalTrials.gov Identifier: NCT00674609
  Purpose

The purpose of this study is to determine whether Sativex® and GW-2000-02 are effective in the management of subjects with intractable cancer-related pain.


Condition Intervention Phase
Palliative Care
Pain
Cancer
Drug: Placebo
Drug: Sativex®
Drug: GW-2000-02
Phase III

MedlinePlus related topics:   Cancer    Palliative Care   

Drug Information available for:   Tetrahydrocannabinol    Cannabis    GW-1000    Cannabidiol   

U.S. FDA Resources

Study Type:   Interventional
Study Design:   Supportive Care, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Parallel Assignment, Efficacy Study
Official Title:   A Double Blind, Randomized, Parallel Group, Placebo Controlled, Comparative Study of the Efficacy, Safety and Tolerability of Cannabis Based Medicine (CBM) Extracts in Patients With Cancer-Related Pain.

Further study details as provided by GW Pharmaceuticals Ltd.:

Primary Outcome Measures:
  • Measure of treatment efficacy was the change in pain score from baseline to end of treatment (week 2) and the use of breakthrough medication during the last three days of test treatment use in the study. [ Time Frame: Pain - end of 2 weeks; Breakthrough Medication - last three days of test treatment ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Use of regular maintenance medication [ Time Frame: End of 2 weeks ] [ Designated as safety issue: No ]
  • Sleep disturbance 0-10 NRS [ Time Frame: End of 2 weeks ] [ Designated as safety issue: No ]
  • Nausea 0-10 NRS [ Time Frame: End of 2 weeks ] [ Designated as safety issue: No ]
  • Memory 0-10 NRS [ Time Frame: End of 2 weeks ] [ Designated as safety issue: No ]
  • Appetite 0-10 NRS [ Time Frame: End of 2 weeks ] [ Designated as safety issue: No ]
  • Concentration 0-10 NRS [ Time Frame: End of 2 weeks ] [ Designated as safety issue: No ]
  • EORTC quality of life questionnaire (EORTC-QLQC30) [ Time Frame: End of 2 weeks ] [ Designated as safety issue: No ]
  • Brief Pain Inventory Short Form [ Time Frame: End of 2 weeks ] [ Designated as safety issue: No ]

Enrollment:   177
Study Start Date:   February 2002
Study Completion Date:   March 2004
Primary Completion Date:   February 2004 (Final data collection date for primary outcome measure)

Arms Assigned Interventions
A: Placebo Comparator Drug: Placebo
Containing colourants and excipients. Subjects received study medication delivered in 100 µl actuations by a pump action oromucosal spray. Maximum permitted dose was eight actuations in any three hour period and 48 actuations in 24 hours.
B: Experimental Drug: Sativex®
Containing D9 tetrahydrocannabinol (THC), 27 mg/ml: cannabidiol (CBD), 25 mg/ml. Subjects received study medication delivered in 100 µl actuations by a pump action oromucosal spray. Maximum permitted dose was eight actuations in any three hour period and 48 actuations (THC 130 mg:CBD 120 mg) in 24 hours.
C: Experimental Drug: GW-2000-02
Containing THC, 27 mg/ml, as extract of Cannabis sativa L. Subjects received study medication delivered in 100 µl actuations by a pump action oromucosal spray. Maximum permitted dose was eight actuations in any three hour period and 48 actuations (THC 130 mg) in 24 hours.

Detailed Description:

This is a two week (two days baseline and two weeks treatment period), multicentre, double blind, randomised, placebo controlled, parallel group study to evaluate the efficacy of Sativex® and GW-2000-02 in subjects with cancer-related pain. Subjects are screened to determine eligibility and completed a two-day baseline period. Subjects then return to the centre for assessment, randomisation and dose introduction. All subjects are allowed to continue using all their current medications, provided that the dose remains stable throughout the study period. Their progress is reviewed after seven to 10 days and at the end of the study (day 14 to 20), or upon withdrawal. Subjects in this study are given the opportunity to be enrolled in an open label extension study (GWEXT0101).

  Eligibility
Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No

Criteria

Inclusion Criteria:

  • Willing and able to give informed consent.
  • Male or female, age 18 years or above.
  • Diagnosed with cancer of any type, which is considered to be terminal.
  • Diagnosed with cancer-related pain which is not wholly alleviated with their current strong opioid treatment and whose level of pain measured on a NRS is ³four on at least one occasion per day, during the two day run-in period, leading up to visit 1.
  • On strong opioid maintenance therapy for at least seven days prior to the screening visit.
  • Willing to abstain from any use of cannabis during the study, other than the study medication.
  • No cannabinoids use (cannabis, Marinol® or Nabilone) for at least seven days before Visit 1 and willing to abstain from any use of cannabis during the study.
  • Clinically acceptable blood results at the screening visit.
  • Able (in the investigators opinion) and willing to undertake and comply with all study requirements.
  • Willing to allow their own general practitioner, and consultant if appropriate, to be informed of study participation.
  • Willing for the Home Office to be notified of his or her participation in the study (applicable to the UK centres only).

Exclusion Criteria:

  • Know history of substance misuse.
  • Known or suspected to have had an adverse reaction to cannabinoids causing psychosis or other severe psychiatric illness.
  • Received any epidural analgesia within 48 hours prior to study entry.
  • Either received, within two weeks of study entry, or due to receive chemotherapy or radiotherapy during the study.
  • Unable to give informed consent.
  • History of any type of schizophrenia, any other psychotic illness, a serious personality disorder, or other significant psychiatric illness other than depression associated with their chronic pain and/or in response to the underlying condition.
  • Currently taking levodopa (Sinemet®, Sinemet plus®, Levodopa®, L-dopa®, Madopar®, Benserazide®).
  • Had a serious cardiovascular disorder, including angina, uncontrolled hypertension, or an uncontrolled symptomatic cardiac arrhythmia.
  • Significant renal or hepatic impairment, who in the opinion of the investigator, were unsuitable for treatment with study medication.
  • History of epilepsy.
  • Had oral cavity cancers or whose previous treatments had included radiotherapy to the floor of the mouth.
  • Female subjects who were pregnant or lactating or of child-bearing potential and were inadequately protected against conception during the study and for three months thereafter.
  • Male subjects who were sexually active and who were not using adequate forms of contraception during the study and for three months thereafter.
  • Subjects who had participated in a clinical research study in the past four weeks, prior to study entry.
  • Planned travel outside the UK during the study (applicable to the UK centres only).
  • Subjects who, in the opinion of the investigator, were unsuitable to participate in the study for any other reason, not mentioned in the entry criteria.
  Contacts and Locations

Please refer to this study by its ClinicalTrials.gov identifier: NCT00674609

Locations
United Kingdom
Shropshire and Mid-Wales Hospice    
      Shrewsbury, United Kingdom, SY3 8HS

Sponsors and Collaborators
GW Pharmaceuticals Ltd.

Investigators
Principal Investigator:     Jeremy R Johnson, MB ChB     Shropshire and Mid-Wales Hospice    
  More Information


Responsible Party:   GW Pharmaceuticals Ltd. ( Mr Richard Potts/ Clinical Operations Director )
Study ID Numbers:   GWCA0101
First Received:   April 28, 2008
Last Updated:   July 10, 2008
ClinicalTrials.gov Identifier:   NCT00674609
Health Authority:   United Kingdom: Medicines and Healthcare Products Regulatory Agency;   Romania: National Medicines Agency;   Belgium: The Federal Public Service (FPS) Health, Food Chain Safety and Environment

Keywords provided by GW Pharmaceuticals Ltd.:
Palliative Care  
Pain  
Cancer  

Study placed in the following topic categories:
Tetrahydrocannabinol
Pain

ClinicalTrials.gov processed this record on October 23, 2008




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