Phase 3
Completed N=277
Long Term Safety and Efficacy Study of Tanezumab in Japanese Adult Subjects With Chronic Low Back Pain
Source: ClinicalTrials.gov NCT02725411 ↗Enrolled (actual)
277
Serious AEs
8.3%
Results posted
Aug 2020
Primary outcomePrimary: Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) — 70; 63; 67; 8 Participants
◆ Published Evidence
Emerging
11citations · ~3 / year
Tanezumab for chronic low back pain: a long-term, randomized, celecoxib-controlled Japanese Phase III safety study.
Summary
This study will investigate the long-term safety and efficacy of a fixed dose of tanezumab 5 mg and 10 mg administered subcutaneously (SC) seven times at 8 week intervals. The primary objective of this study is to evaluate the long term safety of tanezumab 5 mg and 10 mg administrated SC every 8 weeks (7 administrations). In addition, the study will evaluate the long term analgesic efficacy of tanezumab 5 mg and 10 mg SC administered every 8 weeks (7 administrations).
Linked Publications
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Tanezumab for chronic low back pain: a long-term, randomized, celecoxib-controlled Japanese Phase III safety study.
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) |
70; 63; 67; 8; 11; 4 | — |
| PRIMARY Number of Participants With Treatment-Emergent Treatment Related Adverse Events (AEs) and Serious Adverse Events (SAEs) |
11; 7; 12; 1; 1; 0 | — |
| PRIMARY Number of Participants With Clinically Significant Laboratory Test Abnormalities |
1; 0; 1 | — |
| PRIMARY Number of Participants With Clinically Significant Vital Signs Abnormalities |
4; 2; 5 | — |
| PRIMARY Number of Participants With Confirmed Orthostatic Hypotension From Baseline up to Week 80 |
0; 2; 0 | — |
| PRIMARY Change From Screening in Mean Total Symptom Impact Score as Per Survey of Autonomic Symptoms (SAS) at Week 24 |
0.76; 0.86; 1.10; 0.79; 0.93; 0.04 | — |
| PRIMARY Change From Screening in Mean Total Symptom Impact Score as Per Survey of Autonomic Symptoms (SAS) at Week 56 |
0.89; 0.86; 0.35 | — |
| PRIMARY Change From Screening in Mean Total Symptom Impact Scores as Per Survey of Autonomic Symptoms (SAS) at Week 80 |
0.69; 1.26; 0.72 | — |
| PRIMARY Change From Screening in Mean Total Symptom Impact Score as Per Survey of Autonomic Symptoms (SAS) at Early Termination Follow-up Visit 1 |
2.50; 0.82; 2.15 | — |
| PRIMARY Change From Screening in Mean Total Symptom Impact Scores as Per Survey of Autonomic Symptoms (SAS) at Early Termination Follow-up Visit 3 |
1.89; 1.60; 0.88 | — |
| PRIMARY Number of Participants With Clinically Significant Electrocardiogram (ECG) Assessments |
2; 0; 2 | — |
| PRIMARY Percentage of Participants With Individual Adjudicated Joint Safety Outcome/Event |
1; 0; 0; 0; 1; 0 | — |
| PRIMARY Observation Time-Adjusted Event Rate for an Individual Adjudicated Joint Safety Outcome/Event |
8.9; 0; 0; 0; 10.4; 0 | — |
| PRIMARY Percentage of Participants With At Least 1 Total Joint Replacement |
0; 1; 0 | — |
| PRIMARY Observation Time-Adjusted Event Rate for Total Joint Replacement (TJR) Event |
0; 10.4; 0 | — |
| PRIMARY Change From Baseline in Neuropathy Impairment Score (NIS) at Week 2 |
0.84; 1.01; 0.87; -0.04; -0.01; 0.11 | — |
| PRIMARY Change From Baseline in Neuropathy Impairment Score (NIS) at Week 4 |
-0.08; -0.02; 0.11 | — |
| PRIMARY Change From Baseline in Neuropathy Impairment Score (NIS) at Week 8 |
-0.04; 0.15; 0.13 | — |
| PRIMARY Change From Baseline in Neuropathy Impairment Score (NIS) at Week 16 |
-0.02; 0.05; 0.01 | — |
| PRIMARY Change From Baseline in Neuropathy Impairment Score (NIS) at Week 24 |
-0.02; 0.09; 0.28 | — |
| PRIMARY Change From Baseline in Neuropathy Impairment Score (NIS) at Week 32 |
0.00; -0.01; 0.04 | — |
| PRIMARY Change From Baseline in Neuropathy Impairment Score (NIS) at Week 40 |
0.14; 0.04; 0.04 | — |
| PRIMARY Change From Baseline in Neuropathy Impairment Score (NIS) at Week 48 |
0.09; -0.01; 0.04 | — |
| PRIMARY Change From Baseline in Neuropathy Impairment Score (NIS) at Week 56 |
0.09; -0.02; 0.04 | — |
| PRIMARY Change From Baseline in Neuropathy Impairment Score (NIS) at Week 64 |
0.18; 0.01; 0.04 | — |
| PRIMARY Change From Baseline in Neuropathy Impairment Score (NIS) at Week 80 |
0.03; 0.00; 0.17 | — |
| PRIMARY Largest Change From Baseline in Neuropathy Impairment Score (NIS) to Any Post-baseline Visit |
0.33; 0.37; 0.78 | — |
| PRIMARY Number of Participants With Anti Tanezumab Antibodies From Baseline up to Week 80 |
21; 41; 62 | — |
| PRIMARY Number of Participants With Abnormal Physical Examination Findings |
1; 0; 3; 2; 1; 0 | — |
| SECONDARY Change From Baseline in Average Low Back Pain Intensity (LBPI) at Weeks 2, 4, 8, 12, 16, 24, 32, 40, 48, and 56: Multiple Imputation |
-0.47; -0.69; -0.46; -0.83; -1.05; -0.56 | — |
| SECONDARY Change From Baseline in Average Low Back Pain Intensity (LBPI) at Week 64: Observed Data |
-3.60; -3.96; -3.46 | — |
| SECONDARY Change From Baseline in Roland-Morris Disability Questionnaire (RMDQ) Total Scores at Weeks 2, 4, 8, 16, 24, 32, 40, 48, and 56: Multiple Imputation |
-2.09; -2.09; -1.23; -2.41; -2.35; -1.89 | — |
| SECONDARY Change From Baseline in Roland-Morris Disability Questionnaire (RMDQ) Total Score at Week 64: Observed Data |
-4.55; -5.72; -5.02 | — |
| SECONDARY Change From Baseline in the Patient's Global Assessment (PGA) of Low Back Pain at Weeks 2, 4, 8, 16, 24, 32, 40, 48, 56 and 64 |
3.24; 3.14; 3.13; -0.43; -0.40; -0.28 | — |
| SECONDARY Percentage of Participants With Cumulative Percent Change From Baseline in Average Low Back Pain Intensity (LBPI) Score at Weeks 16, 24 and 56 |
89.1; 81.7; 81.5; 85.9; 77.4; 78.3 | — |
| SECONDARY Percentage of Participants With >=30 Percent (%), >=50%, >=70% and >=90% Reduction From Baseline in Weekly Average Low Back Pain Intensity (LBPI) Score at Weeks 16, 24, 40 and 56 |
71.7; 57.0; 58.7; 51.1; 35.5; 32.6 | — |
| SECONDARY Change From Baseline in Brief Pain Inventory-short Form (BPI-sf) Scores for Worst Pain at Weeks 2, 4, 8, 16, 24, 40, 56, and 64 |
-0.82; -0.81; -0.61; -1.25; -1.22; -0.95 | — |
| SECONDARY Change From Baseline in Brief Pain Inventory-short Form (BPI-sf) Scores for Average Pain at Weeks 2, 4, 8, 16, 24, 40, 56, and 64 |
-0.68; -0.78; -0.50; -1.12; -1.28; -1.01 | — |
| SECONDARY Change From Baseline in Brief Pain Inventory-short Form (BPI-sf) Scores for Pain Interference Index at Weeks 2, 4, 8, 16, 24, 40, 56, and 64 |
-0.98; -0.87; -0.78; -1.43; -1.32; -1.16 | — |
| SECONDARY Change From Baseline in Brief Pain Inventory-short Form (BPI-sf) Scores for Pain Interference With General Activity at Weeks 2, 4, 8, 16, 24, 40, 56, and 64 |
-1.10; -1.05; -0.67; -1.68; -1.54; -1.26 | — |
| SECONDARY Change From Baseline in Brief Pain Inventory-short Form (BPI-sf) Scores for Pain Interference With Walking Ability at Weeks 2, 4, 8, 16, 24, 40, 56, and 64 |
-0.89; -1.06; -0.73; -1.37; -1.23; -1.12 | — |
| SECONDARY Change From Baseline in Brief Pain Inventory-short Form (BPI-sf) Scores for Pain Interference With Sleep at Weeks 2, 4, 8, 16, 24, 40, 56, and 64 |
-1.02; -0.77; -0.59; -1.28; -1.37; -0.85 | — |
| SECONDARY Change From Baseline in Brief Pain Inventory-short Form (BPI-sf) Scores for Pain Interference With Normal Work at Weeks 2, 4, 8, 16, 24, 40, 56 and 64 |
-1.04; -1.17; -0.96; -1.49; -1.39; -1.30 | — |
| SECONDARY Percentage of Participants With Chronic Low Back Pain Responders Index at Weeks 16, 24, 40 and 56 |
54.3; 48.4; 50.0; 53.3; 45.2; 42.4 | — |
| SECONDARY Percentage of Participants Achieving Change of >=2 Points From Baseline in Patient's Global Assessment (PGA) of Low Back Pain at Weeks 16, 24, 40 and 56 |
17.4; 12.9; 16.3; 18.5; 15.1; 9.8 | — |
| SECONDARY European Quality of Life-5 Dimension-5 Levels (EQ-5D-5L): Dimensions Scores at Baseline, Weeks 16 and 56 |
2.3; 2.2; 2.3; 1.8; 1.6; 1.6 | — |
| SECONDARY European Quality of Life-5 Dimension-5 Levels (EQ-5D-5L): Overall Health Utility Score/ Index Value |
0.61; 0.62; 0.63; 0.76; 0.77; 0.76 | — |
| SECONDARY Change From Baseline in Work Productivity and Activity Impairment Questionnaire: Low Back Pain (WPAI:LBP)- Percent Work Time Missed Due to Chronic Low Back Pain at Weeks 16, 56 and 64 |
5.0; 5.7; 5.8; -0.8; -4.8; -1.9 | — |
| SECONDARY Change From Baseline in in Work Productivity and Activity Impairment Questionnaire: Low Back Pain (WPAI:LBP)- Percent Impairment While Working Due to Chronic Low Back Pain at Weeks 16, 56 and 64 |
55.4; 53.7; 56.4; -31.6; -24.7; -28.3 | — |
| SECONDARY Change From Baseline in Work Productivity and Activity Impairment Questionnaire: Low Back Pain (WPAI:LBP)- Percent Overall Work Impairment Due to Chronic Low Back Pain at Weeks 16, 56 and 64 |
56.0; 56.0; 57.2; -31.8; -26.8; -27.8 | — |
| SECONDARY Change From Baseline in Work Productivity and Activity Impairment Questionnaire: Low Back Pain (WPAI:LBP)- Percent Activity Impairment Due to Chronic Low Back Pain at Weeks 16, 56 and 64 |
57.8; 53.7; 54.7; -30.1; -25.0; -25.4 | — |
| SECONDARY Number of Participants Who Discontinued Due to Lack of Efficacy |
1; 4; 1 | — |
| SECONDARY Time to Discontinuation Due to Lack of Efficacy |
111; 15; 141; 111; 15; 141 | — |
| SECONDARY Number of Participants Who Took Rescue Medication During Weeks 2, 4, 8, 12, 16, 24, 32, 40, 48, 56 and 64: Observed Data |
36; 24; 33; 30; 23; 27 | — |
| SECONDARY Number of Participants Who Took Rescue Medication During Weeks 2, 4, 8, 12, 16, 24, 32, 40, 48 and 56: Last Observation Carried Forward (LOCF) |
37; 24; 33; 30; 24; 28 | — |
| SECONDARY Number of Days of Rescue Medication Use During Weeks 2, 4, 8, 12, 16, 24, 32, 40, 48, 56 and 64: Observed Data |
0.9; 0.8; 0.8; 0.8; 0.6; 0.7 | — |
| SECONDARY Number of Days of Rescue Medication Use During Weeks 2, 4, 8, 12, 16, 24, 32, 40, 48 and 56: LOCF |
1.0; 0.8; 0.8; 0.8; 0.6; 0.8 | — |
| SECONDARY Amount of Rescue Medication Used in Weeks 2, 4, 8, 12, and 16: Observed Data |
1029; 701; 809; 885; 440; 812 | — |
| SECONDARY Amount of Rescue Medication Used in Weeks 2, 4, 8, 12, and 16: LOCF |
1042; 701; 809; 885; 543; 821 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Visits of Services Received Directly Related to Low Back Pain |
4.9; 3.1; 4.1; 2.0; 3.0; 4.5 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Participants Visited to the Emergency Room Due to Low Back Pain |
0; 0; 0; 0; 0; 2 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Participants Hospitalized Due to Low Back Pain |
0; 1; 1; 1; 1; 1 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Nights Stayed in the Hospital Due to Low Back Pain |
24.0; 2.0; 1.0; 1.0; 2.0 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Participants Who Used Any Aids/Devices for Doing Things |
91; 91; 90; 1; 0; 0 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Participants Who Quit Job Due to Low Back Pain |
3; 2; 5; 1; 2; 1 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Duration Since Quitting Job Due to Low Back Pain |
1.5; 1.6; 2.5; 3.3; 0.7; 0.2 | — |
| SECONDARY Treatment Satisfaction Questionnaire for Medication Version II (TSQM v II) Scores at Weeks 16 and 56 |
61.41; 61.48; 58.05; 56.94; 80.56; 68.75 | — |
| SECONDARY Number of Participants Responding to Patient Reported Treatment Impact Assessment-Modified (mPRTI) at Weeks 16 and 56 for Willingness to Use Study Drug Again |
41; 37; 40; 28; 27; 25 | — |
| SECONDARY Number of Participants Responding to Patient Reported Treatment Impact Assessment-Modified (mPRTI) at Weeks 16 and 56 for Preference of Study Drug Versus Prior Treatment |
38; 33; 31; 25; 26; 30 | — |
Eligibility Criteria
Inclusion Criteria
- Duration of chronic low back pain for ≥3 months, and treatment with agents for low back pain for ≥3 months.
- Primary location of low back pain must be between the 12th thoracic vertebra and the lower gluteal folds, with or without radiation into the posterior thigh, classified as Category 1 or 2 according to the classification of the Quebec Task Force in Spinal Disorders.
- Subjects must be experiencing some benefits from their current stable dose regimen of oral NSAID (celecoxib, loxoprofen or meloxicam) treatment as described in the protocol, be tolerating their NSAID regimen, be taking this medication regularly during the 30 day period prior to the Screening visit and must have had some improvement in low back pain, but still require additional pain relief at Screening.
- Subjects must maintain a stabilized, protocol specified NSAID dose regimen for at least the final 2 or 3 weeks of the Screening period.
- Low Back Pain Intensity (LBPI) score of ≥5 at Screening.
- Subjects must be willing to discontinue all pain medications for chronic low back pain except rescue medication and investigational product and not use prohibited pain medications throughout the duration of the study.
- Female subjects of childbearing potential and at risk for pregnancy must agree to comply with protocol specified contraceptive requirements.
Exclusion Criteria
- Subjects exceeding protocol defined BMI limits.
- Diagnosis of osteoarthritis of the knee or hip as defined by the ACR combined clinical and radiographic criteria.
- Subjects who have Kellgren Lawrence Grade > or =2 radiographic evidence of hip or Grade > or =3 radiographic evidence of knee osteoarthritis will be excluded.
- Subjects who have Kellgren Lawrence Grade < or =2 radiographic evidence of knee osteoarthritis but who do not meet ACR criteria and do not have pain associated with their knee osteoarthritis will be allowed.
- Subjects with symptoms and radiologic findings consistent with osteoarthritis in the shoulder.
- History of lumbosacral radiculopathy within the past 2 years, history of spinal stenosis associated with neurological impairment, or history of neurogenic claudication.
- Back pain due to recent major trauma within 6 months prior to Screening.
- Surgical intervention during the past 6 months for the treatment of low back pain.
- Planned surgical procedure during the duration of the study.
- History or radiographic evidence of other diseases that could confound efficacy or safety assessments (eg, rheumatoid arthritis).
- History or radiographic evidence of orthopedic conditions that may increase the risk of, or confound assessment of joint safety conditions during the study.
- History of osteonecrosis or osteoporotic fracture.
- History of significant trauma or surgery to a knee, hip, or shoulder within the previous year.
- Signs or symptoms of carpal tunnel syndrome in the one year prior to Screening.
- Considered unfit for surgery based upon American Society of Anesthesiologists physical classification system for surgery grading, or subjects who would not be willing to undergo joint replacement surgery if required.
- History of intolerance or hypersensitivity to celecoxib/acetaminophen or any of its excipients or existence of a medical condition or use of concomitant medication for which the use of celecoxib/acetaminophen is contraindicated.
- Use of prohibited medications or prohibited non-pharmacological treatments without the appropriate washout period (if applicable) prior to Screening or IPAP.
- History of known alcohol, analgesic or narcotic abuse within 2 years of Screening.
- Presence of drugs of abuse or illegal drugs in the urine toxicology screen obtained at Screening.
- History of allergic or anaphylactic reaction to a therapeutic or diagnostic monoclonal antibody or IgG-fusion protein.
- Signs and symptoms of clinically significant cardiac disease.
- Poorly controlled hypertension as defined in the protocol or taking an antih
Data sourced from ClinicalTrials.gov (NCT02725411) and the linked publication. Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication. Informational only — not medical advice.