Literature DB >> 21677899

A randomized, double-blind, placebo-controlled study to assess the efficacy and tolerability of gabapentin enacarbil in subjects with restless legs syndrome.

Daniel O Lee1, Ronald B Ziman, A Thomas Perkins, J Steven Poceta, Arthur S Walters, Ronald W Barrett.   

Abstract

STUDY
OBJECTIVE: To evaluate the efficacy and tolerability of gabapentin enacarbil (GEn) 1200 mg or 600 mg compared with placebo in subjects with moderate-to-severe primary restless legs syndrome (RLS).
METHODS: This 12-week, multicenter, double-blind, placebo-controlled study randomized subjects (1:1:1) to GEn 1200 mg, 600 mg, or placebo. Co-primary endpoints: mean change from baseline in International Restless Legs Scale (IRLS) total score and proportion of responders (rated as "very much" or "much" improved) on the investigator-rated Clinical Global Impression-Improvement scale (CGI-I) at Week 12 LOCF for GEn 1200 mg compared with placebo. Secondary endpoints included GEn 600 mg compared with placebo on the IRLS and CGI-I at Week 12 LOCF and subjective measures for sleep. Safety and tolerability assessments included adverse events.
RESULTS: 325 subjects were randomized (GEn 1200 mg = 113; 600 mg = 115; placebo = 97). GEn 1200 mg significantly improved mean [SD] IRLS total score at Week 12 LOCF (baseline: 23.2 [5.32]; Week 12: 10.2 [8.03]) compared with placebo (baseline: 23.8 [4.58]; Week 12: 14.0 [7.87]; adjusted mean treatment difference [AMTD]: -3.5; p = 0.0015), and significantly more GEn 1200 mg-treated (77.5%) than placebo-treated (44.8%) subjects were CGI-I responders (p < 0.0001). Similar significant results were observed with GEn 600 mg for IRLS (AMTD: -4.3; p < 0.0001) and CGI-I (72.8% compared with 44.8%; p < 0.0001). GEn also significantly improved sleep outcomes (Post-Sleep Questionnaire, Pittsburgh Sleep Diary and Medical Outcomes Sleep Scale) compared with placebo. The most commonly reported adverse events were somnolence (GEn 1200 mg = 18.0%; 600 mg = 21.7%; placebo = 2.1%) and dizziness (GEn 1200 mg = 24.3%; 600 mg = 10.4%; placebo = 5.2%). Dizziness increased with increased dose and led to discontinuation in 2 subjects (GEn 1200 mg, n = 1; GEn 600 mg, n = 1). Somnolence led to discontinuation in 3 subjects (GEn 600 mg).
CONCLUSIONS: GEn 1200 mg and 600 mg significantly improve RLS symptoms and sleep disturbance compared with placebo and are generally well tolerated.

Entities:  

Keywords:  GSK1838262; Gabapentin enacarbil; PIVOT RLS II; XP13512; restless legs syndrome

Mesh:

Substances:

Year:  2011        PMID: 21677899      PMCID: PMC3113968          DOI: 10.5664/JCSM.1074

Source DB:  PubMed          Journal:  J Clin Sleep Med        ISSN: 1550-9389            Impact factor:   4.062


  33 in total

1.  Treatment of idiopathic restless legs syndrome (RLS) with gabapentin.

Authors:  S Happe; G Klösch; B Saletu; J Zeitlhofer
Journal:  Neurology       Date:  2001-11-13       Impact factor: 9.910

2.  Gabapentin enacarbil in restless legs syndrome: a phase 2b, 2-week, randomized, double-blind, placebo-controlled trial.

Authors:  Arthur S Walters; William G Ondo; Clete A Kushida; Philip M Becker; Aaron L Ellenbogen; Daniel M Canafax; Ronald W Barrett
Journal:  Clin Neuropharmacol       Date:  2009 Nov-Dec       Impact factor: 1.592

3.  Inter- and intra-subject variability in gabapentin absorption and absolute bioavailability.

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4.  XP13512 [(+/-)-1-([(alpha-isobutanoyloxyethoxy)carbonyl] aminomethyl)-1-cyclohexane acetic acid], a novel gabapentin prodrug: II. Improved oral bioavailability, dose proportionality, and colonic absorption compared with gabapentin in rats and monkeys.

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5.  XP13512 [(+/-)-1-([(alpha-isobutanoyloxyethoxy)carbonyl] aminomethyl)-1-cyclohexane acetic acid], a novel gabapentin prodrug: I. Design, synthesis, enzymatic conversion to gabapentin, and transport by intestinal solute transporters.

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6.  Pharmacokinetics and metabolism of gabapentin in rat, dog and man.

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9.  A saturable transport mechanism in the intestinal absorption of gabapentin is the underlying cause of the lack of proportionality between increasing dose and drug levels in plasma.

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10.  Test-retest reliability and validity of the Pittsburgh Sleep Quality Index in primary insomnia.

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  36 in total

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Authors:  Paul Yeh; Arthur S Walters; John W Tsuang
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Review 2.  Therapies for Restless Legs in Parkinson's Disease.

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4.  Restless legs syndrome: pathophysiology and treatment.

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Review 6.  Restless Legs Syndrome and Other Movement Disorders of Sleep-Treatment Update.

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7.  Dose response of Gabapentin Enacarbil versus placebo in subjects with moderate-to-severe primary restless legs syndrome: an integrated analysis of three 12-week studies.

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Review 9.  Treatment of restless legs syndrome.

Authors:  Cynthia L Comella
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10.  The Effect of Gabapentin Enacarbil on Quality of Life and Mood Outcomes in a Pooled Population of Adult Patients with Moderate-to-Severe Primary Restless Legs Syndrome.

Authors:  Alon Y Avidan; Daniel Lee; Margaret Park; Mark J Jaros; Gwendoline Shang; Richard Kim
Journal:  CNS Drugs       Date:  2016-04       Impact factor: 5.749

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