Evidence map›Paper›PMID 32150255›Full record

Trial reportPain medicine (Malden, Mass.)2020

Measuring Opioid Withdrawal in a Phase 3 Study of a New Analgesic, NKTR-181 (Oxycodegol), in Patients with Moderate to Severe Chronic Low Back Pain.

Jack E Henningfield, Jeffrey Gudin, Richard Rauck, Joseph Gimbel, Mary Tagliaferri, Stephen K Doberstein, Carlo Di Fonzo, Lin Lu, Nathaniel Katz, Suresh Siddhanti and 1 more

Open access · bronzeAbstract readClinical Trial, Phase IIIRandomized Controlled Trial
In one paragraph

Trial report in Pain medicine (Malden, Mass.), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.1field-weighted citation impact, top 24% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 8 citations in OpenAlex.

  1. French-Canadian Translation and Cultural Adaptation of the Clinical Opiate Withdrawal Scale: The COWS-FC.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2022
    Article
  2. Frontiers in pain research (Lausanne, Switzerland) · 2021
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Jack E HenningfieldPinney Associates, Bethesda, Maryland.
Jeffrey GudinEnglewood Hospital and Medical Center, Englewood, New Jersey.
Richard RauckCarolinas Pain Institute and The Center for Clinical Research, Winston-Salem, North Carolina.
Joseph GimbelArizona Research Center, Phoenix, Arizona.
Mary TagliaferriNektar Therapeutics, San Francisco, California.
Stephen K DobersteinNektar Therapeutics, San Francisco, California.
Carlo Di FonzoNektar Therapeutics, San Francisco, California.
Lin LuNektar Therapeutics, San Francisco, California.
Nathaniel KatzTufts University School of Medicine, Boston, Massachusetts.
Suresh SiddhantiNektar Therapeutics, San Francisco, California.
Sidney SchnollPinney Associates, Bethesda, Maryland.
Nektar Therapeutics (United States) · USPinney Associates (United States)Arizona Research Center · USCenter for Clinical Research (United States) · USClinical Solutions · USEnglewood Hospital and Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the SUMMIT-07 trial opioid withdrawal results of NKTR-181 (oxycodegol), a new molecular entity mu-opioid receptor agonist.

designPhase 3, enriched-enrollment, double-blind, randomized-withdrawal study in patients with chronic low back pain (CLBP).

settingConducted in the United States at multiple sites.

methodsSUMMIT-07 was comprised of five periods: screening; NKTR-181 open-label titration (100 to 400 mg twice daily); 12-week randomized, double-blind study drug (NKTR-181 or placebo); one-week study drug taper; and two-week safety follow-up. Permitted rescue medication included hydrocodone 5 mg/acetaminophen 300 mg (two tablets daily) for two weeks after randomization, then acetaminophen 1.0 gm daily for the remainder of the trial. Signs and symptoms of drug withdrawal were evaluated using the Clinical Opiate Withdrawal Scale (COWS); Subjective Opiate Withdrawal Scale (SOWS); Misuse, Abuse, and Diversion Drug Event Reporting System (MADDERS); and withdrawal-related adverse events.

resultsOf 1,190 patients entering titration, one patient had moderate withdrawal (COWS score 13/48 maximum) three days after discontinuing NKTR-181. Of 610 patients randomized (N = 309, NKTR-181; N = 301, placebo), no COWS scores indicating withdrawal at a moderate level or greater (i.e., score ≥13) were observed at any time point. At day 8 after randomization, week 12, and the end of tapering, COWS scores indicating mild withdrawal (<13) were observed in seven (2.4%), one (0.4%), and one (0.5%) placebo patients, respectively, and three (1.0%), one (0.4%), and five (2.3%) NKTR-181 patients, respectively. Mean SOWS scores in both arms were ≤2.8 of 64 possible points at all time points. During the randomized period, of 35 events identified by MADDERS, adjudicators identified 20 possible "withdrawal" events (9 [2.9%] NKTR-181 and 11 [3.7%] placebo).

conclusionsNKTR-181 exhibited a low rate and severity of opioid withdrawal in SUMMIT-07 patients with CLBP.

Indexed as

Low Back PainMorphinansAnalgesicsAnalgesics, OpioidAnimalsDouble-Blind MethodFemaleHumansSwineTreatment OutcomeAnalgesicsAnalgesics, OpioidMorphinansNKTR-181Clinical Opiate Withdrawal Scale (COWS)MADDERSNKTR-181OpioidOxycodegolSubjective Opiate Withdrawal Scale (SOWS)

Identifiers

PMID32150255
PMCPMC7530570
OpenAlexW3010873437

What OpenQuestion holds

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LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.