Brivaracetam to Reduce Neuropathic Pain in Chronic SCI: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Last updated: February 27, 2025
Sponsor: University of Minnesota
Overall Status: Completed

Phase

3

Condition

Neuropathy

Pain (Pediatric)

Oral Facial Pain

Treatment

brivaracetam

Placebo

Clinical Study ID

NCT05639946
Brivaracetam
  • Ages > 18
  • All Genders

Study Summary

Spinal cord injury (SCI) is associated with severe neuropathic pain that is often refractory to pharmacological intervention. Preliminary data suggest brivaracetam is a mechanism-based pharmacological intervention for neuropathic pain in SCI. Based on this and other reports in the literature, SCI-related neuropathic pain is hypothesized to occur largely because of upregulation of synaptic vesicle protein 2A (SV2A) within the substantia gelatinosa of the injured spinal cord. Furthermore, compared to placebo, brivaracetam treatment is hypothesized to reduce severe below-level SCI neuropathic pain and increases parietal operculum (partsOP1/OP4) connectivity strength measured by resting-state functional Magnetic Resonance Imaging (rsfMRI). Circulating miRNA-485 levels may be associated with change in pain intensity due to brivaracetam treatment. The study aims to determine the efficacy of brivaracetam treatment for SCI-related neuropathic pain.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • 18 years of age or older

  • Injured for > 3 months

  • Completed inpatient rehabilitation and living in the community

  • Chronic sublesional neuropathic pain defined as persistent pain (VAS grade 3-10) forthree months or more

  • For people of child-bearing potential: currently practicing an effective form of twotypes of birth control (defined as those, alone or in combination, that result in alow failure rate (i.e., less than 1% per year) when used consistently andcorrectly).

Exclusion

Exclusion Criteria:

  • Progressive myelopathy secondary to posttraumatic cord tethering or syringomyelia

  • Active use of drugs known to interact with brivaracetam: rifampin, carbamazepine,sodium oxybate, buprenorphine, propoxyphene, levetiracetam, and phenytoin.

  • Brain injury or cognitive impairment limiting the ability to follow directions orprovide informed consent

  • Pregnancy or lactation

  • Epilepsy or active treatment for seizure disorder

  • Past or current suicidality

  • Active treatment for psychiatric disease

  • Drug addiction

  • Moderate or heavy alcohol intake (up to four alcoholic drinks for men and three forwomen in any single day, and a maximum of 14 drinks for men and 7 drinks for womenper week)

  • Hepatic cirrhosis, Child-Pugh grades A, B, and C

  • Impaired renal function (GFR<60ml/minute)

  • Contraindications to brivaracetam or pyrrolidine derivatives including allergy

  • Active clinically significant disease (e.g., renal, hepatic, neurological,cardiovascular, pulmonary, endocrine, psychiatric, hematologic, urologic, or otheracute or chronic illness) that, in the opinion of the investigator, would make thepatient an unsuitable candidate for this trial.

  • History of malabsorption or other gastrointestinal (GI) disease that maysignificantly alter the absorption of brivaracetam

  • Use of any investigational drug 30 days prior to enrollment in this study

  • Enrollment in another clinical trial.

Study Design

Total Participants: 44
Treatment Group(s): 2
Primary Treatment: brivaracetam
Phase: 3
Study Start date:
January 01, 2023
Estimated Completion Date:
October 16, 2024

Connect with a study center

  • University of Minnesota

    Minneapolis, Minnesota 55455
    United States

    Site Not Available

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