Diabetic Peripheral NeuropathyMEDIANNCT01990092
The Nutritional Benefits of Metanx in Patients With Diabetic Peripheral Neuropathy (MEDIAN)
A study testing Metanx in people with Diabetic Peripheral Neuropathy and B Vitamin Deficiency, run by Pamlab, Inc. at 25 sites in United States.
Trial summary
The objectives of the MEDIAN study are to evaluate the short-term and long-term safety and nutritional benefits of Metanx® versus placebo in subjects with mild to moderate diabetic peripheral neuropathy (DPN). Read more about this study
- Who is it for?
- Ages 25 to 80 years
- Conditions the study is for
- Diabetic Peripheral Neuropathy, B Vitamin Deficiency
- What is being tested?
- Metanx
- Type of treatment
- Pill or oral medicine
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 238 participants
- Where
- 25 sitesUnited States
- Study dates
- Nov 2013to Mar 2018
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 25 to 80 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Be male or female between 25 and 80 years of age, inclusive, at the time of consent
- Have a diagnosis of diabetes mellitus Type 2 as defined by the American Diabetes Association and on stable therapy as defined per the investigator's opinion for at least 1 month before the Screening Visit.
- Have a diagnosis of DPN established at least 6 months but not greater than 7 years prior to Screening
- If receiving DPN-related medication, doses must be stable for at least 6 weeks and should be taking only one of the following medications compliant with Exclusion Criterion 7:
- Alpha-2-delta ligand [e.g., pregabalin (Lyrica) or gabapentin (Neurontin)
- Anticonvulsant [e.g., carbamazepine, topiramate (Topamax), valproic acid (Depakote) or lamotrigine (Lamictal)]
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- Serotonin-norepinephrine Reuptake Inhibitor (SNRI) [e.g., duloxetine (Cymbalta) or venlafaxine (Effexor)]
- Tricyclic antidepressant (TCA) [e.g., amitriptyline, nortriptyline, imipramine, and desipramine (Norpramin, Pertofrane)]
- Have a score between 3 and 6, inclusive, on the Michigan Neuropathy Screening Instrument (MNSI) Part b
- Have a minimum score of 6 on the NTSS-6 at Screening
- Have negative urinalysis for drugs of abuse, such as amphetamines, barbiturates, cannabinoids, cocaine, or opiates
- Have a negative urine pregnancy test at Screening if female and of childbearing potential
- If female, must be either of nonchildbearing potential (surgically sterile or 2 years postmenopausal) or agree to use two methods of effective contraception such as hormonal contraception, intrauterine device or other mechanical contraception device, or condom plus spermicide during the subject's participation
- If male, must be surgically sterile or agree to use two methods of effective contraception such as condom plus spermicide during the subject's participation
- Have the ability to understand the requirements of the study, have provided written informed consent as evidenced by signature on an informed consent form (ICF) approved by an institutional review board (IRB), and agree to abide by the study restrictions and return to the site for the required assessments
- Have provided written authorization for use and disclosure of protected health information
Who cannot join
- Be pregnant or lactating
- Have a history of amputation, skin ulceration, and/or active Charcot of either foot
- Have a history of previous surgery involving the spine or lower extremity, with residual symptoms of pain or difficulty with movement
- Have Crohn's disease or a history of any type of bariatric surgery or any surgical resection of all or part of the stomach, duodenum, jejunum, and/or ileum. (Previous surgical resections of the colon that spared the stomach, duodenum, jejunum and ileum are allowed.)
- Have a history of surgery or hospitalization within 2 months prior to Screening or planned hospitalization at any time during the study
- Be taking systemic corticosteroids within 2 months prior to Screening, opiates or tramadol hydrochloride within 6 weeks prior to Screening, and/or immunosuppressives, or receiving radiotherapy within 6 months prior to Screening
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- Be taking more than one anticonvulsant, serotonin-norepinephrine reuptake inhibitor (SNRI), or tricyclic antidepressant (TCA)
- Have ongoing evidence of peripheral vascular disease, including greater than one nonpalpable pulse on either foot, history of claudication, or history of lower extremity vascular bypass surgery or angioplasty
- Have circulating glycated hemoglobin (HbA1c) exceeding 11% at Screening
- Have an estimated glomerular filtration rate (eGFR) less than or equal to 40 ml/min using the Modification of Diet in Renal Disease (MDRD) formula at Screening or have end-stage renal disorder requiring hemodialysis
- Have uncontrolled hypertension defined as sustained systolic blood pressure (SBP) greater than 200 mmHg or diastolic blood pressure (DBP) greater than 110 mmHg at screening
- Have lung disease (uncontrolled asthma or shortness of breath) within 2 months prior to Screening
- Use of any of the following supplements within 6 weeks before Screening: evening primrose oil, vitamin B12 injection, greater than 10 mg of vitamin B6, or greater than 800 µg of folate
- Have previously failed two or more prior therapies for painful DPN
- Currently abusing alcohol or drugs or have a history of such abuse within the past 3 years. (Alcohol abuse is defined as more than 2 drink units per day for women and more than 3 drink units per day for men. One drink unit is defined as 1.5 oz [45 mL] of distilled spirits, 5 oz [150 mL] of wine, or 12 oz [360 mL] of beer.)
- Have any nondiabetic cause of peripheral neuropathy
- Have a history of documented lumbar nerve entrapment or symptoms suggestive of a lumbar nerve entrapment
- Have a history of systemic lupus erythematosis, rheumatoid arthritis, Sjögren's syndrome, or mixed connective tissue disease
- If receiving thyroid replacement therapy, should be on a stable dose for at least 6 weeks prior to Screening
- Have a history of a positive HIV test or active Hepatitis B or C infection.
- Have a history or presence of malignancy within 10 years prior to Screening except for basal or squamous cell carcinoma of the skin. Records to be submitted to Pamlab for review and approval to randomize.
- Have prior use of or intolerance to Metanx® or any of its active ingredients
- Have been dosed or used a medical device in another investigational trial within 60 days prior to Screening.
- Have any clinically significant existing medical, psychiatric, or nonmedical condition that in the opinion of the investigator places the subject at undue risk, prevents compliance with the study protocol, or potentially jeopardizes the quality of the data to be generated
Trial locations and contacts
25 sites in 1 country.
25 sites in 1 country
United States25 sites
FutureSearch Trials of Neurology, L.P.
Austin, Texas, 78731
Willis-Knighton Physician Network / WKB Family Medicine Associates
Bossier City, Louisiana, 71111
Meridien Research
Bradenton, Florida, 34208
PAB Clinical Research
Brandon, Florida, 33511
Urgent Care Specialists, LLC dba Hometown Urgent Care & Occupational Health
Dayton, Ohio, 45424
Centex Studies Inc.
Houston, Texas, 77062
Pioneer Research Solutions, Inc.
Houston, Texas, 77098
North Chattahoochee Family Physicians, LLC
Johns Creek, Georgia, 30097
Clinical Trials, Inc.
Little Rock, Arkansas, 72205
Collaborative Neuroscience Network, LLC
Long Beach, California, 90806
Coastal Clinical Research, Inc.
Mobile, Alabama, 36608
Coastal Connecticut Research, LLC
New London, Connecticut, 06320
Tulane University School of Medicine
New Orleans, Louisiana, 70112
Suncoast Clinical Research, Inc.
New Port Richey, Florida, 34652
Strelitz Diabetes Center
Norfolk, Virginia, 23510
Renstar Medical Research
Ocala, Florida, 34471
Suncoast Clinical Research
Palm Harbor, Florida, 34684
CRI Lifetree
Philadelphia, Pennsylvania, 19139
Arizona Research Center
Phoenix, Arizona, 85023
Endeavor Clinical Trials, PA
San Antonio, Texas, 78229
Center for Clinical Research, Inc.
San Francisco, California, 94115
Northeast Clinical Research of San Anotnio, LLC
Schertz, Texas, 78154
Trinity Clinical Research, LLC
Tullahoma, Tennessee, 37388
ClinPoint Trials, LLC
Waxahachie, Texas, 75165
Florida Medical Clinic
Wesley Chapel, Florida, 33544
About this study
Official title: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial to Assess the Safety and Nutritional Benefits of Metanx® in Subjects With Diabetic Peripheral Neuropathy
The objectives of the MEDIAN study are to evaluate the short-term and long-term safety and nutritional benefits of Metanx® versus placebo in subjects with mild to moderate diabetic peripheral neuropathy (DPN). Short-term effects will be evaluated during the first 16 weeks of treatment, and long-term effects will be evaluated over the duration of a 48 week treatment period.
- Being tested
- Metanx, Placebo
- Keywords
- Metanx, B vitamins, neuropathy, nutrition
- Medical subject headings
- Vitamin B Deficiency
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
MetanxOther
Metanx is a prescription medical food.
PlaceboOther
| Study group | Role | What they receive |
|---|---|---|
| Metanx | Experimental | Subjects will take 2 Metanx tablets once daily for 48 weeks. Receives: Other: Metanx |
| Placebo | Placebo comparator | Subjects will take 2 placebo tablets once daily for 48 weeks. Receives: Other: Placebo |
What is being measured
The primary outcome is the main question the study is designed to answer.
Change in plasma methylmalonic acid (MMA) levels
Measured: 16 weeks
Secondary outcomes (8)
Change in plasma 5-methyltetrahydrofolate levels
Measured: 16 weeks
Change in plasma vitamin B6 levels
Measured: 16 weeks
Change in plasma vitamin B12 levels
Measured: 16 weeks
Change in urine microalbumin/creatinine ratio
Measured: 48 weeks
Change in epidermal nerve fiber density
This neuropathy-specific measure will be evaluated to monitor for signs of disease progression.
Measured: 48 weeks
Change in neuropathic disability as measured by the Michigan Neuropathy Screening Instrument part B
This neuropathy-specific measure will be evaluated to monitor for signs of disease progression.
Measured: 48 weeks
Change in neuropathic symptoms as measured by the Neuropathy Total Symptom Score-6questionnaire(NTSS-6)
This neuropathy-specific measure will be evaluated to monitor for signs of disease progression.
Measured: 16 weeks
Change in neuropathic symptoms as measured by the Neuropathy Total Symptom Score-6 questionnaire (NTSS-6)
This neuropathy-specific measure will be evaluated to monitor for signs of disease progression.
Measured: 48 weeks
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted21 Nov 2013 (estimated)
- Study startNov 2013
- Primary completionAug 2016 (estimated)
- Study completionMar 2018 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Diabetic Peripheral NeuropathyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 238 participants (actual)
Sponsor and investigators
- Lead sponsor
- Pamlab, Inc.
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Roy Freeman, MD, Principal investigator, Beth Israel Deaconess Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT01990092
- Sponsor's protocol ID
- M-003
- Acronym
- MEDIAN
- Status last verified
- Jan 2016
- First submitted
- 15 Nov 2013
- Last updated
- 18 Jan 2016
- Results posted
- No
- Data monitoring committee
- No
Study at a glance
From the registry record, last updated by the sponsor on 18 Jan 2016. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial to Assess the Safety and Nutritional Benefits of Metanx® in Subjects With Diabetic Peripheral Neuropathy
- ClinicalTrials.gov ID
- NCT01990092
- Acronym / sponsor ID
- MEDIAN / M-003
- Keywords
- Metanx, B vitamins, neuropathy, nutrition
- Study type
- Interventional
- Recruitment status
- Unknown status
- Enrolment
- 238 participants (actual)
- Lead sponsor
- Pamlab, Inc.Industry (pharma, biotech, devices)
- Study start
- Nov 2013
- Primary completion
- Aug 2016 (estimated)
- Study completion
- Mar 2018 (estimated)
- First posted
- 21 Nov 2013 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The objectives of the MEDIAN study are to evaluate the short-term and long-term safety and nutritional benefits of Metanx® versus placebo in subjects with mild to moderate diabetic peripheral neuropathy (DPN). Short-term effects will be evaluated during the first 16 weeks of treatment, and long-term effects will be evaluated over the duration of a 48 week treatment period.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Metanx | Experimental | Other: MetanxSubjects will take 2 Metanx tablets once daily for 48 weeks. |
| Placebo | Placebo comparator | Other: PlaceboSubjects will take 2 placebo tablets once daily for 48 weeks. |
Who may qualify
- Ages
- 25 to 80 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (16 listed)
- Be male or female between 25 and 80 years of age, inclusive, at the time of consent
- Have a diagnosis of diabetes mellitus Type 2 as defined by the American Diabetes Association and on stable therapy as defined per the investigator's opinion for at least 1 month before the Screening Visit.
- Have a diagnosis of DPN established at least 6 months but not greater than 7 years prior to Screening
- If receiving DPN-related medication, doses must be stable for at least 6 weeks and should be taking only one of the following medications compliant with Exclusion Criterion 7:
- Have a score between 3 and 6, inclusive, on the Michigan Neuropathy Screening Instrument (MNSI) Part b
Key exclusion criteria (24 listed)
- Be pregnant or lactating
- Have a history of amputation, skin ulceration, and/or active Charcot of either foot
- Have a history of previous surgery involving the spine or lower extremity, with residual symptoms of pain or difficulty with movement
- Have Crohn's disease or a history of any type of bariatric surgery or any surgical resection of all or part of the stomach, duodenum, jejunum, and/or ileum. (Previous surgical resections of the colon that spared the stomach, duodenum, jejunum and ileum are allowed.)
- Have a history of surgery or hospitalization within 2 months prior to Screening or planned hospitalization at any time during the study
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| MetanxMetanx is a prescription medical food. | Other | Metanx |
| Placebo | Other | Placebo |
Primary outcome
Change in plasma methylmalonic acid (MMA) levels
Time frame: 16 weeks
8 secondary outcomes
Change in plasma 5-methyltetrahydrofolate levels
Time frame: 16 weeks
Change in plasma vitamin B6 levels
Time frame: 16 weeks
Change in plasma vitamin B12 levels
Time frame: 16 weeks
Change in urine microalbumin/creatinine ratio
Time frame: 48 weeks
Change in epidermal nerve fiber density
Time frame: 48 weeks
Change in neuropathic disability as measured by the Michigan Neuropathy Screening Instrument part B
Time frame: 48 weeks
Change in neuropathic symptoms as measured by the Neuropathy Total Symptom Score-6questionnaire(NTSS-6)
Time frame: 16 weeks
Change in neuropathic symptoms as measured by the Neuropathy Total Symptom Score-6 questionnaire (NTSS-6)
Time frame: 48 weeks
Results and safety
Results are not available in the source record.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 18 Jan 2016.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Roy Freeman, MD principal investigator
Beth Israel Deaconess Medical Center
25 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Metanx in people with Diabetic Peripheral Neuropathy and B Vitamin Deficiency, run by Pamlab, Inc. at 25 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 16 inclusion and 24 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: status not confirmed, as of the sponsor's last update on 18 Jan 2016. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 25 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
Results are not available in the source record.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in plasma methylmalonic acid (MMA) levels (time frame: 16 weeks). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 18 Jan 2016.