Clinical trial NCT05652907: Safety and Efficacy of FSD201 for the Treatment of Chronic Pain Associated With Idiopathic MCAS (MCAD)
Official title: A Randomized, Double-Blind Placebo Controlled Parallel Group Study of Safety and Efficacy of FSD201 in Patients With Chronic Widespread Musculoskeletal Nociplastic Pain Associated With Idiopathic Mast Cell Activation Syndrome (Disorder)
Study type: INTERVENTIONAL
Overall status: TERMINATED
Phase: PHASE2
Conditions: Mast Cell Activation Syndrome
Mast Cell Activation Disorder Idiopathic
Lead sponsor: Quantum Biopharma
Sponsor class: INDUSTRY
First posted: 2022-12-15
Enrollment: 2
Sex: ALL
Minimum age (years): 18
Maximum age (years): 75
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: This study will determine if FSD201 reduces the average daily 24-hour recall pain intensity after 28 and 56 days of treatment in adults with chronic widespread musculoskeletal nociplastic pain.


Eligibility criteria: Key Inclusion Criteria:

* Clinical diagnosis of idiopathic MCAS as per the global consensus diagnostic criteria
* Adults with widespread chronic pain (in three or more body regions);
* Chronic pains of intensity greater than or equal to 4.0 but less than or equal to 9.0 on a Numeric Pain Rating Scale, symptom duration of more than 6 months;
* Subject agrees to use only acetaminophen (up to 1000 mg per dose and not to exceed 3000 mg/day) or diphenhydramine (up to 300 mg/day) as rescue medication for chronic widespread musculoskeletal nociplastic pains throughout the trial;
* The subject is willing to maintain current activity and exercise levels throughout the study;
* During the study, the subject agrees not to initiate or change any non-pharmacologic interventions (including chiropractic care, physical therapy, psychotherapy, and massage therapy). Any ongoing non-pharmacologic intervention must be stable for at least 4 weeks before screening and should be continued for the duration of the study;

Key Exclusion Criteria:

* The subject has pain that cannot be clearly differentiated from or that could interfere with the assessment of chronic musculoskeletal nociplastic pain secondary likely to idiopathic MCAS (post-herpetic neuralgia, traumatic injury, prior surgery, complex regional pain syndrome);
* Adults with chronic cancer pain;
* Adults with inflammatory connective tissue disorder or rheumatological disorder-related pain, for example rheumatoid arthritis;
* Adults with focal musculoskeletal pain;
* Adults with skin diseases (chronic urticaria, pemphigus, lupus, rosacea etc.);
* Adults with endocrinological disorders (acute hypothyroidism, acute adrenal insufficiency etc.);
* Adults with systemic gastrointestinal conditions (Inflammatory bowel disorders);
* Significant psychological comorbidities: PHQ-9 score greater than 20; and GAD-7 score greater than 15 (indication of severe anxiety that could interfere with accurate logging of pain ratings);
* Current or recent (within 12 months of screening) history of a substance use disorder including cannabinoid or alcohol use disorder as defined by the Diagnostic and Statistical Manual of Mental Disorders (5th edition; DSM-5);
* Subject has neurologic disorder unrelated to chronic widespread musculoskeletal nociplastic pains (phantom limb from amputation, vitamin B12 deficiency, chronic inflammatory demyelinating polyneuropathy), circulatory disorder (peripheral artery disease), a skin condition in the area of neuropathy that could alter sensation (plantar ulcer), or other painful conditions (arthritis) that could interfere with reporting of pain due to chronic widespread musculoskeletal nociplastic pains;
* Current severe or uncontrolled major depressive disorder or anxiety disorders. Mild to moderate major depression or anxiety disorders are permitted provided that the investigator assesses the patient as clinically stable and appropriate for entry into the study. Stable doses of SSRIs are allowed for the treatment of depression if the dose is stable for 60 days before Screening Visit;
* Subject has a history of suicide attempt or suicidal behaviour within the last 12 months or has suicidal ideation within the previous 12 months or who is at significant risk to commit suicide, as judged by the Investigator at Screening and/or Randomization Visit;
* Patients with active malignancy or history of malignancy, except for basal cell or squamous cell carcinoma and actinic keratosis. Basal cell carcinoma and small squamous cell carcinoma of the skin which have been excised according to guidelines within the last 5 years or in situ cervical carcinoma that has been fully treated and shows no evidence of recurrence are allowed;
* Individuals with generalized joint hypermobility secondary to hereditary connective tissue disorders like Ehlers Danlos Syndrome;
* Individuals with high baseline serum tryptase levels suggestive of Primary or Secondary MCAS (defined as above the normal range of 2.2 to 13.2 µg/L).

Primary outcomes:
measure: Targeted treatment effect of 30% decrease from baseline to Day 28 in the average daily pain intensity
timeFrame: Day 28
Secondary outcomes:
measure: Percentage of subjects achieving ≥30% reduction in Numerical Pain Rating Scale (NPRS) score at the end of treatment with FSD201 at the end of treatment with FSD201
timeFrame: Day 28, Day 56
measure: Change in Patient Global Impression of Change (PGIC)
timeFrame: Day 56
measure: Change or reduction in patient average daily NPRS
timeFrame: Day 56
measure: Change in Patient-Reported Outcomes Measurement Information System (PROMIS) Sleep Disturbance- Short Form (SF) 8a
timeFrame: Day 56
measure: Change in the PROMIS Pain Interference- SF 8a score
timeFrame: Day 56
measure: Change in the PROMIS General Life Satisfaction- SF 5a
timeFrame: Day 56
measure: Change in the PROMIS Fatigue- SF 8a
timeFrame: Day 56
measure: Reduction of plasma serum mast cell tryptase, IL-6, and IL-1beta during FSD201 treatment
timeFrame: Day 14, Day 28 and Day 56
measure: Percentage of subjects achieving ≥30% reduction in NPRS score
timeFrame: Day 28, Day 56
measure: Change in Daily Sleep Interference Scale (DSIS)
timeFrame: Day 28, Day 56
measure: Change in Patient Global Impression of Change (PGIC)
timeFrame: Day 28, Day 56
measure: Change in pain intensity on the NPRS from baseline to each week of treatment
timeFrame: Day 0 to Day 56
measure: Percentage of subjects achieving ≥50% reduction in NPRS
timeFrame: Week 1 to Week 8
measure: Total amount of rescue medication used
timeFrame: Day 0 to Day 56
measure: Incidence and severity of treatment-emergent adverse events (TEAEs)
timeFrame: Day 0 to Day 56
measure: Incidence and severity of treatment-emergent changes in laboratory values
timeFrame: Day 56
measure: Change from baseline in sitting blood pressure at each in-patient visit
timeFrame: Day 14, Day 28, Day 56
measure: Change from baseline in heart rate at each in-patient visit
timeFrame: Day 14, Day 28, Day 56
measure: Change from baseline in body temperature at each in-patient visit
timeFrame: Day 14, Day 28, Day 56
measure: Change from baseline in oxygen saturation at each in-patient visit
timeFrame: Day 14, Day 28, Day 56
measure: Change from baseline in breathing rate at each in-patient visit
timeFrame: Day 14, Day 28, Day 56
Other outcomes:
Locations:
city: Weldon Spring
country: United States
facility: Saint Charles Clinical Research
state: Missouri
city: New York
country: United States
facility: Norman Marcus Pain Institute
state: New York
city: Toronto
country: Canada
facility: Toronto Rehabilitation Institute
state: Ontario
Study officials:
affiliation: FSD Pharma
name: Andrzej Chruscinski, MD
role: STUDY_DIRECTOR
References: