Novel Use of Probenecid to Alleviate Symptoms of Opioid Withdrawal in People with Chronic Pain Undergoing Voluntary Opioid Tapering: a Pilot Study

Who is this study for? Patients with Chronic Pain, Drug Dependence of Morphine Type
What treatments are being studied? Probenecid
Status: Recruiting
Location: See location...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 2
SUMMARY

The proposed clinical trial will address the problem of opioid withdrawal. Opioids are essential for pain-relief in the short term, but their continued use is associated with a host of adverse effects. People living with chronic pain who were initiated on opioid therapy now find themselves with a major life-changing problem - dependence on opioid medications. Opioid withdrawal symptoms are a key barrier to decreasing or stopping their opioid medication. Currently, there are few medications that ameliorate the symptoms of opioid withdrawal. This problem is a major part of the opioid crisis in Canada, and impacts people across all demographics and socioeconomic status. A misconception is that only individuals with opioid use disorder are susceptible to opioid withdrawal; on the contrary, appropriate use of prescription opioids to manage pain can lead to significant symptoms of opioid withdrawal when it is reduced or stopped. Patients in Alberta who are at risk for opioid withdrawal, either from prescribed use or misuse will be primarily impacted by this trial. The investigators have recently explored the underlying causes of opioid withdrawal and identified an important target in the spinal cord that is responsible for producing withdrawal symptoms in rats and mice. The target, a protein called pannexin-1 (Panx1), is located throughout the body, specifically in the brain and spinal cord. Using sophisticated biochemical, genetic, and pharmacological techniques, the investigators demonstrated how Panx1 on immune cells is implicated in the production of opioid withdrawal symptoms after cessation of fentanyl and morphine in opioid dependent rodents. The investigators then attenuated these symptoms of withdrawal using probenecid, a drug which inherently blocks Panx1 activity. Because probenecid is a safe and clinically available drug, the findings could be immediately translated into clinical therapy to support people who are struggling with the symptoms of opioid withdrawal and provide clinicians with a safe and effective option for caring for this population.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Maximum Age: 80
Healthy Volunteers: f
View:

• Adults with chronic pain. Age greater than or equal to 18 years on the day of enrolment.

• Subjects are currently taking a daily opioid pain medication and planning to taper the dose.

• Participants complete at least one voluntary opioid dose reduction in the twelve-week study period.

• Glomerular filtration rate (GFR) \> 50 mL/min

• Capable of providing informed consent

Locations
Other Locations
Canada
Richmond Road Diagnostic and Treatment Centre
RECRUITING
Calgary
Contact Information
Primary
Tammy Eberle
tammy.eberle@albertahealthservices.ca
403-943-9900
Time Frame
Start Date: 2023-10-31
Estimated Completion Date: 2025-12-31
Participants
Target number of participants: 40
Treatments
Active_comparator: Probenecid 500 mg PO BID
Probenecid 500 mg X 1 PO BID and Placebo X 1 PO BID
Active_comparator: Probenecid 1000 mg PO BID
Probenecid 500mg X 2 PO BID
Placebo_comparator: Placebo PO BID
Placebo X 2 PO BID
Related Therapeutic Areas
Sponsors
Leads: University of Calgary

This content was sourced from clinicaltrials.gov

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