Developing Meaningful Endpoints for Pain Clinical Trials Workshop

Thu, 10/8/2020 - 10:00am - 3:30pm
Thu, 10/15/2020 - 11:00am - 1:30pm

View the Agenda PDF | 71.46 KB

View the Day 1 Videocast 

View the Day 2 Videocast

View the Pre-workshop talks

Description:

More than 25 million Americans suffer from daily chronic pain, a highly debilitating medical condition that is complex and difficult to manage.  In recent decades, there has been an overreliance on the prescription of opioids for chronic pain, contributing to a significant and alarming epidemic of opioid overdose deaths and addiction.  Innovative scientific solutions to develop non-opioid, non-addictive alternative treatment options are thus urgently needed. 

One of the goals of the Helping to End Addiction Long-term (HEAL) Initiative is to accelerate the discovery and preclinical development of new medications and devices to treat pain.  Two recent NINDS workshops focused on (1) identifying endpoints in pre-clinical pain models and (2) discovering biomarkers to enhance pain therapy development.  A logical next step is to identify the scientific gaps and development challenges in moving candidate therapeutics through proof-of-concept studies, early phase clinical trials and to later phases of development including regulatory approval. 

One major challenge facing the development of non-opioid alternative pain medications in each pain condition is the heterogeneity in patient populations combined with high variability in individual responses to any given intervention.  This is further compounded by the diversity of specific disorders associated with pain. Consequently, it is often difficult to define reliable endpoints, both within specific pain conditions and across pain conditions, for evaluation of novel therapeutics. 

The workshop, being held on 2 days, one week apart, is designed to address these critical scientific gaps and identify novel approaches to study outcome measures spanning acute, transitional and chronic pain studies, collaboratively with academic, biopharmaceutical industry and government scientists. The first day will include breakout/subgroup discussions focused on acute pain, transition, and chronic pain followed by subgroup reports and recommendations the 2nd day. Participants are invited to sign up for the breakout group of their choice. Brief pre-recorded presentations will be available for registrants to view online 2 weeks prior to the meeting.

Workshop Goals: 

  • To explore the state-of-the-science clinical trial outcome measures for pain and identify the research needed to stimulate the development of new outcomes in a manner that will withstand rigorous validation
  • To review end points currently in use in phases 1 and 2 studies that could potentially be validated and used in Registration studies.
  • To include broad and diverse representation of academic, biopharmaceutical industry, and government scientists working on the development of critical pain measures
  • To share approaches, tools, and lessons learned that may apply across pain disorders
  • To identify opportunities to help advance the development of outcome measures for therapeutics being developed across the pain chronological spectrum, including those for acute and chronic pain and for therapies that may mitigate the acute-to chronic pain transition.

Workshop Deliverables: 

  • Recommendations for novel outcome measures and endpoints for clinical trials of drug and device pain therapeutics 
  • Recommendations/guidelines for approaches to identifying improved outcome measures and endpoints for clinical trials of pain therapeutics  
  • Publication of a white paper summarizing workshop findings/guidelines

Workshop Chairs:

Robert Dworkin, Ph.D., University of Rochester

Amy Chappell, MD, Pharmaceutical Product Development

Workshop Co-chair Bios PDF | 166.12 KB

Workshop Recordings:

Pain Regulatory Development Pathway

Endpoints for Pain Clinical Trials: Current approaches and accepted endpoints- drugs/biologics

Dr. Naomi Lowy discusses current approaches and accepted endpoints for drug and biologic therapeutics in pain clinical trials.

https://youtu.be/UveBQ0Qb-_o

Current Approaches and Accepted Endpoints: Drugs and Biologics PDF | 502.97 KB

 

Endpoints for Pain Clinical Trials: Current approaches and accepted endpoints- devices

Dr. Carlos Peña discusses current approaches and accepted endpoints for devices in pain clinical trials.

https://youtu.be/fglwOQf9AXc

 

Endpoints for Pain Clinical Trials: Current approaches and accepted endpoints- biomarkers

Dr. Christopher Leptak discusses current approaches and accepted endpoints for biomarker validation in pain clinical trials.

https://youtu.be/CYBy1XsGE3s

 

Endpoints for Pain Clinical Trials: Updated guidance on qualifying outcome measures

Dr. Elektra Papadopoulos discusses updated FDA guidance on qualifying outcome measures for pain clinical trials.

https://youtu.be/2eJtkdKnMSE

Clinical Outcome Assessment: A Regulatory Perspective PDF | 670.88 KB

 

Endpoints for Pain Clinical Trials: Disease-specific approaches-migraine and headache therapeutics

Dr. Heather Fitter discusses disease-specific approaches for pain clinical trials, with specific examples from the approval pathway for migraine and headache therapeutics.

https://youtu.be/FLcutQttgbo

Approval Pathway for Migraine and Headache Products PDF | 296.84 KB

 

Pain Therapeutics Development Pathway

Endpoints for Pain Clinical Trials: Academic/European Perspective 

Dr. Nadine Attal provides an academic/European perspective on the pain therapeutics development pathway and developing meaningful endpoints for pain clinical trials.

https://youtu.be/Ge2nCToQpzQ

The European Perspective With Emphasis on Neuropathic Pain PDF | 4.67 MB

 

Endpoints for Pain Clinical Trials: Industry Perspective 

Dr. David Hewitt provides an industry perspective on the pain therapeutics development pathway and developing meaningful endpoints for pain clinical trials.

https://youtu.be/TY8zycBsjUk

Pain Therapeutics Development Pathway: Industry Perspective  PDF |  bytes

 

Endpoints for Pain Clinical Trials: Patient Perspective

Lynne Matallana provides a patient perspective on the pain therapeutics development pathway and developing meaningful endpoints for pain clinical trials.

https://youtu.be/MaozAIdqDeY

 

Pain Clinical Endpoints Landscape

Endpoints for Pain Clinical Trials: Landscape for clinical outcomes assessment

Dr. Bryce Reeve describes the current landscape for clinical outcomes assessment, including qualifying outcome measures, limitations and flexibility, in pain clinical trials.

https://youtu.be/x8oB4j7PqWQ

Landscape for Clinical Outcome Assessments (COAs) for Pain PDF | 464.68 KB 

 

Endpoints for Pain Clinical Trials: Patient Reported Outcomes

Dr. Robert Edwards describes the current landscape for patient reported outcomes in pain clinical trials.

https://youtu.be/vC_C2OKZGjo

Patient Reported Outcomes PDF | 4.76 MB

 

Endpoints for Pain Clinical Trials: Biomarkers

Dr. Petra Schweinhardt describes the current landscape for biomarkers in pain clinical trials.

https://youtu.be/c8zGMch08hQ

Pain Clinical Endpoints - Biomarkers PDF | 965.08 KB