A randomized, double-blind, placebo-controlled study to assess the efficacy and tolerability of gabapentin enacarbil in subjects with restless legs syndrome

Daniel O. Lee, Ronald B. Ziman, A. Thomas Perkins, J. Steven Poceta, Arthur S. Walters, Ronald W. Barrett, Fares J. Arguello, Eric M. Ball, Lisa Cohen, Michael J. Drass, Stephen Duntley, Mitchell D. Feller, Gerald J. Ferencz, Mark A. Fisher, James E. Garrison, John R. Huddlestone, Mark S. LeDoux, Kurt W. Lesh, Daniel G. Lorch, Stuart J. MennLeslie Moldauer, Charulatha P. Nagar, Thomas Perkins, Michael Rokeach, Richard Shubin, Daniel Vine, J. Catesby Ware, Charles Wells, Paul Wylie

Research output: Contribution to journalArticlepeer-review

85 Scopus citations

Abstract

Study Objective: To evaluate the efficacy and tolerability of gabapentin enacarbil (GEn) 1200 mg or 600 mg compared with placebo in subjects with moderate-to-severe primary restless legs syndrome (RLS). Methods: This 12-week, multicenter, double-blind, placebo-controlled study randomized subjects (1:1:1) to GEn 1200 mg, 600 mg, or placebo. Co-primary endpoints: mean change from baseline in International Restless Legs Scale (IRLS) total score and proportion of responders (rated as "very much" or "much" improved) on the investigator-rated Clinical Global Impression-Improvement scale (CGI-I) at Week 12 LOCF for GEn 1200 mg compared with placebo. Secondary endpoints included GEn 600 mg compared with placebo on the IRLS and CGI-I at Week 12 LOCF and subjective measures for sleep. Safety and tolerability assessments included adverse events. Results: 325 subjects were randomized (GEn 1200 mg = 113; 600 mg = 115; placebo = 97). GEn 1200 mg significantly improved mean [SD] IRLS total score at Week 12 LOCF (baseline: 23.2 [5.32]; Week 12: 10.2 [8.03]) compared with placebo (baseline: 23.8 [4.58]; Week 12: 14.0 [7.87]; adjusted mean treatment difference [AMTD]: -3.5; p = 0.0015), and significantly more GEn 1200 mg-treated (77.5%) than placebo-treated (44.8%) subjects were CGI-I responders (p < 0.0001). Similar significant results were observed with GEn 600 mg for IRLS (AMTD: -4.3; p < 0.0001) and CGI-I (72.8% compared with 44.8%; p < 0.0001). GEn also significantly improved sleep outcomes (Post-Sleep Questionnaire, Pittsburgh Sleep Diary and Medical Outcomes Sleep Scale) compared with placebo. The most commonly reported adverse events were somnolence (GEn 1200 mg = 18.0%; 600 mg = 21.7%; placebo = 2.1%) and dizziness (GEn 1200 mg = 24.3%; 600 mg = 10.4%; placebo = 5.2%). Dizziness increased with increased dose and led to discontinuation in 2 subjects (GEn 1200 mg, n = 1; GEn 600 mg, n = 1). Somnolence led to discontinuation in 3 subjects (GEn 600 mg). Conclusions: GEn 1200 mg and 600 mg significantly improve RLS symptoms and sleep disturbance compared with placebo and are generally well tolerated.

Original languageEnglish
Pages (from-to)282-292
Number of pages11
JournalJournal of Clinical Sleep Medicine
Volume7
Issue number3
DOIs
StatePublished - Jun 15 2011

Keywords

  • GSK1838262
  • Gabapentin enacarbil
  • PIVOT RLS II
  • Restless legs syndrome
  • XP13512

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology
  • Pulmonary and Respiratory Medicine

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