Sativex Low Dose
Range of 1 to 4 sprays per day. Each actuation of oromucosal spray delivers 2.7mg delta-9-tetrahydrocannabinol (THC) and 2.5mg cannabidiol (CBD). Thus maximum daily dose is 10.8mg THC and 10mg CBD.
GW-1000-02Loading study record…
The purpose of this study is to determine the effective dose range and to demonstrate a non-effective dose range of Sativex in patients with advanced cancer, who experience inadequate pain relief even though they are on optimized chronic opioid therapy.
Locally preserved from ClinicalTrials.govOpen ClinicalTrials.govlast source update 2013-06-20
What this record can show
Results are reported by the registry submitter and preserved exactly. They are not independent verification or a treatment recommendation.
Registry facts
Linked local records
Local links use governed condition terms or exact source-reported intervention names. They are navigation candidates, not efficacy claims.
Interventions
Range of 1 to 4 sprays per day. Each actuation of oromucosal spray delivers 2.7mg delta-9-tetrahydrocannabinol (THC) and 2.5mg cannabidiol (CBD). Thus maximum daily dose is 10.8mg THC and 10mg CBD.
GW-1000-02Range of 6 to 10 sprays per day. Each actuation of oromucosal spray delivers 2.7mg delta-9-tetrahydrocannabinol (THC) and 2.5mg cannabidiol (CBD). Thus maximum daily dose is 27mg THC and 25mg CBD.
GW-1000-02Range of 11 to 16 sprays per day. Each actuation of oromucosal spray delivers 2.7mg delta-9-tetrahydrocannabinol (THC) and 2.5mg cannabidiol (CBD). Thus maximum daily dose is 43.2mg THC and 40mg CBD.
GW-1000-02Source-reported results
Results are reported by the registry submitter and preserved exactly. They are not independent verification or a treatment recommendation.
A positive 30% pain response is defined as a reduction of at least 30% in the mean NRS average pain score from baseline to week 5 (last 3 days). The patient was asked "on a scale of '0 to 10', please indicate the number that best describes your pain or average pain in the last 24 hours" where 0 = no pain and 10 = pain as bad as you can imagine. No pain relates to the time prior to the onset of pain due to cancer. The average pain NRS was completed at the same time each day, i.e. bedtime in the evening.
| Group | N | Value | Spread / interval |
|---|---|---|---|
| Sativex High Dose Group | 90 | 22 | 0.46 to 1.76 |
| Sativex Medium Dose Group | 87 | 26 | 0.62 to 2.28 |
| Sativex Low Dose Group | 91 | 30 | 0.72 to 2.60 |
| Placebo | 91 | 24 | - |
Eligibility
primary outcomes
Time frame: 5 Weeks: Baseline (first 3 days) - Week 5 (last 3 days)
A positive 30% pain response is defined as a reduction of at least 30% in the mean NRS average pain score from baseline to week 5 (last 3 days). The patient was asked "on a scale of '0 to 10', please indicate the number that best describes your pain or average pain in the last 24 hours" where 0 = no pain and 10 = pain as bad as you can imagine. No pain relates to the time prior to the onset of pain due to cancer. The average pain NRS was completed at the same time each day, i.e. bedtime in the evening.
secondary outcomes
Time frame: Baseline to end of treatment (Week 5)
The cumulative response to treatment is the percentage changes from baseline in the mean NRS pain score as defined as the 30% response. The pain NRS was completed at the same time each day, i.e. bedtime in the evening. The patient was asked "on a scale of '0 to 10', please indicate the number that best describes your pain or average pain in the last 24 hours" where 0 = no pain and 10 = pain as bad as you can imagine. No pain relates to the time prior to the onset of pain due to cancer.
Time frame: 5 Weeks: Baseline (first 3 days) - End of Treatment (last 3 days of week 5)
The average pain NRS was complete at the same time each day, i.e. bedtime in the evening. The patient was asked "on a scale of '0 to 10', please indicate the number that best describes your pain or average pain in the last 24 hours" where 0 = no pain and 10 = pain as bad as you can imagine. No pain relates to the time prior to the onset of pain due to cancer. A negative value indicates an improvement in pain score from baseline.
Time frame: 5 Weeks: Baseline (first 3 days) - End of Treatment (last 3 days of week 5)
The worst pain NRS was completed at the same time each day, i.e. bedtime in the evening. The patient was asked "on a scale of '0 to 10', please indicate the number that best describes your worst pain in the last 24 hours" where 0 = no pain and 10 = pain as bad as you can imagine. No pain relates to the time prior to the onset of pain due to cancer. A negative value indicates an improvement in worst pain score from baseline.
Time frame: 5 Weeks: Baseline - End of Treatment (Last 3 days of Week 5)
The sleep disruption NRS was completed at the same time each day, i.e. bedtime in the evening. The patient was asked "on a scale of '0 to 10', please indicate how your pain disrupted your sleep last night?" where 0 = did not disrupt sleep and 10 = completely disrupted (unable to sleep at all). A negative value indicates an improvement in sleep disruption score from baseline.
Time frame: Baseline (Visit 2) and End of Treatment (End of Week 5 or premature termination)
The BPI-SF is a 14-item questionnaire that asks patients to rate pain over the prior week and the degree to which it interferes with activities on a 0 to 10 scale, where 0=no pain and 10=pain as bad as you can imagine. Severity is measured as worst pain, least pain, average pain, and pain right now. The severity composite score was calculated as the arithmetic mean of the four severity items(range 0-10). the minimum value is zero and maximum is 10. A higher score represents a poor outcome.
Publications
No exact PMID-linked public article is currently readable locally.
The cumulative response to treatment is the percentage changes from baseline in the mean NRS pain score as defined as the 30% response. The pain NRS was completed at the same time each day, i.e. bedtime in the evening. The patient was asked "on a scale of '0 to 10', please indicate the number that best describes your pain or average pain in the last 24 hours" where 0 = no pain and 10 = pain as bad as you can imagine. No pain relates to the time prior to the onset of pain due to cancer.
| Group | N | Value | Spread / interval |
|---|---|---|---|
| Sativex High Dose Group | 89 | -13 | -30 to 6 |
| Sativex Medium Dose Group | 87 | -20 | -40 to -6 |
| Sativex Low Dose Group | 89 | -20 | -48 to -8 |
| Placebo | 91 | -10 | -33 to 5 |
The average pain NRS was complete at the same time each day, i.e. bedtime in the evening. The patient was asked "on a scale of '0 to 10', please indicate the number that best describes your pain or average pain in the last 24 hours" where 0 = no pain and 10 = pain as bad as you can imagine. No pain relates to the time prior to the onset of pain due to cancer. A negative value indicates an improvement in pain score from baseline.
| Group | N | Value | Spread / interval |
|---|---|---|---|
| Sativex High Dose | 89 | -0.9 | -6.3 to 2.3 |
| Sativex Medium Dose | 87 | -1.2 | -7.3 to 5.7 |
| Sativex Low Dose | 89 | -1.6 | -8.0 to 3.3 |
| Placebo | 91 | -0.8 | -6.0 to 3.7 |
The worst pain NRS was completed at the same time each day, i.e. bedtime in the evening. The patient was asked "on a scale of '0 to 10', please indicate the number that best describes your worst pain in the last 24 hours" where 0 = no pain and 10 = pain as bad as you can imagine. No pain relates to the time prior to the onset of pain due to cancer. A negative value indicates an improvement in worst pain score from baseline.
| Group | N | Value | Spread / interval |
|---|---|---|---|
| Sativex High Dose | 89 | -1.0 | 1.9 |
| Sativex Medium Dose | 87 | -1.2 | 1.8 |
| Sativex Low Dose | 89 | -1.6 | 2.2 |
| Placebo | 91 | -0.9 | 2.0 |
The sleep disruption NRS was completed at the same time each day, i.e. bedtime in the evening. The patient was asked "on a scale of '0 to 10', please indicate how your pain disrupted your sleep last night?" where 0 = did not disrupt sleep and 10 = completely disrupted (unable to sleep at all). A negative value indicates an improvement in sleep disruption score from baseline.
| Group | N | Value | Spread / interval |
|---|---|---|---|
| Sativex High Dose Group | 89 | -0.7 | -1.45 to -0.31 |
| Sativex Medium Dose Group | 87 | -0.9 | -1.45 to -0.31 |
| Sativex Low Dose Group | 89 | -1.5 | -1.45 to -0.31 |
| Placebo | 91 | -0.8 | 2.2 |
The BPI-SF is a 14-item questionnaire that asks patients to rate pain over the prior week and the degree to which it interferes with activities on a 0 to 10 scale, where 0=no pain and 10=pain as bad as you can imagine. Severity is measured as worst pain, least pain, average pain, and pain right now. The severity composite score was calculated as the arithmetic mean of the four severity items(range 0-10). the minimum value is zero and maximum is 10. A higher score represents a poor outcome.
| Group | N | Value | Spread / interval |
|---|---|---|---|
| Sativex High Dose Group | 68 | -1.0 | .09 to .34 |
| Sativex Medium Dose Group | 68 | -1.5 | .09 to .34 |
| Sativex Low Dose Group | 69 | -1.3 | .09 to .34 |
| Placebo | 74 | -1.0 | 1.9 |
The PAC-QoL questionnaire consists of 28 questions divided into the following areas: 4 questions on physical discomfort, 8 questions on psychosocial discomfort, 11 questions on worries/concerns and 5 questions on satisfaction. The PAC-QoL was completed at baseline and then at the end of treatment. An overall score (range 0-4) was calculated at each visit and the difference determined. A positive difference in score represents an improvement.
| Group | N | Value | Spread / interval |
|---|---|---|---|
| Sativex High Dose Group | 70 | 0.0 | -0.04 to 0.26 |
| Sativex Medium Dose Group | 68 | -0.1 | -0.04 to 0.26 |
| Sativex Low Dose Group | 70 | 0.0 | -0.04 to 0.26 |
| Placebo | 74 | -0.1 | 0.6 |
A 7-point Likert-type scale was used, with the question: 'Please assess the status of your pain due to cancer since entry into the study using the scale below' with the markers "very much improved, much improved, slightly improved, no change, slightly worse, much worse or very much worse". At Visit 2 (Baseline) patients wrote a brief description of their pain caused by cancer which was used at Week 5 to aid their memory regarding their symptoms at study start. For each of above markers the number of participants were reported.
| Group | N | Value | Spread / interval |
|---|---|---|---|
| Sativex High Dose Group | 73 | 6 | 0.46 to 1.49 |
| Sativex Medium Dose Group | 71 | 6 | 0.49 to 1.58 |
| Sativex Low Dose Group | 70 | 10 | 0.77 to 2.53 |
| Placebo | 72 | 9 | - |
| Sativex High Dose Group | 73 | 20 | - |
| Sativex Medium Dose Group | 71 | 19 | - |
| Sativex Low Dose Group | 70 | 24 | - |
| Placebo | 72 | 16 | - |
| Sativex High Dose Group | 73 | 25 | - |
| Sativex Medium Dose Group | 71 | 26 | - |
| Sativex Low Dose Group | 70 | 19 | - |
| Placebo | 72 | 28 | - |
| Sativex High Dose Group | 73 | 13 | - |
| Sativex Medium Dose Group | 71 | 13 | - |
| Sativex Low Dose Group | 70 | 13 | - |
| Placebo | 72 | 17 | - |
| Sativex High Dose Group | 73 | 6 | - |
| Sativex Medium Dose Group | 71 | 5 | - |
| Sativex Low Dose Group | 70 | 3 | - |
| Placebo | 72 | 1 | - |
| Sativex High Dose Group | 73 | 1 | - |
| Sativex Medium Dose Group | 71 | 0 | - |
| Sativex Low Dose Group | 70 | 1 | - |
| Placebo | 72 | 1 | - |
| Sativex High Dose Group | 73 | 2 | - |
| Sativex Medium Dose Group | 71 | 2 | - |
| Sativex Low Dose Group | 70 | 0 | - |
| Placebo | 72 | 0 | - |
The MADRS comprises of 10 questions that are completed by the patient to determine their depression level. The MADRS was completed at Visit 2 (Baseline) prior to receiving the study drug and at Visit 4 (Week 5 or premature termination). Each item is scored on a 0-6 scale , where 0=no sadness to 6=extreme and continuous gloom and despondency, and the MADRS score is the sum of the 10 item scores (range 0-60). The higher the score the more severe the depression.
| Group | N | Value | Spread / interval |
|---|---|---|---|
| Sativex High Dose Group | 67 | -0.4 | 0.38 to 3.74 |
| Sativex Medium Dose Group | 66 | -1.0 | 0.38 to 3.74 |
| Sativex Low Dose Group | 66 | -1.1 | 0.38 to 3.74 |
| Placebo | 69 | -2.9 | 9.0 |
| Milestone | Sativex High Dose Group | Sativex Medium Dose Group | Sativex Low Dose Group | Placebo |
|---|---|---|---|---|
| STARTED | 90 | 88 | 91 | 91 |
| COMPLETED | 59 | 67 | 71 | 66 |
| NOT COMPLETED | 31 | 21 | 20 | 25 |
| Event | System | Groups: affected / at risk |
|---|---|---|
| Blood and Lymphatic system disorders | Blood and lymphatic system disorders | Sativex High Dose Group: 0 / 90 · Sativex Medium Dose Group: 0 / 87 · Sativex Low Dose Group: 4 / 91 · Placebo: 2 / 91 |
| Cardiac disorders | Cardiac disorders | Sativex High Dose Group: 0 / 90 · Sativex Medium Dose Group: 0 / 87 · Sativex Low Dose Group: 0 / 91 · Placebo: 1 / 91 |
| Gastrointestinal disorders | Gastrointestinal disorders | Sativex High Dose Group: 4 / 90 · Sativex Medium Dose Group: 3 / 87 · Sativex Low Dose Group: 1 / 91 · Placebo: 2 / 91 |
| General Disorders | General disorders | Sativex High Dose Group: 4 / 90 · Sativex Medium Dose Group: 1 / 87 · Sativex Low Dose Group: 4 / 91 · Placebo: 2 / 91 |
| Hepatobiliary disorders | Hepatobiliary disorders | Sativex High Dose Group: 1 / 90 · Sativex Medium Dose Group: 1 / 87 · Sativex Low Dose Group: 0 / 91 · Placebo: 0 / 91 |
| Infections and Infestations | Infections and infestations | Sativex High Dose Group: 2 / 90 · Sativex Medium Dose Group: 5 / 87 · Sativex Low Dose Group: 4 / 91 · Placebo: 2 / 91 |
| Injury, Poisoning and procedural complications | Injury, poisoning and procedural complications | Sativex High Dose Group: 0 / 90 · Sativex Medium Dose Group: 1 / 87 · Sativex Low Dose Group: 1 / 91 · Placebo: 1 / 91 |
| Investigations | Investigations | Sativex High Dose Group: 1 / 90 · Sativex Medium Dose Group: 0 / 87 · Sativex Low Dose Group: 0 / 91 · Placebo: 0 / 91 |
| Metabolism and Nutrition disorders | Metabolism and nutrition disorders | Sativex High Dose Group: 3 / 90 · Sativex Medium Dose Group: 1 / 87 · Sativex Low Dose Group: 1 / 87 · Placebo: 1 / 91 |
| Musculoskeletal and connective tissue disorders | Musculoskeletal and connective tissue disorders | Sativex High Dose Group: 0 / 90 · Sativex Medium Dose Group: 0 / 87 · Sativex Low Dose Group: 0 / 91 · Placebo: 1 / 91 |
| Neoplasms benign, malignant and unspecified (Incl. Cysts and polyps) | Neoplasms benign, malignant and unspecified (incl cysts and polyps) | Sativex High Dose Group: 13 / 90 · Sativex Medium Dose Group: 12 / 87 · Sativex Low Dose Group: 26 / 91 · Placebo: 15 / 91 |
| Nervous system disorders | Nervous system disorders | Sativex High Dose Group: 3 / 90 · Sativex Medium Dose Group: 1 / 87 · Sativex Low Dose Group: 1 / 91 · Placebo: 0 / 91 |
| Psychiatric disorders | Psychiatric disorders | Sativex High Dose Group: 2 / 90 · Sativex Medium Dose Group: 1 / 87 · Sativex Low Dose Group: 1 / 91 · Placebo: 0 / 91 |
| Renal and urinary disorders | Renal and urinary disorders | Sativex High Dose Group: 4 / 90 · Sativex Medium Dose Group: 0 / 87 · Sativex Low Dose Group: 0 / 91 · Placebo: 1 / 91 |
| Respiratory, thoracic and mediastinal disorders | Respiratory, thoracic and mediastinal disorders | Sativex High Dose Group: 1 / 90 · Sativex Medium Dose Group: 1 / 87 · Sativex Low Dose Group: 1 / 91 · Placebo: 1 / 91 |
| Vascular disorders | Vascular disorders | Sativex High Dose Group: 3 / 90 · Sativex Medium Dose Group: 0 / 87 · Sativex Low Dose Group: 0 / 91 · Placebo: 1 / 91 |
| Event | System | Groups: affected / at risk |
|---|---|---|
| Blood and lymphatic system disorders | Blood and lymphatic system disorders | Sativex High Dose Group: 9 / 90 · Sativex Medium Dose Group: 8 / 87 · Sativex Low Dose Group: 9 / 91 · Placebo: 7 / 91 |
| Cardiac disorders | Cardiac disorders | Sativex High Dose Group: 2 / 90 · Sativex Medium Dose Group: 2 / 87 · Sativex Low Dose Group: 6 / 91 · Placebo: 6 / 91 |
| Ear and labyrinth disorders | Ear and labyrinth disorders | Sativex High Dose Group: 4 / 90 · Sativex Medium Dose Group: 4 / 87 · Sativex Low Dose Group: 0 / 91 · Placebo: 3 / 91 |
| Eye disorders | Eye disorders | Sativex High Dose Group: 1 / 90 · Sativex Medium Dose Group: 4 / 87 · Sativex Low Dose Group: 1 / 91 · Placebo: 1 / 91 |
| Gastrointestinal Disorder | Gastrointestinal disorders | Sativex High Dose Group: 47 / 90 · Sativex Medium Dose Group: 42 / 87 · Sativex Low Dose Group: 36 / 91 · Placebo: 29 / 91 |
| General Disorders | General disorders | Sativex High Dose Group: 24 / 90 · Sativex Medium Dose Group: 18 / 87 · Sativex Low Dose Group: 18 / 91 · Placebo: 20 / 91 |
| Hepatobillary Disorders | Hepatobiliary disorders | Sativex High Dose Group: 2 / 90 · Sativex Medium Dose Group: 1 / 87 · Sativex Low Dose Group: 0 / 91 · Placebo: 0 / 91 |
| Infections and Infestations | Infections and infestations | Sativex High Dose Group: 8 / 90 · Sativex Medium Dose Group: 15 / 87 · Sativex Low Dose Group: 11 / 81 · Placebo: 11 / 91 |
| Injury, poisoning and procedural complications | Injury, poisoning and procedural complications | Sativex High Dose Group: 1 / 90 · Sativex Medium Dose Group: 2 / 87 · Sativex Low Dose Group: 0 / 91 · Placebo: 4 / 91 |
| Investigations | Investigations | Sativex High Dose Group: 5 / 90 · Sativex Medium Dose Group: 9 / 87 · Sativex Low Dose Group: 11 / 91 · Placebo: 3 / 91 |
| Metabolism and nutrition disorders | Metabolism and nutrition disorders | Sativex High Dose Group: 22 / 90 · Sativex Medium Dose Group: 15 / 87 · Sativex Low Dose Group: 11 / 91 · Placebo: 12 / 91 |
| Musculoskeletal and connective tissue disorders | Musculoskeletal and connective tissue disorders | Sativex High Dose Group: 5 / 90 · Sativex Medium Dose Group: 12 / 87 · Sativex Low Dose Group: 6 / 91 · Placebo: 6 / 91 |
| Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
Time frame: Baseline (Visit 2) and End of Treatment (Week 5 or premature termination)
The PAC-QoL questionnaire consists of 28 questions divided into the following areas: 4 questions on physical discomfort, 8 questions on psychosocial discomfort, 11 questions on worries/concerns and 5 questions on satisfaction. The PAC-QoL was completed at baseline and then at the end of treatment. An overall score (range 0-4) was calculated at each visit and the difference determined. A positive difference in score represents an improvement.
Time frame: End of Week 5
A 7-point Likert-type scale was used, with the question: 'Please assess the status of your pain due to cancer since entry into the study using the scale below' with the markers "very much improved, much improved, slightly improved, no change, slightly worse, much worse or very much worse". At Visit 2 (Baseline) patients wrote a brief description of their pain caused by cancer which was used at Week 5 to aid their memory regarding their symptoms at study start. For each of above markers the number of participants were reported.
Time frame: Baseline and End of Treatment (Week 5 or premature termination)
The MADRS comprises of 10 questions that are completed by the patient to determine their depression level. The MADRS was completed at Visit 2 (Baseline) prior to receiving the study drug and at Visit 4 (Week 5 or premature termination). Each item is scored on a 0-6 scale , where 0=no sadness to 6=extreme and continuous gloom and despondency, and the MADRS score is the sum of the 10 item scores (range 0-60). The higher the score the more severe the depression.
| Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
| Sativex High Dose Group: 16 / 90 · Sativex Medium Dose Group: 12 / 87 · Sativex Low Dose Group: 26 / 91 · Placebo: 14 / 91 |
| Nervous system disorders | Nervous system disorders | Sativex High Dose Group: 44 / 90 · Sativex Medium Dose Group: 39 / 87 · Sativex Low Dose Group: 26 / 91 · Placebo: 20 / 91 |
| Psychiatric disorders | Psychiatric disorders | Sativex High Dose Group: 23 / 90 · Sativex Medium Dose Group: 14 / 87 · Sativex Low Dose Group: 13 / 91 · Placebo: 13 / 91 |
| Renal and urinary disorders | Renal and urinary disorders | Sativex High Dose Group: 8 / 90 · Sativex Medium Dose Group: 4 / 87 · Sativex Low Dose Group: 4 / 91 · Placebo: 6 / 91 |
| Respiratory, thoracic and mediastinal disorders | Respiratory, thoracic and mediastinal disorders | Sativex High Dose Group: 7 / 90 · Sativex Medium Dose Group: 6 / 87 · Sativex Low Dose Group: 11 / 91 · Placebo: 6 / 91 |
| Skin and subcuraneous tissue disorders | Skin and subcutaneous tissue disorders | Sativex High Dose Group: 7 / 90 · Sativex Medium Dose Group: 3 / 87 · Sativex Low Dose Group: 3 / 91 · Placebo: 1 / 91 |
| Surgical and medical procedures | Surgical and medical procedures | Sativex High Dose Group: 0 / 90 · Sativex Medium Dose Group: 0 / 87 · Sativex Low Dose Group: 2 / 91 · Placebo: 0 / 91 |
| Vascular Disorders | Vascular disorders | Sativex High Dose Group: 4 / 90 · Sativex Medium Dose Group: 3 / 87 · Sativex Low Dose Group: 5 / 91 · Placebo: 4 / 91 |