Efficacy and Safety of ETX-018810 for the Treatment of Diabetic Peripheral Neuropathic Pain

ETX-018810 is a new chemical entity that is under development as a non-opioid treatment for chronic pain syndromes. ETX-018810 is a prodrug of palmitoylethanolamide (PEA), an endogenous bioactive lipid that has shown efficacy in a broad range of nonclinical inflammatory and neuropathic pain models and in clinical trials in chronic pain indications, including diabetic peripheral neuropathic pain (DPNP).

Inclusion criteria

• The subject is ≥18 and ≤75 years of age at the time of signing ICF.
• The subject has a diagnosis of type 1 or 2 diabetes mellitus.
• The subject has diabetic neuropathy of a symmetrical nature in the lower extremities for ≥6 months to ≤10 years
• The subject reports at least moderate pain intensity
• The subject's onset of neuropathic pain is at least 3 months before the screening visit.
• The subject has used a stable regimen of antidiabetic agents for at least 1 month before the baseline visit or has achieved adequate glycemic control through diet and exercise.
• The subject has clinical laboratory values within normal limits or abnormal values that the investigator deems not clinically significant.
• Sexually active male subjects with female partners of childbearing potential and sexually active female subjects of childbearing potential must agree to practice effective contraception or to remain abstinent during the study and for 4 weeks after the last dose of investigational product
• The subject is capable of giving signed informed consent and agrees to provide authorization for use and release of health records.

Exclusion criteria

• The subject has pain that cannot be clearly differentiated from or that could interfere with the assessment of DPNP.
• The subject has neurologic and/or circulatory disorders that are unrelated to diabetic neuropathy
• The subject has a history of hypoglycemia that disturbed consciousness or ketoacidosis that required hospitalization within the 3 months before screening.
• The subject has clinically significant and/or unstable renal, hepatic, hematologic, immunologic, inflammatory/rheumatologic, respiratory, or cardiovascular disease that would compromise participation in the study in the judgment of the investigator.
• The subject has any neurological disease that could interfere with participation in the study (eg, Huntington's disease, Parkinson's disease, Alzheimer's disease, multiple sclerosis, seizures, epilepsy, stroke).
• The subject has an amputation of a lower extremity. Toe amputation is allowed.
• The subject has clinically significant abnormal electrocardiogram (ECG) findings at screening or baseline.
• The subject is likely to require major surgery during the study.
• The subject is pregnant or lactating.
• The subject is unwilling or unable to discontinue current medications for neuropathic pain, including topical agents.
• The subject is unable to refrain from using nonsteroidal anti-inflammatory drugs (NSAIDs); antiepileptic drugs, steroids, cannabinoids, or major opioids, muscle relaxants, tramadol, or tapentadol throughout the study.
• The subject has used prohibited nonpharmacologic therapies, including acupuncture, transcutaneous electrical nerve stimulation, etc, within 30 days before baseline/Day 1 or anticipates use of such therapies during the study.