# Safety, tolerability, and dose limiting toxicity of lacosamide in patients with painful chronic pancreatitis

> **NIH NIH R01** · INDIANA UNIVERSITY INDIANAPOLIS · 2024 · $304,462

## Abstract

ABSTRACT: Background: Chronic abdominal pain is the hallmark symptom of chronic
pancreatitis (CP), with 50-80% of patients seeking medical attention for pain control. While several
management options are potentially available, outcomes are often disappointing, and opioids
remain a mainstay of therapy. Opioid-induced hyperalgesia (OIH) may occur, a phenomenon
resulting in dose escalation, and appears to be due in part to the effect of opioids on pain-
associated voltage-gated sodium channels. Lacosamide blocks and stabilizes these channels
and may inhibit the effects of OIH. This may result in improved pain control with a decrease in
opioid use. In pre-clinical and clinical trials with neuropathic pain, lacosamide reduced pain scores
and was well tolerated. There are no data, however, evaluating the use of lacosamide in CP
patients. Aims: 1. To evaluate the safety, tolerability and dose-limiting toxicity of adding
lacosamide to opioid therapy in subjects with suspected and definite painful CP; 2. To assess the
feasibility of performance of a pilot study adding lacosamide to opioid therapy in these subjects.
As an exploratory aim, we will assess the efficacy of adding lacosamide to opioid therapy for the
treatment of abdominal pain due to CP. Methods: This is a Phase 1 trial, utilizing the Bayesian
optimal interval (BOIN) design to find the Maximum Tolerated Dose (MTD). The target dose-
limiting toxicity (DLT) rate for the MTD is ɸ = 0.3 and the maximum sample size is 24. Given the
small sample size, anticipated relatively short study period and potential for patient recruitment at
several clinical centers, it is anticipated that all data will be accrued within 36 months of study
initiation. Significance: This study will generate new knowledge regarding the safety, toxicity and
dose-limiting toxicity of lacosamide in CP patients. It is anticipated that lacosamide will prove to
be safe and well-tolerated. The results of this pilot study will then support proceeding with a phase
2 trial assessing the efficacy of lacosamide added to opioid therapy to alleviate abdominal pain
from CP.

## Key facts

- **NIH application ID:** 10828846
- **Project number:** 5R01DK132709-03
- **Recipient organization:** INDIANA UNIVERSITY INDIANAPOLIS
- **Principal Investigator:** Evan L Fogel
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $304,462
- **Award type:** 5
- **Project period:** 2022-04-15 → 2027-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10828846

## Citation

> US National Institutes of Health, RePORTER application 10828846, Safety, tolerability, and dose limiting toxicity of lacosamide in patients with painful chronic pancreatitis (5R01DK132709-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10828846. Licensed CC0.

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