• Robert C Alexander, Karen Raudibaugh, SpieringsEgilius L HELHMedVadis Research Corporation, Waltham., and Nathaniel Katz.
• Takeda Pharmaceuticals International Co., Cambridge.
• Clin J Pain. 2021 Jan 1; 37 (1): 38-42.

ObjectivesIn this study, patients with painful diabetic neuropathy were trained using an experimental pain paradigm in an attempt to enroll a subset of patients who are "pain connoisseurs" and therefore more able to discriminate between active and placebo treatments.MethodsAZD5213, a novel histamine H3 receptor inverse agonist+pregabalin, pregabalin, and placebo were then tested in a 3-period cross-over.ResultsThe study did not provide any evidence of clinical efficacy for AZD5213 when combined with pregabalin in the treatment of painful diabetic neuropathy.DiscussionThe training of study patients in pain reporting and subsequent enrichment with good pain reporters also did not enable the robust detection of the efficacy of pregabalin relative to placebo in a small sample size. Further work is required before recommending the use of "connoisseur" patients in future neuropathic pain studies.

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