A Phase 2 interventional study of Gabapentin gelatin capsules 300mg and Placebo in COVID-19, Olfactory Disorder and Anosmia, sponsored by Washington University School of Medicine. Completed at 1 site in United States. Open to participants aged 18 Years to 65 Years. Per ClinicalTrials.gov, last updated 2025-03-04.
Sponsored by Washington University School of Medicine · Phase 2, Interventional, and Treatment
This study will investigate the efficacy of oral gabapentin in olfactory improvement following Covid-19- associated olfactory dysfunction. This is a randomized, double-blinded, placebo-controlled trial.
The drug will be given over a maximum 14 weeks with up to four weeks titrating up, eight weeks maintaining highest tolerable dose, and up to two weeks tapering down. Change in olfactory function from baseline to completion of 8-week fixed-dose period will be compared between the two study groups. Follow-up assessments will be conducted for both groups 4 weeks after completion of taper down.
7,990 studies on the registry are indexed under COVID-19; 466 are open to participants now.
This study's enrollment of 68 is below the median of 102 across 4,364 interventional studies indexed under COVID-19.
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This arm will be given the active treatment, oral Letco (gabapentin) gelatin capsules of 300mg each. Up to the first four weeks will be a titration period (week 1 300mg TID, week 2 600mg TID, week 3 900mg TID, week 4 1,200mg TID) as tolerated. If intolerable adverse reactions occur, the dosage will be decreased to prior tolerable dose (e.g., if 900mg TID is intolerable, dose will be decreased to 600mg TID). The following eight weeks will be fixed dose, the highest tolerable dose from the titration period. Up to two weeks will be a taper down tailored to the maximum dose the participant reached during the titration and fixed periods. A maximum 14 weeks will mark the end of active treatment. Follow-up assessments will be conducted 4 weeks after completion of the taper-down period.
Drug: Gabapentin gelatin capsules 300mg
Placebo gelatin capsules that look, smell, and taste like gabapentin capsules will be given to the placebo arm. To preserve double-blinding of the study, subjects will receive one capsule TID the first week, the second week two capsules TID, the third week three capsules TID, and fourth week four capsules TID as tolerated. If intolerable, the dose will be decreased to prior tolerable dose. The next eight weeks will be a fixed amount of placebo based on the highest tolerable amount from the titration period. Subjects will then taper-down placebo to imitate the gabapentin arm for maximum two weeks based on highest dose achieved during study. 4 weeks after completion of taper-down, follow-up assessments will be conducted.
Drug: Placebo
Gabapentin is an anti-epileptic also used for nerve pain. This study will investigate the efficacy of gabapentin for olfactory nerve recovery and improvement in post-Covid-19 olfactory dysfunction.
Also known as: Letco
lactose monohydrate NF
Clinical Global Impression of Improvement Scale (CGI-I)
The primary outcome measure was the treatment response rate following the 8-week FD phase as determined by the CGI-I. The CGI-I is a modified 7-point Likert scale of -perceived change. Response options include: (1) much better, (2) somewhat better, (3) slightly better), (4) neither better nor worse, (5) slightly worse, (6) somewhat worse, (7) much worse. The response rate was defined as the number of participants self-reporting at least "slightly better" divided by the number of participants in each treatment group. Th
Time frame: After the 8 week FD phase and four week post-tapper
University of Pennsylvania Smell Identification Test (UPSIT)
Forty different odors are presented in this test. Scoring: Forced choice of 4 responses to identify each smell. Anosmia: score 6-18; severe microsmia: score 19-25, moderate microsmia: 26-30 in women and 26-29 in men; mild microsmia: 31-34 in women and 30-33 in men; and normosmia: score \> 34 in women and \>33 in men. The total UPSIT score can range from 0 to 40 and scores. The MCID in UPSIT score is 4. Scores are interpreted as the level of absolute smell function (i.e., normosmia, mild hyposmia, moderate hyposmia, severe hyposmia, and anosmia), using the age- and sex-related normative classification system described in the UPSIT manual (Table 1)
Time frame: Baseline, after completion of eight-week fixed-dose period, and 4 weeks after completion of taper-down period
Olfactory Dysfunction Outcomes Rating (ODOR)
The ODOR questionnaire is a validated 28-item patient-reported outcome measure which assesses the physical, functional, and emotional consequences of OD. The ODOR is a 28-item instrument with each item scored as either no difficulty or very rarely bothered (0) to complete difficulty or very frequently bothered (4) with a total instrument score range of 0 to 112 points. Higher scores indicate higher degree of dysfunction and limitation. the MCID is 15 points.
Time frame: Baseline, after completion of eight-week fixed-dose period, and 4 weeks after completion of taper-down period
NASAL-7
NASAL-7 is a simple diagnostic tool for olfactory dysfunction that is based on commonly found household items and can be used by adults who suspect olfactory dysfunction. The NASAL-7 was developed by Dr. Piccirillo and colleagues in the Clinical Outcomes Research Office. The NASAL-7, contains 7 household items with each item scored as 0 for 'Cannot Smell', 1 for 'Smells Less Strong/Different Than Normal', and 2 for 'Smells Normal', for a total possible score ranging from 0-14. The following four categories of olfactory function were defined based on NASAL-7 score: anosmia (score 0-4), severe dysfunction (score 5-7), mild dysfunction (score 8-10), and normosmia (score 11-14).
Time frame: Baseline, after completion of eight-week fixed-dose period, and 4 weeks after completion of taper-down period
CGI-Severity of Smell
CGI-Severity. The CGI-Severity scale ranges from 1 to 7, where 1 is normal function and 7 is complete anosmia. This assessment will provide subjective data on patients' baseline olfactory function prior to beginning the trial, after 8-week Fixed-Dose period, and 4 weeks after completion of Taper-Down phase
Time frame: 8-week Fixed-Dose period, and 4 weeks after completion of Taper-Down phase
CGI-S of Parosmia
Clinical Global Impression-Severity Scale for Parosmics (CGI-P). The CGI-P Scale is a global rating of parosmia and the single global rating ranges from 1-5, where 1 is No Distortion, 2 is Mild Distortion, 3 is Moderate Distortion, 4 is Mostly Distorted, and 5 is Complete Distortion. The response on the CGI-P will provide information on the patient's perceived severity of the distortion of their smell.
Time frame: 8-week Fixed-Dose period, and 4 weeks after completion of Taper-Down phase
| Milestone | Gabapentin | Placebo |
|---|---|---|
| Started | 34 | 34 |
| Completed | 26 | 17 |
| Not completed | 8 | 17 |
| Withdrew: Lost to follow-up | 4 | 7 |
| Withdrew: Adverse event | 1 | 4 |
| Withdrew: Pi withdrawal | 1 | 2 |
| Withdrew: Withdrew due to adverse effect | 1 | 0 |
| Withdrew: Medication schedule | 1 | 0 |
| Withdrew: Concern for adverse effects | 0 | 4 |
The primary outcome measure was the treatment response rate following the 8-week FD phase as determined by the CGI-I. The CGI-I is a modified 7-point Likert scale of -perceived change. Response options include: (1) much better, (2) somewhat better, (3) slightly better), (4) neither better nor worse, (5) slightly worse, (6) somewhat worse, (7) much worse. The response rate was defined as the number of participants self-reporting at least "slightly better" divided by the number of participants in each treatment group. Th
| Participants | Gabapentin | Placebo |
|---|---|---|
| Fixed Dose Period | 8 | 20 |
| 4 week post tapper | 7 | 12 |
Forty different odors are presented in this test. Scoring: Forced choice of 4 responses to identify each smell. Anosmia: score 6-18; severe microsmia: score 19-25, moderate microsmia: 26-30 in women and 26-29 in men; mild microsmia: 31-34 in women and 30-33 in men; and normosmia: score \> 34 in women and \>33 in men. The total UPSIT score can range from 0 to 40 and scores. The MCID in UPSIT score is 4. Scores are interpreted as the level of absolute smell function (i.e., normosmia, mild hyposmia, moderate hyposmia, severe hyposmia, and anosmia), using the age- and sex-related normative classification system described in the UPSIT manual (Table 1)
| score on a scale (0-40) | Gabapentin | Placebo |
|---|---|---|
| Baseline | 23 (10 to 31) | 24 (7 to 34) |
| Fixed Dose | 25 (12 to 34) | 25 (15 to 34) |
| Post-taper | 26 (7 to 33) | 25 (9 to 35) |
The ODOR questionnaire is a validated 28-item patient-reported outcome measure which assesses the physical, functional, and emotional consequences of OD. The ODOR is a 28-item instrument with each item scored as either no difficulty or very rarely bothered (0) to complete difficulty or very frequently bothered (4) with a total instrument score range of 0 to 112 points. Higher scores indicate higher degree of dysfunction and limitation. the MCID is 15 points.
| score on a scale (0-112) | Gabapentin | Placebo |
|---|---|---|
| Baseline | 23 (10 to 31) | 54.5 (30 to 96) |
| Fixed Dose | 25.5 (15 to 34) | 49.9 (8 to 96) |
| Post Taper | 25 (9 to 35) | 45 (8 to 85) |
NASAL-7 is a simple diagnostic tool for olfactory dysfunction that is based on commonly found household items and can be used by adults who suspect olfactory dysfunction. The NASAL-7 was developed by Dr. Piccirillo and colleagues in the Clinical Outcomes Research Office. The NASAL-7, contains 7 household items with each item scored as 0 for 'Cannot Smell', 1 for 'Smells Less Strong/Different Than Normal', and 2 for 'Smells Normal', for a total possible score ranging from 0-14. The following four categories of olfactory function were defined based on NASAL-7 score: anosmia (score 0-4), severe dysfunction (score 5-7), mild dysfunction (score 8-10), and normosmia (score 11-14).
| Participants | Gabapentin | Placebo |
|---|---|---|
| Baseline — Anosmia (0-4) | 6 | 10 |
| Baseline — Severe dysfunction (5-7) | 8 | 12 |
| Baseline — Mild dysfunction (8-10) | 2 | 3 |
| Baseline — Normosmia (11-14) | 2 | 1 |
| Fixed Dose — Anosmia (0-4) | 4 | 7 |
| Fixed Dose — Severe dysfunction (5-7) | 5 | 9 |
| Fixed Dose — Mild dysfunction (8-10) | 4 | 6 |
| Fixed Dose — Normosmia (11-14) | 5 | 4 |
| Post taper — Anosmia (0-4) | 5 | 7 |
| Post taper — Severe dysfunction (5-7) | 6 | 6 |
| Post taper — Mild dysfunction (8-10) | 2 | 5 |
| Post taper — Normosmia (11-14) | 3 | 7 |
CGI-Severity. The CGI-Severity scale ranges from 1 to 7, where 1 is normal function and 7 is complete anosmia. This assessment will provide subjective data on patients' baseline olfactory function prior to beginning the trial, after 8-week Fixed-Dose period, and 4 weeks after completion of Taper-Down phase
| Participants | Gabapentin | Placebo |
|---|---|---|
| Assessments of the Secondary Outcome Measures of Study Groups: Baseline — Absent | 4 | 4 |
| Assessments of the Secondary Outcome Measures of Study Groups: Baseline — Poor | 12 | 16 |
| Assessments of the Secondary Outcome Measures of Study Groups: Baseline — Fair | 1 | 4 |
| Assessments of the Secondary Outcome Measures of Study Groups: Baseline — Good | 1 | 1 |
| Assessments of the Secondary Outcome Measures of Study Groups: Baseline — Very good | 0 | 1 |
| Assessments of the Secondary Outcome Measures of Study Groups: Baseline — Excellent | 0 | 0 |
| Fixed Dose — Absent | 3 | 5 |
| Fixed Dose — Poor | 4 | 13 |
| Fixed Dose — Fair | 8 | 4 |
| Fixed Dose — Good | 3 | 3 |
| Fixed Dose — Very good | 0 | 1 |
| Fixed Dose — Excellent | 0 | 0 |
| Post taper — Absent | 2 | 3 |
| Post taper — Poor | 7 | 13 |
| Post taper — Fair | 5 | 6 |
| Post taper — Good | 2 | 2 |
| Post taper — Very good | 0 | 1 |
| Post taper — Excellent | 0 | 0 |
Clinical Global Impression-Severity Scale for Parosmics (CGI-P). The CGI-P Scale is a global rating of parosmia and the single global rating ranges from 1-5, where 1 is No Distortion, 2 is Mild Distortion, 3 is Moderate Distortion, 4 is Mostly Distorted, and 5 is Complete Distortion. The response on the CGI-P will provide information on the patient's perceived severity of the distortion of their smell.
| Participants | Gabapentin | Placebo |
|---|---|---|
| Assessments of Secondary Outcome Measures of Study Groups: Baseline — Complete Distortion | 7 | 6 |
| Assessments of Secondary Outcome Measures of Study Groups: Baseline — Mostly Distorted | 9 | 8 |
| Assessments of Secondary Outcome Measures of Study Groups: Baseline — Moderate Distortion | 2 | 7 |
| Assessments of Secondary Outcome Measures of Study Groups: Baseline — Mild Distortion | 0 | 4 |
| Assessments of Secondary Outcome Measures of Study Groups: Baseline — No Distortion | 0 | 1 |
| Fixed Dose — Complete Distortion | 2 | 3 |
| Fixed Dose — Mostly Distorted | 6 | 6 |
| Fixed Dose — Moderate Distortion | 4 | 9 |
| Fixed Dose — Mild Distortion | 5 | 7 |
| Fixed Dose — No Distortion | 1 | 1 |
| Post tapper — Complete Distortion | 2 | 2 |
| Post tapper — Mostly Distorted | 5 | 9 |
| Post tapper — Moderate Distortion | 6 | 9 |
| Post tapper — Mild Distortion | 2 | 4 |
| Post tapper — No Distortion | 1 | 1 |
Collected over If tolerated, all participants will complete the Titration period (≤ 4 weeks), Fixed-Dose period (8 weeks), and Taper-Down period (2 weeks) for maximum 14 weeks of active participation. In addition, there will be a 4-week, post-Taper completion follow-up for maximum total of 18-week trial duration. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Gabapentin | 0/18 (0%) | 0/18 (0%) | 10/18 (55.6%) |
| Placebo | 0/26 (0%) | 0/26 (0%) | 11/26 (42.3%) |
| Event | Gabapentin | Placebo |
|---|---|---|
| fatigueInvestigations | 10/18 | 11/26 |
| dizzinessInvestigations | 6/18 | 0/26 |
| brain fogInvestigations | 6/18 | 2/26 |
| weight gainInvestigations | 5/18 | 0/26 |
Thirty-four participants were randomized to gabapentin and 34 were randomized to placebo.
| Age, Continuous(years) | Gabapentin | Placebo | Total |
|---|---|---|---|
| Mean | 42 ± 10.6 | 44 ± 15.5 | 43 ± 13.5 |
| Sex: Female, Male(Participants) | Gabapentin | Placebo | Total |
|---|---|---|---|
| Female | 26 | 25 | 51 |
| Male | 8 | 9 | 17 |
| Race (NIH/OMB)(Participants) | Gabapentin | Placebo | Total |
|---|---|---|---|
| American Indian or Alaska Native | 0 | 0 | 0 |
| Asian | 0 | 0 | 0 |
| Native Hawaiian or Other Pacific Islander | 0 | 0 | 0 |
| Black or African American | 2 | 0 | 2 |
| White | 23 | 33 | 56 |
| More than one race | 0 | 0 | 0 |
| Unknown or Not Reported | 2 | 1 | 3 |
| Race/Ethnicity, Customized(Participants) | Gabapentin | Placebo | Total |
|---|---|---|---|
| White | 23 | 33 | 56 |
| Black / African American | 2 | 0 | 2 |
| Hispanic | 0 | 1 | 1 |
| Other | 2 | 0 | 2 |
| Region of Enrollment(participants) | Gabapentin | Placebo | Total |
|---|---|---|---|
| United States | 34 | 34 | 68 |
| University of Pennsylvania Smell Identification Test (UPSIT)(score on a scale (0-40)) | Gabapentin | Placebo | Total |
|---|---|---|---|
| Median | 24.5 (8 to 33) | 25.5 (7 to 34) | 25.0 (7.0 to 34.0) |
| Olfactory Dysfunction Outcomes Rating (ODOR)(score on a scale (0-112)) | Gabapentin | Placebo | Total |
|---|---|---|---|
| Median | 56 (14 to 102) | 54.5 (0 to 101) | 56 (0 to 102) |
| NASAL-7 categories(Participants) | Gabapentin | Placebo | Total |
|---|---|---|---|
| Anosmia (0-4) | 9 | 11 | 20 |
| Severe dysfunction (5-7) | 12 | 16 | 28 |
| Mild dysfunction (8-10) | 4 | 5 | 9 |
| Normosmia (11-14) | 2 | 2 | 4 |
2 further baseline measures are reported on the registry.
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: No
Ran from Jan 2022 to primary completion in Aug 2023, 19 months.
Results were first posted in Mar 2025, 1 year 6 months after primary completion.
Of 359 non-industry phase 2 interventional studies under COVID-19, half reached primary completion within 11 months of starting (the median), counting those still running; a quarter within 5 and three quarters within 18. This study's 19 months is above that.
Counting every sponsor, half of 582 studies reached it within 9 months; a quarter within 5 and three quarters within 16.
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