Recruiting
Phase 1
Phase 2

Hydroxynorketamine

Sponsor:

Rush University Medical Center

Code:

NCT05864053

Conditions

Pain, Neuropathic

Eligibility Criteria

Sex: All

Age: 18 - 70+

Healthy Volunteers: Not accepted

Interventions

Ketamine

(2R,6R)-hydroxynorketamine

Saline

Study Details

Brief summary:

The goal of this randomized double blind three way (1:1:1) cross over clinical trial is to evaluate the effectiveness and duration of analgesia of a single infusion of (2R,6R)-HNK 0.5mg/kg compared with ketamine 0.5mg/kg and saline with a 5-week interval between treatments on pain, pain qualities, physical function, pain interference, sleep disturbance and quality of life in subjects with neuropathic pain of the extremities.

The questions that this study will address are:

1. What is the analgesic efficacy of (2R,6R)-HNK on pain intensity and pain qualities in patients with chronic (>3 month) neuropathic pain (NP).
2. What will be the effective duration of a single infusion of (2R,6R)-HNK in patients with NP.
3. Will (2R,6R)-HNK reduce pain related effects including interference in daily activities of life, sleep disturbances and change the qualities of pain reported by patients.

Participants will receive each of the three study drugs in a random order at 5-week intervals over a 15 week period. The drug will be administered as a 45-minute infusion.

Participants will complete quantitative sensory and pain evaluations and complete patient reported pain outcomes prior to receiving the first study drug and at 7, 14 and 21 and 35 days following study drug administration.

Conditions

Pain, Neuropathic

Study ID

NCT05864053

Start date

Sep 19, 2024

Status verified date

Jul, 2026

Completion date

Aug, 2027

Anticipated

Primary completion date

Apr, 2027

Anticipated

Eligibility Criteria

Eligibility Criteria

Sex: All

Age: 18 - 70+

Healthy Volunteers: Not accepted

Inclusion Criteria:

  • Adult patients (18 to 75 years) with an established diagnosis of chronic (> 3 month) NP of the extremities.
  • Presence of NP as determined at screening using the 10 item Neuropathic Pain Questionnaire (DN4), with a score of ≥4 required for study inclusion.
  • Ability to read and write English sufficiently to complete study related procedures.
  • A body mass index (BMI) (weight \[kg\]/height\[m \]) between 18 and 35 kg/m (inclusive) and weighs between 50 kg and 120 kg (110 - 264 pounds).
  • Blood pressure with subject is in a supine position for approximately 5 minutes between 90 and 145 mmHg systolic and no higher than 90 mmHg diastolic at baseline.
  • A 12-lead ECG with no clinically significant abnormality as judged by the Investigator and QTc interval ≤ 450 milliseconds at baseline.
  • Resting pulse rate between 45 and 100 beats per minute.
  • Clinical laboratory findings and liver function tests within the normal range, or if outside of the normal ranges, deemed not clinically significant in the opinion of the PI.
  • Agree to provide written informed consent and comply with the rules regarding consumption of alcohol, caffeinated beverages, and tobacco/nicotine products during the study.
  • Patients may be taking scheduled or as needed medications for their chronic neuropathic pain and agree to continue taking the scheduled medications throughout the study period.
  • If the subject experiences pain relief they may elect not to take as needed medications.

Exclusion Criteria:

  • Subjects with suspected increased intracranial or intraocular pressure.
  • Subjects that have previously received ketamine for the treatment of a chronic pain diagnoses.
  • Previous or current participation in any clinical study with an investigational drug, device, or biologic within 30 days.
  • Subjects with severe medical illness including (but not limited to) hepatic, cardiovascular, pulmonary, renal, hematologic, endocrine, gastrointestinal, immunologic, dermatologic, neurologic, oncologic, or psychiatric disease that in the opinion of the PI would endanger the safety of the subject or the validity of the study results.
  • Clinically significant acute illness in the 2 weeks prior to dosing.
  • Inability to effectively communicate with research staff.
  • Subjects with known liver disease.
  • Widespread pain or a diagnosis of fibromyalgia.
  • Current diagnosis of mental illness.
  • Pregnancy.
  • Allergy to ketamine or any study drug.
  • Consumption of beverages or food that contain alcohol, grapefruit, poppy seeds, Brussel sprouts, pomegranate, broccoli, char-grilled meat within 2 days prior to drug administration.
  • Use of tobacco or nicotine-containing products within 4 weeks prior to drug administration.
  • Poor peripheral venous access.
  • Subjects in the opinion of the PI should not participate in the study.

Study Design

Enrollment

25 participants

Anticipated

Allocation

Randomized

Intervention Model

Crossover

Primary purpose

Treatment

Interventions and Outcome Measures

Arms

active comparator: Ketamine

Ketamine 0.5mg/kg 45 minute infusion x 1

experimental: (2R,6R)-hydroxynorketamine

(2R,6R)-hydroxynorketamine 0.5mg/kg 45 minute infusion x 1

placebo comparator: Saline

Saline 45 minute infusion x 1

Interventions

Ketamine

Ketamine will be administered over a 45-minute period.

(2R,6R)-hydroxynorketamine

(2R,6R)-Hydroxynorketamine hydrochloride will be administered over a 45-minute period.

Saline

Saline will be administered over a 45-minute period.

Primary outcome measure

  • Pain intensity [ Time Frame: 35 days ]

Central Contacts and Locations

Central contacts

Robert J McCarthy, Pharm D

3125630448robert_j_mccarthy@rush.edu

Rachel Granito, BS

3125632028rachel_granito@rush.edu

Locations

Rush University Medical Center

Recruiting

Chicago, Illinois, United States, 60612

Contacts

Robert J McCarthy, Pharm D

3125630448robert_j_mccarthy@rush.edu

Daniel Torrez, BS

3129422741daniel_torrez@rush.edu

More Information

Sponsor

Rush University Medical Center

Last update posted

Aug 3, 2026

Last verified

Jul, 2026

Keywords

  • pain
  • pain, chronic
  • pain, neuropathic
  • non-opioid analgesic
  • ketamine
  • (2R,6R)-hydroxynorketamine

Trial information was received from ClinicalTrials.gov and was last updated on 2026-09-09. This information was provided to ClinicalTrials.gov by Rush University Medical Center on 2026-08-03.