Biomarkers in Pain and Pain Treatment

February 24, 2020 updated by: Rikard Wicksell

The Effect of Inflammation on Psychological Comorbidity and Behavioral Treatment in Chronic Pain

The goal of this research project is to explore if levels of inflammation predict levels of comorbid mood disorders and treatment success in chronic pain patients. More knowledge in this respect will advance our understanding of chronic pain and comorbid syndromes, and facilitate subgroupings of patients based on the presence and/or level of low-grade inflammation. This research is an important step towards finding an explanation to why treatment effects following behavioral interventions differ across individuals, and generate new hypothesis regarding novel treatment approaches. The specific aims are: 1) to explore if baseline levels of inflammatory biomarkers predict the effects of behavioral intervention and 2) to investigate if baseline levels of inflammatory biomarkers are associated with psychological co-morbidity (e.g. depression, anxiety and fatigue) in patients with chronic pain.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Observational

Enrollment (Actual)

90

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

The patients at the Karolinska Pain Center, suffering from chronic pain that does not respond to any other pain treatments and affects daily functioning severely.

Description

Inclusion Criteria:

  1. Referred to a specialist clinic within pain management
  2. Equal to or older than 18 years
  3. Chronic pain (> 6 months)
  4. The pain is refractory
  5. The pain results in significant functional limitations
  6. Stable medication in the last 2 months and no planned changes in medication (except possibly discontinuation or lowering of current dose)

Exclusion Criteria:

  1. Spontaneous improvement can be expected (without treatment)
  2. Psychiatric comorbidity a) is deemed to be the main reason for the restrictions, or b) should be promptly evaluated and possibly treated, or c) may adversely affect the treatment given in the context of the study
  3. Significant risk of suicide
  4. Poor teamwork, defined as repeated missed appointments during the assessment / investigation phase
  5. Language difficulties (Swedish)

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort
  • Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Treatment success
Time Frame: At last psychological session (3 months post baseline)
The Pain Disability Index
At last psychological session (3 months post baseline)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Comorbid psychological problems
Time Frame: At first psychological session (baseline)
PHQ-9
At first psychological session (baseline)
Blood biomarkers as an effect of treatment
Time Frame: At last psychological session (3 months post baseline)
Pro-inflammatory cytokines
At last psychological session (3 months post baseline)

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Blood biomarkers as predictor for treatment success
Time Frame: At first psychological session (baseline)
Pro-inflammatory cytokines
At first psychological session (baseline)

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Collaborators

Investigators

  • Principal Investigator: Rikard Wicksell, PhD, Karolinska Institutet
  • Study Chair: Bianka Karshikoff, PhD, Karolinska Institutet
  • Study Chair: Linda Holmström, PhD, Karolinska Institutet
  • Study Chair: Mats Lekander, PhD, Karolinska Institutet
  • Study Chair: Jenny Åström, lic psych, Karolinska University Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 6, 2016

Primary Completion (Actual)

December 12, 2018

Study Registration Dates

First Submitted

August 15, 2017

First Submitted That Met QC Criteria

September 1, 2017

First Posted (Actual)

September 6, 2017

Study Record Updates

Last Update Posted (Actual)

February 26, 2020

Last Update Submitted That Met QC Criteria

February 24, 2020

Last Verified

February 1, 2020

More Information

Terms related to this study

Other Study ID Numbers

  • pni-act-2016

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

No

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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