Pancreatic Endotherapy for Refractory Chronic Pancreatitis (PERCePT)
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Locations
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-
Oregon
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Portland, Oregon, United States, 97035
- Oregon Health & Science University
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South Carolina
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Charleston, South Carolina, United States, 29425
- Medical University of South Carolina
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria
- Age ≥ 18 years
- Main pancreatic duct obstruction, defined by the presence of one or both of the following features:
- Main pancreatic duct calcification with upstream main duct dilation ≥6mm.
- Main pancreatic duct stricture, defined by the presence of main pancreatic duct narrowing with upstream main duct dilation ≥6mm.
- Baseline average abdominal pain score ≥4 during the run-in period, based on Ecological Momentary Assessment 11-point Numeric Rating Scale
- Ability to provide written, informed consent
Exclusion Criteria
- Symptoms attributable to a pancreatic pseudocyst or walled off necrosis
- Clinical suspicion of pancreatobiliary malignancy*
- Low probability of follow-up to complete study objectives
- Pregnancy or incarceration
- Medical comorbidities that contraindicate the performance of ERCP
- Previous pancreatic endotherapy
- Current Opioid Misuse Measure score ≥9
- Does not have access to a mobile phone * Pancreatobiliary malignancy
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Sham Comparator: EUS + SHAM
All subjects will undergo anesthesia administered sedation and endoscopic ultrasound (EUS).
The endoscopist will assess the pancreas for parenchymal and ductal features of chronic pancreatitis and confirm the absence of exclusion criteria (such as the presence of an occult pancreatobiliary malignancy).
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Endoscopic Ultrasound
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Experimental: EUS + Pancreatic Endotherapy
If randomized to ERCP with pancreatic endotherapy, the endoscopist will proceed with this intervention immediately following the completion of EUS and treatment allocation (during the same anesthesia).
Pancreatic endotherapy may include any or all of the following maneuvers: pancreatic endoscopic sphincterotomy, stricture dilation using a bougie or hydrostatic balloon catheter, pancreatic stone extraction with or without mechanical or electrohydraulic lithotripsy, extracorporeal shock wave lithotripsy, and stent placement.
Overall technical success will be defined by the ability to insert at least one pancreatic stent across the dominant main pancreatic duct obstruction.
Technical success for pancreatic stone treatment will be defined by the ability to remove all fluoroscopically visible main pancreatic duct stones.
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Pancreatic endotherapy may include any or all of the following maneuvers: pancreatic endoscopic sphincterotomy, stricture dilation using a bougie or hydrostatic balloon catheter, pancreatic stone extraction with or without mechanical or electrohydraulic lithotripsy, extracorporeal shock wave lithotripsy, and stent placement.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Percent Change in Average Daily Pain Score on the Numeric Rating Scale
Time Frame: Day -14 to Day 90
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The percent change in average daily pain score from the daily diaries during the 14-day period preceding the 90-day assessment, compared to the average daily pain reported during the 14-day run-in.
The investigators employed the standardized 11-point Numeric Rating Scale (NRS) to capture average daily pain with the empirically-supported anchors of 0=No Pain and 10=Worst Pain Imaginable.
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Day -14 to Day 90
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change from baseline in pain severity and functional impairment
Time Frame: Baseline to Day 90
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At 90-days, change from baseline in functional impairment due to pain will be examined. The instrument used is Brief Pain Inventory (BPI),
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Baseline to Day 90
|
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Quality of Life: Using the PROMIS 29 instrument
Time Frame: Baseline to Day 90
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Using the PROMIS 29 instrument, quality of life will be assessed through this questionnaire evaluating anxiety, depression, fatigue, pain interference, physical function, sleep disturbance, ability to participate in social roles and activities, and a single pain intensity item.
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Baseline to Day 90
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Opioid Misuse
Time Frame: Baseline to Day 90
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Using the instrument titled Current Opioid Misuse Measure (COMM), this will be evaluated by patient self-reported measures of risk for aberrant medication-related behavior in patients prescribed opioids for chronic pain.
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Baseline to Day 90
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Pain Catastrophizing
Time Frame: Baseline to Day 90
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The instrument titled Pain Catastrophizing Scale (PCS) used to assess pain catastrophizing will do the following:
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Baseline to Day 90
|
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Mechanical pain threshold
Time Frame: Baseline to Day 90
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Using Quantitative Sensory Testing, assess the mechanical pain threshold using the IITC Life Sciences Digital Anesthesiometer applied to the distal phalange of the digiti minimi of the left hand (increased at rate of 10grams/sec; pressure recorded in grams).
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Baseline to Day 90
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Pain tolerance: Quantitative Sensory Testing
Time Frame: Baseline to Day 90
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Using Quantitative Sensory Testing, assess thermal pain tolerance using 5 trials of cutaneous heat stimuli via the thermode of the Medoc TSA-II Neurosensory Analyzer.
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Baseline to Day 90
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Pain wind up
Time Frame: Baseline to Day 90
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Using Quantitative Sensory Testing, assess thermal wind-up pain (3 trials) with the thermode delivering 20 brief suprathreshold thermal pulses at the rate of 1 pulse per 1.5 secs thereby selectively stimulating C-fibers (during the 3 trials of 30sec of repeated heat stimulation, subjects will indicate their level of pain severity using a dynamic visual analogue scale).
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Baseline to Day 90
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Conditioned pain modulation
Time Frame: Baseline to Day 90
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Using Quantitative Sensory Testing, assess conditioned pain modulation (3 trials) using mechanical pain thresholds assessed via the IITC Life Sciences Digital Anesthesiometer applied to the right trapezus (increased at rate of 10grams/sec; pressure recorded in grams) with and without simultaneous stimulation via the ATS thermode.
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Baseline to Day 90
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Gregory Cote, MD, MS, Oregon Health and Science University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Estimated)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- Pro00087299
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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