- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00279903
Is Botox Effective in Relieving Pain From Knee Osteoarthritis?
November 6, 2012 updated by: Mayo Clinic
Intra-articular Botulinum Toxin Type-A in Knee Osteoarthritis - a Randomized, Cortisone Controlled, Double Blind Study.
Patients with painful knee osteoarthritis will be randomly allocated to one of three groups.
Each group will receive a knee injection of: 1) cortisone, 2) low dose Botox, or 3) high dose Botox.
Patients will then be followed for 6 months to see if they have significant pain relief or improvement in their activity level after the injection.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Abstract Botulinum toxin type A (Btx-A) has been extensively studied and used clinically for its muscle paralyzing effects, but there is a growing body of evidence to support a role in pain modulation.
Symptomatic osteoarthritis is a leading cause of pain, functional impairment, and disability, with significant indirect costs to society.
Preliminary evidence suggests that Btx-A has a significant nociceptive effect, when injected intra-articularly, in to painful joints.
The proposed study will evaluate the efficacy and safety of Btx-A injected intra-articularly in 60 subjects with moderate pain and functional impairment secondary to knee osteoarthritis, in a randomized, cortisone-controlled, double blind study, over a 6 month follow up period.
If Btx-A is shown to be of equal or greater efficacy than cortisone in this patient population, it may be an excellent second line treatment for osteoarthritis, in multiple joints, where surgery is contraindicated or deferred due to age, comorbidities, or patient preference.
Further studies examining the mechanism of action at the biochemical level, the clinical effect of Btx-A in other joints (in both osteoarthritis and inflammatory arthritis), the efficacy of Btx-A compared to hyaluronic acid (the only currently available injectable alternative to cortisone), and the side effect profile (effect on adjacent muscle strength, joint position sense, and long-term outcomes) would be indicated.
Study Type
Interventional
Enrollment (Actual)
62
Phase
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Minnesota
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Rochester, Minnesota, United States, 55905
- Mayo Clinic
-
-
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
40 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion criteria:
- A history of knee joint pain for greater than 6 months.
- Medial or lateral tibiofemoral joint line tenderness.
- Unilateral knee pain 6/10 or greater, on average, on the visual analog scale (VAS), that interferes with function most days per week.
- Prior failed treatment with acetaminophen and/or non steroidal anti-inflammatory medications, and physical therapy (quadriceps strengthening).
- Kellgren grade II or III radiographic changes of osteoarthritis.
Exclusion criteria:
- Age less than 40 years.
- Anticoagulation with warfarin or heparin.
- Known allergy or sensitivity to any of the components of the study medications.
- Body mass index greater than 35.
- Previous major reconstructive surgery on the affected knee.
- Previous arthroscopic surgery on the affected knee in the past 12 months.
- History of crystal induced arthropathy.
- Use of aminoglycoside antibiotics, curare-like agents, or history of neuromuscular disease such as myasthenia gravis, amyotrophic lateral sclerosis, or myopathy.
- History of or evidence of active rheumatologic disease, diabetes, severe peripheral neuropathy, clinically evident cardiac or respiratory disease that interferes with functional status, or other serious diseases, including psychiatric disorders.
- Evidence of recent alcohol or drug abuse, or history of medication misuse or addiction.
- Females who are pregnant, breastfeeding, or planning a pregnancy during the study, or who think that they may be pregnant at the start of the study, or females of childbearing potential who are unable or unwilling to use a reliable form of contraception during the study.
- Intra-articular (knee) or systemic steroids in the past 6 months, or intra-articular knee hyaluronic acid injection in the past 6 months.
- Patients who rate their average daily pain as less than 6 on a 10 point VAS scale at the screening visit.
- Concurrent participation in another investigational drug or device study or participation in the 30 days immediately prior to study enrollment.
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
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Cortisone
|
1 cc of 40 mg/cc methylprednisolone will be drawn up in 22 gauge needles with 3 cc of sterile non-preserved 0.9% sodium chloride solution.
Other Names:
|
Experimental: Low Dose Btx-A
|
Participants randomized to Btx-A will be given either a low dose of 100 units or a high dose of 200 units.
The Btx-A dose (100U or 200U) will be resonstituted with 4 cc of sterile non-preserved 0.9% sodium chloride solution.
Other Names:
|
Experimental: High Dose Btx-A
|
Participants randomized to Btx-A will be given either a low dose of 100 units or a high dose of 200 units.
The Btx-A dose (100U or 200U) will be resonstituted with 4 cc of sterile non-preserved 0.9% sodium chloride solution.
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
---|
Decrease in pain at 8 weeks post injection
|
Secondary Outcome Measures
Outcome Measure |
---|
Improvement in function at 2, 4, 8, 12, 26 weeks
|
Improvement in quality of life at 2, 4, 8, 12, 26 weeks
|
Decrease in pain at 2, 4, 12, 26 weeks
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Andrea J. Boon, M.D., Mayo Clinic
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
November 1, 2005
Primary Completion (Actual)
August 1, 2008
Study Completion (Actual)
August 1, 2008
Study Registration Dates
First Submitted
January 18, 2006
First Submitted That Met QC Criteria
January 18, 2006
First Posted (Estimate)
January 20, 2006
Study Record Updates
Last Update Posted (Estimate)
November 7, 2012
Last Update Submitted That Met QC Criteria
November 6, 2012
Last Verified
November 1, 2012
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Joint Diseases
- Musculoskeletal Diseases
- Rheumatic Diseases
- Arthritis
- Osteoarthritis
- Osteoarthritis, Knee
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- Cholinergic Agents
- Anti-Inflammatory Agents
- Membrane Transport Modulators
- Acetylcholine Release Inhibitors
- Neuromuscular Agents
- Botulinum Toxins
- Botulinum Toxins, Type A
- abobotulinumtoxinA
- Cortisone
Other Study ID Numbers
- 1565-05
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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