- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT00435773
Leeches for the Treatment of Knee Osteoarthritis
April 6, 2007 updated by: RWTH Aachen University
Single and Repeated Leech Therapy for the Treatment of Late Stage Knee Osteoarthritis. A Randomized, Placebo Controlled Comparative Trial
Previous studies have not addressed the question, whether or not a repeated leeching can supply symptomatic relief of osteoarthritic pain for extended periods of time.
We present a randomized study to the effectiveness of single and repeated leech therapy in cases with advanced osteoarthritis of the knee using a large patient group compared to a control group, who were both blinded to the actual treatment modality.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment
118
Phase
- Phase 2
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
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Aachen, Germany, 52074
- Department of Orthopaedic Surgery, University Hospital of the RWTH Aachen, Germany
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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
- ADULT
- OLDER_ADULT
- CHILD
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Osteoarthritis of the knee
- Persistent osteoarthritic symptoms for at least 6 months
- Radiographic evidence of late stage osteoarthritis of the knee (stage III-IV)
- History of conservative management including pain medication and physical therapy
Exclusion Criteria:
- Anticoagulant treatment or history of hemophilia
- History or presence of rheumatic diseases leading to secondary osteoarthritis
- Presence of hematological, hepatic, renal or immunological disease
- Insulin-dependant diabetes mellitus
- Intraarticular injections or systemic application of corticosteroids during the 3 preceding months
- History of surgery of the affected knee during the last 3 months or joint replacement
- History of previous leech therapy
- Lack of informed consent
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
- Masking: SINGLE
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
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KOOS Score overall (Clinical score)before intervention, after 1,4 and 6 weeks, 3 and 6 months
|
WOMAC Score overall (Clinical score)before intervention, after 1,4 and 6 weeks, 3 and 6 months
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VAS (Visual analog scale, pain score)before intervention, after 1,4 and 6 weeks, 3 and 6 months
|
Secondary Outcome Measures
Outcome Measure |
---|
Adverse events
|
KOOS subscores before intervention, after 1,4 and 6 weeks, 3 and 6 months
|
WOMAC subscores before intervention, after 1,4 and 6 weeks, 3 and 6 months
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Requirement of pain medication before intervention, after 1,4 and 6 weeks, 3 and 6 months
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Study Chair: Stefan Andereya, MD, Department of Orthopaedic Surgery, University Hospital of the RWTH Aachen, Germany
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.
General Publications
- Hyson JM. Leech therapy: a history. J Hist Dent. 2005 Mar;53(1):25-7.
- Whitaker IS, Izadi D, Oliver DW, Monteath G, Butler PE. Hirudo Medicinalis and the plastic surgeon. Br J Plast Surg. 2004 Jun;57(4):348-53. doi: 10.1016/j.bjps.2003.12.016.
- Rao J, Whitaker IS. Use of Hirudo medicinalis by maxillofacial surgical units in the United Kingdom: current views and practice. Br J Oral Maxillofac Surg. 2003 Feb;41(1):54-5. doi: 10.1016/s0266-4356(02)00284-x. No abstract available.
- Weinfeld AB, Yuksel E, Boutros S, Gura DH, Akyurek M, Friedman JD. Clinical and scientific considerations in leech therapy for the management of acute venous congestion: an updated review. Ann Plast Surg. 2000 Aug;45(2):207-12. doi: 10.1097/00000637-200045020-00021.
- Dabb RW, Malone JM, Leverett LC. The use of medicinal leeches in the salvage of flaps with venous congestion. Ann Plast Surg. 1992 Sep;29(3):250-6. doi: 10.1097/00000637-199209000-00010.
- Hayden RE, Phillips JG, McLear PW. Leeches. Objective monitoring of altered perfusion in congested flaps. Arch Otolaryngol Head Neck Surg. 1988 Dec;114(12):1395-9. doi: 10.1001/archotol.1988.01860240045021.
- Hernandez-Diaz S, Varas-Lorenzo C, Garcia Rodriguez LA. Non-steroidal antiinflammatory drugs and the risk of acute myocardial infarction. Basic Clin Pharmacol Toxicol. 2006 Mar;98(3):266-74. doi: 10.1111/j.1742-7843.2006.pto_302.x.
- Hernandez-Diaz S, Garcia-Rodriguez LA. Epidemiologic assessment of the safety of conventional nonsteroidal anti-inflammatory drugs. Am J Med. 2001 Feb 19;110 Suppl 3A:20S-7S. doi: 10.1016/s0002-9343(00)00682-3.
- Pilcher H. Medicinal leeches: stuck on you. Nature. 2004 Nov 4;432(7013):10-1. doi: 10.1038/432010a. No abstract available.
- Michalsen A, Moebus S, Spahn G, Esch T, Langhorst J, Dobos GJ. Leech therapy for symptomatic treatment of knee osteoarthritis: results and implications of a pilot study. Altern Ther Health Med. 2002 Sep-Oct;8(5):84-8.
- Michalsen A, Klotz S, Ludtke R, Moebus S, Spahn G, Dobos GJ. Effectiveness of leech therapy in osteoarthritis of the knee: a randomized, controlled trial. Ann Intern Med. 2003 Nov 4;139(9):724-30. doi: 10.7326/0003-4819-139-9-200311040-00006.
- Hochberg MC. Multidisciplinary integrative approach to treating knee pain in patients with osteoarthritis. Ann Intern Med. 2003 Nov 4;139(9):781-3. doi: 10.7326/0003-4819-139-9-200311040-00013. No abstract available.
- Guyatt GH, Sackett DL, Cook DJ. Users' guides to the medical literature. II. How to use an article about therapy or prevention. A. Are the results of the study valid? Evidence-Based Medicine Working Group. JAMA. 1993 Dec 1;270(21):2598-601. doi: 10.1001/jama.270.21.2598. No abstract available.
- Wolfe F, Lane NE. The longterm outcome of osteoarthritis: rates and predictors of joint space narrowing in symptomatic patients with knee osteoarthritis. J Rheumatol. 2002 Jan;29(1):139-46.
- Hochberg MC, Altman RD, Brandt KD, Moskowitz RW. Design and conduct of clinical trials in osteoarthritis: preliminary recommendations from a task force of the Osteoarthritis Research Society. J Rheumatol. 1997 Apr;24(4):792-4.
- Altman R, Brandt K, Hochberg M, Moskowitz R, Bellamy N, Bloch DA, Buckwalter J, Dougados M, Ehrlich G, Lequesne M, Lohmander S, Murphy WA Jr, Rosario-Jansen T, Schwartz B, Trippel S. Design and conduct of clinical trials in patients with osteoarthritis: recommendations from a task force of the Osteoarthritis Research Society. Results from a workshop. Osteoarthritis Cartilage. 1996 Dec;4(4):217-43. doi: 10.1016/s1063-4584(05)80101-3. No abstract available.
- Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD. Knee Injury and Osteoarthritis Outcome Score (KOOS)--development of a self-administered outcome measure. J Orthop Sports Phys Ther. 1998 Aug;28(2):88-96. doi: 10.2519/jospt.1998.28.2.88.
- Roos EM, Klassbo M, Lohmander LS. WOMAC osteoarthritis index. Reliability, validity, and responsiveness in patients with arthroscopically assessed osteoarthritis. Western Ontario and MacMaster Universities. Scand J Rheumatol. 1999;28(4):210-5. doi: 10.1080/03009749950155562.
- Whitaker IS, Rao J, Izadi D, Butler PE. Historical Article: Hirudo medicinalis: ancient origins of, and trends in the use of medicinal leeches throughout history. Br J Oral Maxillofac Surg. 2004 Apr;42(2):133-7. doi: 10.1016/S0266-4356(03)00242-0.
- Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988 Dec;15(12):1833-40.
- Lahav A, Burks RT, Greis PE, Chapman AW, Ford GM, Fink BP. Clinical outcomes following osteochondral autologous transplantation (OATS). J Knee Surg. 2006 Jul;19(3):169-73. doi: 10.1055/s-0030-1248101.
- Englund M, Lohmander LS. Patellofemoral osteoarthritis coexistent with tibiofemoral osteoarthritis in a meniscectomy population. Ann Rheum Dis. 2005 Dec;64(12):1721-6. doi: 10.1136/ard.2005.035568. Epub 2005 Apr 20.
- Kessler S, Lang S, Puhl W, Stove J. [The Knee Injury and Osteoarthritis Outcome Score--a multifunctional questionnaire to measure outcome in knee arthroplasty]. Z Orthop Ihre Grenzgeb. 2003 May-Jun;141(3):277-82. doi: 10.1055/s-2003-40083. German.
- Markwardt F, Hauptmann J, Nowak G, Klessen C, Walsmann P. Pharmacological studies on the antithrombotic action of hirudin in experimental animals. Thromb Haemost. 1982 Jun 28;47(3):226-9.
- Brown JE, Baugh RF, Hougie C. The inhibition of the intrinsic generation of activated factor X by heparin and hirudin. Thromb Res. 1980 Jan 1-15;17(1-2):267-72. doi: 10.1016/0049-3848(80)90314-x. No abstract available.
- Dippenaar R, Smith J, Goussard P, Walters E. Meningococcal purpura fulminans treated with medicinal leeches. Pediatr Crit Care Med. 2006 Sep;7(5):476-8. doi: 10.1097/01.PCC.0000235422.23812.B4.
- Ascenzi P, Amiconi G, Bode W, Bolognesi M, Coletta M, Menegatti E. Proteinase inhibitors from the European medicinal leech Hirudo medicinalis: structural, functional and biomedical aspects. Mol Aspects Med. 1995;16(3):215-313. doi: 10.1016/0098-2997(95)00002-x. No abstract available.
- Rigbi M, Levy H, Eldor A, Iraqi F, Teitelbaum M, Orevi M, Horovitz A, Galun R. The saliva of the medicinal leech Hirudo medicinalis--II. Inhibition of platelet aggregation and of leukocyte activity and examination of reputed anaesthetic effects. Comp Biochem Physiol C Comp Pharmacol Toxicol. 1987;88(1):95-8. doi: 10.1016/0742-8413(87)90052-1.
- Scott K. Is hirudin a potential therapeutic agent for arthritis? Ann Rheum Dis. 2002 Jun;61(6):561-2. doi: 10.1136/ard.61.6.561. No abstract available.
- Bush D, Fritz H, Knight C, Mount J, Scott K. A hirudin-sensitive, growth-related proteinase from human fibroblasts. Biol Chem. 1998 Feb;379(2):225-9. doi: 10.1515/bchm.1998.379.2.225.
- de Chalain TM. Exploring the use of the medicinal leech: a clinical risk-benefit analysis. J Reconstr Microsurg. 1996 Apr;12(3):165-72. doi: 10.1055/s-2007-1006471.
- Lineaweaver WC, Hill MK, Buncke GM, Follansbee S, Buncke HJ, Wong RK, Manders EK, Grotting JC, Anthony J, Mathes SJ. Aeromonas hydrophila infections following use of medicinal leeches in replantation and flap surgery. Ann Plast Surg. 1992 Sep;29(3):238-44. doi: 10.1097/00000637-199209000-00008.
- Fenollar F, Fournier PE, Legre R. Unusual case of Aeromonas sobria cellulitis associated with the use of leeches. Eur J Clin Microbiol Infect Dis. 1999 Jan;18(1):72-3. doi: 10.1007/s100960050232. No abstract available.
- Ikizceli I, Avsarogullari L, Sozuer E, Yurumez Y, Akdur O. Bleeding due to a medicinal leech bite. Emerg Med J. 2005 Jun;22(6):458-60. doi: 10.1136/emj.2003.013847.
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
February 1, 2004
Study Completion
December 1, 2004
Study Registration Dates
First Submitted
February 14, 2007
First Submitted That Met QC Criteria
February 14, 2007
First Posted (ESTIMATE)
February 15, 2007
Study Record Updates
Last Update Posted (ESTIMATE)
April 9, 2007
Last Update Submitted That Met QC Criteria
April 6, 2007
Last Verified
April 1, 2007
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- EK 102/03
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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