- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05024448
Glucocorticosteroid Treatment in Acute Unilateral Vestibulopathy (Vestibular Neuronitis)
August 26, 2021 updated by: Nils Guinand, University Hospital, Geneva
Glucocorticosteroid Treatment in Acute Unilateral Vestibulopathy, a Multicentric, Randomized, Double-blind, Placebo-controlled Study
The vestibular system is a part of the inner ear and functions as a motion sensor.
It provides the central nervous system with information about changes of the head position.
This information is essential for the proper functioning of the balance system.
In particular, it ensures effective postural control and gaze stabilization.
Abrupt vestibular deficit is defined as a sudden loss of the vestibular function.
In the acute phase the patient presents mainly with intense rotatory vertigo and instability, most often accompanied by nausea.
The symptoms are exacerbated by head movements.
The diagnosis is made by observation of a spontaneous nystagmus, measurement of a pathological head impulse test and an asymmetric response to caloric tests, in the absence of other neurological symptoms.
Although the etiology is unknown, it could be of viral or vascular origin.
Symptoms usually regress within a few days or weeks.
Vestibular function recovers in about half of the cases, in the other half a central compensation process is set up.
The benefit of a 3-week course of corticosteroids has been demonstrated in one study.
The dosage has been debated.
The aim of this study is to demonstrate the benefit of a 10-day course of oral corticosteroids.
The primary objective is to demonstrate a significant reduction in the rate of asymmetry of caloric response and the secondary objective is to demonstrate a significant reduction in the impact of symptoms assessed with the Dizziness Handicap Inventory (DHI) score at 1 year.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
96
Phase
- Phase 4
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 to 75 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
Medical History :
- severe and prolonged rotatory vertigo;
- acute onset, subacute, within 3 days;
- nausea ;
- imbalance.
Physical examination :
- spontaneous nystagmus beating towards the healthy ear (fast phase);
- no evidence of central vestibular lesion;
- Head impulse test abnormal, at least for the lateral semicircular canal (in some cases, the sign is only detectable for the 2 vertical semicircular canals with specific equipment, mostly not available in current practice);
- areflexia or hyporeflexia (asymetry > 70% calculated according to the classical Jongkees formula [slow phase velocity of the nystagmus in response to caloric stimulation at (right at 30°C + right at 44°C) - ( left at 30°C + left at 44°C ) / (right 30°C + left 30°C + right 44°C + left at 44°C) x 100], in the caloric test (10 cc in 20 s, at 30 and 44° C)
Exclusion Criteria:
- history of vestibular disorders other than benign paroxysmal positionning vertigo (BPPV);
- symptoms lasting more than 3 days;
- cochlear symptoms (deafness before, during or after vertigo);
- central oculomotor dysfunction;
- central vestibular dysfunction;
- signs of brain dysfunction (e.g. epilepsy);
- MRI (if done) abnormal central vestibular pathways;
- psychiatric disease (history of psychiatric disease);
- glaucoma ;
- acute infection (herpes simplex, herpes zoster, corneal herpes, chicken pox, tuberculosis);
- patients already on corticosteroids;
- severe diabetes (fasting blood glucose > 7 mmol/l);
- Severe hypertension (systolic >180; diastolic > 110);
- contraindications to glucocorticoids (peptic ulceration, osteoporosis confirmed by bone density tests or pathological fractures);
- allergy to glucocorticoids or mannitol
- malignant disease;
- cardiac disease (recent myocardial infarction, heart failure);
- liver dysfunction (cirrhosis)
- renal insufficiency;
- Pregnancy or breastfeeding.
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: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Placebo Comparator: Placebo
|
oral administration, 60mg/d for 10d
|
Active Comparator: Prednisone
Prednisone, 60mg/d, for 10 days
|
oral administration, 60mg/d for 10d
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Bithermal calorics asymetry
Time Frame: Day 1
|
Day 1
|
Bithermal calorics asymetry
Time Frame: Day 21
|
Day 21
|
Bithermal calorics asymetry
Time Frame: Day 365
|
Day 365
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Dizziness Hanidcap Inventory (Questionnaire)
Time Frame: Day 1, Day 21, Day 365
|
min: 0 / max:100, higher score is worse
|
Day 1, Day 21, Day 365
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
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)
August 27, 2013
Primary Completion (Actual)
June 9, 2021
Study Completion (Actual)
June 9, 2021
Study Registration Dates
First Submitted
July 28, 2021
First Submitted That Met QC Criteria
August 26, 2021
First Posted (Actual)
August 27, 2021
Study Record Updates
Last Update Posted (Actual)
August 27, 2021
Last Update Submitted That Met QC Criteria
August 26, 2021
Last Verified
August 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Nervous System Diseases
- Otorhinolaryngologic Diseases
- Ear Diseases
- Cranial Nerve Diseases
- Vestibulocochlear Nerve Diseases
- Retrocochlear Diseases
- Vestibular Neuronitis
- Physiological Effects of Drugs
- Anti-Inflammatory Agents
- Antineoplastic Agents
- Glucocorticoids
- Hormones
- Hormones, Hormone Substitutes, and Hormone Antagonists
- Antineoplastic Agents, Hormonal
- Prednisone
Other Study ID Numbers
- PB_2020-00001
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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