- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05558397
Epidural Association of Morphine and Ropivacaine for Cancer Pain Treatment
Effectiveness of Epidural Morphine and Ropivacaine Treatment for Abdominal Cancer Pain in Patients of Brazilian's Public Health System
Study Overview
Status
Conditions
Intervention / Treatment
Study Type
Enrollment (Anticipated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Larissa Helena LT Pacheco, PhD
- Phone Number: +55 (35) 988013379
- Email: larissa.torres@unifal-mg.edu.br
Study Locations
-
-
Minas Gerais
-
Alfenas, Minas Gerais, Brazil, 37137001
- Recruiting
- Larissa Helena Lobo Torres Pacheco
-
Contact:
- Larissa Helena LT Pacheco, PhD
- Phone Number: +55 (35) 988013379
- Email: larissa.torres@unifal-mg.edu.br
-
Principal Investigator:
- Carlos Marcelo Barros, M.D.
-
Sub-Investigator:
- Márcia Helena MC Podestá, PhD
-
Sub-Investigator:
- Liliana B Vieira, PhD
-
Sub-Investigator:
- Carla S Ceron, PhD
-
Sub-Investigator:
- Vanessa B Boralli, PhD
-
Sub-Investigator:
- Carolina Aparecida F Almeida, MSC
-
Sub-Investigator:
- Rafaela F Rodrigues, PhD
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Patients aged between 18 and 75 years,
- both sexes
- diagnosed with abdominal neoplasia and with PPI < 2.0, which indicates a survival of at least 90 days
- have full cognitive conditions
- Patients must also have a caregiver with cognitive conditions.
Exclusion Criteria:
- Patients with technical incapacity to implant the catheter will be excluded, namely: patient refusal, infection at the puncture site and hemodynamic instability.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Control Group (Oral Morphine)
The control group will be composed of 15 patients who will receive oral drug treatment according to the Clinical Protocol and Therapeutic Guidelines for Chronic Pain of the Brazilian Ministry of Health.
The drugs included in the treatment plan are morphine (60 mg/day), pregabalin (150 mg/day) and duloxetine (60 mg/day), available free of charge to the participating patients.
The treatment will be carried out orally in a home environment.
|
Oral administration of morphine, pregabalin or duloxetin
|
Experimental: Interventional Group (Epidural morphine)
The intervention group will be composed of 15 patients who will undergo a surgical procedure for subcutaneous implantation of a catheter (Celsite ST304-19BBraun) that allows epidural administration of morphine and ropivacaine drugs.
The treatment plan for such patients includes Patient Controlled Analgesia (PCA).
Patients in this group will receive, via catheter, an anesthetic solution containing 2.0 mL of morphine (1.0 mg/mL), 3.0 mL of ropivacaine (7.5 mg/mL) and 5.0 mL of distilled water.
For 24 hours after this application, if the patient continues to have pain, they may use a rescue dose of oral morphine of 10 mg.
|
Implantation of an epidural catheter for administration of morphine and ropvacaine
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assessment of effectiveness of epidural morphine/ropivacaine treatment
Time Frame: Up to 60 days
|
Change From Baseline in Pain Scores on the Visual Analog Scale (0 means no pain and 10 means worst pain) in patients in the control group and intervention group for up to 60 days.
|
Up to 60 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Assessment of quality of life
Time Frame: Up to 60 days
|
Change of quality of life score by the European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30), which consists of a likert-type scale ranging from 1 to 4 for functions and symptoms, where 1= not at all, 2=slightly, 3= moderately, and 4 = very much.
If the resulting score on the functional scale is high, this represents a healthy functional level, while a high score on the symptom scale represents a low level of symptom tolerance and treatment side effects.
This scale also assesses overall health, ranging from 1 to 7, with 1=bad and 7 = very good
|
Up to 60 days
|
Assessment of functional status
Time Frame: Up to 60 days
|
Change in the patient's functional status by the Karnofsky Performance Scale (KPS), which ranges from 100% to 0%, where 100% means no evidence of disease and 0% means death
|
Up to 60 days
|
Assessment of progression of disease status
Time Frame: Up to 60 days
|
Change in disease status using the Eastern Cooperative Oncology Group (ECOG) scale, ranging from 0 to 5, where 0 = completely active and 5 =dead
|
Up to 60 days
|
Assessment of patient's clinical-functional status
Time Frame: Up to 60 days
|
Change in clinical-functional status by the Palliative Performance Scale (PPS), which ranges from 100 to 0%, where 100% = good clinical-functional status and 0%= dead
|
Up to 60 days
|
Assessment of disease prognosis
Time Frame: Up to 60 days
|
Change in survival time by the Palliative Prognosis Scale (PPI), which assesses PPS, presence of delirium, dyspnea, oral intake and edema, where each factor presents a score and at the end the scores are summed and the patient is classified into group A (Total Score < 2.0): > 6 weeks survival, group B (Total Score between 2.0 - 4.0): 3 - 6 weeks survival and group C (Total Score > 4.0): < 3 weeks survival
|
Up to 60 days
|
Cost-effectiveness analysis
Time Frame: Up to 60 days
|
For cost-effectiveness analysis, a direct cost analysis using the cost-effectiveness ratio will be used. The costs considered in this study will be the direct non-medical and direct medical costs. For direct cost analysis, the microcosting technique will be used. For economic analysis, the incremental cost-effectiveness ratio (ICER) will be used. Once a CERI is obtained, the result is evaluated by defining a cost-effectiveness threshold, which aims to identify values that society considers feasible, from an economic point of view, to be incorporated as additional costs in society's spending on health (BRASIL, 2014). Once the RCEI is obtained, the next step in a pharmacoeconomic analysis will be to perform a sensitivity analysis of the parameters involved during the research. |
Up to 60 days
|
Quantify the plasma concentration of morphine
Time Frame: Up to 60 days
|
Patients will undergo blood draws to obtain plasma, 1:30h after taking morphine (oral or epidural) which will later be quantified for morphine by gas chromatography.
|
Up to 60 days
|
Correlating plasma morphine concentration with therapeutic effecs
Time Frame: Up to 60 days
|
The amount of morphine found in plasma (outcome 8) will be correlated with the therapeutic effects (pain levels by Visual Analog Scale)
|
Up to 60 days
|
Quantify brain-derived neurotrophic factor (BDNF)
Time Frame: Up to 60 days
|
BDNF quantification will be done in the plasma of the patients, using the BDNF enzyme-linked immunosorbent assay (ELISA) kit from sigma and adverse effects
|
Up to 60 days
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Study Director: Larissa LT Pacheco, PhD, Universidade Federal de Alfenas
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2.543.790
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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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