Efficacy of Botulinum Toxin Versus Placebo on Pain and Health Related Quality of Life of Patients With Piriformis Muscle Syndrome (PiriTox)
A Phase IIb, Randomized, Double-blind, Multicenter Study Evaluating the Efficacy of Botulinum Toxin Versus Placebo on Pain and Health Related Quality of Life of Patients With Piriformis Muscle Syndrome
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Fase 2
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Arnaud Dupeyron
- Telefonnummer: 04.66.68.34.59
- E-mail: arnaud.dupeyron@umontpellier.fr
Studiesteder
-
-
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Besançon, Frankrig
- CHU de Besançon
-
Kontakt:
- Fabrice MICHEL
- Telefonnummer: 03 81 66 89 50
- E-mail: fmichel@chu-besancon.fr
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Bordeaux, Frankrig
- CHU de Bordeaux
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Kontakt:
- Mathieu DE-SEZE
- Telefonnummer: 05.56.79.56.79
- E-mail: mathieu.de-seze@chu-bordeaux.fr
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Nantes, Frankrig
- CHU de Nantes
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Kontakt:
- Julien LABARRE
- Telefonnummer: 02 53 48 21 87
- E-mail: julien.labarre@chu-nantes.fr
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Paris, Frankrig
- Hôpital Universitaire Paris Cochin
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Kontakt:
- François RANNOU
- Telefonnummer: 01 58 41 23 35
- E-mail: francois.rannou@aphp.fr
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Strasbourg, Frankrig
- Institut Universitaire de Réadaptation Clémenceau
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Kontakt:
- Marie-Eve ISNER-HOROBETI
- Telefonnummer: 03.88.21.16.39
- E-mail: marieeve.isner@gmail.com
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Toulouse, Frankrig
- CHU de Toulouse
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-
Gard
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Nîmes, Gard, Frankrig, 30029
- Centre Hospitalier Universitaire de Nîmes
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Kontakt:
- Anissa Megzarri
- Telefonnummer: 04 66 68 68 68
- E-mail: drc@chu-nimes.fr
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Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Objective clinical diagnosis of unilateral piriformis syndrome for at least 3 months (as assessed by Clinical Scoring System for the Diagnosis of Piriformis Muscle Syndrome: score of 8 or greater
- Absence of herniated lumbar disc which can explain radiating pain (MRI or computed tomography (CT) of the lumbar spine)
- Patients not responding to conventional care (physiotherapy, muscle relaxants, analgesics)
- Baseline sciatic pain intensity of at least 4 points on visual analog scale
- Provision of written informed consent
- Patients affiliated to social security system (health insurance coverage).
Exclusion Criteria:
- Bilateral piriformis muscle syndrome.
- History of piriformis syndrome surgery.
- History of botulinum toxin administration.
- Any treatment (general or local) likely to interfere with botulinum toxin or evaluation of the primary endpoint (Corticosteroids, aminoglycosides).
- Corticosteroids in the past 3 weeks.
- Signs of severe fibrosis (on MRI or CT) of the piriformis muscle.
- Other causes of sciatic pain (lumbar root compression, inflammatory, infectious or neoplasic pelvic disease, particularly for inflammatory sacroiliac pain).
- Hip prosthesis on the same side as piriformis syndrome; knee prosthesis is tolerated.
- Contraindication to BT injection:
- History of intolerance, hypersensitivity or known allergy to any botulinum toxin product or excipients;
- Patients with myasthenia gravis or other diseases of the neuromuscular junction;
- Patients with Lambert-Eaton Syndrome;
- Patients with neurological disorders such as dysphagia, swallowing disorders or aspiration pneumonia;
- Current infection at the proposed injection site;
- Long-term anticoagulant therapy ;
- Antibiotics and vaccination are prohibited for 15 days before and after BT injection
- Pregnant or breastfeeding women. Women of child-bearing potential, defined as all women physiologically capable of becoming pregnant must use an effective method of contraception (oral contraceptives, contraceptive injections, intrauterine devices, method of double-barrier contraceptive patches). The contraception should be maintained throughout the study.
- Patients unable to complete the patient diary.
- Inability to understand the reasons for the study; psychiatric disorders judged by the investigator to be incompatible with inclusion in the study.
- Patients with legal disability or limited legal capacity.
- Patients judged as noncompliant.
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Tredobbelt
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: Botulinum toksin injektion
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Incobotulinumtoxin type A (200 U in 2 mL of preservative-free normal saline) will be injected in equally divided doses (1mL; 100 U for incobotulinumtoxin A) into 2 locations in the affected buttock region
|
|
Placebo komparator: Placebo injektion
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Placebo (normal saline solution and excipients described in Xeomin) will be injected in equally divided doses (1mL) into 2 locations in the affected buttock region
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Change in sciatic pain
Tidsramme: From baseline to Week 6
|
Measured on a 0 (no pain) to 10 (worst pain) visual analog scale
|
From baseline to Week 6
|
Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
|
Change in buttock pain intensity
Tidsramme: From baseline to Week 6
|
Measured on a 0 (no pain) to 10 (worst pain) visual analog scale
|
From baseline to Week 6
|
|
Health-related quality of life
Tidsramme: Baseline
|
EuroQol-5 Dimension questionnaire measuring five items representing the five dimensions, and a visual analog scale graduated from 0 to 100 (100 referring to the "best possible state of health").
For each dimension, patients indicate their current state of health to generated a 5-digit number describing the health status (e.g., health status "11111" indicates the absence of problems in each dimension)
|
Baseline
|
|
Health-related quality of life
Tidsramme: Week 6
|
EuroQol-5 Dimension questionnaire measuring five items representing the five dimensions, and a visual analog scale graduated from 0 to 100 (100 referring to the "best possible state of health").
For each dimension, patients indicate their current state of health to generated a 5-digit number describing the health status (e.g., health status "11111" indicates the absence of problems in each dimension)
|
Week 6
|
|
Health-related quality of life
Tidsramme: Week 12
|
EuroQol-5 Dimension questionnaire measuring five items representing the five dimensions, and a visual analog scale graduated from 0 to 100 (100 referring to the "best possible state of health").
For each dimension, patients indicate their current state of health to generated a 5-digit number describing the health status (e.g., health status "11111" indicates the absence of problems in each dimension)
|
Week 12
|
|
Health-related quality of life
Tidsramme: Week 18
|
EuroQol-5 Dimension questionnaire measuring five items representing the five dimensions, and a visual analog scale graduated from 0 to 100 (100 referring to the "best possible state of health").
For each dimension, patients indicate their current state of health to generated a 5-digit number describing the health status (e.g., health status "11111" indicates the absence of problems in each dimension)
|
Week 18
|
|
Health-related quality of life
Tidsramme: Week 24
|
EuroQol-5 Dimension questionnaire measuring five items representing the five dimensions, and a visual analog scale graduated from 0 to 100 (100 referring to the "best possible state of health").
For each dimension, patients indicate their current state of health to generated a 5-digit number describing the health status (e.g., health status "11111" indicates the absence of problems in each dimension)
|
Week 24
|
|
Sciatic pain intensity
Tidsramme: Baseline
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Baseline
|
|
Sciatic pain intensity
Tidsramme: Week 3
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 3
|
|
Sciatic pain intensity
Tidsramme: Week 6
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 6
|
|
Sciatic pain intensity
Tidsramme: Week 9
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 9
|
|
Sciatic pain intensity
Tidsramme: Week 12
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 12
|
|
Sciatic pain intensity
Tidsramme: Week 15
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 15
|
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Sciatic pain intensity
Tidsramme: Week 18
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 18
|
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Sciatic pain intensity
Tidsramme: Week 21
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 21
|
|
Sciatic pain intensity
Tidsramme: Week 24
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 24
|
|
Buttock pain intensity
Tidsramme: Baseline
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Baseline
|
|
Buttock pain intensity
Tidsramme: Week 3
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 3
|
|
Buttock pain intensity
Tidsramme: Week 6
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 6
|
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Buttock pain intensity
Tidsramme: Week 9
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 9
|
|
Buttock pain intensity
Tidsramme: Week 12
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 12
|
|
Buttock pain intensity
Tidsramme: Week 15
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 15
|
|
Buttock pain intensity
Tidsramme: Week 18
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 18
|
|
Buttock pain intensity
Tidsramme: Week 21
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 21
|
|
Buttock pain intensity
Tidsramme: Week 24
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Week 24
|
|
Physical functioning
Tidsramme: Baseline
|
Brief Pain Inventory Short Form; 9-item questionnaire, where Worst Pain Score: 1 - 4 = Mild Pain; Worst Pain Score: 5 - 6 = Moderate Pain; Worst Pain Score: 7 - 10 = Severe Pain
|
Baseline
|
|
Physical functioning
Tidsramme: Week 6
|
Brief Pain Inventory Short Form; 9-item questionnaire, where Worst Pain Score: 1 - 4 = Mild Pain; Worst Pain Score: 5 - 6 = Moderate Pain; Worst Pain Score: 7 - 10 = Severe Pain
|
Week 6
|
|
Physical functioning
Tidsramme: Week 12
|
Brief Pain Inventory Short Form; 9-item questionnaire, where Worst Pain Score: 1 - 4 = Mild Pain; Worst Pain Score: 5 - 6 = Moderate Pain; Worst Pain Score: 7 - 10 = Severe Pain
|
Week 12
|
|
Physical functioning
Tidsramme: Week 18
|
Brief Pain Inventory Short Form; 9-item questionnaire, where Worst Pain Score: 1 - 4 = Mild Pain; Worst Pain Score: 5 - 6 = Moderate Pain; Worst Pain Score: 7 - 10 = Severe Pain
|
Week 18
|
|
Physical functioning
Tidsramme: Week 24
|
Brief Pain Inventory Short Form; 9-item questionnaire, where Worst Pain Score: 1 - 4 = Mild Pain; Worst Pain Score: 5 - 6 = Moderate Pain; Worst Pain Score: 7 - 10 = Severe Pain
|
Week 24
|
|
Perceived change in condition in response to therapy
Tidsramme: Baseline
|
Patient Global Impression of Improvement (PGI-I)
|
Baseline
|
|
Perceived change in condition in response to therapy
Tidsramme: Week 6
|
Patient Global Impression of Improvement (PGI-I)
|
Week 6
|
|
Perceived change in condition in response to therapy
Tidsramme: Week 12
|
Patient Global Impression of Improvement (PGI-I)
|
Week 12
|
|
Perceived change in condition in response to therapy
Tidsramme: Week 18
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Patient Global Impression of Improvement (PGI-I)
|
Week 18
|
|
Perceived change in condition in response to therapy
Tidsramme: Week 24
|
Patient Global Impression of Improvement (PGI-I)
|
Week 24
|
|
Emotional distress
Tidsramme: Baseline
|
Hospital Anxiety and Depression Scale (HADS); 14 items, with responses scored on a scale of 0-3 (3 indicates higher symptom frequencies).
Subscales (anxiety and depression) range from 0 to 21 whereby: normal 0-7, mild 8-10, moderate 11-14, and severe 15-21.
|
Baseline
|
|
Emotional distress
Tidsramme: Week 6
|
Hospital Anxiety and Depression Scale (HADS); 14 items, with responses scored on a scale of 0-3 (3 indicates higher symptom frequencies).
Subscales (anxiety and depression) range from 0 to 21 whereby: normal 0-7, mild 8-10, moderate 11-14, and severe 15-21.
|
Week 6
|
|
Emotional distress
Tidsramme: Week 12
|
Hospital Anxiety and Depression Scale (HADS); 14 items, with responses scored on a scale of 0-3 (3 indicates higher symptom frequencies).
Subscales (anxiety and depression) range from 0 to 21 whereby: normal 0-7, mild 8-10, moderate 11-14, and severe 15-21.
|
Week 12
|
|
Emotional distress
Tidsramme: Week 18
|
Hospital Anxiety and Depression Scale (HADS); 14 items, with responses scored on a scale of 0-3 (3 indicates higher symptom frequencies).
Subscales (anxiety and depression) range from 0 to 21 whereby: normal 0-7, mild 8-10, moderate 11-14, and severe 15-21.
|
Week 18
|
|
Emotional distress
Tidsramme: Week 24
|
Hospital Anxiety and Depression Scale (HADS); 14 items, with responses scored on a scale of 0-3 (3 indicates higher symptom frequencies).
Subscales (anxiety and depression) range from 0 to 21 whereby: normal 0-7, mild 8-10, moderate 11-14, and severe 15-21.
|
Week 24
|
|
Disability for low back pain
Tidsramme: Baseline
|
Oswestry Disability Index (ODI): range 0 to 100.
Zero is equated with no disability and 100 is the maximum disability possible.
|
Baseline
|
|
Disability for low back pain
Tidsramme: Week 6
|
Oswestry Disability Index (ODI): range 0 to 100.
Zero is equated with no disability and 100 is the maximum disability possible.
|
Week 6
|
|
Disability for low back pain
Tidsramme: Week 12
|
Oswestry Disability Index (ODI): range 0 to 100.
Zero is equated with no disability and 100 is the maximum disability possible.
|
Week 12
|
|
Disability for low back pain
Tidsramme: Week 18
|
Oswestry Disability Index (ODI): range 0 to 100.
Zero is equated with no disability and 100 is the maximum disability possible.
|
Week 18
|
|
Disability for low back pain
Tidsramme: Week 24
|
Oswestry Disability Index (ODI): range 0 to 100.
Zero is equated with no disability and 100 is the maximum disability possible.
|
Week 24
|
|
Tolerance of the sitting position
Tidsramme: Baseline
|
Time between the beginning of the sitting position and the onset or worsening of the pain
|
Baseline
|
|
Tolerance of the sitting position
Tidsramme: Week 6
|
Time between the beginning of the sitting position and the onset or worsening of the pain
|
Week 6
|
|
Tolerance of the sitting position
Tidsramme: Week 12
|
Time between the beginning of the sitting position and the onset or worsening of the pain
|
Week 12
|
|
Tolerance of the sitting position
Tidsramme: Week 18
|
Time between the beginning of the sitting position and the onset or worsening of the pain
|
Week 18
|
|
Tolerance of the sitting position
Tidsramme: Week 24
|
Time between the beginning of the sitting position and the onset or worsening of the pain
|
Week 24
|
|
Consumption of painkillers
Tidsramme: Week 24
|
Number of level 1 to 3 analgesics, non-steroidal anti-inflammatory drugs and muscle relaxants
|
Week 24
|
|
Number of patients requiring a second injection botulinum toxin in each arm
Tidsramme: Week 12
|
Number
|
Week 12
|
|
Side effects of injection
Tidsramme: Week 24
|
Side effects of the injection or attributable to the study drug
|
Week 24
|
Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Arnaud Dupeyron, CHU Nîmes
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- PHRCN/2019/AD-1
- 2024-517948-66-00 (Ctis)
Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter
Studerer et amerikansk FDA-reguleret lægemiddelprodukt
Studerer et amerikansk FDA-reguleret enhedsprodukt
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