- ICH GCP
- US Clinical Trials Registry
- Klinisk forsøg NCT02618603
Botulinum Toxin A for Shoulder Pain After Stroke
27. november 2015 opdateret af: TAO WU, Sir Run Run Shaw Hospital
The Effectiveness of Ultrasound Guided Sub-acromial Bursa Injection With Botulinum Toxin A in for Refractory Shoulder Pain After Stroke.
Shoulder pain after stroke is a very common, causing significant morbidity disease.
Subacromial and subdeltoid (SASD) bursitis are common causes of pain or disability of the shoulder joint in stroke patients.
Traditional therapeutic approaches for the shoulder pain therapy including pharmacotherapy, injection therapy, physical therapy, and behavioural modification.
Unfortunately, these therapy methods may not be effective in many patients and long term benefit after treatment is transient, the outcomes may also be incomplete or non-existent.
Botulinum toxin A (BoNT-A) is a neurotoxin that can inhibit not only the acetylcholine at the neuromuscular junctions but also other neurotransmitters such as glutamate, substance P and calcitonin gene related peptide, all of which have been indicated in pain transmission.
Despite the therapeutic benefit of BTX in alleviating painful muscle spasms, its efficacy in SASD bursitis conditions is less clear.
So we perform this study to examine the efficacy of ultrasound guided SASD injection with BoNT-A in reducing refractory shoulder pain after stroke.
Studieoversigt
Status
Ukendt
Intervention / Behandling
Undersøgelsestype
Interventionel
Tilmelding (Forventet)
50
Fase
- Fase 4
Kontakter og lokationer
Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.
Studiesteder
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Zhejiang
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Hang Zhou, Zhejiang, Kina, 310016
- Sir Run Run Shaw Hospital, Medical College of Zhejiang University
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Deltagelseskriterier
Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.
Berettigelseskriterier
Aldre berettiget til at studere
18 år til 80 år (Voksen, Ældre voksen)
Tager imod sunde frivillige
Ingen
Køn, der er berettiget til at studere
Alle
Beskrivelse
Inclusion Criteria:
- Stroke patients with pain around the shoulder or lateral deltoid area and deteriorated during active or passive overhead activity;
- Neer and/or Hawkins tests (+);
- NRS>5 at rest;
- Symptoms lasted for at least for 2 months and were unresponsive to analgesic medication or physical therapy for 1 month.
- Subjects voluntarily sign the informed consent.
- Age between 18 and 80 years old. -
Exclusion Criteria:
- Received earlier subacromial injections of corticosteroids or botulinuim toxin in the last 6 months;
- Shoulder fracture, glenohumeral osteoarthritis, bone tumors or osteonecrosis in plain radiographs.
- Known allergy or sensitivity to study medication or its components.
- Infection or dermatological condition at the injection sites.
- Any medical condition that may put the subject at increased risk with exposure , including diagnosed myasthenia gravis, Eaton-Lambert syndrome, amyotrophic lateral sclerosis, or any other disorder that might have interfered with neuromuscular function.
- QTc criteria: QTc ≥ 450 millisecond (msec) or≥480msec for subjects with Bundle Branch Block-values based on either single electrocardiogram (ECG) values or triplicate ECG averaged QTc values obtained over a brief recording period
- Liver function tests: aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≥2xULN; alkaline phosphatase and bilirubin >1.5xULN (isolated bilirubin >1.5ULN is acceptable if bilirubin is fractionated and direct bilirubin <35%).
- Concurrent use of aminoglycoside antibiotics or other agents that might interfere with neuromuscular function.
- Patients with severe cognitive impairment or neurological diseases affecting the implementation or evaluation of the test, and drug-dependent patients.
- Presence of clinically unstable severe cardiovascular, renal or respiratory disease
Researchers believe there are other factors unfit to participate in this study of patients.
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Studieplan
Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: Randomiseret
- Interventionel model: Parallel tildeling
- Maskning: Tredobbelt
Våben og indgreb
Deltagergruppe / Arm |
Intervention / Behandling |
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Eksperimentel: BoNT-A treatment group
Ultrasound guided sub-acromial bursa injection with BoNT-A (100 u);
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Andre navne:
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Aktiv komparator: Triamcinolone acetonide treatment group
Ultrasound guided sub-acromial bursa injection with Triamcinolone acetonide (40mg)+1% Lidocaine 2 ml;
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Hvad måler undersøgelsen?
Primære resultatmål
Resultatmål |
Tidsramme |
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Change from baseline of pain score (Numeric Rating Scale, NRS)
Tidsramme: The outcome will be undertaken at weeks 0 (baseline), 1,2,4,8, and 12 weeks after injection.
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The outcome will be undertaken at weeks 0 (baseline), 1,2,4,8, and 12 weeks after injection.
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Sekundære resultatmål
Resultatmål |
Tidsramme |
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Passive and/or active shoulder range of motion.
Tidsramme: The outcome will be undertaken at weeks 0 (baseline), 1,2,4,8, and 12 weeks after injection.
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The outcome will be undertaken at weeks 0 (baseline), 1,2,4,8, and 12 weeks after injection.
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Change from baseline of should muscle modified Ashworth scale assess (MAS)
Tidsramme: The outcome will be undertaken at weeks 0 (baseline), 1,2,4,8, and 12 weeks after injection.
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The outcome will be undertaken at weeks 0 (baseline), 1,2,4,8, and 12 weeks after injection.
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Samarbejdspartnere og efterforskere
Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.
Sponsor
Publikationer og nyttige links
Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.
Generelle publikationer
- Lee JH, Lee SH, Song SH. Clinical effectiveness of botulinum toxin type B in the treatment of subacromial bursitis or shoulder impingement syndrome. Clin J Pain. 2011 Jul-Aug;27(6):523-8. doi: 10.1097/AJP.0b013e31820e1310.
- McMahon HT, Foran P, Dolly JO, Verhage M, Wiegant VM, Nicholls DG. Tetanus toxin and botulinum toxins type A and B inhibit glutamate, gamma-aminobutyric acid, aspartate, and met-enkephalin release from synaptosomes. Clues to the locus of action. J Biol Chem. 1992 Oct 25;267(30):21338-43.
- Bach-Rojecky L, Salkovic-Petrisic M, Lackovic Z. Botulinum toxin type A reduces pain supersensitivity in experimental diabetic neuropathy: bilateral effect after unilateral injection. Eur J Pharmacol. 2010 May 10;633(1-3):10-4. doi: 10.1016/j.ejphar.2010.01.020. Epub 2010 Feb 1.
- Hsieh LF, Hsu WC, Lin YJ, Wu SH, Chang KC, Chang HL. Is ultrasound-guided injection more effective in chronic subacromial bursitis? Med Sci Sports Exerc. 2013 Dec;45(12):2205-13. doi: 10.1249/MSS.0b013e31829b183c.
- Wu T, Song HX, Dong Y, Li JH. Ultrasound-guided versus blind subacromial-subdeltoid bursa injection in adults with shoulder pain: A systematic review and meta-analysis. Semin Arthritis Rheum. 2015 Dec;45(3):374-8. doi: 10.1016/j.semarthrit.2015.05.011. Epub 2015 May 21.
- Wu T, Fu Y, Song HX, Ye Y, Dong Y, Li JH. Effectiveness of Botulinum Toxin for Shoulder Pain Treatment: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2015 Dec;96(12):2214-20. doi: 10.1016/j.apmr.2015.06.018. Epub 2015 Jul 17.
Datoer for undersøgelser
Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.
Studer store datoer
Studiestart
1. februar 2016
Primær færdiggørelse (Forventet)
1. juni 2018
Studieafslutning (Forventet)
1. december 2018
Datoer for studieregistrering
Først indsendt
27. november 2015
Først indsendt, der opfyldte QC-kriterier
27. november 2015
Først opslået (Skøn)
1. december 2015
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Skøn)
1. december 2015
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
27. november 2015
Sidst verificeret
1. november 2015
Mere information
Begreber relateret til denne undersøgelse
Nøgleord
Yderligere relevante MeSH-vilkår
- Hjerte-kar-sygdomme
- Karsygdomme
- Cerebrovaskulære lidelser
- Hjernesygdomme
- Sygdomme i centralnervesystemet
- Sygdomme i nervesystemet
- Smerte
- Neurologiske manifestationer
- Ledsygdomme
- Muskuloskeletale sygdomme
- Artralgi
- Slag
- Skuldersmerter
- Lægemidlers fysiologiske virkninger
- Neurotransmittermidler
- Molekylære mekanismer for farmakologisk virkning
- Agenter fra det perifere nervesystem
- Kolinerge midler
- Enzymhæmmere
- Anti-inflammatoriske midler
- Immunsuppressive midler
- Immunologiske faktorer
- Glukokortikoider
- Hormoner
- Hormoner, hormonsubstitutter og hormonantagonister
- Membrantransportmodulatorer
- Acetylcholin-frigivelseshæmmere
- Neuromuskulære midler
- Botulinum toksiner
- Botulinumtoksiner, type A
- abobotulinumtoxinA
- Triamcinolon
- Triamcinolonacetonid
- Triamcinolonhexacetonid
- Triamcinolondiacetat
Andre undersøgelses-id-numre
- 2016137443 (Andet bevillings-/finansieringsnummer: Medical Science and Technology projects of Zhejiang Provincial Health Department)
Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .
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