The ASPIRE Trial: AchilleS tendinoPathy Treated With cortIcosteRoid injEctions (ASPIRE)
Studienübersicht
Status
Status
Bedingungen
Bedingungen
Intervention / Behandlung
Intervention / Behandlung
Detaillierte Beschreibung
Studientyp
Studientyp
Einschreibung (Geschätzt)
Einschreibung
Phase
Phase
- Phase 3
Kontakte und Standorte
Studienkontakt
Studienkontakt
- Name: Kristel van Abswoude, MD
- Telefonnummer: +31 6 49326353
- E-Mail: aspire@erasmusmc.nl
Studienorte
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Rotterdam, Niederlande
- Rekrutierung
- Erasmus MC
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Kontakt:
- k van Abswoude, MD
- Telefonnummer: +31 6 49326353
- E-Mail: aspire@erasmusmc.nl
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Kontakt:
- R.J de Vos, MD/PhD
- Telefonnummer: +31 10 7040136
- E-Mail: r.devos@erasmusmc.nl
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Teilnahmekriterien
Zulassungskriterien
Zulassungskriterien
Studienberechtigtes Alter
- Erwachsene
- Älterer Erwachsener
Akzeptiert gesunde Freiwillige
Beschreibung
Inclusion Criteria:
- Age 18-65 years
- Clinically diagnosed midportion Achilles tendinopathy confirmed by ultrasound
- Symptoms for at least 6 months
- Persistent complaints despite standard care, including education, load management advice and at least 3 months of exercise therapy / exercise programme
Exclusion Criteria:
• Clinical suspicion of insertional Achilles tendinopathy
- Clinical suspicion of Achilles tendon rupture
- Clinical suspicion of plantar flexor tenosynovitis
- Clinical suspicion of sural nerve pathology
- Clinical suspicion of peroneal tendon subluxation or peroneal tendinopathy
- Clinical suspicion of posterior ankle impingement syndrome
- Suspected systemic/inflammatory disorder as cause of symptoms
- Any condition preventing participation in active exercise programme
- History of Achilles tendon rupture of index tendon
- Previous local corticosteroid injection on index Achilles tendon
- Previous surgery on index Achilles tendon
- Refusal to undergo one of the study treatments
- Local skin infection, suspected systemic infection with fever, or other medical condition compromising injection safety
- Vitamin K antagonist use with INR >3.0 within 3 days before injection or unknown INR
- Current pregnancy or breastfeeding
- Medication-induced tendon pathology (quinolones or statins related to symptom onset)
- Inability to provide informed consent
- Participation in another concomitant interventional programme for Achilles tendinopathy
- Known hypersensitivity or allergy to Depo-Medrol or Lidocaine
- Participants with unstable or poorly controlled diabetes mellitus may be excluded at investigator discretion for safety reasons.
Studienplan
Wie ist die Studie aufgebaut?
Designdetails
- Hauptzweck: Behandlung
- Zuteilung: Zufällig
- Interventionsmodell: Parallele Zuordnung
- Maskierung: Vervierfachen
Anzahl der Arme
Waffen und Interventionen
Teilnehmergruppe / ArmTeilnehmergruppe / Arm |
Intervention / BehandlungIntervention / Behandlung |
|---|---|
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Experimental: Corticosteroid and Lidocaine Injection
Participants receive 1-3 ultrasound-guided peritendinous injections of Depo-Medrol (methylprednisolone acetate 40 mg) combined with lidocaine.
All participants receive one injection at baseline; up to two additional injections may be given within the first 8 weeks at intervals of 4 weeks if predefined criteria are met.
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Education, load management advice, and a structured progressive calf-muscle strengthening exercise programme supported by an online website.
Participants receive 1-3 ultrasound-guided peritendinous injections of Depo-Medrol (methylprednisolone acetate 40 mg) combined with lidocaine.
Andere Namen:
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Placebo-Komparator: Placebo Injection
Participants receive 1-3 ultrasound-guided peritendinous placebo injections consisting of lidocaine only.
All participants receive one injection at baseline; up to two additional injections may be given within the first 8 weeks at intervals of at least 4 weeks if predefined criteria are met.
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Education, load management advice, and a structured progressive calf-muscle strengthening exercise programme supported by an online website.
Participants receive 1-3 ultrasound-guided peritendinous placebo injections consisting of lidocaine onl
Andere Namen:
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Was misst die Studie?
Primäre Ergebnismessungen
Primäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Change in disability and symptoms measured with the VISA-A questionnaire.
Zeitfenster: Baseline to 1 year follow-up (timepoints: Baseline, 4 weeks, 8 weeks, 3 months, 6 months, 9 months, and 1-year).
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Change in disability and symptoms during 1-year follow-up, measured with the validated Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire, scored from 0 to 100.
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Baseline to 1 year follow-up (timepoints: Baseline, 4 weeks, 8 weeks, 3 months, 6 months, 9 months, and 1-year).
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Incidence of full-thickness Achilles tendon rupture
Zeitfenster: During 1-year follow-up
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Incidence of full-thickness Achilles tendon ruptures during 1-year follow-up, confirmed by medical records or clinical tests and imaging.
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During 1-year follow-up
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Sekundäre Ergebnismessungen
Sekundäre Ergebnismessungen
Ergebnis Maßnahme |
Maßnahmenbeschreibung |
Zeitfenster |
|---|---|---|
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Minor corticosteroid side effects / corticosteroid safety indicators
Zeitfenster: baseline, 3 months, 6 months, 9 months, and 1 year.
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Body mass (kg)
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baseline, 3 months, 6 months, 9 months, and 1 year.
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Tendon-related symptoms and disability
Zeitfenster: baseline, 3 months, 6 months, 9 months, and 1 year
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TENDINopathy Severity Assessment - Achilles (TENDINS-A) score.
0-100; 0= worts, 100= best
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baseline, 3 months, 6 months, 9 months, and 1 year
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Pain outcomes
Zeitfenster: Assessed at baseline, 3 months, 6 months, 9 months, and 1 year
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Pain during activity, measured on a VAS 0-10 scale
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Assessed at baseline, 3 months, 6 months, 9 months, and 1 year
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Global perceived improvement
Zeitfenster: Assessed at 3 months, 6 months, 9 months, and 1 year
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Global Rating of Change (GROC), 11-point scale
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Assessed at 3 months, 6 months, 9 months, and 1 year
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Physical function / functional test outcomes
Zeitfenster: Assessed at baseline, 3 months, and 1 year
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Maximum VAS pain (0-10) during or after palpation of the Achilles tendon
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Assessed at baseline, 3 months, and 1 year
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Healthcare use
Zeitfenster: Assessed at baseline, 3 months, 6 months, 9 months, and 1 year
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Medical Consumption Questionnaire (iMCQ) for healthcare use The economic evaluation will be published separately. |
Assessed at baseline, 3 months, 6 months, 9 months, and 1 year
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Imaging outcomes: tendon structure
Zeitfenster: Assessed at baseline, 3 months, and 1 year
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Ultrasound and ultrasound tissue characterisation of Achilles tendon where the degree of collagen disorganisation is assed using: echo types I, echo types II, echo types III, echo types IV, combined percentage echo types I + II
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Assessed at baseline, 3 months, and 1 year
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Imaging outcomes: neovascularisation / Doppler flow
Zeitfenster: Assessed at baseline, 3 months, and 1 year
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percentage of Doppler flow within the color box, quantified with the Surface Area Quantification (SAQ) method
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Assessed at baseline, 3 months, and 1 year
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Minor corticosteroid side effects / corticosteroid safety indicators
Zeitfenster: baseline, 3 months, and 1 year.
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Body fat percentage
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baseline, 3 months, and 1 year.
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Minor corticosteroid side effects / corticosteroid safety indicators
Zeitfenster: baseline, 3 months, and 1 year
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Waist circumference (cm)
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baseline, 3 months, and 1 year
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Minor corticosteroid side effects / corticosteroid safety indicators
Zeitfenster: baseline, 3 months, 6 months, 9 months, and 1 year.
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Hot flushes (5-point scale)
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baseline, 3 months, 6 months, 9 months, and 1 year.
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Minor corticosteroid side effects / corticosteroid safety indicators
Zeitfenster: baseline, 3 months, 6 months, 9 months, and 1 year
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Menstrual disturbances (if applicable, 5-point scale)
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baseline, 3 months, 6 months, 9 months, and 1 year
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Minor corticosteroid side effects / corticosteroid safety indicators
Zeitfenster: baseline, 3 months, 6 months, 9 months, and 1 year.
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Sleep disturbances (5-point scale)
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baseline, 3 months, 6 months, 9 months, and 1 year.
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Minor corticosteroid side effects / corticosteroid safety indicators
Zeitfenster: baseline, 3 months, 6 months, 9 months, and 1 year.
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Appetite (5-point scale)
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baseline, 3 months, 6 months, 9 months, and 1 year.
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Physical function / functional test outcomes
Zeitfenster: Assessed at baseline, 3 months, and 1 year
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Maximum VAS pain (0-10) during or after 5 single-leg heel rises
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Assessed at baseline, 3 months, and 1 year
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Physical function / functional test outcomes
Zeitfenster: Assessed at baseline, 3 months, and 1 year
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Maximum VAS pain (0-10) during or after 5 hops
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Assessed at baseline, 3 months, and 1 year
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Physical function / functional test outcomes
Zeitfenster: Assessed at baseline, 3 months, and 1 year
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Heel Rise Endurance Test (HRET) - repetitions
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Assessed at baseline, 3 months, and 1 year
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productivity loss
Zeitfenster: Assessed at baseline, 3 months, 6 months, 9 months, and 1 year
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Institute for Medical Technology Assessment Productivity Cost Questionnaire (iPCQ for productivity loss).
The economic evaluation will be published separately
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Assessed at baseline, 3 months, 6 months, 9 months, and 1 year
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Imaging outcomes: tendon structure on ultrasound
Zeitfenster: Assessed at baseline, 3 months, and 1 year
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tendon volume (cubic centimeters)
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Assessed at baseline, 3 months, and 1 year
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Imaging outcomes: tendon structure on ultrasound
Zeitfenster: Assessed at baseline, 3 months, and 1 year
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maximum cross-sectional area (square cm)
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Assessed at baseline, 3 months, and 1 year
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Imaging outcomes: tendon structure on ultrasound
Zeitfenster: Assessed at baseline, 3 months, and 1 year
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tendon maximum diameter (cm)
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Assessed at baseline, 3 months, and 1 year
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Pain outcomes
Zeitfenster: Assessed at baseline, 3 months, 6 months, 9 months, and 1 year
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Pain after activity, measured on a VAS 0-10 scale
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Assessed at baseline, 3 months, 6 months, 9 months, and 1 year
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Health-related quality of life
Zeitfenster: Assessed at baseline, 3 months, 6 months, 9 months, and 1 year
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Euro Quality of life 5 Dimensions, 5 Levels questionnaire (EQ-5D-5L).
0-100 score.
0=worst, 100=best
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Assessed at baseline, 3 months, 6 months, 9 months, and 1 year
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Return to sport / physical activity level
Zeitfenster: Assessed at baseline, 3 months, 6 months, 9 months, and 1 year.
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Return to desired sports participation using a 7-point scale.
0= worst, 7 full return to sports = best
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Assessed at baseline, 3 months, 6 months, 9 months, and 1 year.
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Minor corticosteroid side effects
Zeitfenster: baseline, 3 months, and 1 year.
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Visible skin abnormalities at the injection site scored as present or absent
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baseline, 3 months, and 1 year.
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Mitarbeiter und Ermittler
Sponsor
Sponsor
Mitarbeiter
Mitarbeiter
Ermittler
Ermittler
- Hauptermittler: Robert Jan de Vos, MD, PhD, Erasmus Medical Centre
Publikationen und hilfreiche Links
Nützliche Links
Studienaufzeichnungsdaten
Haupttermine studieren
Studienbeginn (Tatsächlich)
Studienbeginn
Primärer Abschluss (Geschätzt)
Primärer Abschluss
Studienabschluss (Geschätzt)
Studienabschluss
Studienanmeldedaten
Zuerst eingereicht
Zuerst eingereicht
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst eingereicht, das die QC-Kriterien erfüllt hat
Zuerst gepostet (Tatsächlich)
Zuerst gepostet
Studienaufzeichnungsaktualisierungen
Letztes Update gepostet (Tatsächlich)
Letztes Update gepostet
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Letztes eingereichtes Update, das die QC-Kriterien erfüllt
Zuletzt verifiziert
Zuletzt verifiziert
Mehr Informationen
Begriffe im Zusammenhang mit dieser Studie
Schlüsselwörter
Zusätzliche relevante MeSH-Bedingungen
- Verwaltung des Gesundheitswesens
- Qualität, Zugang und Bewertung im Gesundheitswesen
- Organische Chemikalien
- Qualität der Gesundheitsversorgung
- Polycyclische Verbindungen
- Qualitätsindikatoren, Gesundheitsversorgung
- Anilides
- Amides
- Anilinverbindungen
- Amine
- Acetanilide
- Schwangerschaft
- Schwangerschaft
- Steroide
- Fusions-Ring-Verbindungen
- Schwangerschaften
- Methylprednisolon
- Prednisolon
- Methylprednisolonacetat
- Lidocain
- Sorgfalt
Andere Studien-ID-Nummern
Andere Studien-ID-Nummern
- MEC-2026-0210
- 2025-524057-13-00 (Ctis)
- ZonMw grant number: 1014102241 (Andere Kennung: ZonMw)
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IPD-Sharing-Zeitrahmen
IPD-Sharing-Zugriffskriterien
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