Los Lípidos Marinos Alivian el TMD Doloroso (ADAPT)
Seguridad y Eficacia Analgésica de los Precursores Lipídicos Marinos de Mediadores Especializados Pro-Resolución en Adultos con Dolor Temporomandibular Crónico
The ADAPT study is a single-site, Phase 2b, randomized, quadruple-masked, placebo-controlled trial evaluating an omega-3 dietary supplement enriched with specialized pro-resolving mediator (SPM) precursors in adults with chronic temporomandibular disorder (TMD) pain. The trial will enroll 100 adults aged 18 years or older with examiner-confirmed TMD myalgia or arthralgia will be enrolled at the University of North Carolina at Chapel Hill, Adams School of Dentistry.
Participants are randomized 1:1 to receive either the SPM precursor supplement or a matched placebo daily for 8 weeks. Randomization is stratified by sex, and study agents are identical in appearance to maintain masking.
The study aims to evaluate whether the SPM precursor supplement:
Reduces facial pain intensity compared with placebo.
Changes pressure pain sensitivity at the jaw and other standard body sites.
Affects other aspects of chronic pain, including duration, interference with daily activities, headache burden, anxiety, depression, jaw-related quality of life, and overall patient-reported change.
Participants will record their daily facial pain intensity in paper diaries, complete short questionnaires at baseline, Week 4, and Week 8, and undergo experimental pain testing with a handheld algometer at baseline, Week 4, and Week 8. Safety is monitored through the documentation of all adverse events throughout the study period.
Descripción general del estudio
Estado
Estado
Condiciones
Condiciones
Intervención / Tratamiento
Intervención / Tratamiento
Descripción detallada
Study Overview Participant Procedures Screening/Baseline (Visit 0-1): DC-TMD examination to confirm eligibility; review of medications and health history; baseline questionnaires; pressure pain threshold testing; body manikin pain mapping.
Daily Diaries: Participants record facial pain intensity (0-100 NRS) each day for 8 weeks.
Mid-study Assessment (Week 4, Visit 2): Questionnaires for pain, mood, quality of life; pressure pain threshold testing.
Final Visit (Week 8, Visit 3): Repeat questionnaires, pressure pain testing, and body manikin assessments; blood collection for polyunsaturated fatty acid (PUFA)/oxylipin analysis.
Follow-up Call (1 week post-intervention): Safety check for adverse events.
Study Duration
Total participation: up to 12 weeks (pre-screening, 8-week intervention, 1-week follow-up).
Assessments at baseline, Week 4, Week 8, and follow-up call.
Population and Recruitment Adults ≥18 years with examiner-confirmed TMD myalgia or arthralgia. Participants of all races and ethnicities are eligible; anticipated demographics: ~77% female, 6% Hispanic, 83% White, 8% African American, 9% other.
Overall Goal To provide high-quality evidence on the effects of omega-3 SPM precursors on facial pain, pressure pain sensitivity, psychosocial distress, headache burden, jaw-related quality of life.
Tipo de estudio
Tipo de estudio
Inscripción (Estimado)
Inscripción
Fase
Fase
- No aplica
Contactos y Ubicaciones
Estudio Contacto
Estudio Contacto
- Nombre: Anne E Sanders, PhD
- Número de teléfono: (919) 246-5833
- Correo electrónico: adaptsms@adapt.study
Copia de seguridad de contactos de estudio
- Nombre: Lorraine M King
- Número de teléfono: (919) 246-5833
- Correo electrónico: adaptsms@adapt.study
Ubicaciones de estudio
-
-
North Carolina
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Chapel Hill, North Carolina, Estados Unidos, 27599
- Reclutamiento
- University of North Carolina at Chapel Hill
-
-
Criterios de participación
Criterio de elegibilidad
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion
Pre-screening (before Visit 0):
- Age ≥18 years.
- Pain in jaws, temples, ears, or in front of ears at least 5 days in the past 30 days, occurring monthly over the last 3 months.
- Pain not due to toothache or ear infection.
- Pain intensity ≥30 on a 0-100 numeric rating scale (NRS) during the week before pre-screening.
- Willing to provide written informed consent and follow all study procedures.
- Able to be contacted reliably during the study period.
Visit 0 - Screening/Baseline:
- Meets all pre-screening criteria above.
- Examiner-confirmed TMD diagnosis (myalgia or arthralgia) per DC-TMD criteria.
- Discontinues omega-3 supplements prior to randomization and agrees not to use them during the study.
- Will not initiate new occlusal splint therapy during the study. Participants already using a splint ≥30 days prior may continue.
- Maintains stable facial pain management regimen:
- No changes to regularly scheduled daily pain medications.
- No initiation of new facial pain treatments (pharmacologic, injectable, or non-pharmacologic).
- Episodic prescription pain medications discontinued prior to randomization, except NSAIDs, acetaminophen, or low-dose aspirin.
Visit 1 - Randomization:
- Completes ≥4 of 7 daily symptom diary (DSD) entries before Visit 1.
- Average weekly pain ≥30 on 0-100 NRS, or ≥30 on at least 4 days that week.
Exclusion (Assessed at pre-screening and/or Visit 0):
- Allergy or hypersensitivity to fish or seafood.
- Botulinum toxin injections for facial pain within past 3 months.
- Facial trauma or orofacial surgery within past 6 weeks.
- History of renal failure or dialysis.
- History of hyperthyroidism.
- Immunocompromised state or autoimmune disorder.
- History of seizure disorder or uncontrolled seizures.
- Use of opioid medications in the past 30 days.
- Pregnancy.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Cuadruplicar
Número de brazos
Armas e Intervenciones
Grupo de participantes/brazoGrupo de participantes/brazo |
Intervención / TratamientoIntervención / Tratamiento |
|---|---|
|
Experimental: SPM precursor marine lipid dietary supplement
Experimental Arm - SPM Precursor Marine Lipid Supplement: Participants receive 2 g/day (1 g twice daily) of SPM Active® softgels containing 18-HEPE, 17-HDHA, and 14-HDHA. Softgels are identical in appearance to placebo. Duration: 8 weeks. Placebo Arm - Medium-Chain Triglyceride (MCT) Supplement: Participants receive 2 g/day (1 g twice daily) of MCT oil softgels, identical in appearance to active supplement. Duration: 8 weeks. |
Participants receive omega-3 SPM precursor-enriched marine lipid softgels administered daily for 8 weeks at the dose specified in the protocol. |
|
Comparador de placebos: Medium-chain triglyceride dietary supplement
Participants receive 2 grams per day of a placebo supplement, administered as medium-chain triglyceride (MCT) oil softgels. Participants take 1 gram orally twice daily for 8 weeks. The placebo softgels are identical in appearance and packaging to the active supplement. Participants remain in this arm for the full duration of the study. |
Participants receive matched placebo softgels daily for 8 weeks. |
¿Qué mide el estudio?
Medidas de resultado primarias
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Change in average weekly facial pain intensity
Periodo de tiempo: Baseline (week prior to randomization) through Week 8 (final visit, Day 56 ±7)
|
Net change from baseline to Week 8 in average weekly facial pain intensity, calculated as the mean of daily entries recorded in the Daily Symptom Diary (DSD). Higher scores indicate worse pain. |
Baseline (week prior to randomization) through Week 8 (final visit, Day 56 ±7)
|
|
Rate of treatment-emergent adverse events
Periodo de tiempo: From first dose (Visit 1/Randomization, Day 0) through 7 days after the final dose (Visit 3, Day 56 ±7)
|
Rate of participants experiencing any adverse event (AE) that first appears or worsens after starting the study intervention and up to 7 days after the last dose. Investigators record onset, duration, severity, and relatedness to the study intervention. This measure evaluates the safety of the SPM precursor marine lipid supplement compared with placebo. |
From first dose (Visit 1/Randomization, Day 0) through 7 days after the final dose (Visit 3, Day 56 ±7)
|
Medidas de resultado secundarias
Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
|
Change in TMD pain duration
Periodo de tiempo: From Visit 1 (Randomization, Day 0) through 7 days after the final dose (Visit 3, Day 56 ±7)
|
Change from baseline to Week 8 (Visit 3) in the percentage of waking time with facial pain, expressed in percentage points, based on daily diary entries (0-100 scale). |
From Visit 1 (Randomization, Day 0) through 7 days after the final dose (Visit 3, Day 56 ±7)
|
|
Change in TMD pain intensity and pain interference
Periodo de tiempo: Visit 1 (Randomization, Day 0) to Visit 3 (Final visit, Day 56 ±7)
|
Change from baseline to Week 8 (Visit 3) in TMD pain intensity (current, worst, and average) and interference with daily activities. Assessed using the Graded Chronic Pain Scale (0-10 scale), with higher scores indicating worse pain and greater interference. |
Visit 1 (Randomization, Day 0) to Visit 3 (Final visit, Day 56 ±7)
|
|
Change in headache impact
Periodo de tiempo: Visit 1 (Randomization, Day 0); Visit 2 (Mid-study visit, Day 28 ±7); Visit 3 (Final visit, Day 56 ±7)
|
Change from baseline to Week 8 (Visit 3) in headache impact measured with the Headache Impact Test-6 (HIT-6). Scores range 36-78, with higher scores indicating greater headache-related impact. |
Visit 1 (Randomization, Day 0); Visit 2 (Mid-study visit, Day 28 ±7); Visit 3 (Final visit, Day 56 ±7)
|
|
Change in number of painful body sites
Periodo de tiempo: Visit 1 (Randomization, Day 0); Visit 3 (Final visit, Day 56 ±7)
|
Change from baseline to Week 8 (Visit 3) in the number of anatomical locations marked as painful on anterior and posterior body manikins (range 0-42), with higher scores indicating more widespread pain. |
Visit 1 (Randomization, Day 0); Visit 3 (Final visit, Day 56 ±7)
|
|
Change in pressure pain thresholds
Periodo de tiempo: Visit 0 (Screening/Baseline, 7-21 days before Visit 1), Visit 3 (Final visit, Day 56 ±7)
|
Change from baseline to Week 8 (Visit 3) in pressure pain thresholds (kg) measured bilaterally at five anatomical sites: temporalis, masseter, TM joint, trapezius, and lateral epicondyle. Up to 5 trials per site are performed until two measurements differ by ≤0.2 kg. Higher numbers indicate lower pain sensitivity. |
Visit 0 (Screening/Baseline, 7-21 days before Visit 1), Visit 3 (Final visit, Day 56 ±7)
|
|
Change in state anxiety
Periodo de tiempo: Visit 1 (Randomization, Day 0); Visit 3 (Final visit, Day 56 ±7)
|
Change from Day 0 to Week 8 (Visit 3) in state anxiety measured using the State subscale of the State-Trait Anxiety Inventory (range 20-80), with higher scores indicating greater anxiety. |
Visit 1 (Randomization, Day 0); Visit 3 (Final visit, Day 56 ±7)
|
|
Change in depression
Periodo de tiempo: Visit 1 (Randomization, Day 0); Visit 3 (Final visit, Day 56 ±7)
|
Change from Day 0 to Week 8 (Visit 3) in depressive symptoms measured using the Symptom Checklist-90 (SCL90) Depression subscale (range 0-48), with higher scores indicating more severe symptoms. |
Visit 1 (Randomization, Day 0); Visit 3 (Final visit, Day 56 ±7)
|
|
Change in TMD-related quality of life
Periodo de tiempo: Visit 1 (Randomization, Day 0); Visit 3 (Final visit, Day 56 ±7)
|
Change from Day 0 to Week 8 (Visit 3) in the impact of TMD on daily activities, pain, psychological well-being, and other aspects of quality of life. Measured with a summary score using the Oral Health Impact Profile-TMD (OHIP-TMD, range 0-88), with higher scores indicating greater adverse impact. |
Visit 1 (Randomization, Day 0); Visit 3 (Final visit, Day 56 ±7)
|
|
Change in overall status
Periodo de tiempo: Visit 2 (Mid-study, Day 28 ±7); Visit 3 (Final visit, Day 56 ±7)
|
Change at Weeks 4 (Visit 2) and 8 (Visit 3) in participants' perceived change in activities, symptoms, emotions, and quality of life related to facial pain, assessed using the Patient Global Impression of Change questionnaire (7-point scale), with higher scores reflecting greater improvement. |
Visit 2 (Mid-study, Day 28 ±7); Visit 3 (Final visit, Day 56 ±7)
|
Colaboradores e Investigadores
Patrocinador
Patrocinador
Colaboradores
Colaboradores
Investigadores
Investigadores
- Investigador principal: Anne E Sanders, PhD, University of North Carolina, Chapel Hill
Publicaciones y enlaces útiles
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Actual)
Inicio del estudio
Finalización primaria (Estimado)
Finalización primaria
Finalización del estudio (Estimado)
Finalización del estudio
Fechas de registro del estudio
Enviado por primera vez
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Publicado por primera vez
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización publicada
Última actualización enviada que cumplió con los criterios de control de calidad
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
- Calidad de vida
- Ensayo controlado aleatorizado
- Migraña
- Ácidos grasos omega-3
- Sensibilización central
- Dolor orofacial
- Dolor en la articulación temporomandibular
- Interferencia del dolor
- Mecanismos del dolor crónico
- Sensibilidad al dolor por presión
- Dolor facial crónico
- Mialgia de TMD
- Artralgia de la ATM
- Mediadores pro-resolutivos especializados (SPM)
- Suplemento lipídico marino
- Intervención con suplementos dietéticos
- Pruebas de dolor experimental
- Impacto de la cefalea
- Ansiedad y depresión en el dolor crónico
- Distribución del dolor corporal
Términos MeSH relevantes adicionales
- Dolor
- Manifestaciones neurológicas
- Enfermedades musculoesqueléticas
- Enfermedades Estomatognáticas
- Enfermedades Cerebrales
- Enfermedades del Sistema Nervioso Central
- Enfermedades del Sistema Nervioso
- Enfermedades Musculares
- Desordenes mentales
- Enfermedades Articulares
- Enfermedades de la mandíbula
- Trastornos de cefalea primaria
- Trastornos de dolor de cabeza
- Enfermedades mandibulares
- Trastornos Craneomandibulares
- Condiciones Patológicas, Signos y Síntomas
- Signos y síntomas
- Desórdenes de ansiedad
- Trastornos de migraña
- Trastornos de la articulación temporomandibular
- Dolor facial
Otros números de identificación del estudio
Otros números de identificación del estudio
- 25-0878
- UG3DE033354 (Subvención/contrato del NIH de EE. UU.)
Plan de datos de participantes individuales (IPD)
¿Planea compartir datos de participantes individuales (IPD)?
Descripción del plan IPD
Deidentified individual data that supports the results will be shared beginning 9 to 36 months following publication provided the investigator who proposes to use the data has approval from an Institutional Review Board (IRB), Independent Ethics Committee (IEC), or Research Ethics Board (REB), as applicable, and executes a data use/sharing agreement with UNC.
Marco de tiempo para compartir IPD
beginning 9 and continuing for 36 months following publication
Criterios de acceso compartido de IPD
Investigator has approved IRB, IEC, or REB and an executed data use/sharing agreement with UNC.
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .