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PROs in Chronic Cervical Pain Patients With Accompanying Upper Limb Radiating Pain Treated With Pregabalin

PATIENT-REPORTED-OUTCOMES IN CHRONIC CERVICAL PAIN PATIENTS WITH ACCOMPANYING UPPER LIMB RADIATING PAIN (NEUROPATHIC COMPONENT) TREATED WITH PREGABALIN IN PRIMARY CARE SETTINGS

The purpose of this study is to evaluate the effect of pregabalin on patient reported outcomes compared with conventional analgesic care in chronic cervical pain patients with accompanying upper limb radiating pain (neuropathic component) treated in primary care settings under routine clinical practice.

Aperçu de l'étude

Statut

Complété

Intervention / Traitement

Description détaillée

Rational and background:

Cervical pain with upper limb radiating pain(neuropathic component), such as cervical spondylosis radiculopathy or cervical spondylotic myelopathy, is one of the typical and common neuropathic pain. However, in Japan, large number of those patients are treated with NSAIDs without adequately assessing the cause of pain, despite that α2δ ligand, SNRI (Serotonin and Norepinephrine Reuptake Inhibitors ), and TCA (Tricyclic Antidepressants) are recommended in the clinical guidelines for neuropathic pain. Therefore, treatment satisfaction of these patients is low. This is currently a major issue in treatment for cervical pain with neuropathic component in Japan. In fact, our previous study which assessed the effect of pregabalin in low back pain patients with radiculopathy suggested that the selection of appropriate analgesics according to the cause of pain improved pain related sleep interference, pain and function. However, there are a few reports with regard to effect of pregabalin in cervical pain patients with neuropathic component. Therefore, we propose to conduct an observational study in order to assess the effects of pregabalin in cervical radiculopathy, when added to routine clinical care. The present study can encourage an understanding of the necessary of assessing cause of the pain, and treating with appropriate analgesics.

Research objectives :

To evaluate the effect of pregabalin comparing with the conventional analgesic care in chronic cervical pain patients with accompanying upper limb radiating pain(neuropathic component) treated in primary care settings under routine clinical practice.

Study design:

This is an 8-week, multicenter prospective non-interventional observational study. Subjects who have chronic cervical radiating pain patients with accompanying upper limb radiating pain (with a neuropathic component) and meet all other entry criteria are enrolled at baseline in the duration of study. Study arms are pregabalin with or without usual care vs. usual care (mono/combo therapy). The usual care are assumed NSAIDs, Antidepressants, weak opioids, acetaminophen etc.

The analgesic treatment is determined by the clinical judgment of the physician in charge of patient management. This therapeutic choice is not related to the decision to take part in the study. All enrolled subjects will be received with analgesic treatment. The study requires 3 visits at least, baseline/enrollment visit, Week 4 visit and Week 8 visit (or discontinuation).

Type d'étude

Observationnel

Inscription (Réel)

369

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

      • Fukusima, Japon, 960-8251
        • Fukushima Daiichi Hospital
      • Saga, Japon, 840-8571
        • Saga-Ken Medical Center Koseikan
      • Tokyo, Japon, 104-0031
        • Tokyo Rheumatism Pain Clinic
    • Chiba
      • Ichikawa, Chiba, Japon, 272-0021
        • Satoh Orthopaedic Clinic
      • Ichikawa, Chiba, Japon, 272-0138
        • Shiraishi Orthopaedic Clinic
    • Fukuoka
      • Fukuoka-shi, Fukuoka, Japon, 813-8501
        • Chihaya Hospital
      • Fukuokashi, Fukuoka, Japon, 810-0022
        • Clinic for Sports Medicine and Nutrition
      • Fukuokashi, Fukuoka, Japon, 812-0041
        • Seiwa Orthopedics Surgery Internal Medicine
      • Fukuokashi, Fukuoka, Japon, 812-0046
        • Kiheikai Yoh Orthopedic Clinic
      • Higashi-ku,Fukuoka, Fukuoka, Japon, 813-0017
        • Fukuoka Mirai Hospital
      • Kitakyusyu-shi, Fukuoka, Japon, 800-0057
        • Shin Komonji Hospital
    • Gunma
      • Takasaki-shi, Gunma, Japon, 370-0035
        • Takasaki Pain Clinic
    • Hokkaido
      • Sapporoshi, Hokkaido, Japon, 064-8570
        • Miyanomori Memorial Hospital
    • Hyogo
      • Himeji-shi, Hyogo, Japon, 670-0976
        • Oomuro Orthopedic Clinic
      • Kako-gun, Hyogo, Japon, 675-1115
        • Oonishi Medical Clinic
      • Kobe, Hyogo, Japon, 657-0824
        • Watanabe Orthopaedic Clinic
    • Kanagawa
      • Fujisawa-shi, Kanagawa, Japon, 252-0802
        • Fujisawa Shonandai Hospital
      • Kawasakishi, Kanagawa, Japon, 213-0001
        • Ando Orthopaedics Hospital
      • Sagamiharashi, Kanagawa, Japon, 252-5225
        • General Sagami Kosei Hospital
      • Saitama, Kanagawa, Japon, 356-0004
        • Arai Orthopaedic Clinic
      • Yamato-shi, Kanagawa, Japon, 242-0024
        • Saitoh Orthopedic Sports Clinic
    • Saitama
      • Ageo, Saitama, Japon, 362-0021
        • Ageo Medical Clinic
    • Tokyo
      • Adachi, Tokyo, Japon, 120-0033
        • Nakaicho Clinic
      • Chuo, Tokyo, Japon, 104-0031
        • Kyobashi Orthopaedic Clinic
      • Edogawa, Tokyo, Japon, 133-0057
        • Morishima Clinic
      • Katsushika, Tokyo, Japon, 124-0024
        • Shinkoiwa Ekimae Sogo Clinic
      • Meguro, Tokyo, Japon, 152-0002
        • Meguro Seikeigeka Naika
      • Meguro, Tokyo, Japon, 153-0065
        • Meguro Yuai Clinic
      • Ohta, Tokyo, Japon, 145-0066
        • Takemoto Orthopaedic Clinic
      • Shinagawa, Tokyo, Japon, 140-0014
        • Ohimachi Orthopaedic Clinic
      • Shinnzyuku, Tokyo, Japon, 169-0073
        • Shinjuku Research Park Clinic
      • Suginami, Tokyo, Japon, 166-0003
        • Kouenji Orthopedic Clinic
      • Toshima, Tokyo, Japon, 171-0033
        • Daido Hospital

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

20 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

Méthode d'échantillonnage

Échantillon non probabiliste

Population étudiée

Chronic cervical pain patients with accompanying upper limb radiating pain (neuropathic component) treated with pregabalin or other analgesics

La description

Inclusion Criteria:

Subject who received the enough study information and signed informed consent form.

Subject who had chronic pain with accompanying radiating pain to the superior limb beyond the elbow.

Subject is male or female patient ≧20 years old. Subject who reported neck pain with accompanying radiating pain to superior limb (12 weeks or greater in duration at Visit 0).

Subject who is refractory to previous analgesics for 12 weeks and more. Subject who is able and willing to complete all study related assessment tools and complied with scheduled clinic visits and clinical study procedures.

Subject whose pain NRS ≧5 and PRSIS ≧1 at baseline (based on recall over the past week).

Exclusion Criteria:

Subject who, in the opinion of the investigator, was not likely to complete the trial for whatever reason.

Subject who was treated with Pregabalin within the past 12 weeks (on baseline). Subject who has been regularly treated cervical pain with nerve blocks (such as stellate ganglion block, epidural block, radicular block and trigger point injection etc.).

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

Cohortes et interventions

Groupe / Cohorte
Intervention / Traitement
Pregabalin / Other analgesics
Patients will be treated for 8 weeks with pregabalin in primary care: no intervention
The study is observational.
Other analgesics
Patients will be treated for 8 weeks with other analgesics in usual care: no intervention
The study is observational.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Change From Baseline at 8 weeks in Pain Related Sleep Interference Scale (PRSIS - Past Week Recall)
Délai: Baseline, Visit 2 (week 4), Final visit (week 8 or discontinuation)
The Pain Related Sleep Interference Scale (past week recall) consists of an 11-point numeric rating scale (NRS) ranging from 0 (pain did not interfere with sleep) to 10 (pain completely interfered with sleep). Subjects are to describe how their pain has interfered with their sleep during the past week by choosing the appropriate number between 0 and 10.
Baseline, Visit 2 (week 4), Final visit (week 8 or discontinuation)

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Change From Baseline in Neck Disability Index (NDI)
Délai: Baseline, Visit 2 (week 4), Final visit (week 8 or discontinuation)
The Neck Disability Index (NDI) is an index of how well patients with cervical pain are able to function with regard to daily activities. The score for the index ranges from 0 to 50 with a lower score indicating better function. In the event that a patient has used rescue medication within 12 hours of the clinic visit, the patient should respond to the questions based on their functional ability in the 24 hour period just preceding the use of rescue medication.
Baseline, Visit 2 (week 4), Final visit (week 8 or discontinuation)
Change From Baseline in Pain Numeric Rating Scale (Pain NRS - past week recall)
Délai: Baseline, Visit 2 (week 4), Final visit (week 8 or discontinuation)
The Pain NRS (past week recall) consists of an 11-point numeric rating scale (NRS) ranging from 0 (no pain) to 10 (worst possible pain). Subjects are asked to describe their average pain during the past week by choosing the appropriate number between 0 and 10.
Baseline, Visit 2 (week 4), Final visit (week 8 or discontinuation)
Change From Baseline in Euro Qol- 5 Dimensions -5 Level (EQ-5D-5L)-QOL-Score-
Délai: Baseline, Visit 2 (week 4), Final visit (week 8 or discontinuation)

The EQ-5D-5L is a copyrighted, subject-completed questionnaire designed to assess health-related quality of life in terms of a single index value or utility score. There are two components to the EQ-5D-5L: A Health State Profile and a Visual Analogue Scale (VAS). Recent guidance suggests that the Health State Profile and VAS should be administered together.

The Health State Profile is designed to record the subject's level of current health for five domains comprising a health profile: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Responses from the five domains are used to calculate a single utility index value.

Baseline, Visit 2 (week 4), Final visit (week 8 or discontinuation)
Change From Baseline in Euro Qol- 5 Dimensions -5 Level (EQ-5D-5L)-Visual Analogue Scale -
Délai: Baseline, Visit 2 (week 4), Final visit (week 8 or discontinuation)

The EQ-5D-5L is a copyrighted, subject-completed questionnaire designed to assess health-related quality of life in terms of a single index value or utility score. There are two components to the EQ-5D-5L: A Health State Profile and a Visual Analogue Scale (VAS). Recent guidance suggests that the Health State Profile and VAS should be administered together.

The Visual Analogue Scale (VAS) is designed to rate the subject's current health state on a scale from 0 to 100 where 0 represents the worst imaginable health state and 100 represents the best imaginable health state.

Baseline, Visit 2 (week 4), Final visit (week 8 or discontinuation)
Clinical Global Impression of Change (CGIC)
Délai: Final visit (week 8 or discontinuation)
The CGIC assessment includes one question (1-7 scale) inquiring about the subject's improvement considering their current disease state.
Final visit (week 8 or discontinuation)
Patient Global Impression of Change (PGIC)
Délai: Final visit (week 8 or discontinuation)
The PGIC is a subject-rated instrument that measures change in the subject's overall status on a 7-point scale. Scores range from 1 (very much improved) to 7 (very much worse).
Final visit (week 8 or discontinuation)
Work Productivity and Activity Impairment Questionnaire: (WPAI: GH)
Délai: Final visit (week 8 or discontinuation)
The WPAI: GH is a self-administered questionnaire that measures the effect of general health and symptom severity on work productivity and regular activities. Unlike general health or disease-specific measures, the WPAI:GH assesses function-related endpoints to allow a measure of the economic impact of relative differences in either the safety or efficacy of therapeutic endpoints. In this study, the WPAI: GH will measure the effect of the patient's chronic cervical pain with accompanying upper limb pain (neuropathic component) on work productivity and regular activities.
Final visit (week 8 or discontinuation)

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Publications et liens utiles

La personne responsable de la saisie des informations sur l'étude fournit volontairement ces publications. Il peut s'agir de tout ce qui concerne l'étude.

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

1 octobre 2016

Achèvement primaire (Réel)

24 octobre 2017

Achèvement de l'étude (Réel)

24 octobre 2017

Dates d'inscription aux études

Première soumission

9 août 2016

Première soumission répondant aux critères de contrôle qualité

11 août 2016

Première publication (Estimation)

16 août 2016

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

20 janvier 2021

Dernière mise à jour soumise répondant aux critères de contrôle qualité

15 janvier 2021

Dernière vérification

1 janvier 2019

Plus d'information

Termes liés à cette étude

Plan pour les données individuelles des participants (IPD)

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Description du régime IPD

Pfizer will provide access to individual de-identified participant data and related study documents (e.g. protocol, Statistical Analysis Plan (SAP), Clinical Study Report (CSR)) upon request from qualified researchers, and subject to certain criteria, conditions, and exceptions. Further details on Pfizer's data sharing criteria and process for requesting access can be found at: https://www.pfizer.com/science/clinical_trials/trial_data_and_results/data_requests.

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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