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
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 2
Contatti e Sedi
Contatto studio
Contatto studio
- Nome: Arnaud Dupeyron
- Numero di telefono: 04.66.68.34.59
- Email: arnaud.dupeyron@umontpellier.fr
Luoghi di studio
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Besançon, Francia
- CHU de Besançon
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Contatto:
- Fabrice MICHEL
- Numero di telefono: 03 81 66 89 50
- Email: fmichel@chu-besancon.fr
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Bordeaux, Francia
- CHU de Bordeaux
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Contatto:
- Mathieu DE-SEZE
- Numero di telefono: 05.56.79.56.79
- Email: mathieu.de-seze@chu-bordeaux.fr
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Nantes, Francia
- CHU de Nantes
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Contatto:
- Julien LABARRE
- Numero di telefono: 02 53 48 21 87
- Email: julien.labarre@chu-nantes.fr
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Paris, Francia
- Hôpital Universitaire Paris Cochin
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Contatto:
- François RANNOU
- Numero di telefono: 01 58 41 23 35
- Email: francois.rannou@aphp.fr
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Strasbourg, Francia
- Institut Universitaire de Réadaptation Clémenceau
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Contatto:
- Marie-Eve ISNER-HOROBETI
- Numero di telefono: 03.88.21.16.39
- Email: marieeve.isner@gmail.com
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Toulouse, Francia
- CHU de Toulouse
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Gard
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Nîmes, Gard, Francia, 30029
- Centre Hospitalier Universitaire de Nîmes
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Contatto:
- Anissa Megzarri
- Numero di telefono: 04 66 68 68 68
- Email: drc@chu-nimes.fr
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
- Adulto
- Adulto più anziano
Accetta volontari sani
Descrizione
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.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Triplicare
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
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Sperimentale: Iniezione di tossina botulinica
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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
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Comparatore placebo: Iniezione di placebo
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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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Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Change in sciatic pain
Lasso di tempo: From baseline to Week 6
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Measured on a 0 (no pain) to 10 (worst pain) visual analog scale
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From baseline to Week 6
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Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
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Change in buttock pain intensity
Lasso di tempo: From baseline to Week 6
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Measured on a 0 (no pain) to 10 (worst pain) visual analog scale
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From baseline to Week 6
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Health-related quality of life
Lasso di tempo: 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)
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Baseline
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Health-related quality of life
Lasso di tempo: 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
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Health-related quality of life
Lasso di tempo: 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)
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Week 12
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Health-related quality of life
Lasso di tempo: 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
|
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Health-related quality of life
Lasso di tempo: 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
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Sciatic pain intensity
Lasso di tempo: Baseline
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Baseline
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Sciatic pain intensity
Lasso di tempo: Week 3
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 3
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Sciatic pain intensity
Lasso di tempo: Week 6
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 6
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Sciatic pain intensity
Lasso di tempo: Week 9
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 9
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Sciatic pain intensity
Lasso di tempo: Week 12
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 12
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Sciatic pain intensity
Lasso di tempo: Week 15
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 15
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Sciatic pain intensity
Lasso di tempo: Week 18
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 18
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Sciatic pain intensity
Lasso di tempo: Week 21
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 21
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Sciatic pain intensity
Lasso di tempo: Week 24
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 24
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Buttock pain intensity
Lasso di tempo: Baseline
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
|
Baseline
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Buttock pain intensity
Lasso di tempo: Week 3
|
Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 3
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Buttock pain intensity
Lasso di tempo: Week 6
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 6
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Buttock pain intensity
Lasso di tempo: Week 9
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 9
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Buttock pain intensity
Lasso di tempo: Week 12
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 12
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Buttock pain intensity
Lasso di tempo: Week 15
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 15
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Buttock pain intensity
Lasso di tempo: Week 18
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 18
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Buttock pain intensity
Lasso di tempo: Week 21
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 21
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Buttock pain intensity
Lasso di tempo: Week 24
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Assessed on Visual Analog Scale value (0 = no pain, 10 = worst pain)
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Week 24
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Physical functioning
Lasso di tempo: Baseline
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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
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Baseline
|
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Physical functioning
Lasso di tempo: 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
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Week 6
|
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Physical functioning
Lasso di tempo: 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
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Week 12
|
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Physical functioning
Lasso di tempo: 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
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Week 18
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Physical functioning
Lasso di tempo: 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
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Week 24
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Perceived change in condition in response to therapy
Lasso di tempo: Baseline
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Patient Global Impression of Improvement (PGI-I)
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Baseline
|
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Perceived change in condition in response to therapy
Lasso di tempo: Week 6
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Patient Global Impression of Improvement (PGI-I)
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Week 6
|
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Perceived change in condition in response to therapy
Lasso di tempo: Week 12
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Patient Global Impression of Improvement (PGI-I)
|
Week 12
|
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Perceived change in condition in response to therapy
Lasso di tempo: Week 18
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Patient Global Impression of Improvement (PGI-I)
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Week 18
|
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Perceived change in condition in response to therapy
Lasso di tempo: Week 24
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Patient Global Impression of Improvement (PGI-I)
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Week 24
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Emotional distress
Lasso di tempo: 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.
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Baseline
|
|
Emotional distress
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
|
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Disability for low back pain
Lasso di tempo: Baseline
|
Oswestry Disability Index (ODI): range 0 to 100.
Zero is equated with no disability and 100 is the maximum disability possible.
|
Baseline
|
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Disability for low back pain
Lasso di tempo: 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
|
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Disability for low back pain
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: 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
Lasso di tempo: Baseline
|
Time between the beginning of the sitting position and the onset or worsening of the pain
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Baseline
|
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Tolerance of the sitting position
Lasso di tempo: 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
Lasso di tempo: Week 12
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Time between the beginning of the sitting position and the onset or worsening of the pain
|
Week 12
|
|
Tolerance of the sitting position
Lasso di tempo: Week 18
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Time between the beginning of the sitting position and the onset or worsening of the pain
|
Week 18
|
|
Tolerance of the sitting position
Lasso di tempo: Week 24
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Time between the beginning of the sitting position and the onset or worsening of the pain
|
Week 24
|
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Consumption of painkillers
Lasso di tempo: Week 24
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Number of level 1 to 3 analgesics, non-steroidal anti-inflammatory drugs and muscle relaxants
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Week 24
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|
Number of patients requiring a second injection botulinum toxin in each arm
Lasso di tempo: Week 12
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Number
|
Week 12
|
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Side effects of injection
Lasso di tempo: Week 24
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Side effects of the injection or attributable to the study drug
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Week 24
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Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Investigatore principale: Arnaud Dupeyron, CHU Nîmes
Studiare le date dei record
Studia le date principali
Inizio studio (Stimato)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Termini MeSH pertinenti aggiuntivi
- Dolore
- Manifestazioni neurologiche
- Malattie del sistema nervoso
- Malattie neuromuscolari
- Malattie del sistema nervoso periferico
- Nevralgia
- Dolore pelvico
- Mononeuropatie
- Sindromi da compressione nervosa
- Neuropatia sciatica
- Condizioni patologiche, segni e sintomi
- Segni e sintomi
- Sindrome del muscolo piriforme
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- PHRCN/2019/AD-1
- 2024-517948-66-00 (Ctis)
Informazioni su farmaci e dispositivi, documenti di studio
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Studia un dispositivo regolamentato dalla FDA degli Stati Uniti
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