- ICH GCP
- Rejestr badań klinicznych w USA
- Badanie kliniczne NCT07437313
Marine Lipids Ease Painful TMD (ADAPT)
Bezpieczeństwo i analgetyczna skuteczność morskich prekursorów lipidowych wyspecjalizowanych mediatorów pro-rozwiązujących u dorosłych z przewlekłym bólem stawu skroniowo-żuchwowego
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.
Przegląd badań
Status
Szczegółowy opis
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.
Typ studiów
Zapisy (Szacowany)
Faza
- Nie dotyczy
Kontakty i lokalizacje
Kontakt w sprawie studiów
- Nazwa: Anne E Sanders, PhD
- Numer telefonu: (919) 246-5833
- E-mail: adaptsms@adapt.study
Kopia zapasowa kontaktu do badania
- Nazwa: Lorraine M King
- Numer telefonu: (919) 246-5833
- E-mail: adaptsms@adapt.study
Lokalizacje studiów
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North Carolina
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Chapel Hill, North Carolina, Stany Zjednoczone, 27599
- Rekrutacyjny
- University of North Carolina at Chapel Hill
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Kryteria uczestnictwa
Kryteria kwalifikacji
Wiek uprawniający do nauki
Akceptuje zdrowych ochotników
Płeć kwalifikująca się do nauki
Opis
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 studiów
Jak projektuje się badanie?
Szczegóły projektu
- Główny cel: Leczenie
- Przydział: Randomizowane
- Model interwencyjny: Przydział równoległy
- Maskowanie: Poczwórny
Broń i interwencje
Grupa uczestników / Arm |
Interwencja / Leczenie |
|---|---|
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Eksperymentalny: 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. |
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Komparator placebo: 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. |
Co mierzy badanie?
Podstawowe miary wyniku
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
|
Change in average weekly facial pain intensity
Ramy czasowe: 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)
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Rate of treatment-emergent adverse events
Ramy czasowe: From first dose (Visit 1/Randomization, Day 0) through 7 days after the final dose (Visit 3, Day 56 ±7)
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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)
|
Miary wyników drugorzędnych
Miara wyniku |
Opis środka |
Ramy czasowe |
|---|---|---|
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Change in TMD pain duration
Ramy czasowe: From Visit 1 (Randomization, Day 0) through 7 days after the final dose (Visit 3, Day 56 ±7)
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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)
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Change in TMD pain intensity and pain interference
Ramy czasowe: Visit 1 (Randomization, Day 0) to Visit 3 (Final visit, Day 56 ±7)
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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)
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Change in headache impact
Ramy czasowe: Visit 1 (Randomization, Day 0); Visit 2 (Mid-study visit, Day 28 ±7); Visit 3 (Final visit, Day 56 ±7)
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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)
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Change in number of painful body sites
Ramy czasowe: Visit 1 (Randomization, Day 0); Visit 3 (Final visit, Day 56 ±7)
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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)
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Change in pressure pain thresholds
Ramy czasowe: Visit 0 (Screening/Baseline, 7-21 days before Visit 1), Visit 3 (Final visit, Day 56 ±7)
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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)
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Change in state anxiety
Ramy czasowe: Visit 1 (Randomization, Day 0); Visit 3 (Final visit, Day 56 ±7)
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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)
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Change in depression
Ramy czasowe: Visit 1 (Randomization, Day 0); Visit 3 (Final visit, Day 56 ±7)
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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)
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Change in TMD-related quality of life
Ramy czasowe: Visit 1 (Randomization, Day 0); Visit 3 (Final visit, Day 56 ±7)
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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)
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Change in overall status
Ramy czasowe: Visit 2 (Mid-study, Day 28 ±7); Visit 3 (Final visit, Day 56 ±7)
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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)
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Współpracownicy i badacze
Śledczy
- Główny śledczy: Anne E Sanders, PhD, University of North Carolina, Chapel Hill
Publikacje i pomocne linki
Daty zapisu na studia
Główne daty studiów
Rozpoczęcie studiów (Rzeczywisty)
Zakończenie podstawowe (Szacowany)
Ukończenie studiów (Szacowany)
Daty rejestracji na studia
Pierwszy przesłany
Pierwszy przesłany, który spełnia kryteria kontroli jakości
Pierwszy wysłany (Rzeczywisty)
Aktualizacje rekordów badań
Ostatnia wysłana aktualizacja (Rzeczywisty)
Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości
Ostatnia weryfikacja
Więcej informacji
Terminy związane z tym badaniem
Słowa kluczowe
- Jakość życia
- Randomizowana kontrolowana próba
- Migrena
- Kwasy tłuszczowe omega-3
- Uczulenie ośrodkowe
- Ból ustno-twarzowy
- Ból stawu skroniowo-żuchwowego
- Ingerencja w ból
- Przewlekłe mechanizmy bólu
- Wrażliwość na ból uciskowy
- Przewlekły ból twarzy
- Mialgia TMD
- TMD artralgia
- Wyspecjalizowane mediatory proresolutywne (SPMs)
- Suplement lipidowy z morskich źródeł
- Interwencja suplementem diety
- Testowanie bólu eksperymentalnego
- Wpływ bólu głowy
- Lęk i depresja w przewlekłym bólu
- Rozkład bólu w ciele
Dodatkowe istotne warunki MeSH
- Ból
- Objawy neurologiczne
- Choroby układu mięśniowo-szkieletowego
- Choroby Stomatognatyczne
- Choroby mózgu
- Choroby ośrodkowego układu nerwowego
- Choroby Układu Nerwowego
- Choroby mięśni
- Zaburzenia psychiczne
- Choroby stawów
- Choroby szczęki
- Zaburzenia związane z bólem głowy, pierwotne
- Zaburzenia związane z bólem głowy
- Choroby żuchwy
- Zaburzenia czaszkowo-żuchwowe
- Stany patologiczne, oznaki i objawy
- Objawy i symptomy
- Zaburzenia lękowe
- Zaburzenia migreny
- Zaburzenia stawów skroniowo-żuchwowych
- Ból twarzy
Inne numery identyfikacyjne badania
- 25-0878
- UG3DE033354 (Grant/umowa NIH USA)
Plan dla danych uczestnika indywidualnego (IPD)
Planujesz udostępniać dane poszczególnych uczestników (IPD)?
Opis planu 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.
Ramy czasowe udostępniania IPD
beginning 9 and continuing for 36 months following publication
Kryteria dostępu do udostępniania IPD
Investigator has approved IRB, IEC, or REB and an executed data use/sharing agreement with UNC.
Informacje o lekach i urządzeniach, dokumenty badawcze
Bada produkt leczniczy regulowany przez amerykańską FDA
Bada produkt urządzenia regulowany przez amerykańską FDA
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