Effects of Milnacipran on Widespread Mechanical and Thermal Hyperalgesia of Fibromyalgia Patients
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Purpose
Fibromyalgia syndrome (FM) shares many symptoms common to chronic neuropathic pain, including the characteristic hyperalgesia of the skin (thermal, mechanical) and muscles (mechanical) found in almost all FM patients. Milnacipran, a balance norepinephrine-serotonin re-uptake inhibitor, has been found to reduce pain and improve physical function of FM patients. However, little is known about the pain mechanisms that are affected by this medication. Therefore, the investigator wants to determine the efficacy of milnacipran in reducing pain as well as mechanical and thermal hyperalgesia of FM patients during a randomized, double-blind, placebo controlled trial. Because the investigator expects anti-hyperalgesic effects to coincide or precede with effects on clinical FM pain the proposed duration for this trial is 6 weeks.
| Condition | Intervention |
|---|---|
|
Fibromyalgia |
Drug: Milnacipran |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Double Blind (Subject, Investigator, Outcomes Assessor) Primary Purpose: Basic Science |
| Official Title: | Effects of Milnacipran on Widespread Mechanical and Thermal Hyperalgesia of Fibromyalgia Patients |
- Mechanical and Heat Hyperalgesia [ Time Frame: 2 week intervals ] [ Designated as safety issue: No ]
- Clinical Pain [ Time Frame: daily ] [ Designated as safety issue: No ]
| Estimated Enrollment: | 50 |
| Study Start Date: | November 2009 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Placebo Comparator: Sugar pill
One sugar pill twice daily over 6 weeks
|
Drug: Milnacipran
50 mg BID Oral x 6 Weeks
Other Name: Savella
|
|
Active Comparator: Milnacipran
Milnacipran 50 mg bid over 6 weeks
|
Drug: Milnacipran
50 mg BID Oral x 6 Weeks
Other Name: Savella
|
Eligibility| Ages Eligible for Study: | 30 Years to 65 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Patients with diagnosis of chronic wide-spread pain for at least 3 months, who fulfill the 1990 ACR Criteria for FM.
- Patients with mean pain ratings ≥ 4.0 VAS units, at Screening and Baseline visits.
- Patients, who are able to comprehend and satisfactorily comply with protocol requirements.
- Patients who have not taken any pain medications except acetaminophen within 3 days prior to the Baseline Visit (these medications if taken prior to the Screening Visit must be discontinued at Screening Visit and the Baseline Visit may be scheduled at least 7 days past the last dose of these medications).
- All women of childbearing potential (WOCBP) must have a negative urine pregnancy test at the Screening Visit. All women of childbearing potential participating in the study must use a medically acceptable form of contraception
Exclusion Criteria:
- FM patients unwilling or unable to discontinue analgesics (except Tylenol) for at least 5 drug half-lives prior to enrollment.
- Patient has previously failed treatment with Milnacipran for FM pain.
- Patients who have been treated with MAO inhibitors within 30 days prior to the Baseline Visit.
- Patients who received ECT within 3 months prior to the Screening Visit.
- Women who are pregnant or nursing, or women of childbearing potential who do not use adequate contraception, or who are judged to be unreliable in their use of contraception.
- Patients who have participated in any clinical trial within one month prior to the Screening Visit.
- Patients who have a medical condition that, in the Investigator's opinion, would expose them to an increased risk of a significant adverse event or interfere with assessments of safety and efficacy during the course of the trial.
- Patients with severe renal insufficiency (Creatinine clearance < 30 ml/min)
- Patient has a BDI score >29
- Patients with any current malignancy, or any clinically significant hematological, endocrine, cardiovascular, renal, hepatic, gastrointestinal or neurological disease (including any form of epilepsy). If there is a history of such disease but the condition has been stable for at least the past year and is judged by the investigator not to interfere with the patient's participation in the study, the patient may be included.
- Patients with systolic blood pressure greater than 180 mm Hg or less than 90 mm Hg or diastolic blood pressure greater than 105 mm Hg or less than 50 mm Hg at the Screening visit. Similarly, tachycardia of >110/min is exclusionary.
- Patients who require concomitant therapy with any prohibited prescription or over-the-counter medication, including aspirin (except 81 mg for heart disease) or antidepressant medications.
- Patients who are unable to speak, read, and understand English or are judged by the investigator to be unable or unlikely to follow the study protocol and complete all scheduled visits.
Contacts and Locations| Contact: Ariel L Hoffman, BA | 352-265-8901 |
| United States, Florida | |
| Center for Musculoskeletal Pain Research | Recruiting |
| Gainesville, Florida, United States, 32610 | |
| Contact: Ariel L Hoffman, BA 352-265-8901 Ariel.Hoffman@medicine.ufl.edu | |
| Principal Investigator: Roland Staud, MD | |
| Principal Investigator: | Roland Staud, MD | University of Florida |
More Information
No publications provided
| Responsible Party: | University of Florida |
| ClinicalTrials.gov Identifier: | NCT01294059 History of Changes |
| Other Study ID Numbers: | SAV-MD-06 |
| Study First Received: | February 9, 2011 |
| Last Updated: | March 25, 2013 |
| Health Authority: | United States: Food and Drug Administration |
Keywords provided by University of Florida:
|
Fibromyalgia Hyperalgesia Pain Central Sensitization |
Additional relevant MeSH terms:
|
Fibromyalgia Myofascial Pain Syndromes Hyperalgesia Muscular Diseases Musculoskeletal Diseases Rheumatic Diseases Neuromuscular Diseases Nervous System Diseases Somatosensory Disorders Sensation Disorders Neurologic Manifestations Signs and Symptoms Milnacipran |
Antidepressive Agents Psychotropic Drugs Central Nervous System Agents Therapeutic Uses Pharmacologic Actions Serotonin Uptake Inhibitors Neurotransmitter Uptake Inhibitors Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Serotonin Agents Physiological Effects of Drugs Adrenergic Uptake Inhibitors Adrenergic Agents |
ClinicalTrials.gov processed this record on May 16, 2013