Investigation of Efficacy of Botulinum Toxin A (Dysport) in Chronic Low Back Pain
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|ClinicalTrials.gov Identifier: NCT02221648|
Recruitment Status : Terminated (PI retired and moved- funding sponsor contacted and Oked)
First Posted : August 20, 2014
Results First Posted : March 8, 2016
Last Update Posted : July 20, 2016
The scientific aim of this study is to investigate the efficacy of abobotulinumtoxinA (Dysport - Ipsen Pharmaceuticals) in chronic low back pain.
The investigators hypothesis is that injection of Dysport brand of botulinum toxin type A into erector spinae muscles (extensors of the spine) can relieve low back pain through anti-spasm and analgesic effect of botulinum toxin.
|Condition or disease||Intervention/treatment||Phase|
|Lower Back Pain||Drug: Placebo Drug: AbobotulinumtoxinA Treatment||Phase 2|
This is an investigator initiated, randomized, double blind, placebo-controlled study. A total of 90 patients will be enrolled in the study. The study will be conducted over 4 months. It includes 4 visits and 4 telephone calls. Patients with chronic low back pain (>3 months) who meet inclusion and exclusion criteria and wish to participate in the study may be enrolled. Those who become enrolled will be scheduled for a baseline visit (Week 0). During the baseline visit, subjects will be given the official approved consent form to read and ask questions. Participants to this study will also receive a copy of the Dysport Risk Evaluation and Mitigation Strategy (REMS) statement. After obtaining informed consent signed by the subject, the subjects will be randomization into the Dysport or placebo group. The randomizing will be performed by a nurse and the information will be kept in a pass-worded computer. Blinding means that neither the participant nor the clinical rater will know which group the participant has been initially been assigned.
Each subject will have a neurological examination and fill a demographic form and complete four rating questionnaires (appendix II-V). These include a visual analogue scale for pain (0 to 10) and three quality of life questionnaires which depict quality of life (the American Chronic Pain Association's Quality of Life Scale), how pain affects ability to manage everyday life (Oswestry Low Back Pain Disability Questionnaire), and overall physical and emotional health (Short Form-36). Patients will then receive an injection of either abobotulinumA (Dysport) or normal saline. Dysport or saline will be administered into the paraspinal muscles (extensors or erector spinae) at five levels (L1-L5), regardless of pain location. In the case of unilateral pain, this would amount to 500 units total, and in the case of bilateral pain, to 1000 units total, of Dysport per session.
The primary outcome of the study is number of patients with VAS < 4 ( no or subtle pain) at week 6 after placebo or Dysport injection.
|Study Type :||Interventional (Clinical Trial)|
|Actual Enrollment :||43 participants|
|Intervention Model:||Parallel Assignment|
|Masking:||Triple (Participant, Care Provider, Investigator)|
|Official Title:||Investigation of Efficacy of Botulinum Toxin A (Dysport) in Chronic Low Back Pain|
|Study Start Date :||December 2012|
|Actual Primary Completion Date :||September 2015|
|Actual Study Completion Date :||September 2015|
Placebo Comparator: Placebo
Subjects will be randomization to receive injections with either the study drug (abobotulinumtoxinA) or the placebo group. The subjects will be blinded to which intervention they will receive.
Subjects will be randomization to receive either the study drug or the placebo group.
Active Comparator: AbobotulinumtoxinA Treatment
Subjects will be randomized to receive intervention injections with the study drug arbobotulinumtoxinA.
Drug: AbobotulinumtoxinA Treatment
Subjects receive intervention injections with the study drug arbobotulinumtoxinA.
Other Name: Dysport
- Proportion of Participants With Mild or no Pain on Visual Analog Scale (VAS) [ Time Frame: 6 weeks ]The primary outcome measure in this protocol is the proportion of subjects that have VAS <4 (patients with no or mild pain) at week 6. The pain VAS is a continuous scale comprised of a line 10 centimeters in length, anchored by 2 verbal descriptors, one for each symptom extreme. For pain intensity, the scale is anchored by "no pain" (score of 0) and "worst imaginable pain" (score of 10).
- Number of Patients With Improved Pain Using the Patient Global Impression of Change (PGIC) [ Time Frame: 6 weeks ]
The PGIC is a 7 point scale that requires the clinician to assess how much the patient's pain has improved or worsened relative to a baseline state at the beginning of the intervention. and rated as:
No change (or condition has gotten worse) (1) Almost the same, hardly any change at all (2) A little better, but no noticeable change (3) Somewhat better, but the change has not made any real difference (4) Moderately better, and a slight but noticeable change (5) Better and a definite improvement that has made a real and worthwhile difference (6) A great deal better and a considerable improvement that has made all the difference (7)
This outcome is number of patients who chose a 6 or above on the PGIC 6 weeks after treatment
- Number of Subjects Showing Improvement on Quality of Life Scale for Pain [ Time Frame: 6 weeks ]The Quality of Life Scale: A Measure of Function for People With Pain was developed by the American Chronic Pain Association (ACPA). The patient is asked to rank their quality of life on a scale of zero (non-functioning) to 10 (normal quality of life). Improvement was defined as 2 or more grades of improvement on the scale.
To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.
Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02221648
|United States, Connecticut|
|Yale Medical Group|
|New Haven, Connecticut, United States, 06520|
|Principal Investigator:||Bahman Jabbari, MD||Yale University|