Neuropathic Pain, Osteoarthritis Hand
Conditions
Brief summary
The objective of this multicentric, randomized controlled double-blind clinical trial is to demonstrate the efficacy of transdermal application of capsaicin in patients with painful digital osteoarthritis with a neuropathic pain component. Participants will receive either a transdermal patch of capsaicin 179 mg (8%) or the control treatment (capsaicin 0.04%). Researchers will compare the intensity of pain in the fingers at day 60 in the capsaicin 8% group versus capsaicin 0.04% (control arm)
Detailed description
Visit 0 : Screening visit (D0 - 30 days): Screen for eligibility Visit 1 :Inclusion visit (D0): Randomization and blinded patch application of capsaicin 8% or 0.04% Visit 2: Follow-up visit 1 (D60 + 7 days): Assessment +/- Patch renewal. Patients with finger pain still greater than 4/10 may receive an open application of a capsaicin 8% Visit 3:Follow-up visit 2 (D120 +/- 7 days): Final assessment. For the duration of the study, the patient will record in a notebook: analgesics, anti-inflammatories, corticoids and daily hand pain VAS. Blood samples will be taken at V1 and V2 for subsequent measurement of pro-inflammatory cytokines (IL6, IL8, TNFa) and markers of cartilage degradation, in order to build up a serum library.
Interventions
patch application for 30 minutes on the painful fingers.
DRUGCapsaicine low dose 0.04 %
patch application for 30 minutes on the painful fingers. the low-dose patch has a similar appearance to the active patch. It allows you to keep the blind, because it also causes reactions at the capsaicin application site (erythema, burning).
Sponsors
Grünenthal GmbH
University Hospital, Clermont-Ferrand
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Diagnosis of digital osteoarthritis fulfilling the American College of Rheumatology criteria; * Presence of finger pain of ≥ 40 mm on a visual analogue scale (VAS); * Presence of finger pain with a neuropathic pain component (DN4 score ≥ 4/10) * Inadequate response, adverse reactions, and/or contraindications to conventional analgesics and NSAIDs;
Exclusion criteria
* Patient with isolated rhizarthrosis; * Patient with other joint disease affecting the fingers (gout, chondrocalcinosis, RA, spondyloarthritis, psoriatic arthritis); * Patient with upper extremity pain syndrome that may interfere with the assessment of finger pain; * Patient with another pathology responsible for neuropathic hand pain (carpal tunnel syndrome, diabetic neuropathy, Guyon's tunnel syndrome, cervicobrachial neuralgia, brachial plexitis); * Patient with skin lesions on the fingers (psoriasis, wounds, chronic ulcers, eczema, shingles, dermatitis); * Patient with poorly controlled high blood pressure; * Patient with hypersensitivity to capsaicin; * Patient who had 8% capsaicin patch use in the year prior to the study; * Patient who has received intramuscular, intra-articular or intravenous corticosteroid therapy, another disease-modifying anti-rheumatic therapy (methotrexate, salazopyrine) or an intra-articular injection into the joints of the fingers within the previous 3 months; * Patient wearing wrist or finger orthoses in the previous month; * Patient with fibromyalgia;
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intensity of pain in the fingers | Day 60 | measured on a visual analogic scale ranging from 0 to 100 mm |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Functional index | Day 60 | Modified Functional Index for Hand OsteoArthritis score (FIHOA), Each question is rated from 0 (no difficulty) to 3 (impossible). Total score for the 10 questions: 0 - 30. The higher the score, the greater the functional disability. |
| Anxiety and depression | Day 60 | Hospital Anxiety and Depression Scale score (HADs), Each question is scored from 0 to 3. Total score for the 7 anxiety or depression questions: 0-21. The higher the score, the more anxious or depressed the patient. |
| Functional disability | Day 60 | Cochin Hand Functional Disability Scale score, Each question is rated from 0 (no difficulty) to 5 (impossible). Total score for 18 questions: 0 - 90. The higher the score, the more impaired the physical function. |
| Treatment safety | Day 60 | side effect rate |
| Patient impression of change | Day 60 | Patient Global Impression of Change (PGIC) score. The patient evaluates the degree of improvement of his pain 1. \- Strongly improved 2. \- Moderately improved 3. \- Slightly improved 4. \- No change 5. \- Slightly worsened 6. \- Moderately worsened 7. \- Strongly worsened |
| Painful symptoms of osteoarthritis | Day 60 | Osteoarthritis Symptom Inventory Scale score (OASIS9). Localized pain component = 4 questions rated from 0 (no sensation) to 10 (extreme sensation) score = 0-40. Neuropathic pain component = 2 questions rated from 0 to 10 score = 0-20. Deep pain component = 3 questions rated from 0 to 10 score = 0-30. Total OASIS score: 0-90. A high score indicates intense pain. |
Countries
France
Contacts
Primary ContactLise Laclautre
Outcome results
None listed