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The Therapeutic Effect of Thalidomide in Syringomyelia

Phase 2
Recruiting
Conditions
Syringomyelia
Thalidomide
Interventions
Registration Number
NCT06268093
Lead Sponsor
Xuanwu Hospital, Beijing
Brief Summary

Purpose: This phase II clinical trial aims to evaluate the indications, therapeutic effects and side effects of thalidomide in refractory syringomyelia.

Primary outcome measure: The primary endpoint is the change of ASIA at week 12. The clinical efficacy is defined as ASIA increase ≥ 1 at week 12, as compared with that before thalidomide usage.

Detailed Description

The pathogenesis of syringomyelia is poorly understood and duraplasty or shunting is not always effective. Although it is generally thought that syringomyelia is simply an accumulation of CSF from the subarachnoid space, the pathogenesis is likely to be more complex and may involve cellular and molecular processes.

The investigators supposed that blood spinal cord barrier(BSCB) might play a key role in the pathogenesis of syringomyelia, especially post-traumatic syringomyelia(PTS), and that thalidomide, as an BSCB protection-related drug, would reduce BSCB damage and protect BSCB in syringomyelia.

Primary objectives: This phase II clinical trial aims to evaluate the indications, therapeutic effects and safety of thalidomide in refractory syringomyelia.

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
30
Inclusion Criteria
  • Contraindication to duraplasty and shunting treatment due to history or high risk of severe adverse effects,
  • or non-effective response to duraplasty and shunting treatment in 12 months prior to study entry.
  • Estimated life expectancy must be greater than 12 months.
  • Routine laboratory studies: bilirubin </=1.0 * upper limits of normal (ULN); aspartate aminotransferase (AST or SGOT) or alanine aminotransferase (ALT)< 1.0 * ULN; creatinine <1.0 * ULN; white-cell count >/= 4,000 per cubic millimeter; neutrophils count >/=1500 per cubic millimeter platelets >/= 100,000 per cubic millimeter; Hb >/=110 gram per millilitres; PT, APTT, INR in a normal range.
  • Ability to understand and willingness to sign a written informed consent document, or constant caregivers who well understand and willingness to sign a written informed consent document.
  • Must be able to swallow tablets
Exclusion Criteria
  • Evidence of tumor metastasis, recurrence, or invasion;
  • History of psychiatric diseases ;
  • History of seizures;
  • History of arteriosclerotic cardiovascular diseases (ASCVD), e.g. stroke, myocardial infaction, unstable angina, within 6 months;
  • New York Heart Association Grade II or greater congestive heart failure;
  • Serious and inadequately controlled cardiac arrhythmia;
  • Significant vascular disease, e.g. moderate or severe carotid stenosis, aortic aneurysm, history of aortic dissection;
  • Severe infection;
  • History of allergy to relevant drugs;
  • Pregnancy, lactation, or fertility program in the following 12 months;
  • History or current diagnosis of peripheral nerve disease;
  • Abnormal in liver and renal function;
  • Active tuberculosis;
  • Transplanted organs;
  • Human immunodeficiency virus;
  • Participation in other experimental studies.

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
ThalidomideThalidomideOral Thalidomide
Primary Outcome Measures
NameTimeMethod
ASIA Score1 day before and 3 days, 3 months after drug treatment

American Spinal Injury Association(ASIA) Score for evaluating the spinal cord function, degree of the spinal cord function, motor1-100, sensory 1-224, higher scores mean a better outcome

Secondary Outcome Measures
NameTimeMethod
syringomyelia remission1 day before and 3 days, 3 months after drug treatment

syringomyelia remission is defined as ≥ 25% reduction in syringomyelia volume on T2 images at week 12, as compared with that before thalidomide usage

The evoked electromyographic signal (eEMG) potential1 day before and 3 days, 3 months after drug treatment

The evoked electromyographic signal (eEMG) potential is the standard index

Visual Analog Scale (VAS)1 day before and 3 days, 3 months after drug treatment

degree of the pain, 1-10, higher scores mean a worse outcome

Klekamp and Sammi syringomyelia scale1 day before and 3 days, 3 months after drug treatment

for evaluating the spinal cord function, higher scores mean a better outcome

modified Japanese Orthopaedic Association Scores (mJOA)1 day before and 3 days, 3 months after drug treatment

Motor function, sensory, bladder function;for evaluating the spinal cord function;0-17, higher scores mean a better outcome

xuanwu syringomyelia scale1 day before and 3 days, 3 months after drug treatment

for evaluating the spinal cord function, for evaluating the spinal cord function;0-18, higher scores mean a worse outcome

Incidence of complications1 day before and 3 days, 3 months after drug treatment

Incidence of complications

Trial Locations

Locations (1)

Fengzeng Jian

🇨🇳

Beijing, Beijing City, China

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