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Study of Sulfasalazine in Treating Painful Neuropathy

Phase 2
Terminated
Conditions
Painful Neuropathy
Interventions
Drug: placebo
Drug: Sulfasalazine
Registration Number
NCT01667029
Lead Sponsor
Massachusetts General Hospital
Brief Summary

The investigators hypothesize that sulfasalazine, an FDA-approved medication for rheumatoid arthritis and ulcerative colitis, may be beneficial in neuropathic pain conditions. In this study, the investigators will evaluate whether sulfasalazine improves pain due to painful peripheral neuropathy.

Detailed Description

Not available

Recruitment & Eligibility

Status
TERMINATED
Sex
All
Target Recruitment
8
Inclusion Criteria
  • Painful neuropathy
  • Michigan Neuropathy Screening Instrument score of 3 or greater
  • no obvious alternative explanation for neuropathy
  • average baseline pain > 4/10
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Exclusion Criteria
  • other severe pain
  • anticipated difficulty weaning off medications
  • past or current psychiatric disorder as determined by Mini International Neuropsychiatric Interview
  • medical contraindication to sulfasalazine
  • not proficient in English (due to heavy use of questionaires)
  • pregnant or breast feeding women
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Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
placeboplacebooral placebo pill twice daily for two weeks.
sulfasalazineSulfasalazine1 g oral twice daily for 2 weeks
Primary Outcome Measures
NameTimeMethod
Pain Score (First Treatment Period)second week of two week treatment period

Average pain score will be the average of daily pain scores (0-10) recorded by the subject in a pain diary during the second week of the two week treatment period. Higher scores are worse (0=no pain, 10=pain as bad as you can imagine).

Secondary Outcome Measures
NameTimeMethod
Number of Patients With >=50% Pain Reduction (Using the Crossover Comparison Structure of the Study)Assessed at end of two week treatment period

Average pain score will be the average of daily pain scores (0-10) recorded by the subject in a pain diary during baseline and the second week of each of the two week treatment periods. Higher scores are worse (0=no pain, 10=pain as bad as you can imagine). Percent pain reduction will be calculated from BL to end of treatment period 1 (2 weeks) and from end of treatment period 1 to end of treatment period 2 (2 weeks), based on average pain scores at each time point.

Physical Functioning Score Assessed Using the Brief Pain Inventory (BPI) Interference Scale (Using the Crossover Comparison Structure of the Study)Assessed at end of two week treatment period

The BPI interference items are general activity, mood, walking ability, normal work (including housework), relations with other people, sleep, and enjoyment of life. The seven items are rated from 0 (pain does not interfere) to 10 (pain completely interferes).

Emotional Functioning (First Treatment Period Only)Assessed at end of two week treatment period

Will be assessed by the Beck Depression Inventory (BDI) total score. The BDI has 21 items, each scored 0-3. Higher values are worse. The total score is the sum of the 21 items and ranges from 0-63.

Overall Improvement (First Treatment Period Only)Will be assessed at end of two week treatment period

The Patient Global Impression of Change (PGIC) reflects a patient's belief about the efficacy of treatment. Item 1 is as follows: Since beginning treatment at this clinic, how would you describe the change (if any) in ACTIVITY LIMITATIONS, SYMPTOMS, EMOTIONS, and OVERALL QUALITY OF LIFE, related to your painful condition? (tick ONE box) (1=No change (or condition has gotten worse), 2=Almost the same, hardly any change at all, 3=A little better, but no noticeable change, 4=Somewhat better, but the change has not made any real difference, 5=Moderately better, and a slight but noticeable change, 6=Better, and a definite improvement that has made a real and worthwhile difference, 7=A great deal better, and a considerable improvement that has made all the difference). Item 2 is as follows: In a similar way, please circle the number below that matches your degree of change since beginning care at this clinic (0-10 scale): 0= Much better, 5= No change, 10= Much worse.

Missed Medication Dose (First Treatment Period Only)Assessed during two week treatment period

Number of missed medication doses

Pain Score (Using the Crossover Comparison Structure of the Study)Assessed at end of two week treatment period

Average pain score will be the average of daily pain scores (0-10) recorded by the subject in a pain diary during the second week of the two week treatment period. Higher scores are worse (0=no pain, 10=pain as bad as you can imagine).

Physical Functioning Score Assessed Using the Brief Pain Inventory (BPI) Interference Scale (First Treatment Period Only)Assessed at end of two week treatment period

The BPI interference items are general activity, mood, walking ability, normal work (including housework), relations with other people, sleep, and enjoyment of life. The seven items are rated from 0 (pain does not interfere) to 10 (pain completely interferes).

Categorical Rating of Pain Intensity (First Treatment Period Only)Assessed at end of two week treatment period

Assessed using number of days rated as none, mild, moderate, or severe in pain diary

Breakthrough Treatment (Using the Crossover Comparison Structure of the Study)Assessed during two week treatment period

Number of days breakthrough pain medication was taken

Missed Medication Doses (Using the Crossover Comparison Structure of the Study)Assessed during two week treatment period

Number of missed medication doses

Number of Patients With >=50% Pain Reduction (First Treatment Period)second week of two week treatment period

Average pain score will be the average of daily pain scores (0-10) recorded by the subject in a pain diary at baseline and during the second week of the two week treatment period. Higher scores are worse (0=no pain, 10=pain as bad as you can imagine). Percent pain reduction will be calculated from BL to end of treatment period 1 (2 weeks), based on average pain scores at each time point.

Physical Functioning Score Assessed Using the Euroquality of Life (EQ-5D) Metrics (First Treatment Period Only)Assessed at end of two week treatment period

The EQ-5D physical functioning items are mobility self-care, and usual activities. These three items are rated from 1 (no problems) to 5 (unable).

Physical Functioning Score Assessed Using the Euroquality of Life (EQ-5D) (Using the Crossover Comparison Structure of the Study)Assessed at end of two week treatment period

The EQ-5D physical functioning items are mobility self-care, and usual activities. These three items are rated from 1 (no problems) to 5 (unable).

Overall Improvement (Using the Crossover Comparison Structure of the Study)Will be assessed at end of two week treatment period

The Patient Global Impression of Change (PGIC) reflects a patient's belief about the efficacy of treatment. Item 1 is as follows: Since beginning treatment at this clinic, how would you describe the change (if any) in ACTIVITY LIMITATIONS, SYMPTOMS, EMOTIONS, and OVERALL QUALITY OF LIFE, related to your painful condition? (tick ONE box) (1=No change (or condition has gotten worse), 2=Almost the same, hardly any change at all, 3=A little better, but no noticeable change, 4=Somewhat better, but the change has not made any real difference, 5=Moderately better, and a slight but noticeable change, 6=Better, and a definite improvement that has made a real and worthwhile difference, 7=A great deal better, and a considerable improvement that has made all the difference). Item 2 is as follows: In a similar way, please circle the number below that matches your degree of change since beginning care at this clinic (0-10 scale): 0= Much better, 5= No change, 10= Much worse.

Emotional Functioning (Using the Crossover Comparison Structure of the Study)Assessed at end of two week treatment period

Will be assessed by the Beck Depression Inventory (BDI) total score. The BDI has 21 items, each scored 0-3. Higher values are worse. The total score is the sum of the 21 items and ranges from 0-63.

Categorical Rating of Pain Intensity (Using the Crossover Comparison Structure of the Study)Assessed at end of two week treatment period

Assessed using number of days rated as none, mild, moderate, or severe in pain diary

Breakthrough Treatment (First Treatment Period Only)Assessed during two week treatment period

Number of days breakthrough pain medication was taken

Trial Locations

Locations (1)

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

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