跳至主要内容
临床试验/NCT01038323
NCT01038323
已完成
4 期

A Pilot Study on the Combined Use of Cognitive Behavioral Therapy (CBT) and Milnacipran

Indiana University1 个研究点 分布在 1 个国家目标入组 58 人2009年12月

概览

阶段
4 期
干预措施
CBT and milnacipran
疾病 / 适应症
Fibromyalgia
发起方
Indiana University
入组人数
58
试验地点
1
主要终点
Change in Weekly Average Pain Intensity
状态
已完成
最后更新
9年前

概览

简要总结

Fibromyalgia Syndrome (FMS) afflicts 2% of the U.S. population and have huge individual and societal costs in terms of quality of life, social and work functioning, health care use, and lost productivity. Although single therapy approaches such as medication, graduated exercise, and Cognitive Behavioral Therapy (CBT) are well-established treatment approaches, the majority of FMS continue to report significant levels of pain and pain-related disability. Testing the efficacy of using combination therapies such and CBT with medication has considerable potential to maximize treatment response. Also, exploring the biological and psychological mechanisms underlying combination treatment may pave the way for developing new treatments for FMS sufferers.

We chose to study drug and CBT for several reasons: 1) the scarcity of trials that manipulate medications along with CBT in FMS, 2) the prohibitive nature of adding an exercise treatment arm in a study that has both time and budgetary constraints, 3) the complexity in understanding the mechanism of actions of 3 different modes of intervention in one clinical trial, and 4) the desire to explore mechanisms in this program of research, in particular the potential effects of a biological intervention (drug) on what is traditionally considered a psychological outcome (pain-related attributions and cognition) and the potential effects of a psychological intervention (CBT) on what is traditionally considered a physiological outcome (pain sensitivity).

详细描述

Qualified participants will take part in a 21-week clinical research study entitled, "Drug and Talk Therapy for Fibromyalgia". We are doing this study to better understand how talk therapies, such as education and cognitive behavioral therapy (CBT), can improve the therapeutic benefits of drug for fibromyalgia. Savella ®, (milnacipran) is an FDA approved drug for fibromyalgia. The safety and efficacy of Savella has been established in two US-based clinical studies involving over 2,000 patients with fibromyalgia. Because Savella has already been shown to be effective when used in isolation to treat fibromyalgia, we are conducting the study to determine whether combination treatment (Savella + talk therapy) is more efficacious than just Savella alone or talk therapy alone. Volunteers will be randomized (like flipping a coin) on two different levels: 1. Each participate will be randomized into one of two groups for medication: One group will receive Savella and the other group will receive a placebo (no medicinal value). Both the medication and the placebo will look identical and subjects will not be told into which group they have been placed until the completion of the study. Each participants has 66% chance of receiving Savella and 34% chance of getting the placebo. 2. The second level of randomization will be to determine which type of talk therapies you will be assigned to. Subjects will be randomly assigned to receive educational instruction relevant to fibromyalgia, OR cognitive behavioral therapy which includes a workbook. Both talk therapies will be provided over the phone once a week for 8 weeks. Each phone session may last for 30 minutes. Importantly, both talk therapies can provide coping tools and information designed to help manage fibromyalgia symptoms. Study Overview: Subjects will be asked to visit the Fibromyalgia Clinical Research Center on five separate occasions: Initial Screening (today's visit), Week 1, Week 2, Week 9, and Week 21. VISIT 1: 1. Informed consent and initial screening questionnaire,physical assessment 2. Issue a 'pain score' wrist monitor with instructions to record current pain level three times a day for one week VISIT 2: 1. Submit your pain recording 2. Complete the self-assessment questionnaires via computer 3. Vital signs check 4. Undergo pain sensitivity testing 5. If qualified, subjects be randomized to receive Savella or placebo AND to receive education or cognitive behavioral therapy VISIT 3: 1. We will assess the subject's willingness to continue participation. 2. Review medication diary and medication side-effect checklist. 3. Schedule PHONE Therapy sessions: 8 thirty minute calls VISIT 4: 1. One week prior to this visit, subjects will receive a 'pain score' monitor in order to enter current pain levels three times a day for one week. Then report for this visit. 2. Review side effect checklist, medication diary. 3. Completion of self-assessment questionnaires via computer 4. Undergo pain sensitivity testing VISIT 5: 1. One week prior to this visit, subjects will receive a 'pain score' monitor in order to enter current pain levels three times a day for one week. Then report for this visit. 2. Review side effect checklist, medication diary. 3. Completion of self-assessment questionnaires via computer 4. Undergo pain sensitivity testing 5. Upon visit completion, participants will receive a reduced dose regimen of the medication along with written and verbal instructions to safely discontinue the study medication.

注册库
clinicaltrials.gov
开始日期
2009年12月
结束日期
2012年9月
最后更新
9年前
研究类型
Interventional
研究设计
Factorial
性别
All

研究者

责任方
Sponsor

入排标准

入选标准

  • Must be between the ages of 18 to 65 years of age
  • Must have been diagnosed with fibromyalgia by a rheumatologist
  • Must have an overall body pain average score ≥ 4
  • Must be on stable doses of your current medication for at least past four weeks
  • Must report all medication including herbal supplements and over-the-counter medications that you are currently taking to a member of the research team.
  • Must limit any changes in your medication(s)during the 21-week study time period unless medically necessary
  • Must be willing to maintain a medication diary provided to you during the 21-week study period
  • Must be willing to abstain (not take) any fibromyalgia related medication (including over-the-counter)for at least 6-hours prior to each of the three testing visits. (Otherwise, you may take these medication immediately after pain sensitivity testing has been completed and as prescribed in-between visits)
  • Must experience the symptoms of fibromyalgia syndrome (FMS) that decreases (limits) your ability to perform daily activities.
  • Exclusions Criteria:

排除标准

  • 未提供

研究组 & 干预措施

CBT and milnacipran

Subjects randomized to this group will receive a combination of eight telephone sessions of Cognitive Behavior Therapy (CBT) and a 21-week regimen of milnacipran.

干预措施: CBT and milnacipran

CBT and placebo

Subjects randomized to this arm will receive a series of eight telephone sessions of Cognitive Behavioral Therapy (CBT) along with a 21-week regimen of a placebo(sugar pill)medication.

干预措施: CBT with a placebo

Educational with milnacipran

Subjects randomized to this group will receive a series of eight educational phone calls regarding fibromyalgia along with a 21-week regimen of milnacipran.

干预措施: Educational with milnacipran

结局指标

主要结局

Change in Weekly Average Pain Intensity

时间窗: Baseline and Week 21clinic visits

Change in weekly average pain intensity score from baseline to week 21 (scale from -10 to +10; the more negative the value, the better in terms of pain reduction)

次要结局

  • Change in Evoked Pain Scores(Baseline and Week 21 clinic visits)
  • Identification of Group Assignment(week 21)

研究点 (1)

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