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Topiramate for Cryptogenic Sensory Peripheral Neuropathy in Metabolic Syndrome (CSPN)

Phase 2
Completed
Conditions
Cryptogenic Sensory Peripheral Neuropathy in Metabolic Syndrome
Interventions
Other: Placebo
Registration Number
NCT02878798
Lead Sponsor
Virginia Commonwealth University
Brief Summary

The TopCSPN trial is a double blinded randomized placebo controlled study of oral topiramate as a potential disease modifying therapy for cryptogenic sensory peripheral neuropathy (CSPN). Patients with CSPN who also have metabolic syndrome (defined by the ATPIII criteria) who do not have an alternative cause for neuropathy will be potentially eligible. The co primary outcome measures are change in the Norfolk Quality of Life - Diabetic Neuropathy (NQOL-DN) Scale and intraepidermal nerve fiber density (IEFND) at the distal thigh. The treatment phase will last 24 months.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
132
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboAn overencapsulated placebo of identical color, shape and packaging to topiramate will be used.
TopiramatetopiramateOral topiramate
Primary Outcome Measures
NameTimeMethod
Norfolk Quality of Life - Diabetic Neuropathy96 weeks (expressed as a slope in change of total score/52 weeks)

Difference in NQOL between treatment groups over 96 weeks. The Norfolk QOL-DN is a validated 47-item, patient-reported outcome measure, sensitive to the different features of diabetic neuropathy (DN) including small fiber, large fiber, and autonomic function. A lower score is better. The range of the score is from -4 to 136. The slope of the change in total Norfolk QOL-DD is calculated as the change in total score/52 weeks (one year)

Intraepidermal Nerve Fiber Density (IENFD)96 weeks

Difference in IENFD change between treatment groups over 96 weeks (fibers/mm) (i.e. the slope of change). A skin biopsy is obtained. The sample is stained for nerve fibers. The rate of change in IENFD in fibers/mm is calculated over the 96 week duration of the study and expressed in change in fibers/mm/year (defined as 52 weeks) over the study period (i.e. the slope of change expressed and change in IENFD in fibers/mm over a 52 week period).

Secondary Outcome Measures
NameTimeMethod
Brief Pain Inventory - Diabetic Neuropathy (BPI-DN) Pain Interference96 weeks (expressed as a change in change in pain interference/52weeks)

Pain interference score. Each item is scored from 0-10 with a total possible number of points of 70, higher worse. The range of the score is 0-70. The change in score is expressed as a slope of change in pain interference score/52 weeks (one year)

Brief Pain Inventory - Diabetic Neuropathy (BPI-DN) Average Pain Intensity96 weeks (expressed as a slope of change over 52 weeks)

Average pain severity. Each item is scored 0-10 with a total of 40 possible points, higher is worse. The range of the score is 0-40. The slope of the change in this score is expressed as change/one year (defined as 52 weeks)

Utah Early Neuropathy Scale96 weeks (expressed as a slope of change in total UENS over 52 weeks).

The UENS is a validated examination score of neuropathy severity based on a physical examination (Singleton et al 2008). Total score is 42 (minimum 0 and maximum 42). The higher the score, the worse the outcome is. The change in UENS over the 96 week period is expressed as a slope of change in total UENS over one year defined as 52 weeks.

Sural Sensory Amplitude (SSA)96 weeks (slope of change in mV/52weeks)

Change in SSA measured in microvolts. SSA is measured by electrically stimulating a nerve through the skin and recording the response. A larger value is better. The normal values vary based on age, with a minimum of 0 (absent). Across all ages, the lower limit of normal is 6 microvolts, although the normal cutoff declines with aging. The change in SSA over the 96 week study period is expressed as a slope of change in uV/52 weeks (the 52 week log (mV) change of non-zero values).

Peroneal Motor Conduction Velocity (PMCV)96 weeks (expressed as a slope of change in meter/sec over 52 weeks)

PMCV change. PMCV is measured by electrically stimulating the nerve through the skin at two different locations and measuring how fast the response travels between the two in meters/second. A higher value is better. The slope of the change in PMCV is expressed as change in meters/second/52 weeks (one year).

Body Mass Index (BMI)96 weeks (slope of change in kg/m2/52 weeks)

BMI change in kg/m2. BMI is a measure of weight relative to height. The slope of the change in BMI over the study was expressed as change in kg/m2/52 weeks.

Hemoglobin A1CThe annual slope of the change in A1C over 96 weeks expressed in change in percent/52 weeks

Slope of the Hemoglobin A1C change. A1C is measured in percent. It provides an estimate of how high blood sugar has been over the past three months. A higher value indicates poor diabetic control.

Serum Triglycerides (TRG)96 weeks (slope of change mg/dl over 52 weeks)

TRG change. TRG are a type of lipid or fat circulating in the blood. A higher value is associated with increased cardiovascular risk. The slope of the change in TRG was calculated as change in mg/dl over 52 weeks (one year).

LDL Cholesterol96 weeks (expressed as a slope of change in mg/dl/52 weeks)

LDL change. LDL is "bad" cholesterol, measured in mg/dL. A higher value is associated with elevated cardiovascular risk. A slope of change is calculated change in LDL in mg/dL/52 weeks (one year)

HDL Cholesterol96 weeks (expressed as slope of change in mg/dL/52 weeks)

HDL change. HDL is "good cholesterol", measured in mg/dL. A lower value is associated with higher cardiovascular risk. The slope of change is calculated as change in mg/dL/52 weeks (one year)

Trial Locations

Locations (20)

Vanderbilt University Medical Center

🇺🇸

Nashville, Tennessee, United States

Virginia Commonwealth University

🇺🇸

Richmond, Virginia, United States

University of Miami

🇺🇸

Miami, Florida, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

Ohio State University

🇺🇸

Columbus, Ohio, United States

University of Pennsylvania

🇺🇸

Philadelphia, Pennsylvania, United States

UT Southwestern Medical Center

🇺🇸

Dallas, Texas, United States

Eastern Virginia Medical Center

🇺🇸

Norfolk, Virginia, United States

University of Utah

🇺🇸

Salt Lake City, Utah, United States

University of Rochester Medical Center

🇺🇸

Rochester, New York, United States

Barrow Neurological Institute

🇺🇸

Phoenix, Arizona, United States

University of Alabama Birmingham

🇺🇸

Birmingham, Alabama, United States

University of Michigan Neurology Clinical Trials Organization

🇺🇸

Ann Arbor, Michigan, United States

Washington University School of Medicine

🇺🇸

Saint Louis, Missouri, United States

Columbia University Medical Center

🇺🇸

New York, New York, United States

Wake Forest University Baptist Medical Center

🇺🇸

Winston-Salem, North Carolina, United States

Massachusetts General Hospital

🇺🇸

Boston, Massachusetts, United States

University of California Irvine

🇺🇸

Orange, California, United States

University of Iowa

🇺🇸

Iowa City, Iowa, United States

University of Kansas Medical Center

🇺🇸

Kansas City, Kansas, United States

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