Low-dose Naltrexone for Bladder Pain Syndrome: A Randomized Placebo-controlled Prospective Pilot Trial
Overview
- Phase
- Phase 2
- Intervention
- Naltrexone
- Conditions
- Bladder Pain Syndrome
- Sponsor
- Stanford University
- Enrollment
- 40
- Locations
- 1
- Primary Endpoint
- The proportion of subjects in the LDN and placebo groups that are responders with greater than 20% reductions in 7-day average of worst daily Numeric Rating Scale of Pain scores after 8 weeks of treatment.
- Status
- Suspended
- Last Updated
- 2 years ago
Overview
Brief Summary
Interstitial cystitis/Bladder Pain Syndrome (IC/PBS) is a constellation of symptoms of pelvic discomfort that includes both bladder-related pain as well as urinary frequency, urgency, and nocturia in the absence of an identifiable etiology that affects likely more than 5.4 million patients in the United States. There is a significant overlap in patients with IC/PBS and those with fibromyalgia and chronic pelvic pain syndrome. Low-dose naltrexone (LDN) has been shown to be effective for the treatment of chronic pain conditions.
The primary aim of this study is to evaluate if LDN improves pain scores and lower urinary tract symptoms in patients with IC/PBS. A secondary aim is to show that it has a low adverse event profile.
Investigators
Jennifer Hah
Assistant Professor
Stanford University
Eligibility Criteria
Inclusion Criteria
- •Men and women with non-Hunner and Hunner lesion disease
- •Meeting AUA definition of BPS: An unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder associated with lower urinary tract symptoms of greater than 6 weeks duration in the absence of infection or other identifiable cause.
- •Stable treatment for 1 month
- •7-day maximum of pain scores at least 4/10 on the numerical rating scale of pain in the bladder/pelvic area. Urinary frequency 8 or higher while awake. Nocturia 2 or higher. BPIC-SS
- •Agreement to not take opioids through the duration of the trial
Exclusion Criteria
- •Substance Use Disorder Diagnosis including Opioid Use Disorder Diagnosis
- •Known allergy to naltrexone or naloxone
- •Participation in another clinical trial
- •Current or planned pregnancy, or breastfeeding
- •Chronic pain in another location of the body that is more severe than that related to BPS.
- •Any intravesical instillation in last 8 weeks
- •If on Elmiron, stable dose for last 3 months
- •If on amitriptyline, stable dose for last 3 months
- •Any botox within last 6 months
- •Treatment for Hunners in the last 6 months
Arms & Interventions
Low-dose naltrexone
4.5mg of naltrexone to be taken one hour prior to bedtime nightly for 8 weeks.
Intervention: Naltrexone
Placebo
Placebo tablet (sugar-pill) to be taken one hour prior to bedtime nightly for 8 weeks.
Intervention: Placebo
Outcomes
Primary Outcomes
The proportion of subjects in the LDN and placebo groups that are responders with greater than 20% reductions in 7-day average of worst daily Numeric Rating Scale of Pain scores after 8 weeks of treatment.
Time Frame: Will compare pre-intervention to week 8.
Secondary Outcomes
- Change in Brief Pain Inventory Score(At pre-intervention to week 8.)
- Change in average frequency and nocturia during a 5-day voiding diary(At pre-intervention to week 8.)
- Change in Bladder Pain/Interstitial Cystitis Symptom Score(At pre-intervention to week 8)
- Change in O'Leary Sant symptom scores(At pre-intervention to week 8)
- Change in O'Leary Sant Problem Indices scores(At pre-intervention to week 8)
- Change in PROMIS sleep dysfunction score(At pre-intervention to week 8)
- Change in PROMIS Sleep-Related Impairment(At pre-intervention to week 8)
- Change in PROMIS pain interference score(At pre-intervention to week 8)
- Change in PROMIS fatigue score(At pre-intervention to week 8)
- Change in Global response assessment scale score(At pre-intervention to week 8)
- Change in PROMIS pain behavior score(At pre-intervention to week 8)
- Change in PROMIS physical function score(At pre-intervention to week 8)
- Change in PROMIS anxiety score(At pre-intervention to week 8)
- Change in PROMIS depression score(At pre-intervention to week 8)