MedPath

Oral Curcumin for the Treatment of Pain of Thumb Base Joint (CMC) Arthritis

Phase 1
Conditions
Arthritis of Carpometacarpal Joint of Left Thumb
Arthritis of Carpometacarpal Joint of Right Thumb
Interventions
Drug: Placebo
Registration Number
NCT06359665
Lead Sponsor
Brent DeGeorge
Brief Summary

The goal of this clinical trial is to learn about the use of turmeric (Curcumin) as a treatment for pain of thumb-joint arthritis. Turmeric is commonly being used as an over-the-counter treatment for musculoskeletal pain. Clinical trials have demonstrated a pain-relief benefit for knee osteoarthritis, however no clinical trial has been performed to establish efficacy of curcumin in humans for thumb-joint arthritis. The main question\[s\] it aims to answer are:

* Is Turmeric more effective than placebo at relieving pain for thumb-joint arthritis? A placebo is a look-alike substance that contains no active drug.

* Is Turmeric more effective than placebo at improving patient-reported outcomes for CMC arthritis?

* Is Turmeric safe for participants with thumb-joint arthritis?

Participants will:

* take 4 weeks of daily Turmeric capsules,

* take 4 weeks of daily placebo capsules

* answer daily surveys about how they are feeling and functioning.

Detailed Description

This randomized controlled trial of oral curcumin for the treatment of pain of CMC arthritis will investigate the therapeutic potential of curcumin as an oral treatment for pain of CMC arthritis. Rationale: Curcumin is commonly being used as an over-the-counter treatment for musculoskeletal pain. Clinical trials have demonstrated a pain-relief benefit for knee osteoarthritis, however no clinical trial has been performed to establish efficacy of curcumin in humans for CMC arthritis. Hypothesis: Curcumin is more effective than placebo for relieving pain and improving patient-reported outcomes for CMC arthritis Study Design: The study design will be a double-blind, randomized controlled trial with crossover. Treatment will be blinded to the subjects and investigators. Patients will be randomly assigned 4 weeks of the Curcumin or control and then crossover to the other condition for 4 additional weeks. Patients will take the oral curcumin or control placebo capsule twice daily. Subjects will be advised to observe adverse effects.

The study design will be a double-blind randomized control trial with crossover. Treatment will be blinded to the subjects and investigators. Patients will be randomly assigned 4 weeks of the case (curcumin) or control capsules and then crossover to the other condition for 4 more weeks with a 2-week washout interval between. Patients will take one oral capsule by mouth twice daily. The subjects will be advised to observe for physiologic changes, skin changes, or other adverse effects. If mild to severe adverse events are noticed, the patient's will discontinue the use of the capsules, and appropriate care and observation will be taken. Each condition will last for 4 weeks and then subjects will be contacted by the study coordinator to facilitate crossover into the other condition following a 2-week washout period. To capture any delayed-onset adverse events, subjects will attend a follow-up visit seven days following the last dose of the curcumin capsule.

Recruitment & Eligibility

Status
ENROLLING_BY_INVITATION
Sex
All
Target Recruitment
100
Inclusion Criteria
  1. Provision of signed and dated informed consent form.

  2. Stated willingness to comply with all study procedures and availability for the duration of the study.

  3. Male or female, aged 18 years or older.

  4. For females, must be willing to use an approved form of birth control during this study. Acceptable forms of birth control:

    • Norplant
    • IUD (intrauterine device)
    • Birth Control Patch
    • Depo-Provera
    • Sterilization

    The following may be used if combined with other birth control methods:

    • Condoms
    • Diaphragm
    • Jellies or foam
    • Cervical cap
    • Sponge
  5. For males, must be willing to not father a baby for the duration of the study and for 90 days after the last dose of study drug, or donate to a sperm back during this time. Must be willing to use an approved form of birth control during this time. Acceptable forms of birth control:

    • Condoms
    • Sterilization
  6. Daily visual analog pain greater than 5 and ≤ 9 out of 10.

  7. Duration of pain for greater than 30 days.

  8. Presence of radiographically confirmed diagnosis of thumb basal joint arthritis

Exclusion Criteria
  1. Participant does not speak English.

  2. Participant is blind.

  3. Severe cardiac, pulmonary, liver, gastrointestinal and hematological disease (including coagulopathy), and /or renal disease.

  4. Abnormal hematological, coagulation, and/or liver function test results.

  5. Coumadin use at time of screening.

  6. Use of any anticoagulant and antiplatelet medication.

  7. History of mental illness.

  8. Participant who is incarcerated.

  9. History of drug or substance abuse.

  10. Pre-existing curcumin or turmeric product usage within 3 months of the study period.

  11. Participant has had a corticosteroid injection ≤ 60 days prior.

  12. Participant has had prior surgery for osteoarthritis treatment

  13. Participant who has fibromyalgia and post-operative pain.

  14. Females who are pregnant, nursing or planning a pregnancy

  15. Participants within 14 days of the study procedure taking prescription or non-prescription medication which are substrates of CYP3A4:

    • Itraconazole,
    • Ketoconazole,
    • Azamulin,
    • Troleandomycin,
    • Verapamil,
    • John's wart,
    • Phenobarbital,
  16. Participants within 14 days of the study procedure taking prescription or non-prescription medication which are substrates of CYP2C19:

    • Nootkatone,
    • Ticlopidine,
    • Rifampin,
    • Omeprazole),
  17. Participants within 14 days of the study procedure taking prescription or non-prescription medication which are substrates of CYP2C8:

    • Montelukast,
    • Quercetin,
    • Phenelzine,
    • Rifampin,
    • Clopidogrel ,
  18. Participants within 14 days of the study procedure taking prescription or non-prescription medication which are substrates of CYP2C9:

    • Sulfaphenazole,
    • Tienilic acid,
    • Carbamazepine,
    • Apoflutamide ,
    • Fluconazole,
    • Celecoxib,
  19. Participants within 14 days of the study procedure taking prescription or non-prescription medication which are substrates of CYP1A2:

    • alpha-Naphthoflavone,
    • Furafylline,
    • Phenytoin,
    • Rifampin,
    • Ritonavir,
    • smoking,
    • Teriflunomide,
    • Ciprofloxacin,
    • oral contraceptives,
    • Allopurinol
  20. Participants within 14 days of the study procedure taking prescription or non-prescription medication which are substrates of CYP2B6 :

    • Sertraline,
    • Phencyclidine,
    • Thiotepa,
    • Ticlopidine,
    • Carbamazepine,
    • Efavirenz,
    • Rifampin,
    • Bupropion)

Study & Design

Study Type
INTERVENTIONAL
Study Design
CROSSOVER
Arm && Interventions
GroupInterventionDescription
Oral curcuminCurcuminOral curcumin 500 mg capsules taken twice each day for 4 weeks.
PlaceboPlaceboOral placebo capsules taken twice each day for 4 weeks.
Primary Outcome Measures
NameTimeMethod
Change from Baseline in Pain on the Visual Analog Pain (VAS) ScoreBaseline and Week 4, Week 6

The Visual Analog Pain (VAS) Score is a validated, self-reported subjective measure for measuring acute and chronic pain. Possible scores range from 0 (no pain) to 10 (worst possible pain). Change = (Week (4 or 6) Score - Baseline Score).a validated, self-report

Change from Baseline in Pain on the Visual Analog Pain (VAS) Score - crossover conditionBaseline and Week 10, Week 12

The Visual Analog Pain (VAS) Score is a validated, self-reported subjective measure for measuring acute and chronic pain. Possible scores range from 0 (no pain) to 10 (worst possible pain). Change = (Week Change = (Week (10 or 12) Score - Baseline Score).

Secondary Outcome Measures
NameTimeMethod
Change from Baseline in the Mean Seated Trough Cuff Systolic Blood PressureWeek 4 and Week 6

Blood pressure (SBP and DBP) in mmHg using Sphygmomanometer will be assessed by the researchers at baseline and follow-up

Change from Baseline in Pain on the Australian/Canadian Hand Osteoarthritis (AUSCAN) IndexBaseline and Week 10, Week 12

The AUSCAN Index is a 15-item scale measuring pain (5 items), stiffness (1 item) and function (9 items) during the preceding 48 hours. Possible scores range from 0 (none) to 4 (extreme). Change = (Week (10, 12) Score - Baseline Score)

Change from baseline in serum liver panel parameters: Alanine transaminase (ALT), Alkaline phosphatase (ALP) and Aspartate aminotransferase (AST)Through study completion, an average of 12 weeks

Change from baseline in serum liver panel parameters: ALT, ALP and AST (International units per liter) at baseline and follow up

Change from Baseline in Normal Function on the Single Assessment Numerical Evaluation (SANE) ScoreBaseline and Week 4, Week 6

The SANE Score is a self-reported subjective measure for measuring percentage of normal function. Possible scores range from 0 (most abnormal) to 100 (normal). Change = (Week (4 or 6) Score - Baseline Score)

Change from Baseline in Normal Function on the Single Assessment Numerical Evaluation (SANE) Score - crossover conditionBaseline and Week 10, Week 12

The SANE Score is a self-reported subjective measure for measuring percentage of normal function. Possible scores range from 0 (most abnormal) to 100 (normal). Change = (Week 10, Week 12 Score - Baseline Score)

Change from Baseline in Quality of Life on the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health-10 Score - crossover conditionBaseline and Week 10, Week 12

The PROMIS Global Health-10 is a validated, self-reported subjective measure for measuring generic health related quality of life. Possible scores range from 0 (most severe impairment) to 20 (best health). Change = (Week (10 or 12) Score - Baseline Score)

Change from Baseline in Pain interference on the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference ScoreBaseline and Week 4, Week 6

The PROMIS Pain Interference is a validated, self-reported subjective measure for measuring generic health related quality of life. Possible scores range from 0 (does not interfere) to 10 (completely interferes). Change = (Week (4, 6) Score - Baseline Score)

Change from Baseline in Pain interference on the Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity (UE) ScoreBaseline and Week 10, Week 12

The PROMIS UE computer adaptive test is a validated computer adaptive test to assess upper extremity functional status. Change = (Week (10, 12) Score - Baseline Score)

Change from Baseline in Disability on The Quick Disability of the Arm, Shoulder (QuickDASH).Baseline and Week 4

The QuickDASH is a validated, self-reported 11-item scale measuring disability. Possible scores range from 0 (no disability) to 100 (most severe disability. Change = (Week 4 Score - Baseline Score)

Change from Baseline in Disability on The Quick Disability of the Arm, Shoulder (QuickDASH) - crossover conditionBaseline and Week 10

The QuickDASH is a validated, self-reported 11-item scale measuring disability. Possible scores range from 0 (no disability) to 100 (most severe disability. Change = (Week 10 Score - Baseline Score)

Change from Baseline in perseverance on the Brief Resilience Index (BRI)Baseline and Week 4, Week 6

The BRI is a validated, self-reported 6-item validated tool to assess for resilience. Possible scores range from 1 (low resilience) to 5 (high resilience). Change = (Week (4, 6) Score - Baseline Score)

Change from Baseline in perseverance on the Brief Resilience Index (BRI) - crossover conditionBaseline and Week 10, Week 12

The BRI is a validated, self-reported 6-item validated tool to assess for resilience. Possible scores range from 1 (low resilience) to 5 (high resilience). Change = (Week (10, 12) Score - Baseline Score)

Number of Participants With Treatment-Related Adverse EventsThrough study completion, an average of 12 weeks

Treatment-related adverse events will be reported throughout the study by self-report and clinician-driven questions at each visit

Change from Baseline in heart rateWeek 4 and Week 6

Heartbeats per minute (BPM) will be assessed by the researchers at baseline and follow-up

Change from baseline in serum comprehensive metabolic panel (CMP) parameters: glucose, blood urea nitrogen (BUN), Creatinine, CalciumThrough study completion, an average of 12 weeks

Change from baseline in serum comprehensive metabolic panel (CMP) parameters: glucose, BUN, Creatinine, Calcium (mg/dL) at baseline and follow up

Change from Baseline in Quality of Life on the Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health-10 ScoreBaseline and Week 4, Week 6

The PROMIS Global Health-10 is a validated, self-reported subjective measure for measuring generic health related quality of life. Possible scores range from 0 (most severe impairment) to 20 (best health). Change = (Week (4 or 6) Score - Baseline Score)

Change from Baseline in Pain interference on the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference Score - crossover conditionBaseline and Week 10, Week 12

The PROMIS Pain Interference is a validated, self-reported subjective measure for measuring generic health related quality of life. Possible scores range from 0 (does not interfere) to 10 (completely interferes). Change = (Week (10, 12) Score - Baseline Score)

Change from baseline in serum comprehensive metabolic panel (CMP) parameters: estimated glomerular filtration rate (eGFR)Through study completion, an average of 12 weeks

Change from baseline in serum comprehensive metabolic panel (CMP) parameters: eGFR (mL/min/1.73m2) at baseline and follow up

Change from baseline in serum comprehensive metabolic panel (CMP) parameters: BilirubinThrough study completion, an average of 12 weeks

Change from baseline in serum comprehensive metabolic panel (CMP) parameters: Bilirubin (umol/L) at baseline and follow up

Change from baseline in serum comprehensive metabolic panel (CMP) parameters: Protein, AlbuminThrough study completion, an average of 12 weeks

Change from baseline in serum comprehensive metabolic panel (CMP) parameters: Protein, Albumin (g/dL) at baseline and follow up

Change from baseline in serum complete blood count (CBC) parameters: Red Blood Cells (CBC), White Blood Cells (WBC), PlateletsThrough study completion, an average of 12 weeks

Change from baseline in serum complete blood count (CBC) parameters: RBC, WBC, Platelets (uL) at baseline and follow up

Change from baseline in serum complete blood count (CBC) parameters: HemoglobinThrough study completion, an average of 12 weeks

Change from baseline in serum complete blood count (CBC) parameters: Hemoglobin (g.dL) at baseline and follow up

Change from baseline in serum comprehensive metabolic panel (CMP) parameters: Sodium, Potassium, Chloride, Carbon DioxideThrough study completion, an average of 12 weeks

Change from baseline in serum comprehensive metabolic panel (CMP) parameters: Sodium, Potassium, Chloride, Carbon Dioxide (meq/L) at baseline and follow up

Change from baseline in serum comprehensive metabolic panel (CMP) parameters: Prothrombin time- International normalized ratio (PT-INR)Through study completion, an average of 12 weeks

Change from baseline in serum comprehensive metabolic panel (CMP) parameters: Prothrombin time- International normalized ratio (PT (seconds)-INR) at baseline and follow up

Change from baseline in serum complete blood count (CBC) parameters: HematocritThrough study completion, an average of 12 weeks

Change from baseline in serum complete blood count (CBC) parameters: Hematocrit (percentage) at baseline and follow up

Change from baseline in serum complete blood count (CBC) parameters: Mean Corpuscular Volume (MCV)Through study completion, an average of 12 weeks

Change from baseline in serum complete blood count (CBC) parameters: Mean Corpuscular Volume (MCV) (pg) at baseline and follow up

Change from baseline in serum complete blood count (CBC) parameters: the amount of hemoglobin per red blood cell.(MCH)Through study completion, an average of 12 weeks

Change from baseline in serum complete blood count (CBC) parameters: the amount of hemoglobin per red blood cell.(MCH) (pg) at baseline and follow up

Trial Locations

Locations (1)

University of Virginia

🇺🇸

Charlottesville, Virginia, United States

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