Home
Search
Study Topics
Glossary
|
|
|
|
|
|
Sponsored by: |
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) |
---|---|
Information provided by: | National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) |
ClinicalTrials.gov Identifier: | NCT00000428 |
This study will compare the effectiveness of combination therapy with the drugs amitriptyline and fluoxetine (AM+FL) and amitriptyline (AM) alone in the treatment of people with fibromyalgia. Doctors will treat each study participant with both AM + FL and AM alone for 6 weeks at a time. The study uses a method that combines results from treatment of individual patients to assess overall treatment effectiveness and help individual patients and their physicians with their treatment decisions. This study will also help compare the results of community-based studies (studies involving private doctors) and studies based at clinical research centers.
Condition | Intervention | Phase |
---|---|---|
Fibromyalgia |
Drug: Amitriptyline Drug: Amitriptyline plus Fluoxitine |
Phase IV |
Study Type: | Interventional |
Study Design: | Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Active Control, Crossover Assignment, Efficacy Study |
Official Title: | Combining N-of-1 Trials to Assess Fibromyalgia Therapies |
Enrollment: | 58 |
Study Start Date: | September 2000 |
Study Completion Date: | March 2004 |
Primary Completion Date: | March 2004 (Final data collection date for primary outcome measure) |
Arms | Assigned Interventions |
---|---|
1: Experimental
Patients received each intervention multiple times in random-order crossover design.
|
Drug: Amitriptyline
Amitriptyline 25 mg po
Drug: Amitriptyline plus Fluoxitine
Amitriptyline 25 mg po plus Fluoxitine 20 mg po
|
This study will use the combined N-of-1 method to compare the effectiveness of the combination therapy amitriptyline and fluoxetine (AM+FL) versus amitriptyline (AM) alone in patients with fibromyalgia (FM). It will also compare community-based and center-based trial results. We will ask community-based, board-certified rheumatologists to participate as investigators and we will also carry out a center-based study (at Newton-Wellesley Hospital). Physicians will ask patients meeting eligibility criteria to participate in this study and undergo an N-of-1 trial.
Each N-of-1 trial will consist of three paired crossover periods (each 6-weeks long) during which the patient will receive either AM + placebo (placebo every morning and AM 25 mg at night) or combination treatment AM+FL (FL 20 mg in the morning and AM 25 mg at night). The dispensing pharmacy will carry out paired randomization.
We will assess patient evaluations and outcome measures at baseline prior to trial, at the end of each treatment period, and 3 months after completion of the N-of-1 trial. In addition, at baseline, we will obtain demographic information, an electrocardiogram, and baseline blood tests. We may ask patients to have additional blood tests at the period evaluations. We will also do a pregnancy test for all women of child-bearing age enrolling in the study. The main study outcome measure will be the Fibromyalgia Impact Questionnaire (FIQ). Additional measures will include the Visual Analog Scales (VAS) for pain, sleep, global well-being; Physician VAS for global well-being; and tender-point score.
We will analyze the results of the N-of-1 trials in two ways: (1) using only the individual patient's results (classic one-sided t-test) and (2) using the patient's results in combination with the results of other patients who underwent similar trials (the combined N-of-1 approach). To obtain the latter information, we will include each patient's results for the collective analysis. We will provide these results back to the physicians and will record the final treatment decisions the physicians reach with their patients. In addition, we will ask both physicians and patients to comment on their participation in an N-of-1 trial and this research process. Followup of patients 3 months after completion of their N-of-1 trial will include determining current medication and a current outcome assessment. Investigators will record all adverse drug reactions and patients withdrawn from studies. They will also record the reason for withdrawal for all patients choosing to withdraw. We will include results from patients who drop out due to reasons other than drug reactions in the combined N-of-1 analyses if completed period pair results are available. An independent safety officer will review all withdrawals.
Results of individual patient trials will be confidential; however, we will combine these results (after removal of patient identifiers) with the results of other patients, and will publish the overall results of this study. We will maintain the connection of results to patient identifiers only to enable us to provide results to individual investigators and their patients.
Ages Eligible for Study: | 18 Years to 60 Years |
Genders Eligible for Study: | Both |
Accepts Healthy Volunteers: | No |
Inclusion Criteria:
Exclusion Criteria:
United States, Massachusetts | |
Newton-Wellesley Hospital | |
Newton, Massachusetts, United States, 02162 | |
Office of Jacqueline Feuer, MD | |
Needham, Massachusetts, United States, 02192 | |
Office of Raphael Kieval, MD | |
Brockton, Massachusetts, United States, 02402 | |
Office of Eileen Winston, MD | |
Framingham, Massachusetts, United States, 01702 | |
Office of Ronald J. Rapoport, MD | |
Fall River, Massachusetts, United States, 02720 | |
Office of Sharon A. Stotsky, MD | |
North Reading, Massachusetts, United States, 01864 | |
Office of Nicola Mogavero, MD | |
Melrose, Massachusetts, United States, 02176 |
Principal Investigator: | Deborah R. Zucker | New England Medical Center/ Tufts University School of Medicine |
Responsible Party: | Tufts-New England Medical Center ( Deborah Zucker, MD, PhD ) |
Study ID Numbers: | R01 AR45416, NIAMS-038 |
Study First Received: | January 18, 2000 |
Last Updated: | March 5, 2008 |
ClinicalTrials.gov Identifier: | NCT00000428 |
Health Authority: | United States: Federal Government |
Fibromyalgia Syndrome (FMS) Amitriptyline Fluoxetine |
Fluoxetine Muscular Diseases Neuromuscular Diseases Musculoskeletal Diseases Myofascial Pain Syndromes |
Fibromyalgia Amitriptyline Pain Rheumatic Diseases |
Neurotransmitter Uptake Inhibitors Neurotransmitter Agents Molecular Mechanisms of Pharmacological Action Adrenergic Agents Adrenergic Uptake Inhibitors Nervous System Diseases Physiological Effects of Drugs Psychotropic Drugs Pharmacologic Actions |
Antidepressive Agents, Tricyclic Analgesics, Non-Narcotic Sensory System Agents Therapeutic Uses Analgesics Peripheral Nervous System Agents Central Nervous System Agents Antidepressive Agents |