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Home > "A" Clinical Trials Conditions > Assessing Fibromyalgia Treatments  Assessing Fibromyalgia Treatments
Assessing Fibromyalgia Treatments
For Condition: Fibromyalgia
Status: No longer recruiting
Sponsor(s): National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) ,
Synopsis: 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.
Details: 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.
Eligibility:
Study Type: Interventional, Treatment, Randomized, Double-Blind, Placebo Control, Crossover Assignment, Efficacy Study
Minimum Age/Maximum Age: 18 Years/60 Years
Genders: Both
Protocol Entry Criteria: Inclusion Criteria: - Patients who meet fibromyalgia criteria as defined by the American College of Rheumatology - No systemic illness (current or past) or other contraindications to taking study medications (e.g. known hypersensitivity) - Age 18-60 - Patient willingness, and physician agreement, to discontinue CNS medications/NSAIDs/analgesics for 1 week prior to starting their trial - Patient informed consent and agreement to participate in an N-of-1 trial Exclusion Criteria: - Patients who are currently pregnant or who plan to become pregnant during the study period - Patients with any contraindications to using either amitriptyline or fluoxetine
Total Enrollment: 120
Location and Contact Information:
Overall Study Official:
DeborahZucker, Principal Investigator, New England Medical Center/ Tufts University School of Medicine
Office of Jacqueline Feuer, MD
Needham, Massachusetts, 02192
United States
Office of Raphael Kieval, MD
Brockton, Massachusetts, 02402
United States
Office of Nicola Mogavero, MD
Melrose, Massachusetts, 02176
United States
Office of Eileen Winston, MD
Framingham, Massachusetts, 01702
United States
Newton-Wellesley Hospital
Newton, Massachusetts, 02162
United States
Office of Sharon A. Stotsky, MD
North Reading, Massachusetts, 01864
United States
Office of Ronald J. Rapoport, MD
Fall River, Massachusetts, 02720
United States
Additional Information:
Study ID Numbers: NIAMS-038; R01 AR45416
Study Start Date: September 2000
Record last reviewed: February 2004
Additional information available at: clinicaltrials.gov
Clinicaltrials.gov Reference link: NCT00000428
Other Fibromyalgia Studies:
1. Efficacy of Acupuncture in the Treatment of Fibromyalgia
2. Support, Health, and Fibromyalgia
3. Fibromyalgia: A Randomized Controlled Trial of a Mind/Body Intervention
4. Biomarkers of Homeopathy in Fibromyalgia
5. Tailored Treatments of Fibromyalgia
Related Studies:
Other Fibromyalgia Clinical Trials
Other Massachusetts Clinical Trials
Other Brockton Clinical Trials
Assessing Fibromyalgia Treatments
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