Lower Back Pain Clinical Trial
Official title:
Investigation of Efficacy of Botulinum Toxin A (Dysport) in Chronic Low Back Pain
The scientific aim of this study is to investigate the efficacy of abobotulinumtoxinA
(Dysport - Ipsen Pharmaceuticals) in chronic low back pain.
The investigators hypothesis is that injection of Dysport brand of botulinum toxin type A
into erector spinae muscles (extensors of the spine) can relieve low back pain through
anti-spasm and analgesic effect of botulinum toxin.
This is an investigator initiated, randomized, double blind, placebo-controlled study. A
total of 90 patients will be enrolled in the study. The study will be conducted over 4
months. It includes 4 visits and 4 telephone calls. Patients with chronic low back pain (>3
months) who meet inclusion and exclusion criteria and wish to participate in the study may
be enrolled. Those who become enrolled will be scheduled for a baseline visit (Week 0).
During the baseline visit, subjects will be given the official approved consent form to read
and ask questions. Participants to this study will also receive a copy of the Dysport Risk
Evaluation and Mitigation Strategy (REMS) statement. After obtaining informed consent signed
by the subject, the subjects will be randomization into the Dysport or placebo group. The
randomizing will be performed by a nurse and the information will be kept in a pass-worded
computer. Blinding means that neither the participant nor the clinical rater will know which
group the participant has been initially been assigned.
Each subject will have a neurological examination and fill a demographic form and complete
four rating questionnaires (appendix II-V). These include a visual analogue scale for pain
(0 to 10) and three quality of life questionnaires which depict quality of life (the
American Chronic Pain Association's Quality of Life Scale), how pain affects ability to
manage everyday life (Oswestry Low Back Pain Disability Questionnaire), and overall physical
and emotional health (Short Form-36). Patients will then receive an injection of either
abobotulinumA (Dysport) or normal saline. Dysport or saline will be administered into the
paraspinal muscles (extensors or erector spinae) at five levels (L1-L5), regardless of pain
location. In the case of unilateral pain, this would amount to 500 units total, and in the
case of bilateral pain, to 1000 units total, of Dysport per session.
The primary outcome of the study is number of patients with VAS < 4 ( no or subtle pain) at
week 6 after placebo or Dysport injection.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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