Osteoarthritis Clinical Trial
Official title:
A Double-Blind, Placebo-Controlled, Enriched Enrollment Randomized Withdrawal Study to Evaluate the Efficacy of Milnacipran in the Treatment of Pain Due to Osteoarthritis
The present study will aim to evaluate the efficacy of milnacipran in the treatment of pain
due to osteoarthritis (OA), that is, to determine whether milnacipran provides superior
efficacy to placebo in patients with OA. Milnacipran is a serotonin-norepinephrine reuptake
inhibitor (SNRI) that is currently approved in the United States in the treatment of major
depressive disorder and fibromyalgia. There is increased evidence to suggest that SNRIs may
be effective in the treatment of chronic pain conditions, such as OA.
The hypothesis in this study is that the survival time (time from randomization to loss of
efficacy) of milnacipran group is superior to that of placebo group.
The study design is a Double-Blind, Placebo-Controlled, Enriched Enrollment Randomized
Withdrawal Study. This means that, upon entry into the study, all subjects will enter an
open-label period during which they will take milnacipran for 4 weeks. Subjects will taper
their dose up to one 100mg tablet twice daily for a total of 200mg per day. After 4 weeks,
the subject will return to the clinic and be re-evaluated.
Only subjects who meet certain criteria are then randomized to continue in the double-blind
period of the study. Once a subject is randomized, he or she will take either milnacipran or
placebo for another 4 weeks. Following the double-blind period, subjects will be tapered off
the study medication and will receive a phone call once each week for 2 weeks for follow-up
assessments.
Throughout the study, subjects will complete various questionnaires and other test
procedures aimed at sub-typing subjects based on pain mechanisms.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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