Clinical Trials Logo

Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT00838500
Other study ID # CUF 1497
Secondary ID
Status Completed
Phase Phase 3
First received February 5, 2009
Last updated September 28, 2012
Start date May 2008
Est. completion date November 2011

Study information

Verified date September 2012
Source Association Francaise pour la Recherche Thermale
Contact n/a
Is FDA regulated No
Health authority France: Ministry of Health
Study type Interventional

Clinical Trial Summary

The main objective of this study is to test the hypothesis that a 3 week intensive course of spa therapy can reduce the risk of leg ulcers in patients with advanced chronic venous insufficiency (C4a-b and C5 of the CEAP classification) at one year.


Description:

Chronic venous insufficiency affects to differing extents half of the French population. The most advanced forms, with skin changes (CEAP clinical classes C4-5-6) affect 5% of the population and are those most often indicated for spa treatment. A venous condition is recognized as justifying spa therapy by 12 spa resorts in France. However, no specific or global benefit has been clearly scientifically shown for such therapy. One methodologically sound study (Carpentier 2009) demonstrated a benefit of spa therapy using a non-clinical intermediate endpoint (severity of skin changes). No study has shown efficacy of spa therapy in the primary and secondary prevention of the major and most common complication of advanced chronic venous insufficiency: leg ulcers.

Vascular hemodynamics and in particular venous return from the lower limbs is subject to the laws of physics. Thus, the roles of the calf muscle venous pump and hydrostatic pressure in venous insufficiency rationalizes the use of balneotherapy techniques in the management of this pathology.

The spa therapy techniques used in the context of venous insufficiency have well-defined physiopathic targets and the hemodynamic and microcirculatory effects of some of them have been demonstrated. The high degree of satisfaction of patients taking the waters annually for venous conditions indirectly testifies to their enhanced well-being. Among venous indications, the prevention of post-thrombotic syndrome is one of the best recognized by the medical profession.Nevertheless, there has been no real validation of this indication with an acceptable methodology that meets the canons of evidence based medicine.


Recruitment information / eligibility

Status Completed
Enrollment 425
Est. completion date November 2011
Est. primary completion date December 2010
Accepts healthy volunteers No
Gender Both
Age group 18 Years and older
Eligibility Inclusion Criteria:

- Both sexes, more than 18 years old patients with a phlebological indication of spa treatment, with advanced chronic venous insufficiency, class C4a, or b or C5 of CEAP classification (leg ulcers must be healed since 3 months at least)

- Available for a spa treatment during 18 days (immediate or late spa)and a follow-up period of 18 months

- Voluntary to participate to the study,informed consent form signed after appropriate information

- Affiliation to the social security system or equivalent

Exclusion Criteria:

- Pregnancy, parturient or breast feeding

- No psychiatric illness or social situation that would preclude study compliance

- Leg ulcer in progress

- Leg ulcer healed for less than 3 months

- Refusal to consent

- Refusal of spa treatment

- Contra-indication of spa treatment(cancer in progress, psychiatric disorders, immunodeficiency)

- Arteriopathy of lower limb with an Ankle Brachial Pressure Index (ABPI)< 0.7, symptomatic neuropathy, erysipelas within 5 years prior to inclusion

- Surgical or endovascular treatment of the venous disease planned during the first year or during the six months prior to inclusion

- No previous phlebological spa treatment within 6 months prior to inclusion

Study Design

Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Investigator), Primary Purpose: Treatment


Related Conditions & MeSH terms


Intervention

Drug:
Immediate spa treatment
1st year, soon after randomization: Spa treatment of 18 days. Spa treatment : the most adapted to the concerned pathology and common to all of spa resorts(walk in a specially pool, whirlpool bath with automatic air and water massages cycles, massaging shower...)
Late spa treatment
2nd year, soon after 12 months visit: Spa treatment of 18 days. Spa treatment : the most adapted to the concerned pathology and common to all of spa resorts(walk in a specially pool, whirlpool bath with automatic air and water massages cycles, massaging shower...)

Locations

Country Name City State
France Cabinet médical Albertville
France Cabinet médical Angouleme
France Cabinet médical Bagnoles de l'Orne
France Cabinet médical Barbotan Les Thermes
France Cabinet médical Bayonne
France Cabinet médical Belfort
France Hopital thermal DAX
France University Hospital Grenoble Grenoble
France Cabinet médical Montlucon
France Cabinet médical Montpellier
France Cabinet médical PAU
France Cabinet médical Rochefort
France Cabinet médical Tarbes

Sponsors (3)

Lead Sponsor Collaborator
Association Francaise pour la Recherche Thermale Floralis, Université Joseph Fourier

Country where clinical trial is conducted

France, 

References & Publications (9)

Carpentier PH, Maricq HR, Biro C, Ponçot-Makinen CO, Franco A. Prevalence, risk factors, and clinical patterns of chronic venous disorders of lower limbs: a population-based study in France. J Vasc Surg. 2004 Oct;40(4):650-9. — View Citation

Carpentier PH, Satger B. Randomized trial of balneotherapy associated with patient education in patients with advanced chronic venous insufficiency. J Vasc Surg. 2009 Jan;49(1):163-70. doi: 10.1016/j.jvs.2008.07.075. Epub 2008 Oct 1. — View Citation

Constant F, Collin JF, Guillemin F, Boulangé M. Effectiveness of spa therapy in chronic low back pain: a randomized clinical trial. J Rheumatol. 1995 Jul;22(7):1315-20. — View Citation

Eklöf B, Rutherford RB, Bergan JJ, Carpentier PH, Gloviczki P, Kistner RL, Meissner MH, Moneta GL, Myers K, Padberg FT, Perrin M, Ruckley CV, Smith PC, Wakefield TW; American Venous Forum International Ad Hoc Committee for Revision of the CEAP Classification. Revision of the CEAP classification for chronic venous disorders: consensus statement. J Vasc Surg. 2004 Dec;40(6):1248-52. Review. — View Citation

Ernst E, Saradeth T, Resch KL. A single blind randomized, controlled trial of hydrotherapy for varicose veins. Vasa. 1991;20(2):147-52. — View Citation

Labropoulos N, Leon LR Jr. Duplex evaluation of venous insufficiency. Semin Vasc Surg. 2005 Mar;18(1):5-9. Review. — View Citation

Launois R, Reboul-Marty J, Henry B. Construction and validation of a quality of life questionnaire in chronic lower limb venous insufficiency (CIVIQ). Qual Life Res. 1996 Dec;5(6):539-54. — View Citation

Prandoni P, Lensing AW, Prins MH, Frulla M, Marchiori A, Bernardi E, Tormene D, Mosena L, Pagnan A, Girolami A. Below-knee elastic compression stockings to prevent the post-thrombotic syndrome: a randomized, controlled trial. Ann Intern Med. 2004 Aug 17;141(4):249-56. — View Citation

Rutherford RB, Padberg FT Jr, Comerota AJ, Kistner RL, Meissner MH, Moneta GL. Venous severity scoring: An adjunct to venous outcome assessment. J Vasc Surg. 2000 Jun;31(6):1307-12. — View Citation

Outcome

Type Measure Description Time frame Safety issue
Primary Occurrence of a leg ulcer within the year following the inclusion. The ulcer will be classified C5 of CEAP (healed ulcer) or C6 (non healed ulcer)at the follow up visit. 1 year Yes
Secondary Healing time of the leg ulcers within the first year 12 months No
Secondary Quality of life: Euroqol EQ 5D, CIVIQ2 Scale Inclusion - 6 months - 12 months- 18 months No
Secondary Aggravation level defined as at least 20% increase of the modified Rutherford score and mean comparison of this score at 1 year Inclusion - 12 months - 18 months No
Secondary Visual analog scale for leg symptoms Monthly (until 18 months) No
Secondary Evaluation of the costs involved by the venous insufficiency at 1 year (treatments, physical treatments, hospitalization) Inclusion - 6, 12 and 18 months No
See also
  Status Clinical Trial Phase
Completed NCT05507346 - A Clinical Study to Evaluate the Effectiveness of a Novel Portable Non-Pneumatic Active Compression Device vs. an Advanced Pneumatic Compression Device for Treating Lower Extremity Lymphedema N/A
Completed NCT04469361 - The Effect of Training on Hemodynamic Factors in Ballet Dancer
Recruiting NCT05633277 - Outcomes of Sclerotherapy of the Ulcer Bed Compared to a Combination of Ablation and Injections N/A
Completed NCT03283800 - Copper Impact on Venous Insufficiency and Lipodermatosclerosis N/A
Terminated NCT03311269 - A Study Evaluating ClariVein With a Sclerosing Agent for the Treatment of Venous Insufficiency Phase 2
Withdrawn NCT01680809 - Compliance of Compression Therapy in Healed Venous Ulcerations N/A
Completed NCT00617825 - Feasibility Study of Cryotherapy for Chronic Venous Disorders N/A
Active, not recruiting NCT00270972 - The Evaluation of OrCel for the Treatment of Venous Ulcers N/A
Completed NCT01701661 - Compression Therapy Versus Surgery in the Treatment of Superficial Venous Reflux N/A
Active, not recruiting NCT06369207 - Investigation of the Transmission Pathways of Reflux in Patients With Chronic Venous Insufficiency
Completed NCT04461132 - The Effect of Manual Lymphatic Drainage N/A
Recruiting NCT04546750 - Prospective Cohort Study for Varicose Veins Incidence and Natural Course
Not yet recruiting NCT03543007 - Evaluating the Safety and Efficacy of GrafixPLâ„¢PRIME for the Treatment of Chronic Venous Leg Ulcers N/A
Active, not recruiting NCT02397226 - Lower Limb Venous Insufficiency and the Effect of Radiofrequency Treatment Versus Open Surgery N/A
Not yet recruiting NCT01110512 - Comparative Efficacy of Two Preparations of the Association Diosmin (450 mg) + Hesperidin (50 mg) in the Treatment of Chronic Venous Insufficiency (CVI) Phase 3
Completed NCT00565604 - Safety and Efficacy of Endovenous Laser Ablation for the Resolution of Incompetent Perforator Veins N/A
Completed NCT01298908 - Comparison of Treatments in Venous Insufficiency N/A
Active, not recruiting NCT00841178 - Endovenous Laser Therapy (EVLT) for Sapheno-Popliteal Incompetence and Short Saphenous Vein (SSV) Reflux: A RCT N/A
Not yet recruiting NCT03652025 - The Effectiveness of Trans-catheter Foam Sclerotherapy of Pelvic and Atypical Lower Limb Varicosities N/A
Completed NCT03755180 - Exercise Training in Venous Insufficiency N/A