Degenerative Joint Disease Clinical Trial
Official title:
Platelet-Rich Plasma Versus Corticosteroid Injection as Treatment for Degenerative Pathology of the Temporomandibular Joint
NCT number | NCT01920373 |
Other study ID # | 468485 |
Secondary ID | |
Status | Withdrawn |
Phase | Phase 1 |
First received | August 8, 2013 |
Last updated | March 10, 2015 |
Start date | November 2013 |
Verified date | March 2015 |
Source | Kaiser Permanente |
Contact | n/a |
Is FDA regulated | No |
Health authority | United States: Food and Drug Administration |
Study type | Interventional |
1.0 BACKGROUND AND HYPOTHESES
1.1 Osteoarthritis is a continuous and entirely physiologic adaptive process that occurs in
every joint. These include the replication of cells that produce matrix, enzymes, protease
inhibitors, cytokines, and other peptides. Along with the synthesis of new tissue there is a
release of breakdown products into the synovial fluid. Enzymes and phagocytes are required
to clear these breakdown products. Normal tissue turnover involves synthesis and breakdown
in well-regulated balance. In the degenerative state this balance is upset producing
inflammation-derived alterations to the synovium, cartilage, capsule, tendons, and bone.
Common causes of such alterations include increased loading, physical stress, and traumatic
injury to the joint.
1.2 The rationale for the use of corticosteroids in temporomandibular joint therapy is that
they inhibit prostaglandin synthesis and decrease the activity of collagenase and other
enzymes that degrade the articular cartilage. Platelet rich plasma is a novel therapeutic
agent that has several potential advantages over corticosteroids for the treatment of
degenerative pathology of the temporomandibular joint. Platelet rich plasma has been shown
to have anti-inflammatory, analgesic, and anti-bacterial properties. It also restores
intra-articular hyaluronic acid, increases glycosaminoglycan condrocyte synthesis, balances
joint angiogenesis, and provides a scaffold for stem cell migration. Autologous platelet
rich plasma injections for treatment of knee cartilage degenerative lesions and
osteoarthritis have shown longer efficacy than hyaluronic acid injections in reducing pain
and recovering articular function. Similarly, platelet rich plasma has shown to have better
outcomes than corticosteroid injections in the management of lateral epicondylitis, and
better outcomes than hyaluronic acid injections in the management of osteochondral lesions
of the talus.
1.3 Current treatments for degeneration and osteoarthritis of the temporomandibular joint
are focused primarily on palliation by reducing inflammation and inflammatory mediators.
This study seeks to validate a therapeutic agent that has the potential to actively prevent
the progression of degeneration in addition to reducing pain and inflammation
Status | Withdrawn |
Enrollment | 0 |
Est. completion date | |
Est. primary completion date | November 2013 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | Both |
Age group | N/A and older |
Eligibility |
Inclusion Criteria: The following diagnostic criteria for patient selection are to be
used: - Patients will need to have a history of chronic pain (at least 3 months) refractory to conservative therapy with non-steroidal anti-inflammatory medications, muscle relaxants, diet modifications and splint therapy - Patients will also need to have imaging findings (radiography or magnetic resonance imaging) that show mild to severe degenerative changes of the temporomandibular joint Exclusion Criteria: Exclusion criteria will include - Patients with systemic disorders such as rheumatic diseases, hematologic diseases, active infections, immunosuppression - Patients receiving therapy with anticoagulants |
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Subject), Primary Purpose: Health Services Research
Country | Name | City | State |
---|---|---|---|
United States | Kaiser Permanente Los Angeles Medical Center | Los Angeles | California |
Lead Sponsor | Collaborator |
---|---|
Kaiser Permanente |
United States,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Pain relief | Changes in pain relief will be evaluated at 1, 3, and six month intervals using the Pain resource centers TMJ scale. | 24 weeks | No |
Secondary | Improvement in function | The patients improvement in function will be evaluated at 1,3, and 6 months for improvement using the pain resource centers TMJ scale. | 24 weeks | No |
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