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Safety and Efficacy of Fluoxetine in Juvenile Fibromyalgia

Primary Purpose

Juvenile Primary Fibromyalgia Syndrome (JPFS), Fibromyalgia

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Fluoxetine
Sponsored by
University of Cincinnati
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Juvenile Primary Fibromyalgia Syndrome (JPFS) focused on measuring Fibromyalgia, Juvenile

Eligibility Criteria

13 Years - 18 Years (Child, Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria: Female or male outpatients 13 to 18 years of age. Fulfillment of the American College of Rheumatology (ACR) criteria for primary fibromyalgia. Ability to understand and cooperate with study procedures. Provision of parental written informed consent and verbal and written assent from the adolescent for participation in the study. Exclusion Criteria: Unwillingness or inability on the part of the parent to provide written informed consent or for the adolescent to provide verbal and written assent. Lifetime history of psychosis, hypomania or mania. Diagnosis of alcohol or substance abuse or dependence within 6 months prior to screening visit. Patients judged to be at serious suicide or homicide risk. Girls who are pregnant or lactating. Girls of childbearing potential who are not using a medically accepted method of contraception (including barrier or hormonal methods). Clinically unstable medical or psychiatric conditions that could interfere with the absorption, metabolism, excretion, or safety of fluoxetine or interfere with the assessment of disease severity. Inability to exclude traumatic injury, regional or structural rheumatic disease, or infectious arthropathy as the etiology of their relevant fibromyalgia symptoms and that would interfere with interpretation of outcome measures (e.g., osteoarthritis, bursitis, tendonitis). History of an autoimmune disease or inflammatory arthritis, such as systemic lupus erythematosis (SLE) or rheumatoid arthritis (RA). Treatment with a monoamine oxidase inhibitor, tricyclic, selective serotonin reuptake inhibitor (SSRI) antidepressant, or lithium within 2 weeks prior to beginning study medication. Treatment with analgesic medication (with the exception of acetaminophen and over-the-counter NSAIDs) within one week prior to beginning study medication. Treatment with any other excluded medication that cannot be discontinued at the screening visit. Previous treatment with fluoxetine. Treatment with any investigational medications within 30 days prior to screening.

Sites / Locations

  • Women's Health Research Program

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Fluoxetine

Arm Description

All eligible patients were started on Fluoxetine at 10 mg once daily. The dose was flexibly dosed based on pain efficacy and tolerability to a final dose between 10 and 60 mg once daily.

Outcomes

Primary Outcome Measures

Average Pain Severity Score
The primary outcome measure was average pain severity on the Pediatric Pain Questionnaire's 100-mm visual analog scale. (0=no pain and 100 = severe pain )

Secondary Outcome Measures

The Clinical Global Impression of Severity
Measures severity of illness at the time of the assessment on a scale of 1 (normal, not at all ill) to 7 (among the most extremely ill).
The Patient Global Impression of Improvement
Measures the patient's impression of improvement since baseline on a scale of 1 (very much better) to 7 (very much worse).
The Functional Disability Inventory-child Version
A self-report inventory that assesses patients' ability to perform a variety of daily physical, social, and recreational activities. The scale ranges from 0 (no disability) to 60 (severe disability).
The Functional Disability Inventory-parent Version
Consists of the same 15 items as the child version but allows the parent to provide their perception of the child's difficulty in performing daily physical, social, and recreational activities. The score ranges from 0 (no disability) to 60 (severe disability).
Children's Depression Inventory
A 27-item, self-report measure of depressive symptoms with a score range of 0 (no depressive symptoms) to 54 (severe depressive symptoms.
Multidimensional Anxiety Scale for Children
A 39-item self-report inventory that assesses four areas of anxiety symptoms (emotional, cognitive, physical, and behavioral). Score ranges from 0 (no anxiety symptoms) to 117 (severe anxiety symptoms).
Fibromyalgia Impact Questionnaire Modified for Children
A 19 item self-report instrument that measures overall impact of fibromyalgia including assessments of function, pain, fatigue, sleep quality, stiffness, anxiety and depression. Score range from 0 (no impact) to 100 (severe impact).

Full Information

First Posted
June 26, 2005
Last Updated
February 6, 2017
Sponsor
University of Cincinnati
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1. Study Identification

Unique Protocol Identification Number
NCT00115804
Brief Title
Safety and Efficacy of Fluoxetine in Juvenile Fibromyalgia
Official Title
An Open-Label Clinical Trial of Fluoxetine Treatment of Juvenile Primary Fibromyalgia Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
February 2017
Overall Recruitment Status
Completed
Study Start Date
June 2005 (undefined)
Primary Completion Date
February 2011 (Actual)
Study Completion Date
February 2011 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Cincinnati

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this research is to conduct an open, pilot trial to assess the efficacy and safety of fluoxetine in the treatment of Juvenile Primary Fibromyalgia Syndrome (JPFS).
Detailed Description
Fibromyalgia is a common condition that is often challenging to treat. It is defined by the American College of Rheumatology (ACR) as widespread pain of at least 3 months duration in combination with tenderness at 11 or more of 18 specific tender point sites on the body. The prevalence of JPFS in children and adolescents in the general population of the United States is unknown. Studies from Israel, Mexico, and Italy have estimated that the prevalence rate of JPFS in school children ranges from 1.24% to 6.20%, with girls making up the majority of cases. Information from a national registry in the United States indicates that JPFS accounts for about 7.7% of new patient diagnoses in a pediatric rheumatology setting. The mean age of onset of pediatric JPFS is 12 years. As in adults, JPFS has been diagnosed in children and adolescents using the ACR criteria. JPFS often leads to substantial morbidity and disability. For example, adolescents with JPFS reported significantly greater functional disability and greater number of school absences than those with other rheumatic diseases such as juvenile RA or lupus. The presence of high levels of pain and disability at this critical developmental stage place adolescents with JPFS at greater risk for long term social and occupational difficulties. Early diagnosis and effective intervention are therefore of critical importance.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Juvenile Primary Fibromyalgia Syndrome (JPFS), Fibromyalgia
Keywords
Fibromyalgia, Juvenile

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Masking Description
Open Label
Allocation
N/A
Enrollment
6 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Fluoxetine
Arm Type
Experimental
Arm Description
All eligible patients were started on Fluoxetine at 10 mg once daily. The dose was flexibly dosed based on pain efficacy and tolerability to a final dose between 10 and 60 mg once daily.
Intervention Type
Drug
Intervention Name(s)
Fluoxetine
Other Intervention Name(s)
Prozac
Intervention Description
Fluoxetine po 10-60 mg/day for 12 weeks. Fluoxetine was started at 10 mg once daily. The dose was flexibly dosed based on pain efficacy and tolerability to a final dose between 10 and 60 mg once daily
Primary Outcome Measure Information:
Title
Average Pain Severity Score
Description
The primary outcome measure was average pain severity on the Pediatric Pain Questionnaire's 100-mm visual analog scale. (0=no pain and 100 = severe pain )
Time Frame
Daily on average in the past week.
Secondary Outcome Measure Information:
Title
The Clinical Global Impression of Severity
Description
Measures severity of illness at the time of the assessment on a scale of 1 (normal, not at all ill) to 7 (among the most extremely ill).
Time Frame
at the time of the assessment
Title
The Patient Global Impression of Improvement
Description
Measures the patient's impression of improvement since baseline on a scale of 1 (very much better) to 7 (very much worse).
Time Frame
since baseline, at the time of the assessment
Title
The Functional Disability Inventory-child Version
Description
A self-report inventory that assesses patients' ability to perform a variety of daily physical, social, and recreational activities. The scale ranges from 0 (no disability) to 60 (severe disability).
Time Frame
Over the "last few days."
Title
The Functional Disability Inventory-parent Version
Description
Consists of the same 15 items as the child version but allows the parent to provide their perception of the child's difficulty in performing daily physical, social, and recreational activities. The score ranges from 0 (no disability) to 60 (severe disability).
Time Frame
Over the "last few days."
Title
Children's Depression Inventory
Description
A 27-item, self-report measure of depressive symptoms with a score range of 0 (no depressive symptoms) to 54 (severe depressive symptoms.
Time Frame
Over the past 2 weeks.
Title
Multidimensional Anxiety Scale for Children
Description
A 39-item self-report inventory that assesses four areas of anxiety symptoms (emotional, cognitive, physical, and behavioral). Score ranges from 0 (no anxiety symptoms) to 117 (severe anxiety symptoms).
Time Frame
Over the past week.
Title
Fibromyalgia Impact Questionnaire Modified for Children
Description
A 19 item self-report instrument that measures overall impact of fibromyalgia including assessments of function, pain, fatigue, sleep quality, stiffness, anxiety and depression. Score range from 0 (no impact) to 100 (severe impact).
Time Frame
Over the past week.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
13 Years
Maximum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female or male outpatients 13 to 18 years of age. Fulfillment of the American College of Rheumatology (ACR) criteria for primary fibromyalgia. Ability to understand and cooperate with study procedures. Provision of parental written informed consent and verbal and written assent from the adolescent for participation in the study. Exclusion Criteria: Unwillingness or inability on the part of the parent to provide written informed consent or for the adolescent to provide verbal and written assent. Lifetime history of psychosis, hypomania or mania. Diagnosis of alcohol or substance abuse or dependence within 6 months prior to screening visit. Patients judged to be at serious suicide or homicide risk. Girls who are pregnant or lactating. Girls of childbearing potential who are not using a medically accepted method of contraception (including barrier or hormonal methods). Clinically unstable medical or psychiatric conditions that could interfere with the absorption, metabolism, excretion, or safety of fluoxetine or interfere with the assessment of disease severity. Inability to exclude traumatic injury, regional or structural rheumatic disease, or infectious arthropathy as the etiology of their relevant fibromyalgia symptoms and that would interfere with interpretation of outcome measures (e.g., osteoarthritis, bursitis, tendonitis). History of an autoimmune disease or inflammatory arthritis, such as systemic lupus erythematosis (SLE) or rheumatoid arthritis (RA). Treatment with a monoamine oxidase inhibitor, tricyclic, selective serotonin reuptake inhibitor (SSRI) antidepressant, or lithium within 2 weeks prior to beginning study medication. Treatment with analgesic medication (with the exception of acetaminophen and over-the-counter NSAIDs) within one week prior to beginning study medication. Treatment with any other excluded medication that cannot be discontinued at the screening visit. Previous treatment with fluoxetine. Treatment with any investigational medications within 30 days prior to screening.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Lesley M Arnold, M.D.
Organizational Affiliation
Women's Health Research Program
Official's Role
Principal Investigator
Facility Information:
Facility Name
Women's Health Research Program
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45219
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety and Efficacy of Fluoxetine in Juvenile Fibromyalgia

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