A Double Blind Placebo Study to Determine the Effectiveness of Theramine on the Management of Chronic Back Pain
Primary Purpose
Chronic Low Back Pain
Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Theramine (A medical food)
Theraprofen
Ibuprofen
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Low Back Pain focused on measuring Medical food, Theramine, Ibuprofen, Amino acids, Convenience Pack Kit
Eligibility Criteria
Inclusion Criteria:
- Back pain lasting greater than six (6) weeks. Pain must be present on at least 5 out of 7 days during each of the two weeks prior to screening visit
- Analgesic medication used to treat pain at least 4 out of last 7 days and at least 10 days in the last month
- Men and non-pregnant, non-lactating women over the age of 18 and under the age of 75, able to read, understand and sign English-language informed consent, with diagnosis of back pain and baseline back pain greater than 40 mm out of 100 mm on visual analog scale
- Those taking an NSAID for pain must discontinue use during a washout period based on the attached five (5) half-lives of drug chart
- If undergoing physical therapy for back pain, therapy must be stable at least three (3) weeks prior to study and remain the same throughout study
- If using psychoactive medication which might have analgesic effects, (i.e. anti-depressants or anti-convulsants-), treatment must be stable for at least three (3) months prior to study
- For men and women of child-bearing potential, must be willing to use adequate contraception and not be pregnant or impregnate their partner during the entire time of study
- Must be willing to commit to all clinical visits during study-related procedures, including required discontinuation (washout) of analgesic or anti-inflammatory medication prior to Day 1 randomization. The patient must agree to using acetaminophen for rescue medication
Exclusion Criteria:
- Patients with back surgery in the past six (6) months
- Patients with significant neurologic impairment, as diagnosed on screening physical examination
- Patients with evidence or history of fracture of the spine in the past year
- Patients not fluent in English
- Use of aspirin for non-arthritic conditions, unless at a dose less than or equal to 325 mg a day, and must be stable for at least one (1) month prior to screening
- Use of controlled substances and/or opiate analgesic for pain, for more than 5 days within the last 30 days prior to screening visit
- Receipt of an oral intramuscular or soft-tissue injection of corticosteroid within one (1) month prior to screening
- Participation in a clinical trial within the one (1) month prior to screening
- History of epidurals in the past three (3) months
- History of alcohol or substance abuse
- Uncontrolled or unstable serious cardiovascular, pulmonary, gastrointestinal or urogenital, endocrine, neurologic or psychiatric disorder
- History of gastrointestinal bleed or documented gastric or duodenal ulcer
Sites / Locations
- Targeted Medical Pharma
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Active Comparator
Active Comparator
Arm Label
Theramine active and ibuprofen placebo
Theramine and Ibuprofen (Theraprofen)
Theramine placebo and Ibuprofen
Arm Description
2 capsules Theramine twice daily with one ibuprofen-like placebo once daily.
Two capsules Theramine twice daily with Ibuprofen 400mg once daily.
Two Theramine-like placebo twice daily and one ibuprofen 400mg.
Outcomes
Primary Outcome Measures
Roland-Morris Lower Back Pain Scale
The primary efficacy outcome will be the change from baseline in awakening stiffness and pain subscale scores obtained from the Roland-Morris Lower Back Pain.
Secondary Outcome Measures
Visual Analog Scale Evaluation
The primary efficacy outcome will be the change from baseline in awakening stiffness and pain subscale scores obtained from the Visual Analog Scale Evaluation.
Oswestry Low Back Pain Scale
Functionality outcomes obtained from the Oswestry Low Back Pain Scale
C-reactive protein
Percent change in c-reactive protein levels from baseline to Day 28.
Interleukin-6
Percent change in Il-6 level from baseline to Day 28.
Amino Acid Panel
Change in amino acid turnover rate from baseline to Day 28.
Full Information
NCT ID
NCT01490905
First Posted
November 22, 2011
Last Updated
December 9, 2011
Sponsor
Targeted Medical Pharma
1. Study Identification
Unique Protocol Identification Number
NCT01490905
Brief Title
A Double Blind Placebo Study to Determine the Effectiveness of Theramine on the Management of Chronic Back Pain
Official Title
A Double Blind Placebo Study to Determine the Effectiveness of Theramine on the Management of Chronic Back Pain
Study Type
Interventional
2. Study Status
Record Verification Date
December 2011
Overall Recruitment Status
Completed
Study Start Date
September 2010 (undefined)
Primary Completion Date
February 2011 (Actual)
Study Completion Date
April 2011 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Targeted Medical Pharma
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This research protocol will compare Theramine to a non-steroidal anti-inflammatory drug (NSAID) in the treatment of chronic back pain. The study will examine the efficacy and tolerability of Theramine alone in patients with chronic back pain in comparison to the NSAID, Ibuprofen, and the co-administration of Ibuprofen with Theramine.
Detailed Description
The diagnosis and management of back pain is a challenge for both primary care physicians and specialists. Establishing an etiology can be difficult and often problematic, with treatment options capable of producing serious and potentially life threatening side effects. Treatments often exert a modest impact on the natural history of the condition. Non-steroidal anti-inflammatory drugs (NSAIDs) are frequently prescribed to treat chronic back pain. NSAIDs are only moderately effective in relieving pain. NSAIDs are the leading cause of drug-induced gastrointestinal bleeds, the most common cause of drug-induced morbidity and mortality particularly at high dose. They can also exacerbate hypertension, edema and produce nephrotoxicity. The effects are also dose dependent. Recent data indicates NSAIDs are a risk factor for myocardial infarction, particularly at high doses. Recent data also indicates NSAIDs disrupt collagen repair in injured tissue. Muscle relaxants and narcotic analgesics show limited efficacy and often produce sedation, constipation or inappropriate usage. Physical therapy and local modalities often are not satisfying, costly, and require considerable investment of patient time.
Neurotransmitter depletion has been demonstrated to contribute to chronic pain states. Increased nutrient requirements associated with pain syndromes and the consequent reduced production of neurotransmitters contribute to maladaptive pain responses. The ability to enhance neurotransmitter production associated with pain syndromes is limited by multiple factors, specifically unavailability of adequate essential amino acids in the diet and increased turnover rates of amino acids needed to produce neurotransmitters in pain syndromes. Other factors such as prolonged pharmaceutical use deplete the nerve cells of neurotransmitters. Attempts to modify brain neurochemistry have focused on single neurotransmitters such as serotonin or GABA. However, this approach fails to address the complexity and complementary influences of multiple neurotransmitters on patient perception of pain and suffering.
Theramine is a proprietary prescription Medical Food which concurrently enhances several neurotransmitters that are involved in pain modulation and sensation by providing neurotransmitter precursors in the form of amino acids, (see attached Monograph for detailed discussion). Small trials have found Theramine effective in reducing and modifying pain without demonstrable side effects. Theramine simultaneously stimulates the production of the neurotransmitters serotonin, GABA, brain induced cortisol, nitric oxide, and glutamate.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Low Back Pain
Keywords
Medical food, Theramine, Ibuprofen, Amino acids, Convenience Pack Kit
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
127 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Theramine active and ibuprofen placebo
Arm Type
Active Comparator
Arm Description
2 capsules Theramine twice daily with one ibuprofen-like placebo once daily.
Arm Title
Theramine and Ibuprofen (Theraprofen)
Arm Type
Active Comparator
Arm Description
Two capsules Theramine twice daily with Ibuprofen 400mg once daily.
Arm Title
Theramine placebo and Ibuprofen
Arm Type
Active Comparator
Arm Description
Two Theramine-like placebo twice daily and one ibuprofen 400mg.
Intervention Type
Other
Intervention Name(s)
Theramine (A medical food)
Intervention Description
Theramine two capsules twice daily for 28 days.
Intervention Type
Drug
Intervention Name(s)
Theraprofen
Intervention Description
Theramine two capsules twice daily and ibuprofen 400mg once daily for 28 days.
Intervention Type
Drug
Intervention Name(s)
Ibuprofen
Intervention Description
Ibuprofen 400mg once daily for 28 days.
Primary Outcome Measure Information:
Title
Roland-Morris Lower Back Pain Scale
Description
The primary efficacy outcome will be the change from baseline in awakening stiffness and pain subscale scores obtained from the Roland-Morris Lower Back Pain.
Time Frame
28 Days
Secondary Outcome Measure Information:
Title
Visual Analog Scale Evaluation
Description
The primary efficacy outcome will be the change from baseline in awakening stiffness and pain subscale scores obtained from the Visual Analog Scale Evaluation.
Time Frame
28 days
Title
Oswestry Low Back Pain Scale
Description
Functionality outcomes obtained from the Oswestry Low Back Pain Scale
Time Frame
28 Days
Title
C-reactive protein
Description
Percent change in c-reactive protein levels from baseline to Day 28.
Time Frame
28 Days
Title
Interleukin-6
Description
Percent change in Il-6 level from baseline to Day 28.
Time Frame
28 Days
Title
Amino Acid Panel
Description
Change in amino acid turnover rate from baseline to Day 28.
Time Frame
28 Days
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Back pain lasting greater than six (6) weeks. Pain must be present on at least 5 out of 7 days during each of the two weeks prior to screening visit
Analgesic medication used to treat pain at least 4 out of last 7 days and at least 10 days in the last month
Men and non-pregnant, non-lactating women over the age of 18 and under the age of 75, able to read, understand and sign English-language informed consent, with diagnosis of back pain and baseline back pain greater than 40 mm out of 100 mm on visual analog scale
Those taking an NSAID for pain must discontinue use during a washout period based on the attached five (5) half-lives of drug chart
If undergoing physical therapy for back pain, therapy must be stable at least three (3) weeks prior to study and remain the same throughout study
If using psychoactive medication which might have analgesic effects, (i.e. anti-depressants or anti-convulsants-), treatment must be stable for at least three (3) months prior to study
For men and women of child-bearing potential, must be willing to use adequate contraception and not be pregnant or impregnate their partner during the entire time of study
Must be willing to commit to all clinical visits during study-related procedures, including required discontinuation (washout) of analgesic or anti-inflammatory medication prior to Day 1 randomization. The patient must agree to using acetaminophen for rescue medication
Exclusion Criteria:
Patients with back surgery in the past six (6) months
Patients with significant neurologic impairment, as diagnosed on screening physical examination
Patients with evidence or history of fracture of the spine in the past year
Patients not fluent in English
Use of aspirin for non-arthritic conditions, unless at a dose less than or equal to 325 mg a day, and must be stable for at least one (1) month prior to screening
Use of controlled substances and/or opiate analgesic for pain, for more than 5 days within the last 30 days prior to screening visit
Receipt of an oral intramuscular or soft-tissue injection of corticosteroid within one (1) month prior to screening
Participation in a clinical trial within the one (1) month prior to screening
History of epidurals in the past three (3) months
History of alcohol or substance abuse
Uncontrolled or unstable serious cardiovascular, pulmonary, gastrointestinal or urogenital, endocrine, neurologic or psychiatric disorder
History of gastrointestinal bleed or documented gastric or duodenal ulcer
Facility Information:
Facility Name
Targeted Medical Pharma
City
Los Angeles
State/Province
California
ZIP/Postal Code
90077
Country
United States
12. IPD Sharing Statement
Links:
URL
http://tmedpharma.com
Description
Targeted Medical Pharma
Learn more about this trial
A Double Blind Placebo Study to Determine the Effectiveness of Theramine on the Management of Chronic Back Pain
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