Validity and Reliability of Diagnostic Findings of SI Joint Blocking (VaReFi)
Primary Purpose
SI Joint Pain
Status
Terminated
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
0.75% bupivacaine
.75% bupivacaine
.75% bupivacaine
Sponsored by
About this trial
This is an interventional diagnostic trial for SI Joint Pain focused on measuring SI joint pain, SI joint dysfunction, degenerative sacroiliitis, sacroiliac joint disruption
Eligibility Criteria
Inclusion Criteria:
- Age 21-75 at time of screening.
- Patient has buttocks, groin and/or leg pain suspected to be from one SI joint (left or right).
- Patient has positive Fortin finger test*.
- Patient has a current average SI joint pain rating of at least 5 on 0-10 numerical rating scale**.
- Patient has at least 3 positive physical SI joint examination findings in the targeted SI joint.
- Investigator believes that diagnostic SI joint block is indicated now, and that no other (hip/back, etc.) diagnostic test is required at this time.
- Patient has signed study-specific informed consent form.
- Patient has the necessary mental capacity to participate and is physically able to comply with study protocol requirements (including avoiding taking pain medication 8 hours prior to and 4 hours after each scheduled block).
Exclusion Criteria:
- Patient has history of any surgical procedure of the targeted SI joint (except for prior RF ablation of the SI joint).
- Patient has suspected bilateral SIJ pain and bilateral injections are indicated.
- Patient has history of chronic pain syndrome (e.g., fibromyalgia).
- Patient has any medical or other condition that would interfere with study participation or data validity.
- Patient is currently pregnant.
- Patient has known allergy to contrast used or local anesthetic used (bupivacaine).
- Patient has had one or more steroid SI joint injection(s) of the targeted side in the last 3 months.
- Patient is a prisoner or a ward of the state.
- Patient is participating in another investigational study related to back or SI joint pain (Exclude if participating in trials other than the SIFI study (NCT01640353) or the INSITE Study (NCT01681004). Subjects on these two SI-BONE sponsored trials may be eligible for VaReFi.)
- Patient is known or suspected drug or alcohol abuser.
- Patient has known or suspected psychiatric disease (e.g., schizophrenia, major depression, personality disorders) that could interfere with study participation .
- Patient is unable to isolate suspected SI joint pain to the SI joint but rather has generalized pain.
- Patient has known or suspected alternative cause for pain at/near SI joint (e.g., lumbar disc degeneration, lumbar facet arthropathy, hip osteoarthritis or labral tear)
Sites / Locations
- Orthopedic Center of Southern Illinois
- Bluegrass Orthopaedics and Hand Care Research, LLC
- Cleveland Clinic
- Penn State College Of Medicine
- Precision Spine Care
- Physicians' Research Options, LLC
- Virginia iSpine Research Institute, Inc
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm Type
Active Comparator
Active Comparator
Active Comparator
Arm Label
1st sequence
2nd sequence
3rd sequence
Arm Description
Blinded 3 blocks (2 bupivacaine, 1 sham block)
Blinded 3 blocks (2 bupivacaine, 1 sham block)
Blinded 3 blocks (2 bupivacaine, 1 sham block)
Outcomes
Primary Outcome Measures
Numeric Rating Scale
Change in SI joint pain from prior to injection to 30 minutes, 60 minutes, 2 hours, 4 hours after injection. Changes compared over 3 injections, where type of block is blinded.
Is response to bupivacaine different than response to sham block Is response to bupivacaine during second injection similar to that during first injection?
Secondary Outcome Measures
Subgroup analysis by diagnosis at 1 month post 3rd block (7 weeks post 1st injection) and 6 month post 3rd injection visit ( 27 weeks post 1st injection).
Look at responses in patients who have been diagnosed with an SI joint condition vs. patients who have no SI joint condition diagnosis.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01874236
Brief Title
Validity and Reliability of Diagnostic Findings of SI Joint Blocking
Acronym
VaReFi
Official Title
VaReFi Validity and Reliability of Diagnostic Findings of SI Joint Blocking
Study Type
Interventional
2. Study Status
Record Verification Date
September 2019
Overall Recruitment Status
Terminated
Why Stopped
Data could not be interpreted. Re-design efforts failed.
Study Start Date
April 22, 2013 (Actual)
Primary Completion Date
September 30, 2014 (Actual)
Study Completion Date
September 30, 2014 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
SI-BONE, Inc.
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The purpose of the trial is to confirm the validity and reliability of diagnostic SI joint blocks.
Detailed Description
Subjects with suspected SI joint pain will undergo 3 SI joint blocks, 2 with local anesthetic and 1 sham block.
The sequence of blocks is randomly assigned. This study examines both the test-retest reliability of response to diagnostic sacroiliac (SI) joint injection and the specificity of response to local anesthetic or sham block. The goal of the study is to validate the use of diagnostic SI joint block.
Subjects with pain suspected to be generated by one SI joint will undergo three diagnostic SI joint blocks each separated by one week. Two blocks will be with local anesthetic (LA) and one will be a sham block (SB). Both the Coordinator (collecting pain assessments) and subject will be blinded to the sequence of blocks (LA or SB each time). The sequence of blocks will be randomly assigned for each subject on study. The subject's participation in the study is complete after 6-month post-procedure assessment.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
SI Joint Pain
Keywords
SI joint pain, SI joint dysfunction, degenerative sacroiliitis, sacroiliac joint disruption
7. Study Design
Primary Purpose
Diagnostic
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
28 (Actual)
8. Arms, Groups, and Interventions
Arm Title
1st sequence
Arm Type
Active Comparator
Arm Description
Blinded 3 blocks (2 bupivacaine, 1 sham block)
Arm Title
2nd sequence
Arm Type
Active Comparator
Arm Description
Blinded 3 blocks (2 bupivacaine, 1 sham block)
Arm Title
3rd sequence
Arm Type
Active Comparator
Arm Description
Blinded 3 blocks (2 bupivacaine, 1 sham block)
Intervention Type
Drug
Intervention Name(s)
0.75% bupivacaine
Other Intervention Name(s)
Blinded 3 blocks (2 bupivacaine, 1 sham block)
Intervention Description
Week 1: SI joint injection with .75% bupivacaine Week 2: SI joint injection with .75% bupivacaine Week 3: SI joint sham block
Intervention Type
Drug
Intervention Name(s)
.75% bupivacaine
Other Intervention Name(s)
Blinded 3 blocks (2 bupivacaine, 1 sham block)
Intervention Description
Week 1: SI join sham block Week 2: SI joint injection with .75% bupivacaine Week 3: SI joint injection with .75% bupivacaine
Intervention Type
Drug
Intervention Name(s)
.75% bupivacaine
Other Intervention Name(s)
Blinded 3 blocks (2 .75% bupivacaine, 1 sham block)
Intervention Description
Week 1: SI join injection with .75% bupivacaine Week 2: SI join sham block Week 3: SI joint injection with .75% bupivacaine
Primary Outcome Measure Information:
Title
Numeric Rating Scale
Description
Change in SI joint pain from prior to injection to 30 minutes, 60 minutes, 2 hours, 4 hours after injection. Changes compared over 3 injections, where type of block is blinded.
Is response to bupivacaine different than response to sham block Is response to bupivacaine during second injection similar to that during first injection?
Time Frame
Baseline, 30 minutes and 60 minutes, 2 and 4 hours post injection (x 3 injections, each 1 week apart), and 1 month post 3rd injection visit (7 weeks post 1st injection).
Secondary Outcome Measure Information:
Title
Subgroup analysis by diagnosis at 1 month post 3rd block (7 weeks post 1st injection) and 6 month post 3rd injection visit ( 27 weeks post 1st injection).
Description
Look at responses in patients who have been diagnosed with an SI joint condition vs. patients who have no SI joint condition diagnosis.
Time Frame
7 weeks after 1st block & and 27 weeks after 1st block
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age 21-75 at time of screening.
Patient has buttocks, groin and/or leg pain suspected to be from one SI joint (left or right).
Patient has positive Fortin finger test*.
Patient has a current average SI joint pain rating of at least 5 on 0-10 numerical rating scale**.
Patient has at least 3 positive physical SI joint examination findings in the targeted SI joint.
Investigator believes that diagnostic SI joint block is indicated now, and that no other (hip/back, etc.) diagnostic test is required at this time.
Patient has signed study-specific informed consent form.
Patient has the necessary mental capacity to participate and is physically able to comply with study protocol requirements (including avoiding taking pain medication 8 hours prior to and 4 hours after each scheduled block).
Exclusion Criteria:
Patient has history of any surgical procedure of the targeted SI joint (except for prior RF ablation of the SI joint).
Patient has suspected bilateral SIJ pain and bilateral injections are indicated.
Patient has history of chronic pain syndrome (e.g., fibromyalgia).
Patient has any medical or other condition that would interfere with study participation or data validity.
Patient is currently pregnant.
Patient has known allergy to contrast used or local anesthetic used (bupivacaine).
Patient has had one or more steroid SI joint injection(s) of the targeted side in the last 3 months.
Patient is a prisoner or a ward of the state.
Patient is participating in another investigational study related to back or SI joint pain (Exclude if participating in trials other than the SIFI study (NCT01640353) or the INSITE Study (NCT01681004). Subjects on these two SI-BONE sponsored trials may be eligible for VaReFi.)
Patient is known or suspected drug or alcohol abuser.
Patient has known or suspected psychiatric disease (e.g., schizophrenia, major depression, personality disorders) that could interfere with study participation .
Patient is unable to isolate suspected SI joint pain to the SI joint but rather has generalized pain.
Patient has known or suspected alternative cause for pain at/near SI joint (e.g., lumbar disc degeneration, lumbar facet arthropathy, hip osteoarthritis or labral tear)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Aaron Calodney, MD
Organizational Affiliation
Texas Spine and Joint Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Orthopedic Center of Southern Illinois
City
Mount Vernon
State/Province
Illinois
ZIP/Postal Code
62864
Country
United States
Facility Name
Bluegrass Orthopaedics and Hand Care Research, LLC
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40509
Country
United States
Facility Name
Cleveland Clinic
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44195
Country
United States
Facility Name
Penn State College Of Medicine
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Facility Name
Precision Spine Care
City
Tyler
State/Province
Texas
ZIP/Postal Code
75701
Country
United States
Facility Name
Physicians' Research Options, LLC
City
Sandy
State/Province
Utah
ZIP/Postal Code
84070
Country
United States
Facility Name
Virginia iSpine Research Institute, Inc
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23235
Country
United States
12. IPD Sharing Statement
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Validity and Reliability of Diagnostic Findings of SI Joint Blocking
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