Hyaluronan in the Treatment of Painful Achilles Tendinopathy.
Primary Purpose
Tendinopathy
Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
hyaluronic acid sodium salt
ESWT
Sponsored by
About this trial
This is an interventional treatment trial for Tendinopathy focused on measuring tendinopathy, hyaluronan, tendon, hyaluronic acid, extracorporeal shock wave
Eligibility Criteria
Inclusion Criteria:
- Male and female patients between 18 and 75 years of age.
- Good general health condition.
- Signed written informed consent.
- Painful Achilles midportion tendinopathy since more or equal than 6 weeks.
- Pain according to VAS (Huskisson, 100 mm) more or equal than 40 mm.
- Ensured compliance of subjects over the whole study period.
Exclusion Criteria:
- Concomitant or previous participation in a clinical investigation within the last 3 months prior to study inclusion.
- Infection or relevant skin disease at study relevant site.
- Blood coagulation disorder or intake of blood thinner (e.g. Marcumar).
- Known hypersensitivity to hyaluronic acid (HA) preparations or to the constituents mannitol, sodium chloride, disodium phosphate and sodium dihydrogenphosphate.
- Contra-indications for ESWT application in study relevant area (e.g. recent surgery, malignant tumour, local osteomyelitis or open epiphysis).
- Severe intercurrent illness (e.g. uncontrolled diabetes mellitus, peripheral neuropathy), which in the opinion of the investigator, may put the patient at risk when participating in the study, or affect the patient's ability to take part in the study.
- Concomitant disease at study relevant site (e.g. insertion tendinopathy at Achilles tendon) influencing study evaluation.
- Diseases or characteristics judged by the investigator to be incompatible with the assessments and/or procedures for the study evaluation.
- Intake of concomitant medications not allowed which might interfere with the functional assessment of the study (e.g. immunosuppressive drugs within the last 3 months).
- Previous therapies (except non-steroidal anti-inflammatory drugs (NSAID)) at study relevant site within the last 4 weeks prior to study inclusion.
- Use of NSAIDs within the last week prior to study treatment.
- Recent history of drug and/or alcohol abuse (within the last 6 months).
- Pregnant or lactating females.
- Participants of childbearing age (pre-menopausal) who do not accept the use of methods of birth control with pearl index of at least 1 (i.e. oral contraceptives, vaginal ring, hormone-releasing Intrauterine Device (IUD), implants, depot syringes, hormone patch, double barrier method, tubal ligation, vasectomised partner,…) during the treatment period and the first 4 weeks of follow-up period.
- Subjects not capable of contracting and of understanding the nature, risks, significance and implications of the clinical investigation and unable to form a rational intention in the light of these facts.
- Subjects unable to understand informed consent or having a high probability of non compliance to the study procedures and / or non completion of the study according to investigator's judgement (e.g. illiteracy, insufficient knowledge of local language).
Sites / Locations
- Universitair Ziekenhuis Antwerpen, Fysische Geneeskunde en Revalidatie
- Praxiszentrum Orthopädie-Unfallchirurgie Nordrhein
Arms of the Study
Arm 1
Arm 2
Arm Type
Other
Active Comparator
Arm Label
ESWT (Extracorporal Shock Wave Therapy)
hyaluronic acid sodium salt
Arm Description
Three applications in weekly interval.
Two injections of 2% (40 milligrams (mg) / 2 millilitres (ml)) hyaluronan in weekly interval.
Outcomes
Primary Outcome Measures
Victorian Institute of Sports Assessment-Achilles (VISA-A score)
The validated questionnaire will be used to evaluate the outcome in Achilles tendinopathy. The score ranges from '0' to '100' whereas '0' denotes 'no activity / maximum pain' and '100' denote 'maximum activity / no pain'.
Secondary Outcome Measures
Victorian Institute of Sports Assessment-Achilles (VISA-A score)
The validated questionnaire will be used to evaluate the outcome in Achilles tendinopathy. The score ranges from '0' to '100' whereas '0' denotes 'no activity / maximum pain' and '100' denote 'maximum activity / no pain'.
Victorian Institute of Sports Assessment-Achilles (VISA-A score)
The validated questionnaire will be used to evaluate the outcome in Achilles tendinopathy. The score ranges from '0' to '100' whereas '0' denotes 'no activity / maximum pain' and '100' denote 'maximum activity / no pain'.
Victorian Institute of Sports Assessment-Achilles (VISA-A score)
The validated questionnaire will be used to evaluate the outcome in Achilles tendinopathy. The score ranges from '0' to '100' whereas '0' denotes 'no activity / maximum pain' and '100' denote 'maximum activity / no pain'.
Victorian Institute of Sports Assessment-Achilles (VISA-A score)
The validated questionnaire will be used to evaluate the outcome in Achilles tendinopathy. The score ranges from '0' to '100' whereas '0' denotes 'no activity / maximum pain' and '100' denote 'maximum activity / no pain'.
Visual Analogue Scale of pain (VAS; 100 mm)
Intensity of pain will be evaluated on the Huskisson VAS pain scale on which 0 mm indicate 'no pain' and 100 mm indicate 'extreme pain'.
Visual Analogue Scale of pain (VAS; 100 mm)
Intensity of pain will be evaluated on the Huskisson VAS pain scale on which 0 mm indicate 'no pain' and 100 mm indicate 'extreme pain'.
Visual Analogue Scale of pain (VAS; 100 mm)
Intensity of pain will be evaluated on the Huskisson VAS pain scale on which 0 mm indicate 'no pain' and 100 mm indicate 'extreme pain'.
Visual Analogue Scale of pain (VAS; 100 mm)
Intensity of pain will be evaluated on the Huskisson VAS pain scale on which 0 mm indicate 'no pain' and 100 mm indicate 'extreme pain'.
Visual Analogue Scale of pain (VAS; 100 mm)
Intensity of pain will be evaluated on the Huskisson VAS pain scale on which 0 mm indicate 'no pain' and 100 mm indicate 'extreme pain'.
Patient's and investigator's global evaluation of study-relevant tendon complaints
Measured by Clinical Global Impression (CGI) 7-point scale, ranking from 'very much improved' to 'very much worse' condition.
Patient's and investigator's global evaluation of study-relevant tendon complaints
Measured by Clinical Global Impression (CGI) 7-point scale, ranking from 'very much improved' to 'very much worse' condition.
Patient's and investigator's global evaluation of study-relevant tendon complaints
Measured by Clinical Global Impression (CGI) 7-point scale, ranking from 'very much improved' to 'very much worse' condition.
Patient's and investigator's global evaluation of study-relevant tendon complaints
Measured by Clinical Global Impression (CGI) 7-point scale, ranking from 'very much improved' to 'very much worse' condition.
Clinical Parameters
Redness
Warmth
Swelling
Tenderness on palpation
Crepitus on motion
Accumulation of tissue fluid
Measured by 5-point scale, ranking from 'none' to 'extreme' intensity.
Clinical Parameters
Redness
Warmth
Swelling
Tenderness on palpation
Crepitus on motion
Accumulation of tissue fluid
Measured by 5-point scale, ranking from 'none' to 'extreme' intensity.
Clinical Parameters
Redness
Warmth
Swelling
Tenderness on palpation
Crepitus on motion
Accumulation of tissue fluid
Measured by 5-point scale, ranking from 'none' to 'extreme' intensity.
Clinical Parameters
Redness
Warmth
Swelling
Tenderness on palpation
Crepitus on motion
Accumulation of tissue fluid
Measured by 5-point scale, ranking from 'none' to 'extreme' intensity.
Clinical Parameters
Redness
Warmth
Swelling
Tenderness on palpation
Crepitus on motion
Accumulation of tissue fluid
Measured by 5-point scale, ranking from 'none' to 'extreme' intensity.
Frequency of test product-related Adverse Events
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01954108
Brief Title
Hyaluronan in the Treatment of Painful Achilles Tendinopathy.
Official Title
Hyaluronan in the Treatment of Painful Achilles Tendinopathy.
Study Type
Interventional
2. Study Status
Record Verification Date
November 2015
Overall Recruitment Status
Completed
Study Start Date
December 2013 (undefined)
Primary Completion Date
July 2015 (Actual)
Study Completion Date
October 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
TRB Chemedica AG
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The primary objective of this study is to compare OSTENIL® TENDON (2% hyaluronan) and Extracorporeal Shock Wave (ESWT) therapy in the treatment of painful Achilles tendinopathy.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Tendinopathy
Keywords
tendinopathy, hyaluronan, tendon, hyaluronic acid, extracorporeal shock wave
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
62 (Actual)
8. Arms, Groups, and Interventions
Arm Title
ESWT (Extracorporal Shock Wave Therapy)
Arm Type
Other
Arm Description
Three applications in weekly interval.
Arm Title
hyaluronic acid sodium salt
Arm Type
Active Comparator
Arm Description
Two injections of 2% (40 milligrams (mg) / 2 millilitres (ml)) hyaluronan in weekly interval.
Intervention Type
Device
Intervention Name(s)
hyaluronic acid sodium salt
Other Intervention Name(s)
OSTENIL® TENDON
Intervention Type
Device
Intervention Name(s)
ESWT
Primary Outcome Measure Information:
Title
Victorian Institute of Sports Assessment-Achilles (VISA-A score)
Description
The validated questionnaire will be used to evaluate the outcome in Achilles tendinopathy. The score ranges from '0' to '100' whereas '0' denotes 'no activity / maximum pain' and '100' denote 'maximum activity / no pain'.
Time Frame
Day 90 (plus or minus 3 days)
Secondary Outcome Measure Information:
Title
Victorian Institute of Sports Assessment-Achilles (VISA-A score)
Description
The validated questionnaire will be used to evaluate the outcome in Achilles tendinopathy. The score ranges from '0' to '100' whereas '0' denotes 'no activity / maximum pain' and '100' denote 'maximum activity / no pain'.
Time Frame
Day 0
Title
Victorian Institute of Sports Assessment-Achilles (VISA-A score)
Description
The validated questionnaire will be used to evaluate the outcome in Achilles tendinopathy. The score ranges from '0' to '100' whereas '0' denotes 'no activity / maximum pain' and '100' denote 'maximum activity / no pain'.
Time Frame
Day 7 (plus or minus 1 day)
Title
Victorian Institute of Sports Assessment-Achilles (VISA-A score)
Description
The validated questionnaire will be used to evaluate the outcome in Achilles tendinopathy. The score ranges from '0' to '100' whereas '0' denotes 'no activity / maximum pain' and '100' denote 'maximum activity / no pain'.
Time Frame
Day 28 (plus or minus 3 days)
Title
Victorian Institute of Sports Assessment-Achilles (VISA-A score)
Description
The validated questionnaire will be used to evaluate the outcome in Achilles tendinopathy. The score ranges from '0' to '100' whereas '0' denotes 'no activity / maximum pain' and '100' denote 'maximum activity / no pain'.
Time Frame
Day 180 (plus or minus 3 days)
Title
Visual Analogue Scale of pain (VAS; 100 mm)
Description
Intensity of pain will be evaluated on the Huskisson VAS pain scale on which 0 mm indicate 'no pain' and 100 mm indicate 'extreme pain'.
Time Frame
Day 0
Title
Visual Analogue Scale of pain (VAS; 100 mm)
Description
Intensity of pain will be evaluated on the Huskisson VAS pain scale on which 0 mm indicate 'no pain' and 100 mm indicate 'extreme pain'.
Time Frame
Day 7 (plus or minus 1 day)
Title
Visual Analogue Scale of pain (VAS; 100 mm)
Description
Intensity of pain will be evaluated on the Huskisson VAS pain scale on which 0 mm indicate 'no pain' and 100 mm indicate 'extreme pain'.
Time Frame
Day 28 (plus or minus 3 days)
Title
Visual Analogue Scale of pain (VAS; 100 mm)
Description
Intensity of pain will be evaluated on the Huskisson VAS pain scale on which 0 mm indicate 'no pain' and 100 mm indicate 'extreme pain'.
Time Frame
Day 90 (plus or minus 3 days)
Title
Visual Analogue Scale of pain (VAS; 100 mm)
Description
Intensity of pain will be evaluated on the Huskisson VAS pain scale on which 0 mm indicate 'no pain' and 100 mm indicate 'extreme pain'.
Time Frame
Day 180 (plus or minus 3 days)
Title
Patient's and investigator's global evaluation of study-relevant tendon complaints
Description
Measured by Clinical Global Impression (CGI) 7-point scale, ranking from 'very much improved' to 'very much worse' condition.
Time Frame
Day 7 (plus or minus 1 day)
Title
Patient's and investigator's global evaluation of study-relevant tendon complaints
Description
Measured by Clinical Global Impression (CGI) 7-point scale, ranking from 'very much improved' to 'very much worse' condition.
Time Frame
Day 28 (plus or minus 3 days)
Title
Patient's and investigator's global evaluation of study-relevant tendon complaints
Description
Measured by Clinical Global Impression (CGI) 7-point scale, ranking from 'very much improved' to 'very much worse' condition.
Time Frame
Day 90 (plus or minus 3 days)
Title
Patient's and investigator's global evaluation of study-relevant tendon complaints
Description
Measured by Clinical Global Impression (CGI) 7-point scale, ranking from 'very much improved' to 'very much worse' condition.
Time Frame
Day 180 (plus or minus 3 days)
Title
Clinical Parameters
Description
Redness
Warmth
Swelling
Tenderness on palpation
Crepitus on motion
Accumulation of tissue fluid
Measured by 5-point scale, ranking from 'none' to 'extreme' intensity.
Time Frame
Day 0
Title
Clinical Parameters
Description
Redness
Warmth
Swelling
Tenderness on palpation
Crepitus on motion
Accumulation of tissue fluid
Measured by 5-point scale, ranking from 'none' to 'extreme' intensity.
Time Frame
Day 7 (plus or minus 1 day)
Title
Clinical Parameters
Description
Redness
Warmth
Swelling
Tenderness on palpation
Crepitus on motion
Accumulation of tissue fluid
Measured by 5-point scale, ranking from 'none' to 'extreme' intensity.
Time Frame
Day 28 (plus or minus 3 days)
Title
Clinical Parameters
Description
Redness
Warmth
Swelling
Tenderness on palpation
Crepitus on motion
Accumulation of tissue fluid
Measured by 5-point scale, ranking from 'none' to 'extreme' intensity.
Time Frame
Day 90 (plus or minus 3 days)
Title
Clinical Parameters
Description
Redness
Warmth
Swelling
Tenderness on palpation
Crepitus on motion
Accumulation of tissue fluid
Measured by 5-point scale, ranking from 'none' to 'extreme' intensity.
Time Frame
Day 180 (plus or minus 3 days)
Title
Frequency of test product-related Adverse Events
Time Frame
Up to Day 180
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:
Male and female patients between 18 and 75 years of age.
Good general health condition.
Signed written informed consent.
Painful Achilles midportion tendinopathy since more or equal than 6 weeks.
Pain according to VAS (Huskisson, 100 mm) more or equal than 40 mm.
Ensured compliance of subjects over the whole study period.
Exclusion Criteria:
Concomitant or previous participation in a clinical investigation within the last 3 months prior to study inclusion.
Infection or relevant skin disease at study relevant site.
Blood coagulation disorder or intake of blood thinner (e.g. Marcumar).
Known hypersensitivity to hyaluronic acid (HA) preparations or to the constituents mannitol, sodium chloride, disodium phosphate and sodium dihydrogenphosphate.
Contra-indications for ESWT application in study relevant area (e.g. recent surgery, malignant tumour, local osteomyelitis or open epiphysis).
Severe intercurrent illness (e.g. uncontrolled diabetes mellitus, peripheral neuropathy), which in the opinion of the investigator, may put the patient at risk when participating in the study, or affect the patient's ability to take part in the study.
Concomitant disease at study relevant site (e.g. insertion tendinopathy at Achilles tendon) influencing study evaluation.
Diseases or characteristics judged by the investigator to be incompatible with the assessments and/or procedures for the study evaluation.
Intake of concomitant medications not allowed which might interfere with the functional assessment of the study (e.g. immunosuppressive drugs within the last 3 months).
Previous therapies (except non-steroidal anti-inflammatory drugs (NSAID)) at study relevant site within the last 4 weeks prior to study inclusion.
Use of NSAIDs within the last week prior to study treatment.
Recent history of drug and/or alcohol abuse (within the last 6 months).
Pregnant or lactating females.
Participants of childbearing age (pre-menopausal) who do not accept the use of methods of birth control with pearl index of at least 1 (i.e. oral contraceptives, vaginal ring, hormone-releasing Intrauterine Device (IUD), implants, depot syringes, hormone patch, double barrier method, tubal ligation, vasectomised partner,…) during the treatment period and the first 4 weeks of follow-up period.
Subjects not capable of contracting and of understanding the nature, risks, significance and implications of the clinical investigation and unable to form a rational intention in the light of these facts.
Subjects unable to understand informed consent or having a high probability of non compliance to the study procedures and / or non completion of the study according to investigator's judgement (e.g. illiteracy, insufficient knowledge of local language).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Thierry De Vroey, Dr. med.
Organizational Affiliation
Universitair Ziekenhuis Antwerpen, Fysische Geneeskunde en Revalidatie
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Nils Lynen, Dr. med.
Organizational Affiliation
Praxiszentrum Orthopädie-Unfallchirurgie Nordrhein
Official's Role
Principal Investigator
Facility Information:
Facility Name
Universitair Ziekenhuis Antwerpen, Fysische Geneeskunde en Revalidatie
City
Edegem
ZIP/Postal Code
2650
Country
Belgium
Facility Name
Praxiszentrum Orthopädie-Unfallchirurgie Nordrhein
City
Aachen
State/Province
Nordrhein-Westfalen
ZIP/Postal Code
52062
Country
Germany
12. IPD Sharing Statement
Citations:
PubMed Identifier
27639439
Citation
Lynen N, De Vroey T, Spiegel I, Van Ongeval F, Hendrickx NJ, Stassijns G. Comparison of Peritendinous Hyaluronan Injections Versus Extracorporeal Shock Wave Therapy in the Treatment of Painful Achilles' Tendinopathy: A Randomized Clinical Efficacy and Safety Study. Arch Phys Med Rehabil. 2017 Jan;98(1):64-71. doi: 10.1016/j.apmr.2016.08.470. Epub 2016 Sep 14.
Results Reference
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Hyaluronan in the Treatment of Painful Achilles Tendinopathy.
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