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Treatment for Sacroiliac Joint Pain Using Platelet-rich Plasma (PRP) Versus Steroid/Anesthetic

Primary Purpose

Low Back Pain, Sacroiliac Joint Synovitis

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Sacroiliac intra-articular injection
Sponsored by
University of Utah
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Low Back Pain

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  • Adult (>18 y/o) males and females referred for therapeutic injection to the investigators spine interventional service by a physiatrist or pain anesthesiologist with a clinical diagnosis of SIJ pain confirmed by history
  • 50% or greater reduction in pain by a diagnostic anesthetic block using no more than 1.5 cc 2% lidocaine performed under imaging guidance by a pain interventionalist (PM&R, Pain Anesthesia, or Neuroradiology Spine Intervention).
  • Baseline pain must be >/=4 by numeric rating scale (NRS), at least 6 weeks in chronicity, and must not be multi-factorial (related to radiculopathy or axial pain localizing elsewhere) by physical examination or confounding medical history (infection, inflammatory spondyloarthropathy, or osseous metastatic disease).

Exclusion Criteria:

  • SIJ steroid treatment within the prior 6 months.
  • Patients with a history of infection currently on antibiotic therapy
  • Usage of systemic immunosuppressants
  • Pregnancy

Sites / Locations

  • University of UtahRecruiting
  • Veterans Administration Salt Lake City Health Care SystemRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Platelet-rich Plasma

Steroid/Anesthetic

Arm Description

Patients will receive an intra-articular injection 3 mL of autologous platelet-rich plasma in the sacroiliac joint.

Patients will receive an intra-articular injection 40 mg Depo-medrol mixed with 2 mL 0.25% bupivicaine in the sacroiliac joint.

Outcomes

Primary Outcome Measures

Numeric Rating Scale
Validated pain scale rating pain on a scale of 0 through 10. 0 for no pain, and 10 for the highest pain the patient can imagine.

Secondary Outcome Measures

Modified Oswestry Disability Questionnaire
Validated questionnaire used to evaluate function in patients with low back pain. The final score/index ranges from 0-100. A score of 0-20 reflects minimal disability, 21-40 moderate disability, 41-60 severe disability, 61-80 crippled, and 81-100 bed-bound.
Short-Form 12 Survey
Validated survey used to evaluate function in patients with low back pain. Scores range from 0 to 100, with higher scores indicating better physical and mental health functioning.
Functional testing
2 validated tests for low back pain "get up and go," "5 time sit to stand." Shorter times indicate better physical function, and longer times indicate poorer physical function.
Opiate/pain medication usage questionnaire
Questionnaire on type, dose, and frequency of pain medications being used by the patient. All opiates will be converted to the morphine milligram equivalent scale with lower values indicating lower opiate content and higher values indicating higher opiate content

Full Information

First Posted
October 20, 2021
Last Updated
October 17, 2023
Sponsor
University of Utah
Collaborators
Radiological Society of North America
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1. Study Identification

Unique Protocol Identification Number
NCT05121961
Brief Title
Treatment for Sacroiliac Joint Pain Using Platelet-rich Plasma (PRP) Versus Steroid/Anesthetic
Official Title
Treatment for Sacroiliac Joint Pain Using Platelet-rich Plasma (PRP) Regenerative Therapy: A Randomized Controlled Trial in Comparison With Steroid/Anesthetic Injection With Advanced MR Analysis
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
February 22, 2020 (Actual)
Primary Completion Date
June 30, 2024 (Anticipated)
Study Completion Date
June 30, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Utah
Collaborators
Radiological Society of North America

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to determine if platelet-rich plasma is superior to steroid/anesthetic for the treatment of sacroiliac joint pain.
Detailed Description
All patients with sacroiliac joint pain diagnosed by a back pain specialist will undergo physical examination maneuvers and a test lidocaine injection of the joint. Patients who meet eligibility requirements will be randomized in a single-blind randomized controlled manner with a 50% chance of receiving platelet-rich plasma versus steroid/anesthetic injection of the sacroiliac joint(s).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Low Back Pain, Sacroiliac Joint Synovitis

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Single-blind randomized controlled trial
Masking
Participant
Masking Description
Patients will be blinded to which injectate they received.
Allocation
Randomized
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Platelet-rich Plasma
Arm Type
Experimental
Arm Description
Patients will receive an intra-articular injection 3 mL of autologous platelet-rich plasma in the sacroiliac joint.
Arm Title
Steroid/Anesthetic
Arm Type
Active Comparator
Arm Description
Patients will receive an intra-articular injection 40 mg Depo-medrol mixed with 2 mL 0.25% bupivicaine in the sacroiliac joint.
Intervention Type
Procedure
Intervention Name(s)
Sacroiliac intra-articular injection
Intervention Description
CT guided injection of platelet-rich plasma versus steroid/anesthetic into the sacroiliac joint
Primary Outcome Measure Information:
Title
Numeric Rating Scale
Description
Validated pain scale rating pain on a scale of 0 through 10. 0 for no pain, and 10 for the highest pain the patient can imagine.
Time Frame
Change between baseline and 3-months post-intervention
Secondary Outcome Measure Information:
Title
Modified Oswestry Disability Questionnaire
Description
Validated questionnaire used to evaluate function in patients with low back pain. The final score/index ranges from 0-100. A score of 0-20 reflects minimal disability, 21-40 moderate disability, 41-60 severe disability, 61-80 crippled, and 81-100 bed-bound.
Time Frame
Change between baseline and 3-months post-intervention
Title
Short-Form 12 Survey
Description
Validated survey used to evaluate function in patients with low back pain. Scores range from 0 to 100, with higher scores indicating better physical and mental health functioning.
Time Frame
Change between baseline and 3-months post-intervention
Title
Functional testing
Description
2 validated tests for low back pain "get up and go," "5 time sit to stand." Shorter times indicate better physical function, and longer times indicate poorer physical function.
Time Frame
Change between baseline and 3-months post-intervention
Title
Opiate/pain medication usage questionnaire
Description
Questionnaire on type, dose, and frequency of pain medications being used by the patient. All opiates will be converted to the morphine milligram equivalent scale with lower values indicating lower opiate content and higher values indicating higher opiate content
Time Frame
Change between baseline and 3-months post-intervention

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult (>18 y/o) males and females referred for therapeutic injection to the investigators spine interventional service by a physiatrist or pain anesthesiologist with a clinical diagnosis of SIJ pain confirmed by history 50% or greater reduction in pain by a diagnostic anesthetic block using no more than 1.5 cc 2% lidocaine performed under imaging guidance by a pain interventionalist (PM&R, Pain Anesthesia, or Neuroradiology Spine Intervention). Baseline pain must be >/=4 by numeric rating scale (NRS), at least 6 weeks in chronicity, and must not be multi-factorial (related to radiculopathy or axial pain localizing elsewhere) by physical examination or confounding medical history (infection, inflammatory spondyloarthropathy, or osseous metastatic disease). Exclusion Criteria: SIJ steroid treatment within the prior 6 months. Patients with a history of infection currently on antibiotic therapy Usage of systemic immunosuppressants Pregnancy
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Mariya A Chadovich
Phone
801-916-0582
Email
Mariya.Chadovich@hsc.utah.edu
First Name & Middle Initial & Last Name or Official Title & Degree
Suyi Niu
Phone
801-585-1021
Email
Suyi.Niu@hsc.utah.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Miriam Peckham, MD
Organizational Affiliation
University of Utah
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84132
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mariya Chadovich
Phone
801-916-0582
Email
Mariya.Chadovich@hsc.utah.edu
First Name & Middle Initial & Last Name & Degree
Suyi Niu
Phone
801-585-1021
Email
Suyi.Niu@hsc.utah.edu
First Name & Middle Initial & Last Name & Degree
Miriam Peckham, MD
First Name & Middle Initial & Last Name & Degree
Zachary McCormick, MD
First Name & Middle Initial & Last Name & Degree
Lubdha Shah, MD
First Name & Middle Initial & Last Name & Degree
Troy Hutchins, MD
First Name & Middle Initial & Last Name & Degree
Yoshimi Anzai, MD
Facility Name
Veterans Administration Salt Lake City Health Care System
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84148
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Mariya Chadovich
Phone
801-916-0582
Email
Mariya.Chadovich@hsc.utah.edu
First Name & Middle Initial & Last Name & Degree
Suyi Niu
Phone
801-585-1021
Email
Suyi.Niu@hsc.utah.edu
First Name & Middle Initial & Last Name & Degree
Miriam Peckham, MD
First Name & Middle Initial & Last Name & Degree
Lubdha Shah, MD
First Name & Middle Initial & Last Name & Degree
Troy Hutchins, MD
First Name & Middle Initial & Last Name & Degree
Yoshimi Anzai, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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Treatment for Sacroiliac Joint Pain Using Platelet-rich Plasma (PRP) Versus Steroid/Anesthetic

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