Trial Outcomes & Findings for Lumbar Stenosis Outcomes Research (LUSTOR) (NCT NCT00638443)

NCT ID: NCT00638443

Last Updated: 2016-06-20

Results Overview

Using the Numeric Rating Scale (NRS) (0=no pain, 10=worst pain imaginable)the time to first symptoms (Tfirst) with a NRS score greater than or equal to 4 (moderate pain level), with treadmill ambulation was measured.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

29 participants

Primary outcome timeframe

10 days

Results posted on

2016-06-20

Participant Flow

Participants were recruited from the Neuromedicine Pain Treatment Center between May 2008 and February 2010

33 participants recruited; 4 excluded (did not meet inclusion criteria based on evoked pain being less than moderate intensity during treadmill ambulation).

Participant milestones

Participant milestones
Measure
Pregabalin First, Diphenhydramine Second
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days; washout 7 days; Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days
Diphenhydramine First, Pregabalin Second
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days; washout 7 days; Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
First Intervention
STARTED
14
15
First Intervention
COMPLETED
12
14
First Intervention
NOT COMPLETED
2
1
Washout
STARTED
12
14
Washout
COMPLETED
12
14
Washout
NOT COMPLETED
0
0
Second Intervention
STARTED
12
14
Second Intervention
COMPLETED
12
14
Second Intervention
NOT COMPLETED
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Pregabalin First, Diphenhydramine Second
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days; washout 7 days; Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days
Diphenhydramine First, Pregabalin Second
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days; washout 7 days; Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
First Intervention
Adverse Event
2
1

Baseline Characteristics

Lumbar Stenosis Outcomes Research (LUSTOR)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
All Study Participants
n=29 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days
Age, Categorical
<=18 years
0 Participants
n=5 Participants
Age, Categorical
Between 18 and 65 years
8 Participants
n=5 Participants
Age, Categorical
>=65 years
21 Participants
n=5 Participants
Age, Continuous
69.76 years
STANDARD_DEVIATION 8.22 • n=5 Participants
Sex: Female, Male
Female
9 Participants
n=5 Participants
Sex: Female, Male
Male
20 Participants
n=5 Participants
Region of Enrollment
United States
29 participants
n=5 Participants

PRIMARY outcome

Timeframe: 10 days

Population: The analyses included all enrolled randomized subjects according to the inclusion and exclusion criteria except for the three who withdrew from the trial prior to the completion of the study. One dropped out of the study due to an adverse event (dizziness).

Using the Numeric Rating Scale (NRS) (0=no pain, 10=worst pain imaginable)the time to first symptoms (Tfirst) with a NRS score greater than or equal to 4 (moderate pain level), with treadmill ambulation was measured.

Outcome measures

Outcome measures
Measure
Pregabalin
n=26 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 Participants
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
Time to First Symptoms of Moderate Pain
2.52 minutes
Standard Deviation 2.83
3.06 minutes
Standard Deviation 3.11

SECONDARY outcome

Timeframe: 10 days

Population: Outcome measures were obtained for all subjects as described in the Analysis Population Description of the primary outcome above.

Subjects were instructed to walk on the treadmill and to tell the research coordinator to stop testing when they reached the point at which they typically would need to stop and sit down, or until 15 minutes had elapsed. At defined intervals subjects were asked what their pain level was according to the NRS. When the subject reached their maximum distance, they were asked their NRS score. This was recorded as final pain intensity. Using the Numeric Rating Scale (NRS) (0=no pain, 10=worst pain imaginable)the time to first symptoms (Tfirst) with a NRS score greater than or equal to 4 (moderate pain level), with treadmill ambulation was measured.

Outcome measures

Outcome measures
Measure
Pregabalin
n=26 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 Participants
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
Final Pain as Measured by NRS
1.82 units on a scale
Standard Error .35
1.53 units on a scale
Standard Error .35

SECONDARY outcome

Timeframe: 10 days

Population: Outcome measures were obtained for all subjects as described in the Analysis Population Description of the primary outcome above.

Subjects were instructed to walk on the treadmill and to tell the research coordinator to stop testing when they reached the point at which they typically would need to stop and sit down, or until 15 minutes had elapsed. When the subject reached their maximum distance, the treadmill testing was stopped. This was recorded as total distance based on number of minutes and seconds walked. Minutes was converted to meters based on calculation of defined speed of the treadmill.

Outcome measures

Outcome measures
Measure
Pregabalin
n=26 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 Participants
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
Total Distance
237.49 meters
Standard Error 27.47
261.55 meters
Standard Error 27.47

SECONDARY outcome

Timeframe: 10 days

Population: Outcome measures were obtained for all subjects as described in the Analysis Population Description of the primary outcome above.

After the subject completed the treadmill test they were asked to immediately return to the seated position. At this point a timer was started. When the subjects pain level returned to baseline (level of pain subject felt in a seated position before walking) the time was stopped. This was recorded as recovery time. Maximum recovery time is 15 minutes.

Outcome measures

Outcome measures
Measure
Pregabalin
n=26 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 Participants
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
Recovery Time
2.36 minutes
Standard Error .43
3.15 minutes
Standard Error .43

SECONDARY outcome

Timeframe: 10 days

Population: Outcome measures were obtained for all subjects as described in the Analysis Population Description of the primary outcome above.

Subjects were instructed to walk on the treadmill and to tell the research coordinator to stop testing when they reached the point at which they typically would need to stop and sit down, or until 15 minutes had elapsed. At defined intervals (every 30 seconds) subjects were asked what their pain level was according to the NRS. The area under the curve of present pain intensity multiplied by the amount of time the subject walked.

Outcome measures

Outcome measures
Measure
Pregabalin
n=26 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 Participants
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
Area Under the Curve
100.59 units on a scale * minutes
Standard Error 5.15
95.26 units on a scale * minutes
Standard Error 5.15

SECONDARY outcome

Timeframe: 10 days

Population: Outcome measures were obtained for all subjects as described in the Analysis Population Description of the primary outcome above.

The VAS asked subjects to place a mark indicative of their low back pain during the past day on a 100mm line, with 0mm representing no pain and 100mm representing extreme pain.

Outcome measures

Outcome measures
Measure
Pregabalin
n=26 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 Participants
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
Visual Analog Scale (VAS)
52.31 units on a scale
Standard Deviation 27.49
46.31 units on a scale
Standard Deviation 24.44

SECONDARY outcome

Timeframe: 10 days

Population: Outcome measures were obtained for all subjects as described in the Analysis Population Description of the primary outcome above.

The ODI is a set of 10 questions each with five choices (maximum score of 5 points per question) designed to determine how back pain has affected the ability to manage everyday life (pain intensity, personal care, lifting, walking, sitting, standing, sleeping, social life, traveling, and change positions). A total score range of 0-50; score of 0 indicates no disability and a score of 50 would indicate 100% disability.

Outcome measures

Outcome measures
Measure
Pregabalin
n=26 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 Participants
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
Oswestry Disability Index (ODI) Score
37.77 units on a scale
Standard Error 2.76
36.49 units on a scale
Standard Error 2.76

SECONDARY outcome

Timeframe: 10 days

Population: Outcome measures were obtained for all subjects as described in the Analysis Population Description of the primary outcome above.

The SSS is a series of questions asking about symptom severity, physical function, and satisfaction. The symptom severity section is a set of 7 questions (maximum score is 5 points per question) and asks to rate pain for each question based on no pain, mild, moderate, severe or very severe pain. The total score (maximum=35) is added up and divided by seven. The maximum score for the symptom severity section (score=5) indicates very severe symptom severity.

Outcome measures

Outcome measures
Measure
Pregabalin
n=26 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 Participants
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
Swiss Spinal Stenosis (SSS) Score- Symptom Severity
3.09 units on a scale
Standard Error .12
2.94 units on a scale
Standard Error .12

SECONDARY outcome

Timeframe: 10 days

Population: Outcome measures were obtained for all subjects as described in the Analysis Population Description of the primary outcome above.

The SSS is a series of questions asking about symptom severity, physical function, and satisfaction. The physical function section is a series of 5 questions (maximum 4 points per question) and asks to rate function for each question based on comfortably, sometimes with pain, always with pain, no functional ability. The total score (max=20) is divided by five. The maximum score for the physical function section (max=4) indicates no ability to function.

Outcome measures

Outcome measures
Measure
Pregabalin
n=26 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 Participants
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
Swiss Spinal Stenosis- Physical Function
2.40 units on a scale
Standard Error 0.09
2.94 units on a scale
Standard Error 0.09

SECONDARY outcome

Timeframe: 10 days

Population: Outcome measures were obtained for all subjects as described in the Analysis Population Description of the primary outcome above.

The mBPI is a series of questions that rates the severity and impact of pain on daily function. The questionnaire is made up of 4 pain severity items using the NRS scale, and seven pain interference sub-scales. The final interference score is an average of the seven sub-scales (0 indicating no interference and 10 indicating complete interference).

Outcome measures

Outcome measures
Measure
Pregabalin
n=26 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 Participants
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
Modified Brief Pain Inventory (mBPI)- Interference Score
3.70 units on a scale
Standard Error 0.42
3.58 units on a scale
Standard Error 0.42

SECONDARY outcome

Timeframe: 10 days

Population: Outcome measures were obtained for all subjects as described in the Analysis Population Description of the primary outcome above.

The RMDQ consists of 24 yes/no statements about activity limitations due to back pain. These questions center on movement, ambulation, and self-care activities. Positive (yes) answers each contribute 1 point to cumulative score with total scores ranging from 0 (no disability) to 24 (severely disabled).

Outcome measures

Outcome measures
Measure
Pregabalin
n=26 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 Participants
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
Roland Morris Disability Questionnaire
12.98 units on a scale
Standard Error .92
11.48 units on a scale
Standard Error .92

SECONDARY outcome

Timeframe: 10 days

Population: Outcome measures were obtained for all subjects as described in the Analysis Population Description of the primary outcome above.

Subjects were asked to rate their low back pain according to the PGA. PGA is the impact of disease activity. PGA was measured on a 5-point scale, where 1=very good, 2=good, 3=fair, 4=poor, and 5=very poor.

Outcome measures

Outcome measures
Measure
Pregabalin
n=26 Participants
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 Participants
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
Patient Global Assessment (PGA)
2.75 units on a scale
Standard Error .19
2.83 units on a scale
Standard Error 0.19

Adverse Events

Pregabalin

Serious events: 0 serious events
Other events: 15 other events
Deaths: 0 deaths

Diphenhydramine

Serious events: 0 serious events
Other events: 6 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Pregabalin
n=26 participants at risk
Pregabalin started at 75mg twice daily for 3 days; pregabalin increased to 150mg twice daily for 7 days; pregabalin reduced to 75mg twice daily for 3 days.
Diphenhydramine
n=26 participants at risk
Diphenhydramine started at 6.25mg twice daily for 3 days; diphenhydramine increased to 12.5mg twice daily for 7 days; diphenhydramine reduced to 6.25mg twice daily for 3 days.
General disorders
Dizziness
34.6%
9/26 • Number of events 9
0.00%
0/26
Gastrointestinal disorders
Diarrhea
11.5%
3/26 • Number of events 3
7.7%
2/26 • Number of events 2
General disorders
Somnolence
19.2%
5/26 • Number of events 5
7.7%
2/26 • Number of events 2
General disorders
Dry mouth
15.4%
4/26 • Number of events 4
0.00%
0/26
Gastrointestinal disorders
Nausea
3.8%
1/26 • Number of events 1
7.7%
2/26 • Number of events 2
Skin and subcutaneous tissue disorders
Peripheral edema
19.2%
5/26 • Number of events 5
3.8%
1/26 • Number of events 1

Additional Information

John Markman, MD

University of Rochester

Phone: 585-340-8926

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place