Evaluation of Post Burn Rehabilitation Population for Itch Control

NCT ID: NCT00782054

Last Updated: 2008-10-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE4

Total Enrollment

23 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-09-30

Study Completion Date

2008-04-30

Brief Summary

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Severe itching following burn injury is a common complication. As many as 87% of burn patients report severe itching. The intense itching can increase anxiety and can interfere with sleep and normal activities of daily living thus affecting quality of life. Often the itching will become so intense patients will scratch or rub the skin until an open wound develops. Current treatment for itching includes antihistamines, steroids. and/or moisturizers, but too often, the patient does not receive relief, even from drugs, and suffers undesirable side effects.

Swiss-American Products, Inc, has developed a new skin moisturizer containing a blend of endopeptidase enzymes. These products have resolved itching in other types of skin disease such as dermatitis. The hypothesis that itching can be reduced through the use of these endopeptidase enzyme containing products in the post burn population will be tested.

Detailed Description

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The mechanism of pruritus is poorly understood, but much stems from the inflammatory process during wound healing. Damaged nerve endings, substance P, mast cells releasing histamines, and presence of inflammatory prostaglandins can induce neuropathic and peripheral pruritoceptive itching. Absence of oil glands leading to dry skin and itching further aggravate the itching.

Swiss-American Products, Inc, has developed new non-prescription skin products containing a blend of endopeptidase enzymes in a moisturizer base to aid the body during recovery from injury and inflammation. In Stage II and III pressure ulcers, an amorphous hydrogel containing the enzymes was observed to help resolve inflammation and enhance healing. Anecdotal reports indicate a fast release cream with the enzymes, applied to insect stings and bites on intact skin resolved the itching and reduced, sometimes even preventing, edema. In a case study of chronic persistent contact dermatitis, one product was successfully used for immediate relief of pruritus and the slow release version was used for relief at night. Several centers have independently reported the resolution of pruritus associated with cellulitis in subjects with chronic wounds.

The hypothesis that itching can be reduced through the use of endopeptidase enzyme containing product in the post burn population will be tested. The use of the product has not been previously evaluated in burn subjects with pruritus. The primary objective of the preliminarily study would be to detect reduction of post burn itching through the use of the endopeptidase enzyme containing product.

Conditions

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Pruritus Itching Burn Pruritus

Keywords

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pruritus itch burn endopeptidase moisturizer randomized controlled

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Active

moisturizer with endopeptidases

Group Type ACTIVE_COMPARATOR

Provase

Intervention Type OTHER

NDC:60230-8573-0 Over the counter (OTC) moisturizer containing 2% dimethicone and a blend of endopeptidases. Use topically to affected area every 8 hours.

Placebo

moisturizer without endopeptidases

Group Type PLACEBO_COMPARATOR

Control moisturizer

Intervention Type OTHER

Over the counter (OTC) moisturizer containing 2% dimethicone. Use topically to affected area every 8 hours. Does NOT contain endopeptidases. Placebo intervention is identical to active intervention EXCEPT it does not contain endopeptidases.

Interventions

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Provase

NDC:60230-8573-0 Over the counter (OTC) moisturizer containing 2% dimethicone and a blend of endopeptidases. Use topically to affected area every 8 hours.

Intervention Type OTHER

Control moisturizer

Over the counter (OTC) moisturizer containing 2% dimethicone. Use topically to affected area every 8 hours. Does NOT contain endopeptidases. Placebo intervention is identical to active intervention EXCEPT it does not contain endopeptidases.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Post burn subject must be experiencing pruritus as defined by
* at least three episodes of itch during the past week AND
* itching occurs at least twice during the episode day AND
* itching lasts for more than 5 minutes and is bothersome
* TBSA of burn is between 10 and 70%
* Currently performing rehabilitation at Villa Medica Rehabilitation Hospital
* Subject available for 4 weeks
* Test area has complete epithelialization
* Subject is willing to complete daily diary
* Subject is male or female and over 18 years of age

Exclusion Criteria

* Subject will be excluded if pruritus is of nonburn etiology
* Subject requires topical steroids, topical antihistamines, or other topical medication and such medication cannot be discontinued
* Subject with known sensitivity to the enzyme papain or to the papaya fruit
* Subject requires immunosuppressives such as systemic steroid therapy, cancer chemotherapeutic agents
* Subject presently requires morphine for pain relief
* Subject is a known alcohol or drug abuser
* Subject is unable to communicate pain and itch scores or medication used
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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McGill University

OTHER

Sponsor Role collaborator

Hospital de readaptation Villa Medica

UNKNOWN

Sponsor Role collaborator

Precision Consulting

UNKNOWN

Sponsor Role collaborator

Swiss-American Products, Inc

INDUSTRY

Sponsor Role lead

Responsible Party

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Hospital de readaptation Villa Medica

Principal Investigators

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Leo LaSalle, M.D.

Role: PRINCIPAL_INVESTIGATOR

Villa Medica Rehabilitation Hospital

Bernadette Nedelec, BSc, OT, PhD

Role: STUDY_CHAIR

McGill University

Locations

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Villa Medica Rehabilitation Hospital

Montreal, Quebec, Canada

Site Status

Countries

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Canada

References

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Field T, Peck M, Scd, Hernandez-Reif M, Krugman S, Burman I, Ozment-Schenck L. Postburn itching, pain, and psychological symptoms are reduced with massage therapy. J Burn Care Rehabil. 2000 May-Jun;21(3):189-93. doi: 10.1067/mbc.2000.105087.

Reference Type BACKGROUND
PMID: 10850898 (View on PubMed)

Dunnick CA, Gibran NS, Heimbach DM. Substance P has a role in neurogenic mediation of human burn wound healing. J Burn Care Rehabil. 1996 Sep-Oct;17(5):390-6. doi: 10.1097/00004630-199609000-00004.

Reference Type BACKGROUND
PMID: 8889861 (View on PubMed)

Yosipovitch G, Fleischer A. Itch associated with skin disease: advances in pathophysiology and emerging therapies. Am J Clin Dermatol. 2003;4(9):617-22. doi: 10.2165/00128071-200304090-00004.

Reference Type BACKGROUND
PMID: 12926980 (View on PubMed)

Matheson JD, Clayton J, Muller MJ. The reduction of itch during burn wound healing. J Burn Care Rehabil. 2001 Jan-Feb;22(1):76-81; discussion 75. doi: 10.1097/00004630-200101000-00017.

Reference Type BACKGROUND
PMID: 11227690 (View on PubMed)

Baker RA, Zeller RA, Klein RL, Thornton RJ, Shuber JH, Marshall RE, Leibfarth AG, Latko JA. Burn wound itch control using H1 and H2 antagonists. J Burn Care Rehabil. 2001 Jul-Aug;22(4):263-8. doi: 10.1097/00004630-200107000-00003.

Reference Type BACKGROUND
PMID: 11482684 (View on PubMed)

Parnell LK, Ciufi B, Gokoo CF. Preliminary use of a hydrogel containing enzymes in the treatment of stage II and stage III pressure ulcers. Ostomy Wound Manage. 2005 Aug;51(8):50-60.

Reference Type BACKGROUND
PMID: 16234576 (View on PubMed)

Barnett L, Parnell LK. Contact dermatitis treated with new topical products: a case study. Ostomy Wound Manage. 2001 Sep;47(9):47-53.

Reference Type BACKGROUND
PMID: 11889744 (View on PubMed)

Yosipovitch G, Goon AT, Wee J, Chan YH, Zucker I, Goh CL. Itch characteristics in Chinese patients with atopic dermatitis using a new questionnaire for the assessment of pruritus. Int J Dermatol. 2002 Apr;41(4):212-6. doi: 10.1046/j.1365-4362.2002.01460.x.

Reference Type BACKGROUND
PMID: 12031029 (View on PubMed)

Yosipovitch G, Zucker I, Boner G, Gafter U, Shapira Y, David M. A questionnaire for the assessment of pruritus: validation in uremic patients. Acta Derm Venereol. 2001 May;81(2):108-11. doi: 10.1080/00015550152384236.

Reference Type BACKGROUND
PMID: 11501646 (View on PubMed)

Nedelec B, Shankowsky HA, Tredget EE. Rating the resolving hypertrophic scar: comparison of the Vancouver Scar Scale and scar volume. J Burn Care Rehabil. 2000 May-Jun;21(3):205-12. doi: 10.1067/mbc.2000.104750.

Reference Type BACKGROUND
PMID: 10850901 (View on PubMed)

Related Links

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http://www.mcgill.ca

McGill University Homepage

http://www.villamedica.ca

Villa Medica Rehabilitation Hospital Homepage

Other Identifiers

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C-05-08573

Identifier Type: -

Identifier Source: org_study_id