Fibromyalgia Treatment Trial With Gabapentin and Osteopathic Manipulative Medicine

NCT ID: NCT01107574

Last Updated: 2013-08-28

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

PHASE3

Total Enrollment

41 participants

Study Classification

INTERVENTIONAL

Study Start Date

2004-04-30

Study Completion Date

2010-04-30

Brief Summary

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This study assesses the benefits of intervention with gabapentin, Osteopathic Manipulative Medicine or both for improvement of the symptoms of Fibromyalgia. This study also seeks to determine whether these treatments will decrease the number and severity of tender points, improve structure, function and the overall pain level of each patient from the baseline of the study to the end. This study is designed to evaluate whether subjects subjectively experience an improved quality of life and increased function as a result of these interventions corresponding to objective improvements.

Detailed Description

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An 8-week, randomized, study was designed to compare gabapentin (900 mg/day) (n = 8 patients) with OMM (n = 11 patients) with Combined treatment of gabapentin (900 mg/day) plus OMM (n = 7 patients) for efficacy and safety in treating pain, fatigue, depression and function associated with fibromyalgia.

The primary outcome measures were measured during week 2 and week 8 to evaluate efficacy of each arm and compare efficacy between each arm at improving structure, function and pain. The Baker Wong Brief Pain Inventory (BPI) was evaluated weekly for average pain severity score (range 0-10, where 0 = no pain and 10 = pain as bad as you can imagine). Fibromyalgia Impact Questionnaire (FIQ) a tool that evaluates function and health status was administered at week 2 and week 8 for comparison of functioning at the baseline and end of the study. The total number of Tender Points (0-18) as determined by the American College of Rheumatology was counted at week 2 and week 8 to compare number of tender points from the baseline to the end. Dolorimetry in Kg/cm2 as measured by the Fischer Dolorimeter were measured on the 4 most severe tender points at week 2 and week 8 to compare severity of tender points from baseline to end of study. The Osteopathic Structural Examination which measures free range of motion of joints in degrees was measured with goniometry at week 2 and week 8 to evaluate degrees of free range of motion improved from baseline. The Clinical Global Impression which is a likert scale of 1-5 asking patients to evaluate how they feel about their overall health was taken at week 2 and week 8 to see if overall subjective thoughts of health were improved from baseline.

Conditions

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Fibromyalgia

Keywords

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Chronic Pain, tenderpoints, insomnia, mood disorder, fatigue

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Caregivers Investigators Outcome Assessors

Study Groups

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Gabapentin and Osteopathic Manipulative Medicine

6 weeks of both Gabapentin 900 mg HS given orally was accompanied with Osteopathic Manipulative Medicine treatment 30 minutes weekly to the tender points of the musculoskeletal system of each patient for 6 weeks.

Group Type EXPERIMENTAL

Gabapentin and Osteopathic Manipulative Medicine

Intervention Type OTHER

Combination therapy of gabapentin 900 mg po HS for 6 weeks and Osteopathic Manipulative Medicine 30 minute treatment weekly for each patient based on Osteopathic Structural Examination and Tender point Examination

Gabapentin

Gabapentin was given orally at 900 mg at HS weekly for 6 weeks.

Group Type EXPERIMENTAL

Gabapentin

Intervention Type DRUG

Gabapentin 900 mg po HS for 6 weeks treatment per patients enrolled in the Gabapentin Arm

Osteopathic Manipulative Medicine

6 weeks of Osteopathic Manipulative Medicine Treatment was applied to the patients tender points in the musculoskeletal system weekly by a 30 minute treatment.

Group Type EXPERIMENTAL

Osteopathic Manipulative Medicine

Intervention Type PROCEDURE

Based on Osteopathic Structural Examination and Tender point Examination a 30 minute treatment of Osteopathic Manipulative Medicine was applied to each patient every week for 6 weeks.

Interventions

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Gabapentin

Gabapentin 900 mg po HS for 6 weeks treatment per patients enrolled in the Gabapentin Arm

Intervention Type DRUG

Osteopathic Manipulative Medicine

Based on Osteopathic Structural Examination and Tender point Examination a 30 minute treatment of Osteopathic Manipulative Medicine was applied to each patient every week for 6 weeks.

Intervention Type PROCEDURE

Gabapentin and Osteopathic Manipulative Medicine

Combination therapy of gabapentin 900 mg po HS for 6 weeks and Osteopathic Manipulative Medicine 30 minute treatment weekly for each patient based on Osteopathic Structural Examination and Tender point Examination

Intervention Type OTHER

Other Intervention Names

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Neurontin Osteopathic Manipulation Treatment Combined OMM and Neurontin

Eligibility Criteria

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Inclusion Criteria

* Female or male patients were eligible for the study if they were 18-65 years of age and met the ACR criteria for fibromyalgia (\[1\]).

Exclusion Criteria

* Patients with other rheumatic or medical disorders that contributed to the symptoms of fibromyalgia were excluded.
* Rheumatoid arthritis, inflammatory arthritis, or autoimmune disease;
* Pain from traumatic injury or structural or regional rheumatic disease;
* Rheumatoid arthritis, inflammatory arthritis, or autoimmune disease;
* Unstable medical or psychiatric illness;
* Lifetime history of psychosis, hypomania or mania, epilepsy, or dementia;
* Substance abuse in the last 6 months;
* Serious risk of suicide;
* Pregnancy or breastfeeding;
* Unacceptable contraception in those of childbearing potential;
* Patients who, in the opinion of the investigator, were treatment refractory; and prior failed treatment with gabapentin, pregabalin or OMM.
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Touro University,Vallejo,California

UNKNOWN

Sponsor Role collaborator

Good Samaritan Regional Medical Center, Oregon

OTHER

Sponsor Role lead

Responsible Party

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Cynthia S. Marske DO

Program Director Internal Medicine Residency

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Alejandro Gugliucci, MD, PhD

Role: STUDY_DIRECTOR

Touro University-CA, Vallejo

Locations

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Touro University College of Osteoapathic Medicine

Vallejo, California, United States

Site Status

Countries

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United States

References

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Antai-Otong D. The art of prescribing. Depression and fibromyalgia syndrome (FMS): pharmacologic considerations. Perspect Psychiatr Care. 2005 Jul-Sep;41(3):146-8. doi: 10.1111/j.1744-6163.2005.00028.x. No abstract available.

Reference Type BACKGROUND
PMID: 16138826 (View on PubMed)

Arnold LM, Goldenberg DL, Stanford SB, Lalonde JK, Sandhu HS, Keck PE Jr, Welge JA, Bishop F, Stanford KE, Hess EV, Hudson JI. Gabapentin in the treatment of fibromyalgia: a randomized, double-blind, placebo-controlled, multicenter trial. Arthritis Rheum. 2007 Apr;56(4):1336-44. doi: 10.1002/art.22457.

Reference Type BACKGROUND
PMID: 17393438 (View on PubMed)

Bennett RM. Emerging concepts in the neurobiology of chronic pain: evidence of abnormal sensory processing in fibromyalgia. Mayo Clin Proc. 1999 Apr;74(4):385-98. doi: 10.4065/74.4.385.

Reference Type BACKGROUND
PMID: 10221469 (View on PubMed)

Blunt KL, Rajwani MH, Guerriero RC. The effectiveness of chiropractic management of fibromyalgia patients: a pilot study. J Manipulative Physiol Ther. 1997 Jul-Aug;20(6):389-99.

Reference Type BACKGROUND
PMID: 9272472 (View on PubMed)

Gamber RG, Shores JH, Russo DP, Jimenez C, Rubin BR. Osteopathic manipulative treatment in conjunction with medication relieves pain associated with fibromyalgia syndrome: results of a randomized clinical pilot project. J Am Osteopath Assoc. 2002 Jun;102(6):321-5.

Reference Type BACKGROUND
PMID: 12090649 (View on PubMed)

Hains G, Hains F. A combined ischemic compression and spinal manipulation in the treatment of fibromyalgia: a preliminary estimate of dose and efficacy. J Manipulative Physiol Ther. 2000 May;23(4):225-30.

Reference Type BACKGROUND
PMID: 10820294 (View on PubMed)

Johnson SM, Kurtz ME. Osteopathic manipulative treatment techniques preferred by contemporary osteopathic physicians. J Am Osteopath Assoc. 2003 May;103(5):219-24.

Reference Type BACKGROUND
PMID: 12776762 (View on PubMed)

Maizels M, McCarberg B. Antidepressants and antiepileptic drugs for chronic non-cancer pain. Am Fam Physician. 2005 Feb 1;71(3):483-90.

Reference Type BACKGROUND
PMID: 15712623 (View on PubMed)

McCleane G. Gabapentin reduces chronic benign nociceptive pain: a double-blind, placebo-controlled cross-over study. The Pain Clinic. 2000; 12(2):81-85.

Reference Type BACKGROUND

Noller V, Sprott H. Prospective epidemiological observations on the course of the disease in fibromyalgia patients. J Negat Results Biomed. 2003 Aug 23;2:4. doi: 10.1186/1477-5751-2-4.

Reference Type BACKGROUND
PMID: 12969513 (View on PubMed)

Rivera J, Gonzalez T. The Fibromyalgia Impact Questionnaire: a validated Spanish version to assess the health status in women with fibromyalgia. Clin Exp Rheumatol. 2004 Sep-Oct;22(5):554-60.

Reference Type BACKGROUND
PMID: 15485007 (View on PubMed)

Hansen HC. Treatment of chronic pain with antiepileptic drugs: a new era. South Med J. 1999 Jul;92(7):642-9. doi: 10.1097/00007611-199907000-00001.

Reference Type BACKGROUND
PMID: 10414471 (View on PubMed)

Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990 Feb;33(2):160-72. doi: 10.1002/art.1780330203.

Reference Type BACKGROUND
PMID: 2306288 (View on PubMed)

Related Links

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http://www.tu.edu

Department of Research

Other Identifiers

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04-01-2004

Identifier Type: -

Identifier Source: org_study_id