Effectiveness and Safety of Early Intramuscular Botulinum Toxin Injections to Prevent Shoulder Deformity in Babies With Obstetrical Brachial Plexus Palsy

NCT ID: NCT03198702

Last Updated: 2025-02-04

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

RECRUITING

Clinical Phase

PHASE3

Total Enrollment

62 participants

Study Classification

INTERVENTIONAL

Study Start Date

2018-05-17

Study Completion Date

2025-04-30

Brief Summary

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In children population with obstetrical brachial plexus palsy (OBPP), shoulder musculoskeletal deformity is the main cause of morbidity, with a loss of range of shoulder motion, pain and a reduction in social participation. Some uncontrolled studies shows that early injections of botulinum toxin (BTI) in the internal shoulder rotator muscles (which cause the deformity) are one of the most promising treatment for the prevention of bony deformity.

The main objective of this study will be the evaluation of the effectiveness of BTI in the internal shoulder rotator muscles at the age of 12 months in preventing an increase in posterior subluxation of the glenohumeral joint in babies with OBPP (evaluated at the ages of 11 months and 18 months), compared to the Sham group.

Detailed Description

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Conditions

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Obstetrical Brachial Plexus Palsy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

First group or "toxin" group: the babies will receive BOTOX injections at the age of 12 months in the shoulder muscles.

Second group or "sham" group:the babies receive the same procedure but no injection.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Toxin group

The babies receive a botulinum toxin type A injection at the age of 12 months

Group Type EXPERIMENTAL

Botulinum toxin type A injection

Intervention Type DRUG

A total of 8UI/kg will be injected in the internal shoulder rotator muscles: 2UI/kg in the sub scapular muscle, 3UI/kg in the pectoralis major muscle and 3UI/kg in the teres major/latissimus dorsi muscle.

Sham group

The babies receive a simulated injection procedure at the age of 12 months

Group Type SHAM_COMPARATOR

Sham

Intervention Type OTHER

The injection is mimed, the procedure is the same as the botulinum toxin injection.

Interventions

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Botulinum toxin type A injection

A total of 8UI/kg will be injected in the internal shoulder rotator muscles: 2UI/kg in the sub scapular muscle, 3UI/kg in the pectoralis major muscle and 3UI/kg in the teres major/latissimus dorsi muscle.

Intervention Type DRUG

Sham

The injection is mimed, the procedure is the same as the botulinum toxin injection.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Male and female babies with unilateral OBPP
* Age between 10 and 11 months
* Presenting one of 2 risk factors for posterior subluxation of the humeral head (10° less passive external ROM of the affected shoulder compared with the contralateral shoulder and/or a score strictly less than 6 on the AMS for shoulder external rotation and abduction, elbow flexion or supination)
* Signature of the consent form by (the) parent(s) over the age of majority

Exclusion Criteria

* Bilateral OBPP
* Microsurgery or secondary muscle surgery planned between 12 and 18 months of age
* Contraindications to the use of botulinum toxin
* Contraindications to MRI
* MRI not possible in the Paediatric Day Hospital setting because of contraindications to the sedation protocol or due to organisational constraints
* Parents inapt to provide consent for the participation of their child
* Parents under the age of 18 years
Minimum Eligible Age

10 Months

Maximum Eligible Age

11 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University Hospital, Brest

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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CHRU Brest

Brest, , France

Site Status RECRUITING

Institut Régionnal de Réadaptation Centre de Réadaptation pour enfant

Flavigny-sur-Moselle, , France

Site Status NOT_YET_RECRUITING

ESEAN (Etablissement de Santé pour Enfants et Adolescents de la région Nantaise)

Nantes, , France

Site Status NOT_YET_RECRUITING

CHU Nîmes

Nîmes, , France

Site Status RECRUITING

CHU Rennes

Rennes, , France

Site Status RECRUITING

CHU St Etienne

Saint-Etienne, , France

Site Status NOT_YET_RECRUITING

Hôpital national de saint maurice

Saint-Maurice, , France

Site Status RECRUITING

Countries

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France

Central Contacts

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Sylvain Brochard, Pr

Role: CONTACT

(+33) 02 98 22.33.73

Facility Contacts

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Sylvain BROCHARD, Pr

Role: primary

02 98 22 33 73

Chritelle PONS, Dr

Role: backup

02 98 22 33 73

Jennifer BASTIEN, Dr

Role: primary

03 54 59 19 33

Fanny DALMONT, Dr

Role: backup

03 54 59 19 50

Guy LETELLIER, Dr

Role: primary

Mélanie PORTE, Dr

Role: primary

04 66 68 68 68

Philippe VIOLAS, Dr

Role: primary

02 99 28 43 21

Madeleine ASLAN, Dr

Role: primary

04 77 82 80 37

Vincent GAUTHERON, Pr

Role: backup

04 77 82 80 00

Nathaly QUINTERO, Dr

Role: primary

01 43 96 63 50

Anne-Gaëlle PY, Dr

Role: backup

References

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Pons C, Eddi D, Le Gal G, Garetier M, Ben Salem D, Houx L, Fitoussi F, Quintero N, Brochard S; POPB-TOX Group. Effectiveness and safety of early intramuscular botulinum toxin injections to prevent shoulder deformity in babies with brachial plexus birth injury (POPB-TOX), a randomised controlled trial: study protocol. BMJ Open. 2019 Sep 30;9(9):e032901. doi: 10.1136/bmjopen-2019-032901.

Reference Type DERIVED
PMID: 31575585 (View on PubMed)

Other Identifiers

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POPB-TOX RB15.050

Identifier Type: -

Identifier Source: org_study_id

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