Lidocaine Patch 1.8% for Moderate to Severe Pain From Carpal Tunnel Syndrome
NCT ID: NCT04245371
Last Updated: 2023-06-08
Study Results
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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COMPLETED
PHASE4
45 participants
INTERVENTIONAL
2020-02-24
2023-05-07
Brief Summary
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Detailed Description
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For all measures, participants will serve as their own matched control. Comparisons will be made between significant improvements on active versus placebo treatment arms. The first two-week treatment period is Arm 1; the second two-week period is considered the cross-over arm.
Participants failing treatment will be offered standard of care treatment of steroid injection. All participants will wear a brace for the duration of the study per standard clinical practice.
Conditions
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Study Design
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RANDOMIZED
CROSSOVER
TREATMENT
TRIPLE
Study Groups
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Active
Lidocaine Patch 1.8% applied to affected hand at night for 2 weeks following FDA approved dosing recommendations, i.e. 12 hours during each 24-hour daily cycle.
Lidocaine 1.8%
Topical Patch
Placebo
Placebo Patch applied to affected hand at night for 2 weeks for 12 hours during each 24-hour daily cycle.
Placebo
Matching Placebo Patch
Interventions
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Lidocaine 1.8%
Topical Patch
Placebo
Matching Placebo Patch
Eligibility Criteria
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Inclusion Criteria
* Participants with Carpal Tunnel Syndrome, confirmed by CT6;
* Pain score of at least 4, based on an 11-point numeric rating scale (NRS) (scale of 0-10), at the screening (baseline) visit;
* Able and willing to provide a written informed consent;
* Able and willing to follow study instructions;
* Able and willing to return to clinic for follow-up visits;
* Able and willing to complete a daily diary;
* Intact skin over the affected wrist;
* Woman of childbearing age agreeing to use 2 forms of contraception.
Exclusion Criteria
* Participants must not have pain at other sites that interfere with their ability to report site-specific pain related to the study (bilateral CT is an exclusion);
* Participants must NOT have cognitive or psychological impairment that interferes with the ability to complete study related assessments;
* Participants with mild (NRS less than 4) or no pain (only numbness) at baseline prior to randomization;
* Opioid tolerance (receiving at least 1 week of oral morphine 60 mg/day OR transdermal fentanyl 25 mcg/hour OR oral oxycodone 30 mg/day OR oral hydromorphone 8 mg/day OR an equianalgesic dose of any other opioid);
* History of sensitivity or allergy to lidocaine or ZTLIDO;
* Irritated, abraded, or otherwise non-intact skin over the affected wrist;
* Concurrently taking tocainide, mexiletine, or local anesthetics;
* Participants with history of or at significant risk for methemoglobinemia;
* Participation in another study of investigational drugs or devices within 30 days before screening, or previous participation in a Lidocaine Patch study;
* Known to or suspected of not being able to comply with the study protocol;
* Any clinically significant condition that would, in the investigator's opinion, preclude study participation for instance alcohol, medication or drug dependency, neurotic personality, psychiatric illness, epilepsy or suicide risk;
* Pregnancy or nursing mother;
* Woman in childbearing age without satisfactory contraception;
* Presence of possible other cause/s for hand pain (i.e., radicular pain, arthritis, injury, surgery) that could confound assessment or self-evaluation of the pain due to Carpal Tunnel Syndrome;
* Participants using topically applied analgesic compounds on the affected area;
18 Years
ALL
Yes
Sponsors
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Scilex Ltd.
INDUSTRY
John Papakonstantinou, MD
OTHER
Responsible Party
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John Papakonstantinou, MD
Orthopaedic Surgeon, Hand and Upper Extremity Surgeon
Principal Investigators
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John Papakonstantinou, MD
Role: PRINCIPAL_INVESTIGATOR
Michigan Orthopaedic & Spine Surgeons
Locations
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Michigan Orthopaedic & Spine Surgeons
Rochester Hills, Michigan, United States
Countries
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References
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Chung SY, Kwak JM, Kang S, Son SH, Kim JD, Yoon JS. Predictive Variables for Sonographically Guided Corticosteroid Injection in Mild-to-Moderate Carpal Tunnel Syndrome. Ann Rehabil Med. 2018 Apr;42(2):213-221. doi: 10.5535/arm.2018.42.2.213. Epub 2018 Apr 30.
Chesterton LS, Blagojevic-Bucknall M, Burton C, Dziedzic KS, Davenport G, Jowett SM, Myers HL, Oppong R, Rathod-Mistry T, van der Windt DA, Hay EM, Roddy E. The clinical and cost-effectiveness of corticosteroid injection versus night splints for carpal tunnel syndrome (INSTINCTS trial): an open-label, parallel group, randomised controlled trial. Lancet. 2018 Oct 20;392(10156):1423-1433. doi: 10.1016/S0140-6736(18)31572-1.
Moghtaderi AR, Jazayeri SM, Azizi S. EMLA cream for carpal tunnel syndrome: how it compares with steroid injection. Electromyogr Clin Neurophysiol. 2009 Sep-Oct;49(6-7):287-9.
Leppert W, Malec-Milewska M, Zajaczkowska R, Wordliczek J. Transdermal and Topical Drug Administration in the Treatment of Pain. Molecules. 2018 Mar 17;23(3):681. doi: 10.3390/molecules23030681.
Sears ED, Meerwijk EL, Schmidt EM, Kerr EA, Chung KC, Kamal RN, Harris AHS. Variation in Nonsurgical Services for Carpal Tunnel Syndrome Across a Large Integrated Health Care System. J Hand Surg Am. 2019 Feb;44(2):85-92.e1. doi: 10.1016/j.jhsa.2018.11.002. Epub 2018 Dec 20.
Okamura A, Guidetti BC, Caselli R, Borracini JA, Moraes VY, Belloti JC. HOW DO BOARD-CERTIFIED HAND SURGEONS MANAGE CARPAL TUNNEL SYNDROME? A NATIONAL SURVEY. Acta Ortop Bras. 2018 Jan-Feb;26(1):48-53. doi: 10.1590/1413-785220182601181880.
Graham B. The value added by electrodiagnostic testing in the diagnosis of carpal tunnel syndrome. J Bone Joint Surg Am. 2008 Dec;90(12):2587-93. doi: 10.2106/JBJS.G.01362.
Aroori S, Spence RA. Carpal tunnel syndrome. Ulster Med J. 2008 Jan;77(1):6-17.
Related Links
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FULL PRESCRIBING INFORMATION of ZTLIDO (lidocaine topical system) 1.8%
Other Identifiers
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CTS2020
Identifier Type: -
Identifier Source: org_study_id
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