Trial Outcomes & Findings for The Effect of Minocycline and N-acetylcysteine for the Treatment of Fibromyalgia (NCT NCT04594733)

NCT ID: NCT04594733

Last Updated: 2024-01-30

Results Overview

The FIQR (Revised Fibromyalgia Impact Questionnaire) is comprised of 21 questions spread across 3 domains: function, overall impact, symptoms, scored on an 11-point numeric rating scale. The questions are framed with the context of the past 7 days. The instructions ask the patient to rate the difficulty on a scale of 0-10 (0 = No difficulty, and 10 = Very difficult) which indicates how much difficulty they have experienced in doing the specified activity during the past 7 days. Each item is rated on a scale from 0 - 10, and the raw scores on each subscale. Then, the score on the function subscale is divided by 3, the overall impact subscale divided by 1, and the symptoms subscale divided by 2. These final scores from each subscale are then added up for the total FIQR score The total score can range from 0 -100. The total FIQR score is the sum of each section. A lower score means a better outcome. Higher scores indicate more severe impact.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

14 participants

Primary outcome timeframe

Evaluated at baseline (prior to intervention) then again after treatment which occurs at week 8 and week 18

Results posted on

2024-01-30

Participant Flow

Participant milestones

Participant milestones
Measure
Placebo Followed by Minocycline (200 mg Daily) and NAC (1200 mg Daily)
Participants will be randomized to 8 weeks of placebo, minimum 2 week washout period, and then 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily) followed by a final 2 week washout Placebo followed by minocycline (200 mg daily) and NAC (1200 mg daily): Placebo followed by minocycline (200 mg daily) and NAC (1200 mg daily)
Minocycline (200 mg Daily) and NAC (1200 mg Daily) Followed by Placebo
Participants will be randomized to 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily), minimum 2 week washout period, and then 8 weeks of placebo followed by a final 2 week washout minocycline (200 mg daily) and NAC (1200 mg daily) followed by placebo: minocycline (200 mg daily) and NAC (1200 mg daily) followed by placebo
First Intervention (8 Weeks)
STARTED
7
7
First Intervention (8 Weeks)
Received Intervention
7
7
First Intervention (8 Weeks)
COMPLETED
7
3
First Intervention (8 Weeks)
NOT COMPLETED
0
4
First Washout (2 Weeks)
STARTED
7
3
First Washout (2 Weeks)
COMPLETED
7
3
First Washout (2 Weeks)
NOT COMPLETED
0
0
Second Intervention (8 Weeks)
STARTED
7
3
Second Intervention (8 Weeks)
COMPLETED
5
3
Second Intervention (8 Weeks)
NOT COMPLETED
2
0
Second Washout (2 Weeks)
STARTED
5
3
Second Washout (2 Weeks)
COMPLETED
5
3
Second Washout (2 Weeks)
NOT COMPLETED
0
0

Reasons for withdrawal

Reasons for withdrawal
Measure
Placebo Followed by Minocycline (200 mg Daily) and NAC (1200 mg Daily)
Participants will be randomized to 8 weeks of placebo, minimum 2 week washout period, and then 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily) followed by a final 2 week washout Placebo followed by minocycline (200 mg daily) and NAC (1200 mg daily): Placebo followed by minocycline (200 mg daily) and NAC (1200 mg daily)
Minocycline (200 mg Daily) and NAC (1200 mg Daily) Followed by Placebo
Participants will be randomized to 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily), minimum 2 week washout period, and then 8 weeks of placebo followed by a final 2 week washout minocycline (200 mg daily) and NAC (1200 mg daily) followed by placebo: minocycline (200 mg daily) and NAC (1200 mg daily) followed by placebo
First Intervention (8 Weeks)
Withdrawal by Subject
0
1
First Intervention (8 Weeks)
Lost to Follow-up
0
3
Second Intervention (8 Weeks)
Lost to Follow-up
2
0

Baseline Characteristics

The Effect of Minocycline and N-acetylcysteine for the Treatment of Fibromyalgia

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Placebo Followed by Minocycline (200 mg Daily) and NAC (1200 mg Daily)
n=7 Participants
Participants will be randomized to 8 weeks of placebo, minimum 2 week washout period, and then 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily) followed by a final 2 week washout Placebo followed by minocycline (200 mg daily) and NAC (1200 mg daily): Placebo followed by minocycline (200 mg daily) and NAC (1200 mg daily)
Minocycline (200 mg Daily) and NAC (1200 mg Daily) Followed by Placebo
n=7 Participants
Participants will be randomized to 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily), minimum 2 week washout period, and then 8 weeks of placebo followed by a final 2 week washout minocycline (200 mg daily) and NAC (1200 mg daily) followed by placebo: minocycline (200 mg daily) and NAC (1200 mg daily) followed by placebo
Total
n=14 Participants
Total of all reporting groups
Age, Continuous
45.3 years
STANDARD_DEVIATION 17.2 • n=5 Participants
51.6 years
STANDARD_DEVIATION 9.98 • n=7 Participants
48.4 years
STANDARD_DEVIATION 13.9 • n=5 Participants
Sex: Female, Male
Female
7 Participants
n=5 Participants
7 Participants
n=7 Participants
14 Participants
n=5 Participants
Sex: Female, Male
Male
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=5 Participants
2 Participants
n=7 Participants
4 Participants
n=5 Participants
Race (NIH/OMB)
White
4 Participants
n=5 Participants
5 Participants
n=7 Participants
9 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=5 Participants
0 Participants
n=7 Participants
1 Participants
n=5 Participants
Duration of Formal Diagnosis
0-1 years
0 participants
n=5 Participants
2 participants
n=7 Participants
2 participants
n=5 Participants
Duration of Formal Diagnosis
1-2 years
1 participants
n=5 Participants
1 participants
n=7 Participants
2 participants
n=5 Participants
Duration of Formal Diagnosis
3-5 years
1 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
Duration of Formal Diagnosis
5-10 years
4 participants
n=5 Participants
3 participants
n=7 Participants
7 participants
n=5 Participants
Duration of Formal Diagnosis
>10 years
1 participants
n=5 Participants
1 participants
n=7 Participants
2 participants
n=5 Participants
Duration of Symptoms
1-2 years
1 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
Duration of Symptoms
3-5 years
1 participants
n=5 Participants
0 participants
n=7 Participants
1 participants
n=5 Participants
Duration of Symptoms
5-10 years
1 participants
n=5 Participants
2 participants
n=7 Participants
3 participants
n=5 Participants
Duration of Symptoms
>10 years
4 participants
n=5 Participants
5 participants
n=7 Participants
9 participants
n=5 Participants
Fibromyalgia Impact Questionnaire (FIQR) Score
67.6 units on a scale
STANDARD_DEVIATION 12.9 • n=5 Participants
58.4 units on a scale
STANDARD_DEVIATION 16.2 • n=7 Participants
63.0 units on a scale
STANDARD_DEVIATION 14.9 • n=5 Participants
The Pain, Enjoyment of Life and General Activity (PEG) Score
7.29 units on a scale
STANDARD_DEVIATION 1.20 • n=5 Participants
6.90 units on a scale
STANDARD_DEVIATION 1.74 • n=7 Participants
7.10 units on a scale
STANDARD_DEVIATION 1.41 • n=5 Participants
Patient Health Questionnaire-2 (PHQ-2) Score
4 units on a scale
n=5 Participants
2 units on a scale
n=7 Participants
2 units on a scale
n=5 Participants
Generalized Anxiety Disorder 2 (GAD-2) Score
2 units on a scale
n=5 Participants
2 units on a scale
n=7 Participants
2 units on a scale
n=5 Participants
Widespread Pain Index (WPI) Score
14.3 units on a scale
STANDARD_DEVIATION 3.90 • n=5 Participants
10.6 units on a scale
STANDARD_DEVIATION 4.12 • n=7 Participants
12.4 units on a scale
STANDARD_DEVIATION 4.31 • n=5 Participants
Symptom Severity Score (SS score) - Part 2a
7 units on a scale
n=5 Participants
5 units on a scale
n=7 Participants
6 units on a scale
n=5 Participants
Symptom Severity (SS) 2b Score
1 units on a scale
n=5 Participants
2 units on a scale
n=7 Participants
1.5 units on a scale
n=5 Participants
Total Symptom Severity (SS) Score
8.57 units on a scale
STANDARD_DEVIATION 1.9 • n=5 Participants
7.14 units on a scale
STANDARD_DEVIATION 2.34 • n=7 Participants
7.86 units on a scale
STANDARD_DEVIATION 2.18 • n=5 Participants

PRIMARY outcome

Timeframe: Evaluated at baseline (prior to intervention) then again after treatment which occurs at week 8 and week 18

The FIQR (Revised Fibromyalgia Impact Questionnaire) is comprised of 21 questions spread across 3 domains: function, overall impact, symptoms, scored on an 11-point numeric rating scale. The questions are framed with the context of the past 7 days. The instructions ask the patient to rate the difficulty on a scale of 0-10 (0 = No difficulty, and 10 = Very difficult) which indicates how much difficulty they have experienced in doing the specified activity during the past 7 days. Each item is rated on a scale from 0 - 10, and the raw scores on each subscale. Then, the score on the function subscale is divided by 3, the overall impact subscale divided by 1, and the symptoms subscale divided by 2. These final scores from each subscale are then added up for the total FIQR score The total score can range from 0 -100. The total FIQR score is the sum of each section. A lower score means a better outcome. Higher scores indicate more severe impact.

Outcome measures

Outcome measures
Measure
Placebo Treatment Period
n=10 Participants
Participants will be randomized to 8 weeks of placebo
Minocycline (200 mg Daily) and NAC (1200 mg Daily) Treatment Period
n=7 Participants
Participants will be randomized to 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily).
Change in Revised Fibromyalgia Impact Questionnaire (FIQR) Score From Baseline to After Treatment Occurring at Weeks 8 and 18
4.37 Score
Interval -2.31 to 11.1
12.1 Score
Interval 6.3 to 17.9

SECONDARY outcome

Timeframe: Evaluated at baseline (prior to intervention) then again after treatment which occurs at week 8 and week 18

In the PEG score, a higher score indicates more severe pain and pain-related interference. The PEG has 3 separate numerical scales. Each has ratings 0-10.The first scale asks individuals to rate their pain, on average, over the past week, the second asks to rate how pain has interfered with their enjoyment of life in the past week, the third asks individuals to rate how pain has interfered with general activities. The PEG scale is scored by averaging the three numbers. The final score helps to track and monitor pain levels over time. The PEG score should decrease when treatment is effective.

Outcome measures

Outcome measures
Measure
Placebo Treatment Period
n=10 Participants
Participants will be randomized to 8 weeks of placebo
Minocycline (200 mg Daily) and NAC (1200 mg Daily) Treatment Period
n=7 Participants
Participants will be randomized to 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily).
Change in Pain, Enjoyment of Life and General Activity (PEG) Scale From Baseline to After Treatment Occurring at Weeks 8 and 18
0.64 score on a scale
Interval -0.36 to 1.64
1.24 score on a scale
Interval 0.37 to 2.12

SECONDARY outcome

Timeframe: Evaluated at baseline (prior to intervention) then again after treatment which occurs at week 8 and week 18

The change in depression scale (PHQ-2) by evaluating the number of days the participant feels down, depressed or hopeless and has little interest or pleasure in doing things rated as not at all (0), several days (1), more than half the days (2), or nearly every day (3) by scoring the 2 questions from 0-3 as indicated. Scores range from 0-6, with the higher score meaning the patient experiencing more severe symptoms.

Outcome measures

Outcome measures
Measure
Placebo Treatment Period
n=10 Participants
Participants will be randomized to 8 weeks of placebo
Minocycline (200 mg Daily) and NAC (1200 mg Daily) Treatment Period
n=7 Participants
Participants will be randomized to 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily).
Change in Patient Health Questionnaire (PHQ-2) From Baseline to After Treatment Occurring at Weeks 8 and 18
0.12 score on a scale
Interval -0.55 to 0.8
0.23 score on a scale
Interval -0.38 to 0.84

SECONDARY outcome

Timeframe: Evaluated at baseline (prior to intervention) then again after treatment which occurs at week 8 and week 18

The Generalized Anxiety Disorder 2-item (GAD-2) screens for generalized anxiety disorder 1. Two questions are asked, with the scoring of each ranging from 0-3, then both numbers added together, with possible scores ranging from 0-6. A total score of at least 3 points indicates possible anxiety disorder. The higher the score, the more severe anxiety.

Outcome measures

Outcome measures
Measure
Placebo Treatment Period
n=10 Participants
Participants will be randomized to 8 weeks of placebo
Minocycline (200 mg Daily) and NAC (1200 mg Daily) Treatment Period
n=7 Participants
Participants will be randomized to 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily).
Change in General Anxiety Disorder (GAD-2) Score From Baseline to After Treatment Occurring at Weeks 8 and 18
-0.02 score on a scale
Interval -0.7 to 0.66
0.72 score on a scale
Interval 0.1 to 1.33

SECONDARY outcome

Timeframe: immediately after each treatment at week 8 (first intervention) and week 18 (second intervention)

Patient Global Impression of Change (PGIC) has the subject will reporting whether there was a change in their activity, limitations, symptoms, emotions and overall quality of life by rating "no change", "almost the same", "a little better", "somewhat better", "moderately better", "better" or "a great deal better". Participants will also rate degrees of change from much better (0), 5 (no change), to much worse (10). The higher the score, the worse their impression of their health status was worse than previously. Scores will range from no change to a great deal better, and from 0 (much better) to 10 (much worse).

Outcome measures

Outcome measures
Measure
Placebo Treatment Period
n=10 Participants
Participants will be randomized to 8 weeks of placebo
Minocycline (200 mg Daily) and NAC (1200 mg Daily) Treatment Period
n=7 Participants
Participants will be randomized to 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily).
Patient Global Impression of Change (PGIC)
1.6 units on a scale
Standard Error 0.72
2.8 units on a scale
Standard Error 0.79

OTHER_PRE_SPECIFIED outcome

Timeframe: Evaluated at baseline (prior to intervention) then again after treatment which occurs at week 8 and week 18

Participants will rate change using modified 2010 American College of Rheumatology Preliminary Diagnostic Criteria for Fibromyalgia (modified ACR 2010) by answering questions related to their areas of pain, amount of medication required for pain, and symptoms.

Outcome measures

Outcome data not reported

Adverse Events

Placebo

Serious events: 0 serious events
Other events: 5 other events
Deaths: 0 deaths

Minocycline 200 mg Daily + NAC 1200mg Daily

Serious events: 0 serious events
Other events: 8 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Placebo
n=10 participants at risk
Participants will be randomized to 8 weeks of placebo, minimum 2 week washout period, and then 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily) followed by a final 2 week washout Placebo followed by minocycline (200 mg daily) and NAC (1200 mg daily): Placebo followed by minocycline (200 mg daily) and NAC (1200 mg daily)
Minocycline 200 mg Daily + NAC 1200mg Daily
n=14 participants at risk
Participants will be randomized to 8 weeks of a combination minocycline (200 mg daily) and NAC (1200 mg daily), minimum 2 week washout period, and then 8 weeks of placebo followed by a final 2 week washout minocycline (200 mg daily) and NAC (1200 mg daily) followed by placebo: minocycline (200 mg daily) and NAC (1200 mg daily) followed by placebo
General disorders
Malaise
10.0%
1/10 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
35.7%
5/14 • Number of events 5 • Adverse event data was collected weekly from weeks 1-19.
General disorders
Other
20.0%
2/10 • Number of events 2 • Adverse event data was collected weekly from weeks 1-19.
7.1%
1/14 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
General disorders
Drowsiness
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
21.4%
3/14 • Number of events 3 • Adverse event data was collected weekly from weeks 1-19.
Nervous system disorders
Light headedness
10.0%
1/10 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
14.3%
2/14 • Number of events 2 • Adverse event data was collected weekly from weeks 1-19.
Nervous system disorders
Vertigo
10.0%
1/10 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
7.1%
1/14 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
Nervous system disorders
Photosensitivity
10.0%
1/10 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
14.3%
2/14 • Number of events 2 • Adverse event data was collected weekly from weeks 1-19.
Gastrointestinal disorders
Pain with swallowing
10.0%
1/10 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
0.00%
0/14 • Adverse event data was collected weekly from weeks 1-19.
General disorders
Muscle Pain
20.0%
2/10 • Number of events 2 • Adverse event data was collected weekly from weeks 1-19.
28.6%
4/14 • Number of events 4 • Adverse event data was collected weekly from weeks 1-19.
General disorders
Joint Pain
10.0%
1/10 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
35.7%
5/14 • Number of events 5 • Adverse event data was collected weekly from weeks 1-19.
General disorders
Joint Swelling
10.0%
1/10 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
14.3%
2/14 • Number of events 2 • Adverse event data was collected weekly from weeks 1-19.
General disorders
Fatigue
10.0%
1/10 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
21.4%
3/14 • Number of events 3 • Adverse event data was collected weekly from weeks 1-19.
Skin and subcutaneous tissue disorders
Red Itchy Rash
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
7.1%
1/14 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
General disorders
Dizziness
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
21.4%
3/14 • Number of events 3 • Adverse event data was collected weekly from weeks 1-19.
General disorders
Ear Ringing
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
14.3%
2/14 • Number of events 2 • Adverse event data was collected weekly from weeks 1-19.
Nervous system disorders
Headache
10.0%
1/10 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
21.4%
3/14 • Number of events 3 • Adverse event data was collected weekly from weeks 1-19.
Nervous system disorders
Blurry Vision
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
14.3%
2/14 • Number of events 2 • Adverse event data was collected weekly from weeks 1-19.
Gastrointestinal disorders
Abdominal Pain
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
21.4%
3/14 • Number of events 3 • Adverse event data was collected weekly from weeks 1-19.
Gastrointestinal disorders
Diarrhea
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
14.3%
2/14 • Number of events 2 • Adverse event data was collected weekly from weeks 1-19.
Gastrointestinal disorders
Constipation
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
7.1%
1/14 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
General disorders
Nausea
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
14.3%
2/14 • Number of events 2 • Adverse event data was collected weekly from weeks 1-19.
Skin and subcutaneous tissue disorders
Rash
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
7.1%
1/14 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
Skin and subcutaneous tissue disorders
Itchiness
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
7.1%
1/14 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
General disorders
Facial Flushing
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
7.1%
1/14 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
General disorders
Sun Burn
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
7.1%
1/14 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.
Cardiac disorders
Palpitations
0.00%
0/10 • Adverse event data was collected weekly from weeks 1-19.
7.1%
1/14 • Number of events 1 • Adverse event data was collected weekly from weeks 1-19.

Additional Information

Research Coordinator

MUSC

Phone: 843-792-1869

Results disclosure agreements

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