Improving Sleep After TKA Using Mirtazapine and Quetiapine

NCT ID: NCT04728581

Last Updated: 2023-06-02

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

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

165 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-01

Study Completion Date

2027-01-01

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Use of mirtazapine and quetiapine for improvement of sleep quality after TKA

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Background After knee replacement surgery there is a loss of quantity and quality of sleep. Loss of sleep is associated with increased pain perception. Subsequently, patients use more analgesic medication and it takes them longer to fully recover from surgery. Low doses of the tetracyclic antidepressant mirtazapine and the neuroleptic quetiapine are nowadays off-label prescribed for insomnia and improve length and quality of deep sleep phases. Quetiapine and mirtazapine could improve sleep after knee replacement surgery and improve patient recovery. This placebo-controlled, randomized, double-blind study investigates the effect of quetiapine and mirtazapine on functional recovery after total knee arthroplasty.

Methods This is a prospective, single center, double-blinded randomized controlled trial. 165 patients with knee osteoarthritis scheduled for total knee arthroplasty will be randomly allocated to a low-dose quetiapine (LDQ), a low-dose mirtazapine (LDM) group or a placebo group. Outcomes will be evaluated at baseline, 2, 4, 6 and 12 weeks after surgery. Functional outcome after total knee arthroplasty is measured using a patient related outcome measure through the Oxford Knee Score (OKS). In order to measure postoperative sleep quality, patients will be monitored using the Leeds Sleep evaluation questionnaire (LSEQ). Furthermore, pain is registered using a visual analogue scale (VAS), weekly opioid use is monitored, and general health status is reported through the EQ-5D. Analyses will be conducted on an intention-to-treat basis using logistic and linear mixed regression models. This trial complies with the SPIRIT guidelines for randomized controlled trials.

Discussion This study will provide clinicians with evidence whether quetiapine contributes to rehabilitation of patients undergoing fast-track knee replacement surgery.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Osteo Arthritis Knee Insomnia

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
Placebo controlled trial

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

Placebo

use of placebo during first 2 weeks after TKA surgery

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type DRUG

a gelatinous capsule without an active ingredient

Low dose Mirtazapine

Use of Mirtazapine 3.75mg before lights-out, allowed to increase medication to 7.5mg

Group Type EXPERIMENTAL

Mirtazapine

Intervention Type DRUG

Use of 3.75mg mirtazapine before lights-out during first 2 weeks after TKA surgery. With insufficient effect on sleep, patients are allowed to increase medication to 7.5mg mirtazapine.

Low dose Quetiapine

use of Quetiapine 3.125mg before lights-out, allowed to increase medication to 6.25mg

Group Type EXPERIMENTAL

Quetiapine

Intervention Type DRUG

Use of 3.125mg quetiapine before lights-out during first 2 weeks after TKA surgery. With insufficient effect on sleep, patients are allowed to increase medication to 6.25mg mirtazapine.

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Mirtazapine

Use of 3.75mg mirtazapine before lights-out during first 2 weeks after TKA surgery. With insufficient effect on sleep, patients are allowed to increase medication to 7.5mg mirtazapine.

Intervention Type DRUG

Quetiapine

Use of 3.125mg quetiapine before lights-out during first 2 weeks after TKA surgery. With insufficient effect on sleep, patients are allowed to increase medication to 6.25mg mirtazapine.

Intervention Type DRUG

Placebo

a gelatinous capsule without an active ingredient

Intervention Type DRUG

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Indication for TKA

Exclusion Criteria

* use of benzodiazepines
* use of anti-depressants
* use of oxycodone
* patients diagnosed with obstructive sleep apnea syndrome, severe respiratory insufficiency, or myasthenia
* a known hypersensitivity to mirtazapine, quetiapine and/or related to the gelatinous (placebo) capsule
* insufficient understanding of the Dutch language.
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

St. Anna Ziekenhuis, Geldrop, Netherlands

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Walter van der Weegen

PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Knowledge Center for Orthopedic Surgery, St. Anna hospital

Geldrop, , Netherlands

Site Status

St. Anna hospital

Geldrop, , Netherlands

Site Status

Countries

Review the countries where the study has at least one active or historical site.

Netherlands

Central Contacts

Reach out to these primary contacts for questions about participation or study logistics.

Walter van der Weegen

Role: CONTACT

06-34282788

Michiel Siebelt

Role: CONTACT

Facility Contacts

Find local site contact details for specific facilities participating in the trial.

Walter van der Weegen

Role: primary

06-34282788

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

W021-001

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.