Haloperidol for Pain Control in Patients With Acute Musculoskeletal Back Pain in the Emergency Department

NCT ID: NCT06395428

Last Updated: 2024-07-10

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

PHASE4

Total Enrollment

75 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-07-09

Study Completion Date

2027-04-15

Brief Summary

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Single center, double-blind, randomized, controlled trial in patients who present to the emergency department (ED) with a chief complaint of back pain. A total of 150 patients age 18-65 presenting to the emergency department with chief complaint of backpain will be enrolled from April 2024 - April 2025. Patients will be randomized and symptom levels will be recorded at 30, 60, 90, minutes. Follow-up will be performed by telephone at 24 hours.

Detailed Description

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Conditions

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Back Pain Chronic Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

This is a single-center prospective randomized double-blinded non-inferiority trial with potential assessment of superiority comparing haloperidol to ketorolac for the treatment of back pain.
Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators
Treatment allocations will be revealed only after study completion, unless there is concern for a serious adverse event in which case treatment team and patient will be unblinded. Interim analysis will be performed at 34 participants to evaluate for effectiveness and power

Study Groups

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Haloperidol

Haloperidol 5 mg IM haloperidol

Group Type EXPERIMENTAL

Haloperidol

Intervention Type DRUG

Intramuscular injection of drug

Ketoralac

Ketoralac 30 mg IM

Group Type ACTIVE_COMPARATOR

Ketorolac Tromethamine

Intervention Type DRUG

Intramuscular injection of drug

Interventions

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Haloperidol

Intramuscular injection of drug

Intervention Type DRUG

Ketorolac Tromethamine

Intramuscular injection of drug

Intervention Type DRUG

Other Intervention Names

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Haldol Toradol

Eligibility Criteria

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Inclusion Criteria

* Age 18 - 65 years old
* Presenting to the Bronson ED with a chief complaint of acute, non-traumatic back pain
* VAS score \>5 cm

Exclusion Criteria

* Back pain due to traumatic injury
* Experiencing saddle anesthesia
* Has bowel or bladder dysfunction
* Has an abnormal neurological exam
* Requires imaging in ED
* Has a Glascow coma score \<15
* Has one or more abnormal vital signs:

HR\>120, SBP\>180 or \<90, temperature \>38°, O2 saturation\<92%

* Has an allergy to ketorolac or haloperidol
* Has a known diagnosis of Lewy Body Dementia
* Has a known diagnosis of glaucoma.
* Is known to be pregnant or breastfeeding
* Is a prisoner or ward of the state
* Is unable to consent for themselves/ non-english speaking
* In the opinion of the attending physician or investigator the patient should not participate in the research
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bronson Methodist Hospital

UNKNOWN

Sponsor Role collaborator

Western Michigan University School of Medicine

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Jessica McCoy, MD

Role: PRINCIPAL_INVESTIGATOR

Western Michigan University Homer Stryker M.D. School of Medicine

Locations

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Bronson Methodist Hospital

Kalamazoo, Michigan, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Jessica McCoy, MD

Role: CONTACT

269-337-6600

Katharine Mitchell, MA

Role: CONTACT

269-341-8364

Facility Contacts

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Jessica McCoy, MD

Role: primary

269-337-6600

Katharine Mitchell, PhD

Role: backup

269-341-8364

References

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Silberstein SD, Peres MF, Hopkins MM, Shechter AL, Young WB, Rozen TD. Olanzapine in the treatment of refractory migraine and chronic daily headache. Headache. 2002 Jun;42(6):515-8. doi: 10.1046/j.1526-4610.2002.02126.x.

Reference Type BACKGROUND
PMID: 12167140 (View on PubMed)

McCoy JJ, Aldy K, Arnall E, Petersen J. Treatment of Headache in the Emergency Department: Haloperidol in the Acute Setting (THE-HA Study): A Randomized Clinical Trial. J Emerg Med. 2020 Jul;59(1):12-20. doi: 10.1016/j.jemermed.2020.04.018. Epub 2020 May 10.

Reference Type BACKGROUND
PMID: 32402480 (View on PubMed)

Todd KH, Ducharme J, Choiniere M, Crandall CS, Fosnocht DE, Homel P, Tanabe P; PEMI Study Group. Pain in the emergency department: results of the pain and emergency medicine initiative (PEMI) multicenter study. J Pain. 2007 Jun;8(6):460-6. doi: 10.1016/j.jpain.2006.12.005. Epub 2007 Feb 15.

Reference Type RESULT
PMID: 17306626 (View on PubMed)

Edwards J, Hayden J, Asbridge M, Gregoire B, Magee K. Prevalence of low back pain in emergency settings: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2017 Apr 4;18(1):143. doi: 10.1186/s12891-017-1511-7.

Reference Type RESULT
PMID: 28376873 (View on PubMed)

Kea B, Fu R, Lowe RA, Sun BC. Interpreting the National Hospital Ambulatory Medical Care Survey: United States Emergency Department Opioid Prescribing, 2006-2010. Acad Emerg Med. 2016 Feb;23(2):159-65. doi: 10.1111/acem.12862. Epub 2016 Jan 23.

Reference Type RESULT
PMID: 26802501 (View on PubMed)

Hoppe JA, Kim H, Heard K. Association of emergency department opioid initiation with recurrent opioid use. Ann Emerg Med. 2015 May;65(5):493-499.e4. doi: 10.1016/j.annemergmed.2014.11.015. Epub 2014 Dec 18.

Reference Type RESULT
PMID: 25534654 (View on PubMed)

Ruhm CJ. Geographic Variation in Opioid and Heroin Involved Drug Poisoning Mortality Rates. Am J Prev Med. 2017 Dec;53(6):745-753. doi: 10.1016/j.amepre.2017.06.009. Epub 2017 Aug 7.

Reference Type RESULT
PMID: 28797652 (View on PubMed)

Bertrand S, Meynet G, Taffe P, Della Santa V, Fishman D, Fournier Y, Frochaux V, Ribordy V, Rutschmann OT, Hugli O. Opiophobia in Emergency Department Healthcare Providers: A Survey in Western Switzerland. J Clin Med. 2021 Mar 25;10(7):1353. doi: 10.3390/jcm10071353.

Reference Type RESULT
PMID: 33805916 (View on PubMed)

Gueant S, Taleb A, Borel-Kuhner J, Cauterman M, Raphael M, Nathan G, Ricard-Hibon A. Quality of pain management in the emergency department: results of a multicentre prospective study. Eur J Anaesthesiol. 2011 Feb;28(2):97-105. doi: 10.1097/EJA.0b013e3283418fb0.

Reference Type RESULT
PMID: 21119516 (View on PubMed)

Duncan RW, Smith KL, Maguire M, Stader DE 3rd. Alternatives to opioids for pain management in the emergency department decreases opioid usage and maintains patient satisfaction. Am J Emerg Med. 2019 Jan;37(1):38-44. doi: 10.1016/j.ajem.2018.04.043. Epub 2018 Apr 22.

Reference Type RESULT
PMID: 29709398 (View on PubMed)

Rech MA, Griggs C, Lovett S, Motov S. Acute pain management in the Emergency Department: Use of multimodal and non-opioid analgesic treatment strategies. Am J Emerg Med. 2022 Aug;58:57-65. doi: 10.1016/j.ajem.2022.05.022. Epub 2022 May 22.

Reference Type RESULT
PMID: 35636044 (View on PubMed)

Verdu B, Decosterd I, Buclin T, Stiefel F, Berney A. Antidepressants for the treatment of chronic pain. Drugs. 2008;68(18):2611-32. doi: 10.2165/0003495-200868180-00007.

Reference Type RESULT
PMID: 19093703 (View on PubMed)

Kroeze WK, Hufeisen SJ, Popadak BA, Renock SM, Steinberg S, Ernsberger P, Jayathilake K, Meltzer HY, Roth BL. H1-histamine receptor affinity predicts short-term weight gain for typical and atypical antipsychotic drugs. Neuropsychopharmacology. 2003 Mar;28(3):519-26. doi: 10.1038/sj.npp.1300027.

Reference Type RESULT
PMID: 12629531 (View on PubMed)

Kiser RS, Cohen HM, Freedenfeld RN, Jewell C, Fuchs PN. Olanzapine for the treatment of fibromyalgia symptoms. J Pain Symptom Manage. 2001 Aug;22(2):704-8. doi: 10.1016/s0885-3924(01)00302-5.

Reference Type RESULT
PMID: 11495717 (View on PubMed)

Seidel S, Aigner M, Ossege M, Pernicka E, Wildner B, Sycha T. Antipsychotics for acute and chronic pain in adults. J Pain Symptom Manage. 2010 Apr;39(4):768-78. doi: 10.1016/j.jpainsymman.2009.09.008. Epub 2010 Mar 11.

Reference Type RESULT
PMID: 20226624 (View on PubMed)

Inayat F, Virk HU, Ullah W, Hussain Q. Is haloperidol the wonder drug for cannabinoid hyperemesis syndrome? BMJ Case Rep. 2017 Jan 4;2017:bcr2016218239. doi: 10.1136/bcr-2016-218239.

Reference Type RESULT
PMID: 28052951 (View on PubMed)

Cowling M, Covington S, Roehmer C, Musey P. Characterizing the role of haloperidol for analgesia in the Emergency Department. J Pain Manag. 2019;12(2):141-146.

Reference Type RESULT
PMID: 33193995 (View on PubMed)

Related Links

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https://fda.report/DailyMed/c9d0d515-adb7-4f93-8363-0f11771321c9

Haloperidol by Patriot Pharmaceuticals LLC / Johnson \& Johnson Research \& Development, LLC / Janssen Pharmaceutica NV / Janssen Pharmaceutica, NV HALOPERIDOL injection.

Other Identifiers

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WMed-2024-1032

Identifier Type: -

Identifier Source: org_study_id

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