Clinical trial NCT01528332: Blue Light Device for Pain Therapy
Official title: A Prospective, Randomized, Controlled, Double-Blind, Multi-Centre Study to Evaluate the Efficacy and Safety of Blue Light Therapy for Relief of Chronic Musculoskeletal Back Pain
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE3
Conditions: Low Back Pain
Low Back Pain, Recurrent
Musculoskeletal Pain
Chronic Pain
Keywords: Musculoskeletal pain
Back pain
Chronic pain
Lead sponsor: Philips Electronics Nederland BV
Sponsor class: INDUSTRY
First posted: 2012-02-08
Enrollment: 171
Sex: ALL
Minimum age (years): 18
Maximum age (years): 65
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of this study is to determine if the Pain Relief Patch, which shines light of a limited wavelength on the painful area of the back, relieves chronic musculoskeletal back pain. At the same time, this study will gather information on side effects associated with use of the Pain Relief Patch. The study will compare the Pain Relief Patch to a patch that is similar in appearance, but which shines a different, presumed nontherapeutic, wavelength of light.

Detailed description: This study will test the Pain Relief Patch (PRP), a new device containing LEDs that is to be worn on the skin of the painful area, to see if it is effective in relieving chronic musculoskeletal back pain. It will also test the safety of the patch. The LEDs in the PRP emit a certain kind of light (peak wavelength 453 nm) that stimulates the production of nitric oxide (NO) in the skin. NO has been shown to induce a number of actions that should contribute to pain relief, including relaxation of smooth muscle cells, dilation of blood vessels, increased concentrations of oxygen in the cells and washout of metabolic byproducts and toxins caused by cell injury or death. Participants in one treatment group will be treated 5 times over 2 weeks for 30 minutes with PRP patches in the clinic. Participants in the control arm will be treated for the same length of time with a similar device that contains LEDs that emit another wavelength of light that does not induce production of NO. To prevent the influence of expectations on the results, neither the participants nor the medical staff directly responsible for their treatment will be told with which of the test patches the participants are treated. Other clinic staff will be responsible for all activities that could identify treatment arm, including putting the devices on and removing them, and examining the condition of the participants' skin before and after treatment. To get an accurate measure of how effective the devices are, participants will score their pain several times before the treatment period begins, as well as before and after each treatment. They will also complete several pain questionnaires during the study.

Eligibility criteria: Inclusion Criteria:

* Is between 18 and 65 years of age, inclusive
* Is able to consent to participation by signing the informed consent form
* Has had localized mild to moderate (a score ≥ 2 and ≤ 6 on a 0 - 10 point pain intensity VAS) back pain for the 3 months prior to enrollment in study or longer
* Has a mean pain intensity VAS value (calculated from pain intensity VAS at Screening Visit, home assessment and pretreatment at Visit 1) between ≥ 2 and ≤6 at baseline prior to randomization
* Has skin type II, III or IV on the Fitzpatrick skin type scale (Types I - VI)
* Is willing and able to adhere to all study requirements, including accurate completion of VAS and questionnaires at the required time points, and is willing and able to travel to investigator's site to attend all required visits
* Is able to understand the study plan, its conditions, the therapy goals and expected outcomes

Exclusion Criteria:To be eligible for inclusion into this study, the patient must not meet any of the following criteria prior to enrollment:

General:

* Is participating in another clinical study at time of this study, or has participated in another study within the 30 days prior to signing the informed consent form
* Is pregnant or breast-feeding
* Is a sexually active female of childbearing potential and is not using a medically approved form of contraception
* Has moderate or severe arterial hypertension (WHO/ISH grade 2 or higher; systolic BP ≥ 160 and/or a diastolic BP ≥ 100), a history of stroke, myocardial infarction, angina pectoris, arteriosclerotic vascular disease (ASVD), or peripheral vascular disease, or (severe) congestive heart failure
* Is in poor general health
* Is an employee of the investigational site directly affiliated with this study and/or their immediate family members; an employee of the sponsor or the CRO

Back Pain Related:

* Has had any failed back surgery, or has had any surgery to torso, head or back within the previous 8 weeks
* Had an acute dislocation or fracture within the previous 8 weeks
* Has a degenerative central nervous system disease such as Multiple Sclerosis or Parkinson's disease; or a spinal stenosis that contributes to or is the cause of back pain; or Cauda equina syndrome, or other neurological symptoms indicating neuropathy
* Has any sensory deprivation or diagnosis of shingles or postherpetic neuralgia (specifically in mid-trunk region)
* Has wide spread pain
* Has any inflammatory disease that causes pain or any other chronic disease or infection known to cause pain (e.g. spondyloarthropathy, rheumatoid arthritis, Lupus erythematodes, Lyme borreliosis, etc.)
* Has schizophrenia, borderline syndrome or severe depression
* Has or has had cancer
* Has a history of severe osteoporosis (T score of 2.5 and a history of 1 or more bone fractures), or another severe bone disease
* Is unwilling to abstain from other non-drug back pain treatments, such as massage, sauna, transcutaneous electrical nerve stimulation, etc., for the duration of the trial
* Is unwilling to abstain from use of pain medication other than those recommended on steps 1 and 2 of the WHO Analgesic Ladder for the duration of the trial

Treatment Related:

* Has a known sun allergy, or known allergy to any device related material
* Uses steroids or any photosensitizing medication
* Has any known disease or idiopathic dermatosis such as porphyria, polymorphic light eruption, chronic actinic dermatitis, actinic prurigo or solar urticaria that causes photosensitivity
* Has a skin pathology, tattoo etc., or skin disease such as local infection, psoriasis, eczema etc. in the treatment area
* Has any anatomical pathology or other limitation that would prevent successful placement of the device
* Has an implanted medical device (screw, etc.) in or near the treatment area or an active implantable medical device such as cardiac pacemaker, defibrillator, neurostimulator, cochlear implant, active drug administration device anywhere in the body
* Is unwilling to abstain from sunbathing or use of tanning lights for the duration of the trial
* Is in the process of seeking early retirement, or is engaged in outstanding litigation involving back pain

Primary outcomes:
measure: Change From Baseline (Mean of Three Measurements at Screening, Prior to Treatment Visit 1 and Treatment Visit 1 Pretreatment) in the Average Visual Analog Scale (VAS) Pain Intensity Over the 5 Treatment Days
timeFrame: Baseline (Visit 1/day -7, at home and Visit 2/day +1), Treatment (Visits 2-6 post treatment/days +1 to +14)
Secondary outcomes:
measure: Change From Baseline in Roland-Morris Disability Questionnaire (RMDQ) at Visit 5
timeFrame: Baseline (days -7 to +1) to Treatment 5 (day +14)
measure: Change From Baseline in VAS Pain Intensity at Follow up
timeFrame: Baseline (day -7 to 1) to Follow-up (up to day +42)
measure: Change From Treatment in VAS Pain Intensity at Follow up
timeFrame: Treatment (day +1 to +14) to Follow-up (up to day +42)
measure: Change From Baseline in RMDQ at Follow up
timeFrame: Baseline (days -7 to +1) to Follow-up (up to day +42)
measure: Change From Treatment in RMDQ at Follow up
timeFrame: Treatment (days +1 to +14) to Follow up (up to day +42)
measure: Frequency, Severity, Nature and Duration of Adverse Events During the Whole Duration of the Study
timeFrame: Baseline (days -7 to -1) to Follow up (up to day +42)
measure: Vital Sign Parameters
timeFrame: Baseline (days -7 to -1) to Follow up (up to day +42)
measure: Changes From Baseline in Skin Condition
timeFrame: Baseline (days -7 to -1) to Follow up (up to day +42)
measure: Average Visual Analog Scale Pain Relief Over 5 Treatments
timeFrame: 5 treatments (days +1 to +14)
Other outcomes:
Locations:
city: Heidelberg
country: Germany
facility: Clinic for Anaesthesiology and Supra-regional Center of Pain Therapy and Palliative Care, University Hosp Heidelberg
city: Heidelberg
country: Germany
facility: Pain Therapy Section, Dept of Orthopedic Surgery and Traumatology, University Hosp Heidelberg
city: Mannheim
country: Germany
facility: University Medical Care Center Mannheim, Dept of Anaesthesiology and Surgical Care Medicine
Study officials:
affiliation: Clinic for Anaesthesiology and Supra-regional Centre of Pain Therapy and Palliative Care, University Hosp Heidelberg
name: Hubert Bardenheuer, Prof. Dr.
role: PRINCIPAL_INVESTIGATOR
References: