Home Transcutaneous Electrical Acustimulation (TEA)

Официальное название

Effects of Home-based TEA for Abdominal Pain in Patients With Irritable Bowel Syndrome (IBS)

Обзор

This study will assess the efficacy of two active treatments with TEA and a chemical neuromodulator (escitalopram aka Lexapro) versus a sham comparator or control group on abdominal pain.

Подробное описание

The aim of this study is to investigate the potential of TEA to treat abdominal pain in participants with IBS with constipation (IBS-C). The study also aims to compare the electrical neuromodulation therapy (TEA) with medical neuromodulation therapy (escitalopram) in their ability to treat abdominal pain and improve the autonomic dysfunction in participants with IBS-C. This project will investigate the impact of 3 active treatment interventions vs. a sham control intervention on abdominal pain and other IBS symptoms in participants with IBS-C. This is a parallel-group study in which the participants will be divided into 4 treatment groups designed to investigate the feasibility of TEA using optimized parameters in comparison with medical neuromodulation therapy (escitalopram) and sham-TEA. The treatment will be home-based and last for a period of 8 weeks. To preserve scientific integrity and effective masking, certain details of arms and interventions will be made more precise upon or prior to reporting results

Вмешательства

• Устройство TEA
  The TEA device administers a mild electrical shock through the skin, similar to acupuncture. Location sets are described in the protocol, which will be shared with results reporting but are not provided here to maintain masking and, therefore, to safeguard scientific integrity.
• Препарат Lexapro
  This arm will receive treatment with the chemical neuromodulator escitalopram (Lexapro) at 10 mg once per day for 8 weeks. Lexapro is often used as a standard treatment for IBS.

Первичные конечные точки

• Change in abdominal pain/discomfort via daily Visual Analog Scale (VAS) survey [Срок оценки: Daily for 14 weeks]
• Change in global abdominal pain [Срок оценки: Weekly for 14 weeks]

Вторичные конечные точки (9)

• Change in quality of life via Irritable Bowel Syndrome - Quality of Life (IBS-QOL) survey [Срок оценки: Weekly for 14 weeks]
• Change in Hospital Anxiety and Depression Scale (HADS) - Anxiety [Срок оценки: Weekly for 14 weeks]
• Change in Hospital Anxiety and Depression Scale (HADS) - Depression [Срок оценки: Weekly for 14 weeks]
• Change in IBS - Symptom Severity Score (IBS-SSS) [Срок оценки: Once every 10 days for 14 weeks]
• Daily Stool Diary - Change in number of bowel movements [Срок оценки: Daily for 14 weeks]
• Daily Stool Diary - Change in Bristol Stool Form Scale (BSFS) [Срок оценки: Daily for 14 weeks]
• Daily Stool Diary - Change in abdominal bloating [Срок оценки: Daily for 14 weeks]
• Daily Stool Diary - Change sense of urgency [Срок оценки: Daily for 14 weeks]
• Change in Bowel Habits Per Separate IBS-SSS Survey [Срок оценки: Once every 10 days for 14 weeks]

Критерии участия

Критерии включения

• Those with ongoing and symptomatic Irritable Bowel Syndrome with Constipation (IBS-C)
• Significant mean worst abdominal pain severity (as defined by the study protocol, which will be shared with results reporting) on a Visual Analog Scale (VAS) pain score during the Phase-in period
• Symptoms present at least 1 day/week in the last 3 months with symptom onset at least 6 months prior to the diagnosis.
• Abdominal pain is not adequately relieved at the time of screening and the time of randomization.

Критерии исключения

• Unrelated active disorder which may involve abdominal pain, such as inflammatory bowel disease, diabetes or unstable thyroid disease.
• Pregnancy, plans to become pregnant, or lactation. Any potential patient of child-bearing potential will complete a pregnancy test at Visit 1 and if the test is positive that individual will be excluded from future participation.
• Any other condition, which in the opinion of the investigator would impede compliance or hinder the completion of the study
• A history of abdominal surgery (other than cholecystectomy or appendectomy)
• Active use of prucalopride, domperidone, alosetron, tegaserod, warfarin, antipsychotic (e.g., Seroquel, Risperdal), antidiarrheal, or frequent (>2 days/week) use of opioid or antispasmodic medication. Those who frequently use Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) will also be excluded.
• Ongoing use of Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs), or any other serotonin-active medications, including tricyclic antidepressants (TCAs). Individuals on chronic SSRI therapy, including escitalopram, at the initial evaluation will not be enrolled in the study.
• Inability to avoid the following medications: tricyclic antidepressants, Monoamine Oxidase (MAO) inhibitors including, intravenous methylene blue, linezolid, and pimozide, as well as triptans, fentanyl, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John's Wort. - - Participants will be informed that MAO inhibitors cannot be used within 14 days of starting or stopping escitalopram.
• Known hypersensitivity to escitalopram or citalopram including any of the inactive ingredients of these formulations.
• Known allergy to adhesive Electrocardiogram (ECG) electrodes.
• Known angle-closure glaucoma, bipolar disorder, history of seizures or prior suicide attempt or known suicidal thoughts.
• Known QTc prolongation or receiving scheduled therapy with a medication associated with prolongation of QTc (screening to be completed at recruitment as detailed above).

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Рандомизированное

Модель

Параллельные группы

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

США · 1 центр

• University of Michigan — Ann Arbor

Публикации

• Ma D, Han JS, Diao QH, Deng GF, Ping XJ, Jin WJ, Wu LZ, Cui CL, Li XD. Transcutaneous electrical acupoint stimulation for the treatment of withdrawal syndrome in heroin addicts. Pain Med. 2015 May;16(5):839-48. doi: 10.1111/pme.12738. PMID 25989154
• Jiang Y, Liu J, Liu J, Han J, Wang X, Cui C. Cerebral blood flow-based evidence for mechanisms of low- versus high-frequency transcutaneous electric acupoint stimulation analgesia: a perfusion fMRI study in humans. Neuroscience. 2014 May 30;268:180-93. doi: 10.1016/j.neuroscience.2014.03.019. Epub 2014 Mar 20. PMID 24657460
• Qu F, Wang FF, Wu Y, Zhou J, Robinson N, Hardiman PJ, Pan JX, He YJ, Zhu YH, Wang HZ, Ye XQ, He KL, Cui L, Zhao HL, Ye YH. Transcutaneous Electrical Acupoint Stimulation Improves the Outcomes of In Vitro Fertilization: A Prospective, Randomized and Controlled Study. Explore (NY). 2017 Sep-Oct;13(5):306-312. doi: 10.1016/j.explore.2017.06.004. Epub 2017 Jun 30. PMID 28915981
• Yu Y, Wei R, Liu Z, Xu J, Xu C, Chen JDZ. Ameliorating Effects of Transcutaneous Electrical Acustimulation Combined With Deep Breathing Training on Refractory Gastroesophageal Reflux Disease Mediated via the Autonomic Pathway. Neuromodulation. 2019 Aug;22(6):751-757. doi: 10.1111/ner.13021. Epub 2019 Jul 26. PMID 31347247
• Zhang B, Xu F, Hu P, Zhang M, Tong K, Ma G, Xu Y, Zhu L, Chen JDZ. Needleless Transcutaneous Electrical Acustimulation: A Pilot Study Evaluating Improvement in Post-Operative Recovery. Am J Gastroenterol. 2018 Jul;113(7):1026-1035. doi: 10.1038/s41395-018-0156-y. Epub 2018 Jun 21. PMID 29925916

Идентификаторы

NCT: NCT05519683 · HUM00217301 · 5UH3NS115108-04

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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