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Trial registered on ANZCTR
Registration number
ACTRN12615000301561
Ethics application status
Approved
Date submitted
19/03/2015
Date registered
31/03/2015
Date last updated
4/10/2022
Date data sharing statement initially provided
14/12/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
Does amitriptyline reduce pain in knee osteoarthritis?
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Scientific title
Does low dose amitriptyline reduce pain in knee osteoarthritis? A double blind, randomised, pragmatic, placebo controlled clinical trial of amitriptyline compared to active placebo in addition to usual care
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Secondary ID [1]
286336
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Nil
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Universal Trial Number (UTN)
U1111-1168-1721
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Painful knee osteoarthritis
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Condition category
Condition code
Musculoskeletal
294757
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0
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Osteoarthritis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Low-dose amitriptyline; 25mg; to be taken by mouth, in capsule form, alternate days for 2 weeks, then daily administration; 3 month duration
Bottles will be returned at the end of the study to assess compliance.
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Intervention code [1]
291390
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Treatment: Drugs
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Comparator / control treatment
Benztropine 1mg: to be taken by mouth, in capsule form, on alternate days for 2 weeks then daily administration: 3 months duration
Bottles will be returned at the end of the study to assess compliance.
This is an active placebo
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Control group
Placebo
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Outcomes
Primary outcome [1]
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change in knee pain : WOMAC pain
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Assessment method [1]
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Timepoint [1]
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3 months
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Secondary outcome [1]
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Change in WOMAC total
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Assessment method [1]
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Timepoint [1]
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3 months
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Secondary outcome [2]
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Substantial response: the proportion of participants achieving a substantial response (reduction in pain intensity of >= 50%) at 3 months, measured on VAS (0-100mm).
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Assessment method [2]
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Timepoint [2]
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3 months
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Secondary outcome [3]
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Moderate response: the proportion of participants achieving a moderate response (reduction in pain intensity of >= 30%) at 3 months, measured on VAS (0-100mm).
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Assessment method [3]
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Timepoint [3]
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3 months
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Eligibility
Key inclusion criteria
1) Males and females with symptomatic knee OA for at least 3 months, defined by the ACR clinical and radiographic criteria (ie pain and radiographic OA) (Altman, R., et al., Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. . Arthritis Rheum, 1986. 29(8): p. 1039-49.)
2) Pain score of at least 30 mm on a 100 mm visual analogue scale (VAS);
3) Age > 40 years, and < 75 years old
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Minimum age
40
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1) Inability to give informed consent;
2) Intra articular therapy over the past 3 months; Planning knee injection or surgical intervention in the next 4 months
3) Patients with rheumatoid arthritis, other inflammatory arthritis, or significant knee injury;
4) Patients with major depressive disorder for whom anti-depressant therapy is indicated
5) Patients taking medications that are contra-indicated when taking amitriptyline (monoamine oxidase inhibitors, other antidepressants, opioids, drugs that inhibit CYP3A4, etc)
6) Co-morbidity that may limit participation (e.g. any planned joint replacement in the next 4 months, medical conditions e.g. malignancy in the past 5 years other than non-melanoma skin cancer) or relocation;
7) Fibromyalgia, as this is evidence of an alternative underlying explanatory condition
8) Patients with contraindications to amitriptyline therapy eg acute angle glaucoma, prostatism,etc
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation concealment will be ensured by the use of identical, active placebo, and the use of a central automated allocation procedure, with security in place to ensure allocation data cannot be accessed or influenced by any person.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomization will be performed by a computerised random number generator, that will be held by an independent researcher not involved in other aspects of the trial.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
7/07/2015
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Actual
7/07/2015
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Date of last participant enrolment
Anticipated
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Actual
2/09/2021
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Date of last data collection
Anticipated
30/11/2021
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Actual
10/01/2022
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Sample size
Target
160
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Accrual to date
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Final
160
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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The Alfred - Prahran
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Recruitment postcode(s) [1]
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3004 - St Kilda Road Melbourne
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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National Health and Medical Research Council
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Address [1]
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National Health and Medical Research Council
GPO Box 1421
Canberra ACT 2601
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Monash University
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Address
Department of Epidemiology and Preventive Medicine
School of Public Health and Preventive Medicine
Monash University
Alfred Hospital
Commercial Road
Melbourne Vic 3004
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Alfred Human Research Ethics Committee
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Ethics committee address [1]
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Alfred Human Research Ethics Committee Alfred Hospital Commercial Road Prahran 3181 Vic
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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26/11/2014
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Approval date [1]
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19/12/2014
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Ethics approval number [1]
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512/14
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Summary
Brief summary
Knee osteoarthritis is one of the most common forms of arthritis. Pain, the main symptom, is poorly controlled by current treatment strategies. Pain is thought initially to originate from structural changes in an affected joint. However, after a while, in some people, changes occur in the nervous system that perpetuate the pain. These changes are referred to as pain sensitisation. They are not addressed by current treatments. Amitriptyline is commonly used to treat pain related to pain sensitisation, such as in shingles or diabetic neuropathy. This study is a randomised controlled trial of the use of amitriptyline, in addition to usual care, to manage pain in people with painful knee osteoarthritis. People with knee osteoarthritis will be randomised to receiving low dose amitriptyline or a placebo with many of the same side effects of the active drug, benztropine. They will be followed for 12 weeks to determine the effect of amitriptyline on pain, function and other symptoms of knee osteoarthritis.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Prof Anita Wluka
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Address
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Department of Epidemiology and Preventive Medicine
Monash University
Alfred Hospital
Commercial Road
Melbourne VIC 3004
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Country
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Australia
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Phone
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+ 61 3 9903 0555
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Molly Bond
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Address
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Department of Epidemiology and Preventive Medicine
Monash University
Alfred Hospital
Commercial Road
Melbourne VIC 3004
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Country
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Australia
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Phone
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+ 61 3 9903 0553
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Anita Wluka
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Address
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Department of Epidemiology and Preventive Medicine
Monash University
Alfred Hospital
Commercial Road
Melbourne VIC 3004
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Country
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Australia
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Phone
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+ 61 3 9903 0555
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Fax
55664
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
Study participants were not asked to provide consent for data sharing to occur. This study was initiated in 2014.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Effect of low-dose amitriptyline on reducing pain in clinical knee osteoarthritis compared to benztropine: study protocol of a randomised, double blind, placebo-controlled trial.
2021
https://dx.doi.org/10.1186/s12891-021-04690-y
N.B. These documents automatically identified may not have been verified by the study sponsor.
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