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Completed

NCT Number: NCT03380559

A Phase III Study to Evaluate Efficacy of Botulinum Toxin for Treating Epicondylitis

The study aims to demonstrate that intramuscular injection of botulinum toxin with a paralyzing dose coupled with subcutaneous injection of corticoid has greater efficacy than corticoid injection only or toxin injection only for treating lateral epicondylitis in reducing pain at 6 months.

As secondary objectives, the study aims to

* demonstrate improvement of quality of patient's life and positive effect on their resuming to professional activities or sportive activities. * evaluate tolerance of treatment by grip strength measurement and adverse event collection.

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Key information

Conditions

Age range

18 year–60 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 3

Primary location

Service de Médecine Physique et de Réadaptation, Hôpital Raymond Poincaré

Garches, Hauts-de-Seine, 92380, France

About this study

This is a prospective multicenter phase IIIb randomized double-blind placebo-controlled study, to compare efficacy and tolerance of 3 groups of treatments for epicondylitis.

All patients will be randomized in 3 following parallel treatment groups:

Group A : botulinum toxin + corticoid

Group C : placebo of toxin + corticoid

Group T : botulinum toxin + placebo corticoid

The study will be performed in 4 centers in France, targetting 150 patients. The follow-up of each patient will last 6 months after treatment.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patient aged between 18 and 60 years;
  • Physical disability or not;
  • Unilateral lateral epicondylitis more than 3 months, recurrent or not, no response to at least one standard treatment such as: local injection of corticoid, physiotherapy, rest, NSAIDs per os;
  • Signed consent obtained;
  • Covered by health insurance.

Exclusion criteria

  • Central nervous system disorders result in spasticity in epicondylitis limb;
  • History of severe psychiatric disorder;
  • History of myasthenia gravis;
  • Pregnant or breastfeeding woman;
  • Unable to understand or respond to questions;
  • Contraindication to botulinum toxin or corticoid;
  • Treatment with botulinum toxin 3 months prior to baseline;
  • Anticoagulant theraphy;
  • Difficult to follow-up in the study;
  • Patient under guardianship, or deprived of liberty by a judicial order.

Treatment and study plan

Injection, botulinum toxin + corticoid

Drug
  • Intramuscular injection of botulinum toxin (Xeomin® 50 U) under ultrasound control
  • Subcutaneous injection (lateral epicondylitis side) of corticoid (2 ml of Hydrocortancyl® 2,5 %)

Injection, placebo of toxin + corticoid

Drug
  • Intramuscular injection of placebo botulinum toxin (2 ml) under ultrasound control
  • Subcutaneous injection (lateral epicondylitis side) of corticoid (2 ml of Hydrocortancyl® 2,5 %)

Injection, botulinum toxin + placebo corticoid

Drug
  • Intramuscular injection of botulinum toxin (Xeomin® 50 U) under ultrasound control
  • Subcutaneous injection (lateral epicondylitis side) of placebo of corticoid (2 ml of physiological saline solution NaCL 0.9 %)

Primary outcomes

  1. Variation of pain intensity between injection of treatment and 6 months after injection

    Time frame: At the moment of injection

    Evaluate the variation of muscle pain intensity in wrist extensor contractions between the moment of injection and the end of the 6th month with the Visual Analogue Scale (VAS).

  2. Variation of pain intensity between injection of treatment and 6 months after injection

    Time frame: 6 months after injection

    Evaluate the variation of muscle pain intensity in wrist extensor contractions between the moment of injection and the end of the 6th month with the VAS.

Secondary outcomes

  1. Spontaneous pain intensity at rest

    Time frame: Before injection, 3 months after injection and 6 months after injection

    Evaluate pain intensity at rest with the VAS.

  2. Pain intensity of motion of wrist flexion

    Time frame: Before injection, 3 months after injection and 6 months after injection

    Evaluate pain intensity of motion of wrist flexion with the VAS.

  3. Pain intensity at proximal insertion palpation on epicondylitis muscle

    Time frame: Before injection, 3 months after injection and 6 months after injection

    Evaluate pain intensity at proximal insertion palpation on epicondylitis muscle. The palpation will be under ultrasound control.

  4. Number of days of sick leave

    Time frame: 6 months after injection

    Number of days of sick leave will be noted and collected

  5. The percentage of patients returning to professional activity or sportive activity

    Time frame: 6 months after injection

  6. Measurement of prehensile grasp capabilities by a force

    Time frame: At baseline, 3 months after injection, 6 months after injection

    The force will be measured by Jamar Hydraulic hand dynamometer.

  7. Functional outcome after injection

    Time frame: At baseline, 3 months after injection, 6 months after injection

    Outcome will be evaluated by questionnaire Patient Rated Tennis Elbow Evaluation

  8. Anxiety and depression tests

    Time frame: At baseline, 3 months after injection, 6 months after injection

    Hospital Anxiety and Depression scale will be used

  9. Frequence and gravity of adverse events

    Time frame: At baseline, 3 months after injection, 6 months after injection

    Adverse events will be collected and their severity will be reported.

Sponsors and collaborators

Lead sponsor

Assistance Publique - Hôpitaux de Paris

Other

Registry information

Official study title

A Phase III Randomized Double-blind Study to Evaluate Efficacy of Botulinum Toxin for Treating Epicondylitis

Acronym: EPITOX

Important dates

Study start
2019
Primary completion
2021
Study completion
2021
First posted
Dec 21, 2017
Registry last updated
Sep 21, 2023

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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