Current Environment:

Summary

Given the widespread use of anticonvulsants in the pediatric chronic pain population and the absence of scientific data supporting their use, the investigators propose a randomized, double blind, two group parallel design in which a broad group of children and adolescents with chronic neuropathic pain would be randomized to receive either Gabapentin or Oxcarbazepine. The Primary Aim of the Study is to assess the frequencies of successful treatment of pediatric patients with neuropathic pain treated with either Gabapentin or Oxcarbazepine. The Primary Hypotheses are as follows: Hypothesis I: Both Gabapentin and Oxcarbazepine will result in significant reduction in pain scores when compared to each patient's baseline. Hypothesis II: Patients who continue on active drug (Gabapentin or Oxcarbazepine) during the second phase of the trial will report greater pain reduction relative to baseline than patients who are randomized onto placebo at this randomization point. Secondary Aims of the Study are to compare groups treated initially with Gabapentin or Oxcarbazepine with regard to reduction in pain scores (both at rest and with evoked maneuvers), functional disability scores, tolerability, and measures of mood and cognitive functioning. Secondary Hypotheses are that Gabapentin and Oxcarbazepine differ in their effects on: Pain scores at rest and with evoked maneuvers Functional disability scores Tolerability (frequencies of side-effects) Depression and anxiety scales Neuropsychological measures of cognitive processing speed, working memory, and attention.

Conditions

Pediatric Chronic Neuropathic Pain

Recruitment Status

Not yet recruiting

Eligibility Criteria

Inclusion Criteria:

Patients between the ages of 8 and 18 at the time of the study with history of chronic (lasting ≥ 4 weeks) neuropathic pain that includes a known injury to a peripheral nerve and/or a pattern of pain responses that includes allodynia, burning, paresthesias or dysesthesias will be included in this study, provided that informed consent has been given by parents.
Patient's whose pain rates between moderate to severe at the time of inclusion (ranging from 4-10 in a numeric pain rating scale)
Eligible diagnoses include Complex Regional Pain Syndrome, Fibromyalgia, Lumbar Radiculopathy, Spinal Cord Injury, Erythromelalgia, Small Fiber Neuropathies, Traumatic or Post-surgical Peripheral Nerve or Plexus Injuries, and Extremity Pain with severe pain to light touch (allodynia).
Child has age-appropriate spoken and written knowledge of English.
Parent may be able to utilize an interpreter if need be.

Exclusion Criteria:

Unstable psychiatric illness (suicidal ideation, disorganized behavior)
Uncontrolled Seizure disorder
Chronic Headaches only
Abdominal Pain only
Prior experience with anticonvulsants for pain treatment.
Patients with Syndrome of Inappropriate Secretion of Antidiuretic Hormone

Intervention

Intervention Type

Intervention Name

Drug

Gabapentin

Drug

Oxcarbazepine

Other

Placebo

Phase

Phase 3

Gender

All

Minimum Age

8 Years

Maximum Age

18 Years

Download Date

December 11, 2020

Principal Investigator

Monique Ribeiro

Primary Contact Information

Monique Ribeiro, MD

(617) 355-7040

Monique.Ribeiro@childrens.harvard.edu

Kimberly Lobo, MPH

(857) 218-3556

Kimberly.Lobo@childrens.harvard.edu

For more information on this trial, visit clinicaltrials.gov.

Contact

For more information and to contact the study team: