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Trial registered on ANZCTR
Registration number
ACTRN12610000173099
Ethics application status
Approved
Date submitted
4/01/2010
Date registered
25/02/2010
Date last updated
25/02/2010
Type of registration
Prospectively registered
Titles & IDs
Public title
Does gabapentin reduce itch in children with acute severe burns? A prospective randomised double blinded controlled study.
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Scientific title
A comparison of two gabapentin doses with placebo for the management of itch in children with acute burns.
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Secondary ID [1]
1325
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nil
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Universal Trial Number (UTN)
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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:
Pruritus
252180
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Acute burns in children
256462
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Condition category
Condition code
Injuries and Accidents
252377
252377
0
0
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Burns
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Skin
252476
252476
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0
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Dermatological conditions
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Gabapentin oral, two dose regimens:
Group 1: oral gabapentin syrup 5mg/kg three times a day for 28 days.
Group 2: oral gabapentin syrup 10mg/kg three times a day for 28days.
Both groups and the control group will have access to rescue medication for peristent itch. The rescue medication reflects current clinical practice i.e. trimeprazine 0.5mg/kg oral up to every 8hours.
N.b. the study intervention tests a 'preventative action' on itch. Itch that occurs despite the study drug intervention will be managed according to a standard protocol i.e. a 'rescue protocol- given below.
Standardised management of itch in children with burns.
The management of itch will be standardised and include both non-pharmacological and pharmacological interventions. Non-pharmacological interventions include the use of pressure garments where appropriate, skin and scar lubrication if appropriate (healed burns or donor sites), soft tissue mobilisation or massage and play and distraction therapies. Pharmacological intervention will be standardised into three sequential tiers of rescue interventions reflecting current clinical practice.
I) Itch score > 2: Trimeprazine 0.5 mg/kg orally tds for 48 hours.
II) Itch unresponsive to anti-histamine :Ondansetron 0.1 mg/kg orally or IV tds for 24 hours.
III) Persistent itch. Itch causing distress more than 72 hours after commencing anti-histamine: IV naloxone infusion. 0.5/micrograms/kg/hour for 12 hours.
Study drug treatment will continue for 28 days unless a side-effect or adverse event suspected to be related to the study drug is detected.
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Intervention code [1]
241613
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Prevention
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Comparator / control treatment
Placebo:
oral syrup (identical flavouring and natural colour so as to be identical to intervention) administered three times a day for 28 days.
Both study groups and the control group will have access to rescue medication for peristent itch. The rescue medication reflects current clinical practice i.e. trimeprazine 0.5mg/kg oral up to every 8hours.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Presence of itch during the last week of a four week treatment period.
Itch is present if 4 or more itch scores (of the seven recorded scores)are greater than 3 in the last week of observation.
Itch will be measured using a 10 point visual analogue scale (0= 'no itch', and 10 = worst possible itch').
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Assessment method [1]
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Timepoint [1]
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Once per day during the last week of a four week treatment period.
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Secondary outcome [1]
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Average itch score over the entire four week treatment period. Itch scores (either self-reported or reported by carers) will be documented in a diary supplied to all study recruits. Diary entries will be checked at weekly intervals through a phone interview and diaries will be collected for analysis at the end of the study period.
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Assessment method [1]
262439
0
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Timepoint [1]
262439
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Itch is assessed daily during the four week treatment period.
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Secondary outcome [2]
263032
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Use of conventional rescue anti-pruritic medication. (Total number of doses of trimeperazine oral syrup given during the 28 day study period.)
Rescue medication will be available as per current clinical practice for persistent itch with scores >2)
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Assessment method [2]
263032
0
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Timepoint [2]
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Total over 28 day study period.
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Secondary outcome [3]
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Parental satisfaction- assessed through a 5 point scale (0= completely dissatisfied, 4= completely satisfied)
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Assessment method [3]
263037
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Timepoint [3]
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At end of 28 day study period
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Secondary outcome [4]
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Reported itch severity at 3 months after discharge. Assessed on a 10 point visual analogue scale.
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Assessment method [4]
263038
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Timepoint [4]
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At 3 months after discharge.
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Eligibility
Key inclusion criteria
Patients admitted to a burns ward.
Admission within 14 days of an acute burn injury.
Parenteral opioids required for analgesia.
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Minimum age
1
Years
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Maximum age
16
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
Haemodynamic instability.
Previous or current treatment with gabapentin.
Receiveing Anti-epileptic drugs (AEDs).
Intubated and ventilated in a paediatric intensive care (PICU).
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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)
Patients will be identified by the primary investigators. Eligibility will be confirmed.
Following informed consent , a sealed opaque envelope containing an allocation code will be used. The hospital clinical trial pharmacist will hold the allocation schedule and will then dispense the study drug and maintain the blinding.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Randomisation will be by computerised sequence generation and will be stratified by age.
Randomisation will be completed in blocks.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 3
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
15/03/2010
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
90
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
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Recruitment postcode(s) [1]
2511
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2145
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Children's Hospital at Westmead
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Address [1]
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Hawkesbury Road
Westmead 2145
NSW
Australia
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Country [1]
256230
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Australia
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Primary sponsor type
Hospital
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Name
Children's Hospital at Westmead
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Address
Hawkesbury Road
Westmead 2145
NSW
Australia
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Country
Australia
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Secondary sponsor category [1]
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Charities/Societies/Foundations
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Name [1]
251562
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Society of Paediatric Anaesthetists of New Zealand and Australia
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Address [1]
251562
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SPANZA secretariat
PO Box 180
Morisset
New South Wales 2264
Australia
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Country [1]
251562
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
258326
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The Children's Hospital at Westmead Ethics Committee
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Ethics committee address [1]
258326
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The Children's Hospital at Westmead Hawkesbury Road Westmead 2145 NSW Australia
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Ethics committee country [1]
258326
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Australia
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Date submitted for ethics approval [1]
258326
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Approval date [1]
258326
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10/01/2010
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Ethics approval number [1]
258326
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09/CHW/152
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Summary
Brief summary
This randomised, placebo-controlled and blinded study aims to quantify the effect of regular oral gabapentin (28 day course) on the incidence and severity of pruritus in children with acute severe burns. Itch will be assessed using standardised age appropriate itch scales. The primary outcome measure will be the proportion of children who are itch free in the final week of a four week study period. Secondary outcomes will include the average severity of itch during the four week study period and the use of conventional rescue anti-pruritic medication. Other secondary outcomes include parental satisfaction and reported pruritus severity at 3months after discharge (obtained through a follow-up phone interview). Although not the primary focus of this study, the effect of gabapentin on pain scores and opioid requirements in these patients will be explored. The is a single-centre, investigator-driven study that will be conducted within the Burns Unit at the Children’s Hospital at Westmead, which is the referral centre for all children with burns in New South Wales. Modest financial support for this study has been obtained from the Society of Paediatric Anaesthetists of New Zealand and Australia.
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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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Address
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Dr Andrew Weatherall
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Address
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c/o Dept of Anaesthesia
The Children's Hospital at Westmead
Hawkesbury Road
Westmead
NSW 2145
Australia
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Country
13746
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Australia
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Phone
13746
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61 2 9845 0000
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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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Dr Andrew Weatherall
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Address
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c/o Dept of Anaesthesia
The Children's Hospital at Westmead
Hawkesbury Road
Westmead
NSW 2145
Australia
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Country
4674
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Australia
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Phone
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61 2 9845 0000
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Fax
4674
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Email
4674
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[email protected]
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No information has been provided regarding IPD availability
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
No additional documents have been identified.
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