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Trial registered on ANZCTR
Registration number
ACTRN12612000131853
Ethics application status
Approved
Date submitted
25/01/2012
Date registered
30/01/2012
Date last updated
9/10/2017
Type of registration
Prospectively registered
Titles & IDs
Public title
Is amitriptyline effective in the management of chronic low back pain?
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Scientific title
Is low dose amitriptyline more effective than an active placebo in the management of chronic low back pain? A double-blind, randomized, placebo-controlled trial.
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Secondary ID [1]
279751
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None
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Universal Trial Number (UTN)
U1111-1127-3216
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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:
Chronic low back pain
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Condition category
Condition code
Musculoskeletal
285804
285804
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0
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Other muscular and skeletal disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Low-dose amitriptyline; 25mg per day; capsule/oral administration; 6 month duration
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Intervention code [1]
284119
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Treatment: Drugs
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Comparator / control treatment
Benztropine mesylate; 1mg per day; capsule/oral administration; 6 month duration
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Control group
Active
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Outcomes
Primary outcome [1]
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Pain intensity
Measured on the Descriptor Differential Scale (DDS)
Mean pain score
Decrease of 2 units on the DDS
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Assessment method [1]
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Timepoint [1]
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Baseline and 3 and 6 months after intervention commenced
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Primary outcome [2]
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Pain intensity measured on the visual analog scale (VAS, 0-100)
Mean pain score
Minimally clinically important difference: Improvement of 15 points on the VAS
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Assessment method [2]
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Timepoint [2]
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Baseline and 3 and 6 months after intervention commenced.
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Secondary outcome [1]
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Functional status measured on the Roland Morris Disability Questionnaire (RMDQ);
Mean Disability Score;
Minimally clinically important difference: Improvement of 13-16% in disability or 3-4 points on RMDQ.
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Assessment method [1]
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Timepoint [1]
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Baseline and 3 and 6 months after intervention commenced
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Secondary outcome [2]
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Paid/unpaid work absence and hindrance/productivity measured on Short Form Health and Labour Questionnaire (SFHLQ)
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Assessment method [2]
295747
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Timepoint [2]
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Baseline and each month for 6 months after intervention commenced
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Eligibility
Key inclusion criteria
1. Aged 18-75 years
2. Chronic low back pain (Chronic > 3 months in duration; pain in the region bordered above by the costal margin and below by the gluteal folds)
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Minimum age
18
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
- Specific pathological entities, such as infection, metastasis, osteoporosis, fractures.
- Major co-existing illness which might confound assessment of function or for which amitriptyline may be inappropriate
- Another significant musculoskeletal conditions
- History of psychosis
- Patients with any diagnosed depression with or without the use of medication
- Any prior or current use of antidepressants
- Current use of opioids
- Any contra-indication or allergy to amitriptyline
- Pregnancy or planning/trying to become pregnant or breastfeeding
- Inability to provide informed consent
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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)
Randomisation will be based on computer generated random numbers prepared by a statistician who had no involvement in conducting the trial.
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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 2
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Type of endpoint/s
Safety/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
10/02/2012
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Actual
30/04/2012
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Date of last participant enrolment
Anticipated
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Actual
1/11/2015
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Date of last data collection
Anticipated
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Actual
1/06/2016
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Sample size
Target
150
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Accrual to date
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Final
146
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment postcode(s) [1]
4865
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3181
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Recruitment postcode(s) [2]
4878
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3004
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Recruitment postcode(s) [3]
4879
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3065
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Recruitment postcode(s) [4]
4880
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3079
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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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Hospital
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Name [1]
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Alfred Research Ethics Committee
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Address [1]
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Alfred Research Ethics Committee
Alfred Hospital
Commercial Road
Prahran 3181
Vic
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Country [1]
283467
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Australia
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Other collaborator category [1]
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University
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Name [1]
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VU University
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Address [1]
260463
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VU University
De Boelelaan 1085, room U454
1081 HV Amsterdam
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Country [1]
260463
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Netherlands
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Other collaborator category [2]
260476
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Other
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Name [2]
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National Ageing Research Institute
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Address [2]
260476
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34/54 Poplar Rd
Parkville
VIC 3052
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Country [2]
260476
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
286524
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Alfred Research Ethics Committee
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Ethics committee address [1]
286524
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55 Commercial Rd, Melbourne VIC 3004
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
286524
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25/11/2011
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Approval date [1]
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23/12/2011
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Ethics approval number [1]
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HREC/12/Alfred/16, 476/11
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Ethics committee name [2]
298788
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Eastern Health Human Research Ethics Committee
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Ethics committee address [2]
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The Office of Research and Ethics Level 2 5 Arnold Street Box Hill VIC 3128
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Ethics committee country [2]
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Australia
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Date submitted for ethics approval [2]
298788
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15/05/2015
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Approval date [2]
298788
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05/09/2012
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Ethics approval number [2]
298788
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SERP28/1112
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Ethics committee name [3]
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Monash University Human Research Ethics Committee
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Ethics committee address [3]
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Monash University Level 1, Chancellery Building D, Clayton Campus 26 Sports Walk Clayton VIC 3800 Australia
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Ethics committee country [3]
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Australia
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Date submitted for ethics approval [3]
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13/01/2012
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Approval date [3]
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01/02/2012
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Ethics approval number [3]
298789
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CF12/0271 - 2012000106
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Summary
Brief summary
Chronic low back pain is a major public health problem. Antidepressants are one commonly prescribed treatment for low back pain, and are used not only to treat depression and insomnia, but chronic pain. Their use is rapidly increasing, despite lack of supportive evidence and conflicting recommendations from clinical guidelines. Aims: In community-based adults with chronic low back pain, we aim to determine: 1. If low dose amitriptyline (tricyclic antidepressant) is more effective than an active placebo in the management of pain 2. If low dose amitriptyline is more effective than an active placebo in improving disability and reducing work absence and hindrance. Methods: A double-blind, randomized, placebo-controlled trial will be conducted. We will recruit 150 subjects with chronic low back pain. Participants will receive low-dose amitriptyline or an active placebo for 6 months. Pain, disability and work absence and hindrance will be assessed at baseline, 3 and 6 months using valid measures. Implications: If antidepressants are found to be effective, it will provide high quality evidence for their use, potentially enabling this treatment option to be considered by more individuals with chronic low back pain. If we do not find antidepressants to be effective, then this trial will provide strong evidence to review international guidelines that recommend their use and to evaluate the extensive use of tricyclic antidepressants for chronic low back pain.
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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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Dr Donna Urquhart
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Address
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Monash University
The Alfred Centre
99 Commercial Road
Melbourne VIC 3004
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Country
33650
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Australia
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Phone
33650
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61 3 9903 0555
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Fax
33650
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Email
33650
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[email protected]
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Contact person for public queries
Name
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Ms Judy Hankin / Ms Alice Noone
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Address
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Department of Epidemiology and Preventive Medicine
School of Public Health and Preventive Medicine
Monash University
Alfred Hospital
Commercial Road
Melbourne Vic 3004
Australia
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Country
16897
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Australia
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Phone
16897
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+61 3 9903 0553
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Fax
16897
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+61 3 9903 0556
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Email
16897
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[email protected]
OR
[email protected]
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Contact person for scientific queries
Name
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Dr Donna Urquhart or Prof Flavia Cicuttini
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Address
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Department of Epidemiology and Preventive Medicine
School of Public Health and Preventive Medicine
Monash University
Alfred Hospital
Commercial Road
Melbourne Vic 3004
Australia
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Country
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Australia
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Phone
7825
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+61 3 9903 0555
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Fax
7825
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+61 3 9903 0556
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Email
7825
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[email protected]
OR
[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
Source
Title
Year of Publication
DOI
Embase
Is low-dose amitriptyline effective in the management of chronic low back pain? Study protocol for a randomised controlled trial.
2016
https://dx.doi.org/10.1186/s13063-016-1637-1
Embase
Efficacy of Low-Dose Amitriptyline for Chronic Low Back Pain: A Randomized Clinical Trial.
2018
https://dx.doi.org/10.1001/jamainternmed.2018.4222
N.B. These documents automatically identified may not have been verified by the study sponsor.
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