Targeting patient recovery priorities in degenerative cervical myelopathy: design and rationale for the RECEDE-Myelopathy trial-study protocol.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
07 03 2023
Historique:
entrez: 7 3 2023
pubmed: 8 3 2023
medline: 10 3 2023
Statut: epublish

Résumé

Degenerative cervical myelopathy (DCM) is a common and disabling condition of symptomatic cervical spinal cord compression secondary to degenerative changes in spinal structures leading to a mechanical stress injury of the spinal cord. RECEDE-Myelopathy aims to test the disease-modulating activity of the phosphodiesterase 3/phosphodiesterase 4 inhibitor Ibudilast as an adjuvant to surgical decompression in DCM. RECEDE-Myelopathy is a multicentre, double-blind, randomised, placebo-controlled trial. Participants will be randomised to receive either 60-100 mg Ibudilast or placebo starting within 10 weeks prior to surgery and continuing for 24 weeks after surgery for a maximum of 34 weeks. Adults with DCM, who have a modified Japanese Orthopaedic Association (mJOA) score 8-14 inclusive and are scheduled for their first decompressive surgery are eligible for inclusion. The coprimary endpoints are pain measured on a visual analogue scale and physical function measured by the mJOA score at 6 months after surgery. Clinical assessments will be undertaken preoperatively, postoperatively and 3, 6 and 12 months after surgery. We hypothesise that adjuvant therapy with Ibudilast leads to a meaningful and additional improvement in either pain or function, as compared with standard routine care. Clinical trial protocol V.2.2 October 2020. Ethical approval has been obtained from HRA-Wales.The results will be presented at an international and national scientific conferences and in a peer-reviewed journals. ISRCTN Number: ISRCTN16682024.

Identifiants

pubmed: 36882259
pii: bmjopen-2022-061294
doi: 10.1136/bmjopen-2022-061294
pmc: PMC10008337
doi:

Substances chimiques

Adjuvants, Immunologic 0

Types de publication

Clinical Trial Protocol Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e061294

Informations de copyright

© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: MRNK holds a research grant from clinical scientist award and has support for the study from Medicinova. MCP holds research grant award with the NIHR. BD holds research grants with NIHR HTA POLYFIX-DCM, Evelyn Trust (DCM-COINs) and award from National Lottary UK for developing a peer-to-peer support community for Degenerative Cervical myelopathy. BD is also a founder of MoveMed Ltd. PJH holds NIHR research grants.

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Auteurs

Benjamin Davies (B)

Department of Neurosurgery, Cambridge University, Cambridge, UK.

Oliver D Mowforth (OD)

Department of Neurosurgery, Cambridge University, Cambridge, UK.

Stefan Yordanov (S)

Department of Neurosurgery, Cambridge University, Cambridge, UK.

Daniel Alvarez-Berdugo (D)

Cambridge Clinical Trials Unit, Cambridge University Hospital, Cambridge, UK.

Simon Bond (S)

Cambridge Clinical Trials Unit, Cambridge University Hospital, Cambridge, UK.

Marianna Nodale (M)

Cambridge Clinical Trials Unit, Cambridge University Hospital, Cambridge, UK.

Paula Kareclas (P)

Cambridge Clinical Trials Unit, Cambridge University Hospital, Cambridge, UK.

Lynne Whitehead (L)

Pharmacy Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Jon Bishop (J)

Medical Statistician, NIHR Surgical Reconstruction and Microbiology Research Centre, Birmingham, UK.

Siddharthan Chandran (S)

Edinburgh Medical School & Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.

Sarah Lamb (S)

Institute of Health Research, University of Exeter, Exeter, UK.

Mark Bacon (M)

International Spinal Research Trust, London, UK.

Marios C Papadopoulos (MC)

Department of Neurosurgery, St George's Hospital, London, UK.

Michelle Starkey (M)

Myelopathy.org, Cambridge, UK.

Iwan Sadler (I)

Myelopathy.org, Cambridge, UK.

Lara Smith (L)

Myelopathy.org, Cambridge, UK.

Sukhvinder Kalsi-Ryan (S)

Toronto Rehabilitation Institute, Toronto, Ontario, Canada.

Adrian Carpenter (A)

Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.

Rikin A Trivedi (RA)

Department of Neurosurgery, Cambridge University, Cambridge, UK.

Martin Wilby (M)

Department of Neurosurgery, The Walton Centre NHS Foundation Trust, Liverpool, UK.

David Choi (D)

Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK.

Ian B Wilkinson (IB)

Cambridge Clinical Trials Unit, Cambridge University Hospital, Cambridge, UK.

Michael G Fehlings (MG)

Department of Surgery, Toronto Western Hospital and University of Toronto, Toronto, Ontario, Canada.

Peter John Hutchinson (PJ)

Department of Neurosurgery, Cambridge University, Cambridge, UK.

Mark R N Kotter (MRN)

Department of Neurosurgery, Cambridge University, Cambridge, UK Mrk25@medschl.cam.ac.uk.

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Classifications MeSH