Treatment of Thoracic Outlet Syndrome (TOS) With Botox

This study has been completed.
Sponsor:
Collaborator:
Allergan
Information provided by:
University of British Columbia
ClinicalTrials.gov Identifier:
NCT00444886
First received: March 7, 2007
Last updated: February 9, 2011
Last verified: February 2011
  Purpose

The purpose of this study is:

  1. To assess the effect of BOTOX injection to the scalene muscles on the severity of pain from TOS.
  2. To assess the effect of BOTOX injection on numbness and tingling and quality of life.

Condition Intervention Phase
Thoracic Outlet Syndrome
Drug: Botulinum Toxin Type A injection (BOTOX)
Phase 2

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Double Blind (Subject, Investigator)
Primary Purpose: Treatment
Official Title: Treatment of Thoracic Outlet Syndrome With Botulinum Toxin Injection: A Double-Blind, Randomized Controlled Trial

Resource links provided by NLM:


Further study details as provided by University of British Columbia:

Primary Outcome Measures:
  • Pain as measured on Visual Analog Scale (VAS) at 6 weeks, 3 months and 6 months post-intervention [ Time Frame: 6 monhts ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Paresthesias as measured on VAS [ Time Frame: 6 months ] [ Designated as safety issue: No ]
  • Function as measured with Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, SF-36, number of days lost from work [ Time Frame: 6 months ] [ Designated as safety issue: No ]

Estimated Enrollment: 40
Study Start Date: May 2007
Study Completion Date: February 2011
Primary Completion Date: February 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: 1
To assess the effect of BOTOX injection to the scalene muscles on the severity of pain from TOS.
Drug: Botulinum Toxin Type A injection (BOTOX)
Each subject will receive an injection under EMG guidance into the anterior and middle scalene muscles of either 75 units of BTX-A (experimental group), or normal saline (control group). Both groups will be provided with a stretching and strengthening exercise program.
Active Comparator: 2
To assess the effect of BOTOX injection on numbness and tingling and quality of life.
Drug: Botulinum Toxin Type A injection (BOTOX)
Each subject will receive an injection under EMG guidance into the anterior and middle scalene muscles of either 75 units of BTX-A (experimental group), or normal saline (control group). Both groups will be provided with a stretching and strengthening exercise program.

Detailed Description:

Background:

Thoracic Outlet Syndrome (TOS) is a symptom complex consisting of pain, paresthesias and often functional impairment caused by compression of the neurovascular supply to the upper limb. Impingement may occur at the interscalene triangle, and both anesthetic blockade and chemodenervation of the scalene muscles have been shown to temporarily improve symptoms of TOS in non-randomized controlled trials.

Objective:

To assess the effect of Botulinum Toxin Type A (BTX-A) injections into the scalene muscles on pain, paresthesias and function in subjects with TOS.

Hypothesis:

BTX-A injected into the anterior and middle scalene muscles will reduce the irritation on the neurovascular structures at the interscalene triangle in subjects with TOS. This will lead to reductions in pain and paresthesias, and improvements in function when compared with injection of placebo.

Intervention:

Each subject will receive an injection under EMG guidance into the anterior and middle scalene muscles of either 75 units of BTX-A (experimental group), or normal saline (control group). Both groups will be provided with a stretching and strengthening exercise program.

  Eligibility

Ages Eligible for Study:   19 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Age at least 19 years
  • Medically stable
  • Able to give informed consent
  • Meets criteria for clinical diagnosis of TOS
  • Symptoms of TOS present for at least six months
  • Have had EMG studies and a CT or MRI scan of the cervical spine

Exclusion Criteria:

  • Prior treatment with BTX-A
  • Allergy to BTX-A
  • History of botulinum toxicity
  • Prior scalenectomy
  • Surgery for TOS planned within six months
  • Use of blood thinners, i.e., warfarin; unfractionated or low molecular weight heparin
  • History of Myasthenia Gravis, Eaton-Lambert Syndrome or Shy-Drager Syndrome
  • Unable to complete follow-up assessments at 6 weeks, 3 months and 6 months
  • Any abnormalities on EMG, CT or MRI studies suggesting an alternate diagnosis
  • Pregnancy or planned pregnancy within six months
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00444886

Locations
Canada, British Columbia
GF Strong Rehabilitation Centre
Vancouver, British Columbia, Canada, V5Z 2G9
Sponsors and Collaborators
University of British Columbia
Allergan
Investigators
Principal Investigator: Andrew Travlos, MD University of British Columbia
  More Information

No publications provided

Responsible Party: Heather Finlayson, University of British Columbia
ClinicalTrials.gov Identifier: NCT00444886     History of Changes
Other Study ID Numbers: H06-03355, Data not known
Study First Received: March 7, 2007
Last Updated: February 9, 2011
Health Authority: Canada: Health Canada

Keywords provided by University of British Columbia:
Thoracic Outlet Syndrome (TOS)
Botulinum Toxin
Botox
Pain

Additional relevant MeSH terms:
Thoracic Outlet Syndrome
Nerve Compression Syndromes
Peripheral Nervous System Diseases
Neuromuscular Diseases
Nervous System Diseases
Vascular Diseases
Cardiovascular Diseases
Botulinum Toxins, Type A
Botulinum Toxins
Neuromuscular Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Pharmacologic Actions
Anti-Dyskinesia Agents
Central Nervous System Agents
Therapeutic Uses

ClinicalTrials.gov processed this record on April 17, 2014