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THERMES ET VEINES: Spa for Prevention of Leg Ulcers

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00838500
Recruitment Status : Completed
First Posted : February 6, 2009
Last Update Posted : October 1, 2012
Université Joseph Fourier
Information provided by (Responsible Party):
Association Francaise pour la Recherche Thermale

Brief Summary:
The main objective of this study is to test the hypothesis that a 3 week intensive course of spa therapy can reduce the risk of leg ulcers in patients with advanced chronic venous insufficiency (C4a-b and C5 of the CEAP classification) at one year.

Condition or disease Intervention/treatment Phase
Venous Insufficiency Leg Ulcer Varicose Ulcer Drug: Immediate spa treatment Drug: Late spa treatment Phase 3

Detailed Description:

Chronic venous insufficiency affects to differing extents half of the French population. The most advanced forms, with skin changes (CEAP clinical classes C4-5-6) affect 5% of the population and are those most often indicated for spa treatment. A venous condition is recognized as justifying spa therapy by 12 spa resorts in France. However, no specific or global benefit has been clearly scientifically shown for such therapy. One methodologically sound study (Carpentier 2009) demonstrated a benefit of spa therapy using a non-clinical intermediate endpoint (severity of skin changes). No study has shown efficacy of spa therapy in the primary and secondary prevention of the major and most common complication of advanced chronic venous insufficiency: leg ulcers.

Vascular hemodynamics and in particular venous return from the lower limbs is subject to the laws of physics. Thus, the roles of the calf muscle venous pump and hydrostatic pressure in venous insufficiency rationalizes the use of balneotherapy techniques in the management of this pathology.

The spa therapy techniques used in the context of venous insufficiency have well-defined physiopathic targets and the hemodynamic and microcirculatory effects of some of them have been demonstrated. The high degree of satisfaction of patients taking the waters annually for venous conditions indirectly testifies to their enhanced well-being. Among venous indications, the prevention of post-thrombotic syndrome is one of the best recognized by the medical profession.Nevertheless, there has been no real validation of this indication with an acceptable methodology that meets the canons of evidence based medicine.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 425 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Investigator)
Primary Purpose: Treatment
Official Title: Evaluation of the Efficacy of Spa Treatment for Prevention of Leg Ulcers in Advanced Chronic Venous Insufficiency.
Study Start Date : May 2008
Actual Primary Completion Date : December 2010
Actual Study Completion Date : November 2011

Resource links provided by the National Library of Medicine

Arm Intervention/treatment
Active Comparator: Immediate SPA treatment
Immediate spa treatment during 18 days soon after randomization (1 year)
Drug: Immediate spa treatment
1st year, soon after randomization: Spa treatment of 18 days. Spa treatment : the most adapted to the concerned pathology and common to all of spa resorts(walk in a specially pool, whirlpool bath with automatic air and water massages cycles, massaging shower...)

Sham Comparator: Late SPA treatment
Late spa treatment during 18 days soon after 12 months visit (2nd year)
Drug: Late spa treatment
2nd year, soon after 12 months visit: Spa treatment of 18 days. Spa treatment : the most adapted to the concerned pathology and common to all of spa resorts(walk in a specially pool, whirlpool bath with automatic air and water massages cycles, massaging shower...)

Primary Outcome Measures :
  1. Occurrence of a leg ulcer within the year following the inclusion. The ulcer will be classified C5 of CEAP (healed ulcer) or C6 (non healed ulcer)at the follow up visit. [ Time Frame: 1 year ]

Secondary Outcome Measures :
  1. Healing time of the leg ulcers within the first year [ Time Frame: 12 months ]
  2. Quality of life: Euroqol EQ 5D, CIVIQ2 Scale [ Time Frame: Inclusion - 6 months - 12 months- 18 months ]
  3. Aggravation level defined as at least 20% increase of the modified Rutherford score and mean comparison of this score at 1 year [ Time Frame: Inclusion - 12 months - 18 months ]
  4. Visual analog scale for leg symptoms [ Time Frame: Monthly (until 18 months) ]
  5. Evaluation of the costs involved by the venous insufficiency at 1 year (treatments, physical treatments, hospitalization) [ Time Frame: Inclusion - 6, 12 and 18 months ]

Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Both sexes, more than 18 years old patients with a phlebological indication of spa treatment, with advanced chronic venous insufficiency, class C4a, or b or C5 of CEAP classification (leg ulcers must be healed since 3 months at least)
  • Available for a spa treatment during 18 days (immediate or late spa)and a follow-up period of 18 months
  • Voluntary to participate to the study,informed consent form signed after appropriate information
  • Affiliation to the social security system or equivalent

Exclusion Criteria:

  • Pregnancy, parturient or breast feeding
  • No psychiatric illness or social situation that would preclude study compliance
  • Leg ulcer in progress
  • Leg ulcer healed for less than 3 months
  • Refusal to consent
  • Refusal of spa treatment
  • Contra-indication of spa treatment(cancer in progress, psychiatric disorders, immunodeficiency)
  • Arteriopathy of lower limb with an Ankle Brachial Pressure Index (ABPI)< 0.7, symptomatic neuropathy, erysipelas within 5 years prior to inclusion
  • Surgical or endovascular treatment of the venous disease planned during the first year or during the six months prior to inclusion
  • No previous phlebological spa treatment within 6 months prior to inclusion

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00838500

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Cabinet médical
Albertville, France, 73200
Cabinet médical
Angouleme, France, 16000
Cabinet médical
Bagnoles de l'Orne, France, 61140
Cabinet médical
Barbotan Les Thermes, France, 32150
Cabinet médical
Bayonne, France, 64100
Cabinet médical
Belfort, France, 90000
Hopital thermal
DAX, France, 40100
University Hospital Grenoble
Grenoble, France, 38043
Cabinet médical
Montlucon, France, 03100
Cabinet médical
Montpellier, France, 34000
Cabinet médical
PAU, France, 64000
Cabinet médical
Rochefort, France, 17300
Cabinet médical
Tarbes, France, 65000
Sponsors and Collaborators
Association Francaise pour la Recherche Thermale
Université Joseph Fourier
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Principal Investigator: Patrick PC CARPENTIER, Professor Grenoble Hospital - France
Additional Information:

Publications automatically indexed to this study by Identifier (NCT Number):
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Responsible Party: Association Francaise pour la Recherche Thermale Identifier: NCT00838500    
Other Study ID Numbers: CUF 1497
First Posted: February 6, 2009    Key Record Dates
Last Update Posted: October 1, 2012
Last Verified: September 2012
Keywords provided by Association Francaise pour la Recherche Thermale:
Venous insufficiency
Leg ulcer
Modified Rutherford score
Euroquol EQ 5d scale
CIVIQ2 scale
Visual analogic Scale
SPA treatment
Additional relevant MeSH terms:
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Venous Insufficiency
Varicose Ulcer
Leg Ulcer
Pathologic Processes
Skin Ulcer
Skin Diseases
Vascular Diseases
Cardiovascular Diseases
Varicose Veins