Efficacy of Riluzole in Surgical Treatment for Cervical Spondylotic Myelopathy (CSM-Protect) (CSM-Protect)

Tracking Information
First Submitted Date ICMJE	October 23, 2010
First Posted Date ICMJE	December 10, 2010
Last Update Posted Date	September 20, 2018
Study Start Date ICMJE	December 2011
Actual Primary Completion Date	May 1, 2018 (Final data collection date for primary outcome measure)
Current Primary Outcome Measures ICMJE; (submitted: December 8, 2010)	Modified Japanese Orthopedic Association Score (mJOA) [ Time Frame: Before the surgery, 180 days ]; The mJOA is a clinician administered scale. It evaluates four clinical dimensions; motor dysfunction score for upper and lower extremities, sensation loss and sphincter dysfunction. The total score ranges from 0 (worst) to 18 (best).
Original Primary Outcome Measures ICMJE	Same as current
Change History	Complete list of historical versions of study NCT01257828 on ClinicalTrials.gov Archive Site
Current Secondary Outcome Measures ICMJE; (submitted: April 1, 2013)	Nurick Score [ Time Frame: Pre-surgical, 180 days ]Nurick score is a simple measure of neurological dysfunction and ranges from 0 (best) to 6 (worst).; SF-36v2.0 [ Time Frame: Before the surgery, 180 days ]The SF36v2.0 is a health-related quality of life instrument that evaluates health status accross eight health dimensions.; Neck Disability Index (NDI) [ Time Frame: Before the surgery, 180 days ]The NDI evaluates patient self-reported functional outcomes related to neck conditions. The NDI score ranges from 0 (best) to 100 (worst).; Cervical Pain Numeric Rating Scale [ Time Frame: Before the surgery, 180 days ]Simple numeric rating scale with choises of answers from 0 (no pain) to 10 (worst imaginable pain); EQ-5D [ Time Frame: Before the surgery, 180 days ]EQ-5D™ is a standardised instrument for use as a measure of health outcome. It provides a simple descriptive profile and a single index value for health status.; American Spinal Injury Association Score (ASIA) [ Time Frame: Before the surgery, 180 days ]The ASIA impairment scale describes a person's functional impairment as a result of their spinal cord injury.
Original Secondary Outcome Measures ICMJE; (submitted: December 8, 2010)	Nurick Score [ Time Frame: Pre-surgical, 180 days ]Nurick score is a simple measure of neurological dysfunction and ranges from 0 (best) to 6 (worst).; SF-36v2.0 [ Time Frame: Before the surgery, 180 days ]The SF36v2.0 is a health-related quality of life instrument that evaluates health status accross eight health dimensions.; Neck Disability Index (NDI) [ Time Frame: Before the surgery, 180 days ]The NDI evaluates patient self-reported functional outcomes related to neck conditions. The NDI score ranges from 0 (best) to 100 (worst).; Cervical Pain Numeric Rating Scale [ Time Frame: Before the surgery, 180 days ]Simple numeric rating scale with choises of answers from 0 (no pain) to 10 (worst imaginable pain); EQ-5D [ Time Frame: Before the surgery, 180 days ]EQ-5D™ is a standardised instrument for use as a measure of health outcome. It provides a simple descriptive profile and a single index value for health status.; sia American Spinal Injury Association Score (ASIA) [ Time Frame: Before the surgery, 180 days ]The ASIA impairment scale describes a person's functional impairment as a result of their spinal cord injury.
Current Other Outcome Measures ICMJE	Not Provided
Original Other Outcome Measures ICMJE	Not Provided
Descriptive Information
Brief Title ICMJE	Efficacy of Riluzole in Surgical Treatment for Cervical Spondylotic Myelopathy (CSM-Protect)
Official Title ICMJE	Efficacy of Riluzole in Patients With Cervical Spondylotic Myelopathy Undergoing Surgical Treatment. A Randomized, Double-Blind, Placebo-controlled Multi-Center Study
Brief Summary	CSM (Cervical spondylotic myelopathy) is the most common cause of spinal cord injury worldwide. While there is evidence from the recently completed SpineNet prospective study that surgical decompression is an effective treatment for CSM, it is clear that many patients have remaining neurological impairment. While surgery is relatively safe, approximately 3% of patients maintain a neurological problem. Given this background and data from preclinical models of non-traumatic and traumatic spinal cord injury, there is strong evidence to consider the potential benefit of adding a neuroprotective drug which aids in the treatment of patients with CSM whom are undergoing surgical decompression. Riluzole is FDA-approved for the treatment of amyotrophic lateral sclerosis, which has some similar clinical features to CSM. Riluzole is currently under investigation for traumatic spinal cord injury. Given this background, there is a strong basis to consider studying the potential neurological benefits of Riluzole as a treatment to surgical decompression in patients with CSM.
Detailed Description	Not Provided
Study Type ICMJE	Interventional
Study Phase	Phase 3
Study Design ICMJE	Allocation: Randomized; Intervention Model: Parallel Assignment; Masking: Triple (Participant, Investigator, Outcomes Assessor); Primary Purpose: Treatment
Condition ICMJE	Cervical Spondylotic Myelopathy
Intervention ICMJE	Drug: riluzole 50mg BID orally for 14 days prior to surgery and 28 days after the surgery Other Name: Rilutek; Drug: Placebo medication 50mg BID orally for 14 days prior to surgery and 28 days after the surgery
Study Arms	Placebo Comparator: Placebo Placebo medication and decompressive cervical spine surgery Intervention: Drug: Placebo medication; Experimental: Riluzole Riluzole in dose 50mg BID for 14 days prior to surgery and 28 days after the decompressive spine surgery Intervention: Drug: riluzole
Publications *	Fehlings MG, Wilson JR, Karadimas SK, Arnold PM, Kopjar B. Clinical evaluation of a neuroprotective drug in patients with cervical spondylotic myelopathy undergoing surgical treatment: design and rationale for the CSM-Protect trial. Spine (Phila Pa 1976). 2013 Oct 15;38(22 Suppl 1):S68-75. doi: 10.1097/BRS.0b013e3182a7e9b0. Review.
* Includes publications given by the data provider as well as publications identified by ClinicalTrials.gov Identifier (NCT Number) in Medline.
Recruitment Information
Recruitment Status ICMJE	Completed
Actual Enrollment ICMJE; (submitted: December 8, 2010)	270
Original Estimated Enrollment ICMJE	Same as current
Actual Study Completion Date	May 1, 2018
Actual Primary Completion Date	May 1, 2018 (Final data collection date for primary outcome measure)
Eligibility Criteria ICMJE	Inclusion Criteria: Age between 18 and 80 years; Diagnosis of symptomatic cervical spondylotic myelopathy defined as a combination of: one or more of the following symptoms: Numb hands Clumsy hands Impairment of gait Bilateral arm paresthesiae l'Hermitte's phenomena Weakness And, one or more of the following signs: Corticospinal distribution motor deficits Atrophy of hand intrinsic muscles Hyperreflexia Positive Hoffman sign Upgoing plantar responses Lower limb spasticity Broad based, unstable gait And, MRI evidence of cervical spondylotic myelopathy; Scheduled for an elective surgery for cervical spondylotic myelopathy; Preoperative mJOA score ≥8 and ≤14; Women of child bearing potential must be: Postmenopausal defined as amenorrhea for at least 2 years. Surgically sterile, (have had a hysterectomy or bilateral oophorectomy, tubal ligation, or otherwise be incapable of pregnancy) Abstinent (at the discretion of the investigator) Having other congenital or medical condition that prevents subject from becoming pregnant If sexually active, be practicing an effective method of birth control such as hormonal prescription oral contraceptives, progesterone implants or injections, intrauterine device (IUD), or male partner with a vasectomy. A double-barrier method such as condoms, diaphragms or cervical caps with spermicidal foam, cream or gel may be used as a birth control method. Women of childbearing potential must have a negative serum β-human chorionic gonadotropin (β-hCG) pregnancy test or a negative urine pregnancy test at screening before the first dose of study drug is received. Exclusion Criteria: Previous surgery for CSM; Concomitant symptomatic lumbar stenosis; CSM symptoms due to cervical trauma (at the discretion of the investigator); Hypersensitivity to riluzole or any of its components; Neutropenia measured as absolute neutrophil count (ANC) measured in cells per microliter of blood of < 1500 at screening visit; Creatinine level of > 1.2 milligrams (mg) per deciliter (dl) in males or > 1.1 milligrams per deciliter in females at screening visit Liver enzymes (ALT or AST) 3x higher than normal values at screening visit.; Liver enzymes (ALT or AST) 3x higher than normal values at screening visit.; Subject will be using any of the following medications which are classified as CYP1A2 inhibitors or inducers*during the course of the drug regimen: Inhibitors: Ciprofloxacin; Enoxacin; Fluvoxamine; Methoxsalen; Mexiletine; Oral contraceptives; Phenylpropanolamine; Thiabendazole; Zileuton Inducers: Montelukast; Phenytoin *Note: no washout period required; if these medications are discontinued, subjects are eligible to be enrolled in the trial.; Systemic infection such as AIDS, HIV, and active hepatitis; Active malignancy defined as history of invasive malignancy, except if the patient has received treatment and displayed no clinical signs and symptoms for at least five years; Recent history (less than 3 years) of chemical substance dependency or significant psychosocial disturbance that may impact the outcome or study participation; Breastfeeding at screening visit and plan to continue during the course of the study drug; Unlikely to comply with the follow-up evaluation schedule; Unlikely to comply with investigational drug regime; Participation in a clinical trial of another investigational drug or device within the past 30 days; Is a prisoner; Unable to converse, read or write English at elementary school level
Sex/Gender	Sexes Eligible for Study: All
Ages	18 Years to 80 Years (Adult, Older Adult)
Accepts Healthy Volunteers	No
Contacts ICMJE	Contact information is only displayed when the study is recruiting subjects
Listed Location Countries ICMJE	Canada, United States
Removed Location Countries
Administrative Information
NCT Number ICMJE	NCT01257828
Other Study ID Numbers ICMJE	SPN-10-001
Has Data Monitoring Committee	No
U.S. FDA-regulated Product	Not Provided
IPD Sharing Statement	Not Provided
Responsible Party	AOSpine North America Research Network
Study Sponsor ICMJE	AOSpine North America Research Network
Collaborators ICMJE	Not Provided
Investigators ICMJE	Principal Investigator: Michael Fehlings, MD University Health Network, Toronto Study Director: Branko Kopjar, MD University of Washington
PRS Account	AOSpine North America Research Network
Verification Date	September 2018
ICMJE Data element required by the International Committee of Medical Journal Editors and the World Health Organization ICTRP