NCT05302232

Intra-articular Injection of Lidocaine in Inflammatory Arthritis

Status unknown NA Last updated 31 March 2022

What this trial tests

NA trial testing depomedrone 40mg/ml + 1% lidocaine in Inflammatory Arthritis in 80 participants. Status unknown.

Timeline

18 April 2022

Primary endpoint
18 October 2022

18 October 2022

Quick facts

Lead sponsor	Guy's and St Thomas' NHS Foundation Trust
Phase	NA
Status	Status unknown
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	single
Primary purpose	diagnostic
Enrollment	80
Start date	18 April 2022
Primary completion	18 October 2022
Estimated completion	18 October 2022

Drugs / interventions tested

• depomedrone 40mg/ml + 1% lidocaine
• depomedrone 40mg/ml+ 0.9% saline
• painDETECT questionnaire

Conditions studied

• Inflammatory Arthritis — all drugs for Inflammatory Arthritis →

Sponsor

Guy's and St Thomas' NHS Foundation Trust

Who can join

18 and older, any sex, with Inflammatory Arthritis. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

To assess the contributions of peripheral neurons to joint pain, the investigators plan to ask patients to rate the pain in their chosen joint before and after an injection of local anaesthetic (lidocaine) and steroid into their joint. Lidocaine blocks voltage gated sodium channels (VGSCs) leading to a reversible block of action potential propagation in peripheral nerves. If the pain intensity reduces significantly following lidocaine injection, it suggests that the patients' pain is due to peripheral sensitization, and that this is dampened by the local anaesthetic. If the pain intensity does not change or only falls slightly, then other centrally mediated factors are contributing to pain.

Before the investigators can use this method, the investigators need to ensure that reductions in pain score following joint injection are not due to placebo effect. Therefore, as part of this validation study patients will be randomised to receive either lidocaine plus steroid or, as a control, just steroid injection. The steroid is the main part of therapy as it relieves inflammation over a prolonged period, but is slower acting than lidocaine, and should not have an effect within ten minutes. Any improvement in ranking of pain within 10 minutes by patients receiving just steroid will therefore be due to placebo effect. The investigators hypothesis is that there will be a significant difference in change in pain score before and after injection between the study group (lidocaine plus steroid) and control group (0.9% saline plus steroid). This will confirm the absence of a significant placebo effect and mean the differences in change in pain scores seen in the study group are due to differences in pain processing

Publications & conference data

1 peer-reviewed publication reference this trial (live from Europe PMC):

1. A randomised controlled trial of the effect of intra-articular lidocaine on pain scores in inflammatory arthritis.
   Rutter-Locher Z, Norton S, Denk F, McMahon S, et al · · 2024 · cited 8× · PMID 38888846 · DOI 10.1097/j.pain.0000000000003291