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The aim of this randomized trial is to assess the efficacy of EUS-CPB in the alleviation of abdominal pain in patients with chronic pancreatitis.
Chronic pancreatitis is a complex fibroinflammatory disease arising from numerous etiological factors and a variety of clinical manifestations. Abdominal pain is the most debilitating complication and can result in significant morbidity and impact on quality of life. Endoscopic ultrasonography (EUS) has been increasingly utilized for celiac plexus block (EUS-CPB), whereby a steroid in combination with a local anesthetic agent are injected into the celiac plexus within the abdominal cavity. The aim of this randomized trial is to assess the efficacy of EUS-CPB in the alleviation of abdominal pain in patients with chronic pancreatitis.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Endoscopic ultrasound-guided celiac plexus block | Active Comparator | EUS-guided celiac plexus block will be performed. |
|
| Sham | Sham Comparator | Celiac plexus block will not be performed. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| EUS-guided celiac plexus block | Procedure | Under EUS-guidance, celiac plexus block will be performed with injection of bupivacaine and triamcinolone into the area of celiac plexus. |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of adequate pain relief | Rate of adequate pain relief in patients with chronic pancreatitis undergoing endoscopic ultrasound-guided celiac plexus block or sham procedure. Adequate pain relief is defined as a 50% reduction in composite pain score from baseline, measured using the Brief Pain Inventory-Short Form, at 1 month post-intervention. | 1 month |
| Measure | Description | Time Frame |
|---|---|---|
| Technical success | Successful completion of EUS-CPB. | Immediately after procedure |
| Pain scores measured using Visual Analog Scale. | Pain score measured using the Visual Analog Scale. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Charles Melbern Wilcox, MD | Contact | 321-841-2431 | Charles.Wilcox@orlandohealth.com | |
| Barbara J Broome | Contact | 321-841-7031 | barbara.broome@orlandohealth.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Orlando Health | Recruiting | Orlando | Florida | 32806 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39396987 | Derived | Wilcox CM, Bang JY, Buxbaum J, Gardner TB, Hawes R, Kedia P, Mardini SH, Muniraj T, Navaneethan U, Oza VM, Tarnasky P, Thakkar S, Waxman I, Varadarajulu S; US Pancreatic Disease Study Group. Effect of endoscopic ultrasound guided celiac plexus block on the palliation of pain in chronic pancreatitis (EPOCH Trial): study protocol for a randomized multicenter sham-controlled trial 1. Trials. 2024 Oct 14;25(1):676. doi: 10.1186/s13063-024-08478-y. |
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| ID | Term |
|---|---|
| D050500 | Pancreatitis, Chronic |
| ID | Term |
|---|---|
| D010195 | Pancreatitis |
| D010182 | Pancreatic Diseases |
| D004066 | Digestive System Diseases |
| D002908 | Chronic Disease |
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| Sham procedure | Procedure | Celiac plexus will not be performed in this arm. |
|
| 3 months |
| Pain scores measured using the Comprehensive Pain Assessment Tool-Short Form. | Pain score measured using the Comprehensive Pain Assessment Tool-Short Form. | 3 months |
| Quality of life assessment | Quality of life score measured using the Pancreatitis Quality of Life Instrument. | 3 months |
| Opioid analgesic use | Opioid analgesic use measured in morphine equivalent dosage. | 3 months |
| Procedure-related adverse events | Any adverse event occurring as a result of endoscopic intervention. | 3 months |
| Disease-related adverse events | Any adverse event occurring as a result of underlying chronic pancreatitis. | 3 months |
| Hospital admissions for management of chronic pancreatitis. | Number of hospital admissions for management of chronic pancreatitis. | 3 months |
| Length of hospitalization in any patient hospitalized | Length of hospitalization in any patient hospitalized with any adverse event or due to chronic pancreatitis. | 3 months |
| Rate of cross-over to EUS-CPB in patients initially assigned to the sham group. | Rate of cross-over to EUS-CPB in patients initially assigned to the sham group. | 3 months |
| Rate of need for any additional endoscopic, surgical or radiological intervention for chronic pancreatitis. | Rate of need for any additional endoscopic, surgical or radiological intervention for chronic pancreatitis. | 3 months |
| D020969 |
| Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |