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This clinical trial aims to evaluate the potential therapeutic effects of oral supplemental Palmitoylethanolamide (PEA) Phytosome® in managing neuropathic low back pain. The study will involve adult participants diagnosed with neuropathic pain according to established criteria. Eligible participants will be randomized into three groups to receive either PEA Phytosome® supplementation as two different doses or a placebo for a specified period. Data collection will include demographic information, baseline pain intensity, quality of life assessments, and functional outcomes. The primary endpoint will be the reduction in pain intensity, while secondary endpoints will include improvements in quality of life and functional capacity. Safety and tolerability of the supplement will also be assessed. This trial seeks to provide robust clinical evidence of the potential pharmacological effect of PEA's Phytosome® as a potential adjunctive treatment for neuropathic low back pain.
Neuropathic low back pain arises from nerve damage or dysfunction, leading to chronic pain characterized by burning, tingling, or shooting sensations. This condition significantly impacts quality of life and is often refractory to conventional treatments. Palmitoylethanolamide (PEA) is an endogenous lipid mediator known for its anti-inflammatory, analgesic, and neuroprotective properties. PEA exerts its effects by modulating the endocannabinoid system and reducing the activation of mast cells and glial cells, which play a crucial role in chronic pain mechanisms. Its potential as a therapeutic agent for neuropathic pain has been demonstrated in preclinical and clinical studies, making it a promising candidate for managing neuropathic low back pain.
In the present randomized, double-blind, placebo-controlled, parallel-group clinical trial, the investigators aim to evaluate the therapeutic effect of a novel bioavailable oral formulation of PEA's Phytosome® in the management of neuropathic low back pain in healthy adult population.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| 300 mg Palmitoylethanolamide (PEA) group | Experimental | Participants will receive 2 × 300 mg oral PEA Phytosome® tablets daily for one week, and a single tablet from week-7 to week-8, as add-on to the standard of care. |
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| 450 mg Palmitoylethanolamide (PEA) group | Experimental | Participants will receive 1 × 450 mg oral PEA Phytosome® tablet, and 1 placebo tablet daily for 8-weeks as add-on to the standard of care. |
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| Control group | Placebo Comparator | Participants will receive 2 × placebo tablets daily for 8-weeks as add-on to the standard of care. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| 300 mg Palmitoylethanolamide (PEA) Phytosome® | Dietary Supplement | Oral supplement intake |
|
| Measure | Description | Time Frame |
|---|---|---|
| Supplement effect on neuropathic low back symptoms pain as experienced by the patients | Change in The Douleur Neuropathique 4 (DN4) questionnaire score, a 10-item, clinician-administered tool used to identify neuropathic pain. A score of 4 or more out of 10 is the cut-off for defining the presence of neuropathic pain. | 8 weeks |
| Supplement effect on intensity of neuropathic low back pain | Change in neuropathic pain intensity measured by the Numerical Rating Scale (NRS) score, with 0 representing no pain and 10 representing the worst pain. | 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Supplement effect on patients degree of disability | Change in degree of disability due to neuropathic back pain assessed by Oswestry Disability Index (ODI) questionnaire. A score of 0-20% indicates minimal disability, 21-40% moderate disability, 41-60% severe disability, 61-80% crippled, and 81-100% bedridden or completely disabled. | 8 weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lady Reading Hospital | Peshawar | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 26604814 | Background | Keppel Hesselink JM, Kopsky DJ. Palmitoylethanolamide, a neutraceutical, in nerve compression syndromes: efficacy and safety in sciatic pain and carpal tunnel syndrome. J Pain Res. 2015 Oct 23;8:729-34. doi: 10.2147/JPR.S93106. eCollection 2015. | |
| 34069940 | Background | Clayton P, Hill M, Bogoda N, Subah S, Venkatesh R. Palmitoylethanolamide: A Natural Compound for Health Management. Int J Mol Sci. 2021 May 18;22(10):5305. doi: 10.3390/ijms22105305. |
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| 450 mg Palmitoylethanolamide (PEA) Phytosome® | Dietary Supplement | Oral supplement intake |
|
| Control group | Other | Placebo |
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| Supplement effect on patients quality of life | Short Form Health Survey 12 (SF-12) questionnaire score. The SF-12 questionnaire assesses quality of life through 12 items, producing two summary scores: the Physical Component Summary (PCS) and the Mental Component Summary (MCS). Higher scores on both components indicate better physical and mental health, respectively. | 8 weeks |
| Supplement effect on patients sleep quality | Change in patients sleep quality as measured by the Pittsburgh Sleep Quality Index (PSQI) score. A score of 5 or higher suggests clinically significant sleep disturbances. | 8 weeks |
| Change in the number of times the rescue Non-steroidal anti-inflammatory drugs (NSAIDs) needed per week | Change in the weekly NSAIDs doses intake | 8 weeks |
| ID | Term |
|---|---|
| D017116 | Low Back Pain |
| ID | Term |
|---|---|
| D001416 | Back Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| C005958 | palmidrol |
| D035061 | Control Groups |
| ID | Term |
|---|---|
| D015340 | Epidemiologic Research Design |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D012107 | Research Design |
| D008722 | Methods |
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