Overview

Pain Inhibition in Patients With Rheumatoid Arthritis and Central Sensitivity Syndromes

Status:
Unknown status
Trial end date:
1969-12-31
Target enrollment:
0
Participant gender:
Female
Summary
Both patients with peripheral structural pathologies, like rheumatoid arthritis (RA)-patients, or patients with central sensitivity syndromes (CSS) suffer chronic pain. CSS are characterized by an increased responsiveness of central pain neurons. An impaired endogenous pain inhibition is already demonstrated in CSS. In the present study the investigators want to evaluate the efficacy of pain inhibition in response to physical stressors and whether the efficacy is opioid-mediated in two chronic pain populations (RA & CCS) compared to controls. Therefore a triple-blinded randomized controlled trial (RCT) with cross-over design will be performed. The efficacy of wind-up of pain and spatial summation of pain is evaluated before and after a submaximal exercise, while the experimental group receives a selective serotonin reuptake inhibitor. Participants are 20 RA-patients and 20 CSS-patients, more specific patients with fibromyalgia and chronic fatigue syndrome, and 30 healthy controls. This way, the investigators analyze how pain inhibition reacts on different types of physical stressors in different pain patients and if pain inhibition is opioid-mediated.
Phase:
N/A
Accepts Healthy Volunteers?
Accepts Healthy Volunteers
Details
Lead Sponsor:
Vrije Universiteit Brussel
Collaborators:
Artesis University College, Antwerp
Research Foundation Flanders
Universiteit Antwerpen
University Hospital, Antwerp
Treatments:
Citalopram
Serotonin Uptake Inhibitors
Criteria
Inclusion Criteria:

- Each study participant should be aged between 18 and 65 years. All three groups will
be comparable for age, gender, education level and socioeconomic status; both patient
groups will be comparable for illness duration.

- The Central Sensitivity Syndrome (CSS) group will comply with the diagnostic criteria
for Fibromyalgia (FM) as defined by the American College of Rheumatology and the
Centre of Disease Control criteria for Chronic Fatigue Syndrome (CFS).

- At the time of study participation, healthy control subjects cannot suffer any pain
complaints. Sedentary is defined as a sedentary job and < 3 h moderate physical
activity/week. Moderate physical activity is defined as activity demanding at least
the threefold of the energy spent passively.

- Patients have to be able to cycle on a bicycle ergometer.

Exclusion Criteria:

- In order to preclude confounding factors, participants cannot be pregnant (pregnancy
test) or until 1 year postnatal and will be asked to stop medication two weeks prior
to study participation, not to undertake physical exertion, and to refrain from
consuming caffeine, alcohol or nicotine on the day of the experiment. For ethical
reasons, Rheumatoid arthritis(RA)-patients are able to take non-opioid pain medication
as described in the 1st step of the World Health Organization analgesic ladder
(Non-Steroidal Anti-Inflammatory Drugs and paracetamol).