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Trial registered on ANZCTR
Registration number
ACTRN12615001002572
Ethics application status
Approved
Date submitted
10/07/2015
Date registered
25/09/2015
Date last updated
13/12/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
A pilot trial of topical St John’s Wort in the treatment of post-herpetic neuralgia
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Scientific title
A pilot randomised controlled trial of topical St John’s Wort in the treatment of post-herpetic neuralgia
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Secondary ID [1]
287071
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Nil
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Universal Trial Number (UTN)
U1111-1172-0635
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
post-herpetic neuralgia
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Condition category
Condition code
Alternative and Complementary Medicine
295840
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0
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Herbal remedies
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Neurological
295841
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Intervention: A topical olive oil extraction of St John's Wort (Hypericum perforatum).
Dose: 1mL of 0.23mg/mL fresh plant tincture olive oil extraction, administered three times daily.
Duration of use: 4 weeks
Design: 1 week with all participants on placebo, then 4 weeks on intervention/control, then 4 weeks on crossover intervention/control. No washout period between 4 week intervention/control periods.
Mode of administration: topical application will be applied to the area affected by PHN
Strategies used to monitor adherence: empty lotion bottle return and bottle measurement open completion.
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Intervention code [1]
292303
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Treatment: Drugs
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Comparator / control treatment
Placebo - olive oil with red food colouring
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Control group
Placebo
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Outcomes
Primary outcome [1]
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The effectiveness of a herbal treatment on clinical pain measures of post-herpetic neuralgia as measured by Visual Analogue (Pain) Scale (VAS);
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Assessment method [1]
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Timepoint [1]
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Week 1 - end of initial placebo
Weeks 5, 9 - indicate end of each 4 week intervention period (active/control)
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Primary outcome [2]
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The effectiveness of a herbal treatment on clinical quality of life measures of post-herpetic neuralgia as measured by SF-36
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Assessment method [2]
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Timepoint [2]
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Week 1 - end of initial placebo
Weeks 5, 9 - indicate end of each 4 week intervention period (active/control)
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Secondary outcome [1]
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Tolerability of a herbal treatment in PHN (adverse events)
Examples of unlikely, but potential (known) adverse reactions include skin photosensitivity and irritation. Some adverse events and drug interaction are known to occur with internal use (though not topical use), and patients have been issued with a safety sheet asking them to report to study coordinator should these symtpoms (e.g. weight loss, nausea, headache).
Assessed via self-reported outcomes by patients in diary
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Assessment method [1]
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Timepoint [1]
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Week 1 - end of initial placebo
Weeks 5, 9 - indicate end of each 4 week intervention period (active/control)
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Eligibility
Key inclusion criteria
- Any person male or female aged 18-65 presenting with a confirmed diagnosis of herpetic neuralgia.
- Willingness to give written informed consent and willingness to participate to and comply with the study (and who do not meet exclusion criteria – see below).
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Other infectious skin diseases
- Diagnosed hepato-bilary disease/inflammation
- Current or < 6 month substance abuse disorder including alcohol
- Current or < 12 month use of St. John’s wort
- Current or < 1 month of therapeutic agents with narrow therapeutic windows (e.g. warfarin, anti-retroviral mediciations)
- Previous reaction to St. John’s wort
- Medications that maybe pharmacokinetically altered via St. John’s wort including: amitriptyline, anti-coagulants e.g. phenprocoumon, warfarin, anti-fugals e.g. voriconazole, anti-histamines e.g. fexofenadine, benzodiazepines e.g. alprazolam, Chemotherapeutics e.g. irinotecan, digoxin, HIV medication (anti-retrovirals), Immunosuppressants e.g. cyclosporine, methadone, OCP, statins e.g. simvastatin, warfarin (Henderson 2002; Izzo 2004). However this interactions are based on case studies and theoretical interactions and are regarded to be induced by hyperforin (a constituent of St. John’s wort); low or non-standardised hyperforin preparations are regarded to not induce drug interactions as little induction of P-glycoprotein and CYP P450 enzymes occurs (Madabushi et al. 2006).
- Non-English speakers.
- More than 6 months since the onset of acute herpetic rash
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
The study will be blinded by using active and controls with reference numbers allocated by the manufacturer. These will only be revealed at the end of the trial, when the reference number is matched to participants reference number.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Subjects will be randomised in sequence according to the reference numbers provided, using computerised sequence generation (simple randomisation using a randomisation table created by computer software). These will only be revealed at the end of the trial, when the reference number is matched to participants reference number.
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
The people analysing the results/data
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Intervention assignment
Crossover
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Recruiting
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Date of first participant enrolment
Anticipated
1/11/2015
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Actual
1/11/2016
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Funding & Sponsors
Funding source category [1]
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University
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Name [1]
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University of Technology Sydney
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Address [1]
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Faculty of Health, 235-253 Jones St, Ultimo, NSW 2007
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Country [1]
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Australia
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Primary sponsor type
University
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Name
University of Technology Sydney
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Address
Faculty of Health, 235-253 Jones St, Ultimo, NSW 2007
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
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Country [1]
290303
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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University of Technology Sydney
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Ethics committee address [1]
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Faculty of Health, 235-253 Jones St, Ultimo NSW 2007
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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Approval date [1]
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09/04/2015
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Ethics approval number [1]
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2014000104
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Summary
Brief summary
Description: Post-herpetic neuralgia (PHN) is a condition in which there are few effective therapies, and most of those which do show some efficacy have an unfavourable side effect profile. This study will explore whether a widely used clinical complementary therapy may have a role in the treatment of PHN. In addition to confirming whether SJW is effective in PHN, this research will help to build an evidence base for complementary therapies. Despite being widely used, most complementary therapies remain unstudied. This research will help to uncover the effectiveness, or lack thereof, of SJW in PHN. Objectives: Primary – The effectiveness of a herbal treatment on clinical measures of post-herpetic neuralgia. Secondary – Tolerability of a herbal medicine treatment in the treatment of post-herpetic neuralgia Study design: Double-blind randomised cross-over clinical trial Planned sample size: 40-60 (pilot) Selection criteria: Persons with a confirmed diagnosis of herpetic neuralgia. Study procedures: The design of the study is a randomised, placebo controlled pilot trial recruiting 40-45 adults (18-65) with post-herpetic neuralgia (PHN). The clinical trial will be conducted over 9 weeks in 3 phases. All the participants will receive placebo application for the 1st phase (washout-placebo phase - 1 week), then group 1 (determined via randomisation) will continue to take placebo for 4 weeks, while group 2 will receive the active St. John’s Wort topical application (SJW). The next phase involves both groups 1 and 2 crossing over for 4 weeks. The topical application will be applied to the area affected by PHN twice daily, this will differ depending on the severity and extent of PHN in individual patients. Statistical considerations: As a pilot study of a treatment in common clinical use, but with no data to calculate effect size, a pilot trial of 40-60 persons will be conducted. Study duration: 4 weeks (participant). Recruitment will last for 1 year (12 months)
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Jon Wardle
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Address
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Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW 2007
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Country
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Australia
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Phone
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+61 2 9514 4813
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Jon Wardle
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Address
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Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW 2007
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Country
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Australia
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Phone
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+61 2 9514 4813
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Jon Wardle
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Address
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Faculty of Health, University of Technology Sydney, 235-253 Jones St, Ultimo, NSW 2007
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Country
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Australia
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Phone
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+61 2 9514 4813
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Fax
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Email
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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