Study Stopped
There was a delay in recruitment initiation due to COVID-19 and internal logistical challenges. Following this delay, the principal investigator left the study site, and it was determined that the study should be terminated.
IC PaIN Trial: Interstitial Cystitis Pain Improvement With Naltrexone
1 other identifier
interventional
3
1 country
1
Brief Summary
Interstitial cystitis/painful bladder syndrome (IC/PBS) is a debilitating condition with symptoms of urinary urgency, frequency, nocturia (waking up at night to void), and pain, without evidence of urinary tract infection or other identifiable causes. IC/PBS often coexists with other chronic pain syndromes, such as irritable bowel syndrome, chronic fatigue syndrome, and fibromyalgia. Several treatments exist for IC/PBS; some are not effective, others are time consuming for patients to receive, some can take weeks to months before they become effective, and many have risks associated with them. Low-dose naltrexone (LDN) has demonstrated improvement of symptoms in conditions associated with IC/PBS. LDN is defined as less than 5mg of naltrexone. Some adverse effects have been reported with LDN, the most common are vivid dreams, nightmares, and insomnia. The investigators hypothesis LDN will have greater than 30% reduction in symptoms as defined by the Interstitial Cystitis Symptom Index in patients diagnosed with IC/PBS from baseline when compared to placebo. The 30% reduction in pain is a standard outcome measure in the pain literature. This improvement has been seen in prior studies where LDN was used to treat pain syndromes. This will be a randomized double-blinded placebo-controlled prospective trial. Patients meeting diagnostic criteria for IC/PBS by American Urologic Association (AUA) guidelines will be eligible, and then must then meet all applicable inclusion and exclusion criteria. Study participants will sign a consent, complete several questionnaires, give a blood sample to measure liver function tests, and once at home, complete a 24-hour bladder diary. Participants will be randomized to receive either placebo or study medication. Participants will be instructed to take one capsule nightly for two weeks, then increase to two capsules nightly for four weeks. They will be given a log to record the date and time they take the medication. All study participants will also receive first-line behavioral therapy for IC/PBS of a bladder diet and bladder drills. After six weeks, participants will complete a second bladder diary. They will then complete the exit study questionnaires, have a second liver function test, return any unused medication, and meet with their doctor to discuss conventional treatment options for IC/PBS.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at below P25 for phase_4
Started Sep 2021
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
Click on a node to explore related trials.
Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
March 16, 2020
CompletedFirst Posted
Study publicly available on registry
March 18, 2020
CompletedStudy Start
First participant enrolled
September 7, 2021
CompletedPrimary Completion
Last participant's last visit for primary outcome
January 23, 2023
CompletedStudy Completion
Last participant's last visit for all outcomes
February 23, 2023
CompletedResults Posted
Study results publicly available
March 7, 2025
CompletedMarch 7, 2025
February 1, 2025
1.4 years
March 16, 2020
November 18, 2024
February 17, 2025
Conditions
Outcome Measures
Primary Outcomes (2)
Interstitial Cystitis Symptom Index
The effect of LDN (low-dose naltrexone) in decreasing symptoms associated with IC/PBS (interstitial cystitis/painful bladder syndrome) when treating with low-dose naltrexone as scored by the Interstitial Cystitis Symptom Index as compared to placebo. Scores are from 0 to 20, with lower scores indicating less symptoms associated with IC/PBS.
six weeks
Visual Analog Scale
The effect of LDN in decreasing pain associated with IC/PBS when treating with low-dose naltrexone as scored by visual analog scale as compared with placebo. Scores are from 0 to 10, with lower scores indicating less pain.
six weeks
Secondary Outcomes (9)
Change in Interstitial Cystitis Problem Index
prior to initiating treatment and at the conclusion of 6 weeks of treatment
Change in Urinary Frequency
prior to initiating treatment and at the conclusion of 6 weeks of treatment
Change in Number of Nocturia
prior to initiating treatment and at the conclusion of 6 weeks of treatment
Change in Pelvic Pain and Urgency/Frequency Symptoms
prior to initiating treatment and at the conclusion of 6 weeks of treatment
Change in Pelvic Pain and Urgency/Frequency Bother
prior to initiating treatment and at the conclusion of 6 weeks of treatment
- +4 more secondary outcomes
Study Arms (2)
Low-dose naltrexone
EXPERIMENTAL2mg low-dose naltrexone capsules
Placebo
PLACEBO COMPARATORPlacebo capsules
Interventions
2mg of low-dose naltrexone nightly for 2 weeks, then 4mg of low-dose naltrexone nightly for 4 weeks
Eligibility Criteria
You may qualify if:
- Patients aged eighteen and older
- Meet criteria for IC/PBS as defined by the American Urology Association as "an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms or more than six weeks duration, in the absence of infection or other identifiable causes" (8)
- Newly diagnosed and treatment naĂ¯ve for IC/PBS or previously diagnosed with IC/PBS, but who have no received treatment in the past four weeks. Patient who use anti-inflammatory medication on an as needed basis in the four weeks prior to the study will be included.
- Have had a cystoscopy in the last 6 months prior to study entry to rule out confounding conditions
- English speaking
- Working telephone number
- Able to provide a blood sample to evaluate liver enzymes
- Able to attend research visits
You may not qualify if:
- Patients under the age of 18
- Patients with known liver disease, including total bilirubin \>1.2, AST (aspartate aminotransferase) \> 32, ALT (alanine transaminase) \> 54
- Patients with known kidney disease
- Patients who have thyroid disease and who are taking thyroid replacement medications
- Patients with known neurologic disease affecting bladder function
- Patients with known bladder or urethral cancer
- Patients with bladder, urethral, or ureteral calculi
- Patients who have had a positive urine culture or a clinical UTI (Urinary Tract Infection) in the past 6 weeks
- Patients who are currently pregnant or breast feeding (15)
- Patients who are actively using opioid analgesics
- Patients with moderate-severe alcohol use disorder
- Patients who are actively using sleep aids
- Patients who are regularly using anti-inflammatory medications, such as daily Celebrex for arthritis. Those who use an anti-inflammatory medication on an as needed basis may use the medication prior to enrollment in the study.
- Patients who have had a known adverse reaction to naltrexone
- Patients who are acutely ill
- +8 more criteria
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Endeavor Healthlead
Study Sites (1)
Center for Pelvic Health at the NorthShore University HealthSystem
Skokie, Illinois, 60076, United States
Related Publications (46)
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PMID: 30909326BACKGROUNDCui X, Jing X, Lutgendorf SK, Bradley CS, Schrepf A, Erickson BA, Magnotta VA, Ness TJ, Kreder KJ, O'Donnell MA, Luo Y. Cystitis-induced bladder pain is Toll-like receptor 4 dependent in a transgenic autoimmune cystitis murine model: a MAPP Research Network animal study. Am J Physiol Renal Physiol. 2019 Jul 1;317(1):F90-F98. doi: 10.1152/ajprenal.00017.2019. Epub 2019 May 15.
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PMID: 21162697BACKGROUND
Related Links
MeSH Terms
Conditions
Interventions
Condition Hierarchy (Ancestors)
Intervention Hierarchy (Ancestors)
Results Point of Contact
- Title
- Urogynecology Research Coordinator
- Organization
- Endeavor Health
Publication Agreements
- PI is Sponsor Employee
- No
- Restrictive Agreement
- No
Study Design
- Study Type
- interventional
- Phase
- phase 4
- Allocation
- RANDOMIZED
- Masking
- QUADRUPLE
- Who Masked
- PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
- Purpose
- TREATMENT
- Intervention Model
- PARALLEL
- Sponsor Type
- OTHER
- Responsible Party
- PRINCIPAL INVESTIGATOR
- PI Title
- Principal Investigator
Study Record Dates
First Submitted
March 16, 2020
First Posted
March 18, 2020
Study Start
September 7, 2021
Primary Completion
January 23, 2023
Study Completion
February 23, 2023
Last Updated
March 7, 2025
Results First Posted
March 7, 2025
Record last verified: 2025-02
Data Sharing
- IPD Sharing
- Will not share