The Effect of Milnacipran on Fatigue and Quality of Life in Lupus Patients

Loma Linda University (LLU)

Status and phase: Withdrawn; Phase 4

Conditions: Fibromyalgia; Widespread Pain; Systemic Lupus Erythematosus

Treatments: Drug: Milnacipran

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT01359826

5110068

Details and patient eligibility

About

Systemic lupus erythematosus (SLE) is a chronic multi-system autoimmune disease impacting the physical, social, psychological health and quality of life of patients. Fatigue and pain are aspects of SLE patients which affect their health related quality of life (HRQOL). The purpose of this study is to determine the effect of milnacipran on fatigue in SLE patients with widespread pain (WSP) or fibromyalgia syndrome (FMS). A secondary objective will be to determine the effect of milnacipran on pain and quality of life measurements. Fifty SLE male and female patients, 18 years and older, will be recruited for a 15-week study, in which patients will be receive 14 weeks of milnacipran 50-100 mg twice a day or placebo. Measurements of fatigue, pain, and HRQOL will be compared between the milnacipran and placebo groups at the screening visit, baseline visit, week number 6, and week number 14. Milnacipran has been shown to be an effective treatment for pain, fatigue and physical function in FMS patients. To date, no clinical trials have demonstrated efficacy for the treatment of fatigue in SLE patients with concomitant WSP or FMS. The investigators hypothesize, based on FMS studies, that the milnacipran treated patients will have less fatigue than those in the placebo group. In addition, compared to control arm, those treated with the study drug will have less pain and improved quality of life.

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Female or male age 18 or older.
• Has fulfilled the 1997 classification criteria for SLE.
• Has chronic WSP or FMS.
• Score a 40 or more on the visual analog score (VAS) for fatigue.

Exclusion criteria

• Has a chronic inflammatory autoimmune condition other than SLE.
• Has an acute or uncontrolled co-morbid medical condition.
• Uncontrolled narrow angle glaucoma.
• Has been hospitalized in the last four months for a lupus flare.
• Pregnant or breast feeding.
• Has a current or prior major depressive disorder or other DSM IV diagnosis within 2 years of the screening visit.
• The use of antidepressants, MAO inhibitors, antipsychotics or lithium
• The use of pregabalin or milnacipran within 2-4 weeks.
• Has received cyclophosphamide and or rituximab within 4 and 6 months.
• Unable to speak, read, and understand English.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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0 participants in 2 patient groups, including a placebo group

Milnacipran

Experimental group

Description:

Patients administered milnacipran will receive a dose escalation to 50 mg twice a day over 12 days and continued at this dose until week 6. If tolerated and a 15% improvement in fatigue from baseline is achieved by assessment on the FSS, then patients will continue taking 50 mg twice a day until the end of the study on day 98 (week 14). Otherwise, the dose of milnacipran will be titrated upward to 100 mg twice a day over 12 days and continued at this dose until day 98 (week 14).

Treatment:

Drug: Milnacipran

Placebo

Placebo Comparator group

Description:

Placebo tablets administered orally twice a day for 14 weeks.

Treatment:

Drug: Milnacipran