Protocol summary

Study aim
Determining the efficacy and safety of oral high-dose docosahexaenoic acid fish oil and cobalamin supplementation in patients with diabetic neuropathy accompanied by pain
Design
Clinical trial with a control group, with parallel groups, triple blind, randomized, phase 3 on 86 patients. Random Allocation Software (RAS) was used for randomization.
Settings and conduct
Patients attending outpatient clinics at the Emam Reza Hospital of Tabriz University of Medical Sciences who have been diagnosed with diabetic neuropathy will be invited to an initial assessment to determine if they meet the inclusion and exclusion criteria. Then the patients will be randomly assigned to receive either the doxahexanoic acid and vitamin B12 or the placebo for 12 weeks.
Participants/Inclusion and exclusion criteria
Entry conditions: age 45 years and older, suffering from diabetes according to WHO criteria, regular attendance at the hospital's outpatient clinic, documented clinical diagnosis of distal neuropathic pain, experience of neuropathic pain based on the neuropathic pain diagnosis questionnaire ; Conditions of non-entry: clinical evidence of cardiovascular disease (cardiac arrhythmias, stroke, etc.), Renal disease, cerebrovascular disease, allergy to omega-3 supplements or fish
Intervention groups
Intervention group 1: Doxahexaenoic acid oral supplement containing 1000 mg of fish oil (500 mg of docosahexaenoic acid and 150 mg of eicosapentaenoic acid) + oral vitamin B12 2500 micrograms for 12 weeks Intervention group 2: Doxahexanoic acid oral supplement placebo + vitamin B12 placebo for 12 weeks Active and placebo supplements will be prepared in exactly the same way in terms of shape, color and odor.
Main outcome variables
Pain intensity, functional status, and serum levels of nerve growth factor, uric acid, interleukin 6 and 10

General information

Reason for update
Acronym
IRCT registration information
IRCT registration number: IRCT20161022030424N9
Registration date: 2023-10-15, 1402/07/23
Registration timing: prospective

Last update: 2023-10-15, 1402/07/23
Update count: 0
Registration date
2023-10-15, 1402/07/23
Registrant information
Name
Neda Dolatkhah
Name of organization / entity
Country
Iran (Islamic Republic of)
Phone
+98 41 3336 1928
Email address
dolatkhahn@tbzmed.ac.ir
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2023-11-22, 1402/09/01
Expected recruitment end date
2025-03-19, 1403/12/29
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Efficacy and safety of the daily oral supplementation of fish oil with high-dose docosahexaenoic acid content and cobalamin in patients with painful diabetic neuropathy
Public title
Docosahexaenoic acid and cobalamin in diabetic neuropathy
Purpose
Supportive
Inclusion/Exclusion criteria
Inclusion criteria:
Age of 45 and above Having diabetes based on WHO criteria (random plasma glucose ≥11·1 mmol/L, fasting plasma glucose ≥7·0 mmol/L, or 2-hour plasma glucose ≥11·1 mmol/L with oral glucose tolerance test) and based on the patient's record that has been in STABLE condition for at least three months (STABLE hypoglycemic drugs without insulin change +_20% and glycosylated hemoglobin [HbA1c] <9% at screening) Regular attendance at the hospital's outpatient clinic to ensure monitoring of blood sugar control and diabetes complications Documented clinical diagnosis of distal neuropathic pain based on pre-established criteria for peripheral neuropathy, neurological examination and EMG/NCV confirmed Experiencing neuropathic pain by scoring more than four in the Pain Diagnostic Questionnaire (DN4) or scoring more than 12 in the Self-reported Leeds Assessment of Neuropathic Symptoms and Signs (S -LANSS) for at least three months
Exclusion criteria:
Clinical evidence of severe or acute cardiovascular disease (heart attack or stroke in the past year) Atrial fibrillation or other cardiac arrhythmias Renal disease Cerebrovascular disease and any other systemic disease Allergy to omega-3 supplements or fish
Age
From 45 years old
Gender
Both
Phase
3
Groups that have been masked
  • Participant
  • Care provider
  • Investigator
  • Outcome assessor
  • Data analyser
  • Data and Safety Monitoring Board
Sample size
Target sample size: 86
Randomization (investigator's opinion)
Randomized
Randomization description
86 people were divided into two groups in a simple random manner and after matching based on age with random block method using 2 blocks and random array subset selection (RASS) software 1) Doxahexaenoic acid oral supplement containing 1000 mg fish oil (500 mg docosahexaenoic acid and 150 mg of eicosapentaenoic acid) + oral vitamin B12 1000 micrograms 2) placebo are assigned.
Blinding (investigator's opinion)
Double blinded
Blinding description
Active and placebo supplements will be prepared in exactly the same way in terms of shape, color and odor, and will be placed in a small envelope containing 28 capsules for each participant for 4-week consumption. The envelopes will be opened in the order in which the participants enter this stage from number 1, and an envelope containing the supplement will be provided to the participant for one month. Outcome assessors, the person responsible for statistical analysis of the data, and the respondents will be blinded to the type of supplement received until the end of the study..
Placebo
Used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Ethics committee of Tabriz University of Medical Sciences
Street address
Research Vice Chancellor, Tabriz University of Medical Sciences, Daneshgah Ave.
City
Tabriz
Province
East Azarbaijan
Postal code
3692588521
Approval date
2023-09-04, 1402/06/13
Ethics committee reference number
IR.TBZMED.REC.1402.445

Health conditions studied

1

Description of health condition studied
Diabetic Neuropathy
ICD-10 code
G63.2
ICD-10 code description
Polyneuropathy in diseases classified elsewhere

Primary outcomes

1

Description
Pain intensity
Timepoint
Pain intensity measurement at baseline (before intervention) and 12 weeks after intervention
Method of measurement
Visual Analogue Scale

2

Description
Functional status
Timepoint
Functional status measurement at baseline (before intervention) and 12 weeks after intervention
Method of measurement
Sheehan Disability Scale

3

Description
Serum nerve growth factor
Timepoint
Serum nerve growth factor measurement at baseline (before intervention) and 12 weeks after intervention
Method of measurement
Biochemical methods

4

Description
Serum uric Acid
Timepoint
Serum uric acid measurement at baseline (before intervention) and 12 weeks after intervention
Method of measurement
Biochemical methods

5

Description
Serum interleukin 6
Timepoint
Serum interleukin 6 measurement at baseline (before intervention) and 12 weeks after intervention
Method of measurement
Biochemical methods

6

Description
Serum interleukin 10
Timepoint
Serum interleukin 10 measurement at baseline (before intervention) and 12 weeks after intervention
Method of measurement
Biochemical methods

Secondary outcomes

1

Description
Quality of life
Timepoint
Quality of life measurement at the beginning of the study (before the start of the intervention) and 12 weeks after the start of the intervention
Method of measurement
36-item quality of life short form (sf-36)

Intervention groups

1

Description
Intervention group: Doxahexaenoic acid oral supplement containing 1000 mg of fish oil (500 mg of docosahexaenoic acid and 150 mg of eicosapentaenoic acid) manufactured by Karen Pharmaceutical Company one tablet per day + oral vitamin B12 2500 micrograms manufactured by Hakim Pharmaceutical Company, one tablet per day for 12 week
Category
Treatment - Drugs

2

Description
Control group: Doxahexanoic acid oral supplement placebo manufactured by Karen Pharmaceutical Company one tablet per day + oral vitamin B12 placebo manufactured by Hakim Pharmaceutical Company one tablet per day for 12 weeks
Category
Placebo

Recruitment centers

1

Recruitment center
Name of recruitment center
Emam Reza Hospital
Full name of responsible person
Mohammad Rahbar
Street address
Golgasht Str., Azadi Ave.
City
Tabriz
Province
East Azarbaijan
Postal code
3692588521
Phone
+98 41 3336 1928
Email
rahbar63@gmail.com

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Tabriz University of Medical Sciences
Full name of responsible person
Parviz Shahabi
Street address
Research Vice Chancellor, Tabriz University of Medical Sciences, Daneshgah Ave.
City
Tabriz
Province
East Azarbaijan
Postal code
3692588521
Phone
+98 41 3334 4280
Email
parvizshahabi@gmail.com
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Tabriz University of Medical Sciences
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Tabriz University of Medical Sciences
Full name of responsible person
Seyed Kazem Shakouri
Position
Professor
Latest degree
Specialist
Other areas of specialty/work
Physical Medicine
Street address
Emam Reza hospital, Golgasht Str., Azadi Ave.
City
Tabriz
Province
East Azarbaijan
Postal code
3692588521
Phone
+98 41 3336 1928
Email
skshakouri@gmail.com

Person responsible for scientific inquiries

Contact
Name of organization / entity
Tabriz University of Medical Sciences
Full name of responsible person
Neda Dolatkhah
Position
Assistant professor
Latest degree
Ph.D.
Other areas of specialty/work
Nutrition
Street address
Emam Reza hospital, Golgasht Str., Azadi Ave.
City
Tabriz
Province
East Azarbaijan
Postal code
5163995479
Phone
+98 41 3336 1928
Email
neda_dolatkhah@yahoo.com

Person responsible for updating data

Contact
Name of organization / entity
Tabriz University of Medical Sciences
Full name of responsible person
Neda Dolatkhah
Position
Assistant Professor
Latest degree
Ph.D.
Other areas of specialty/work
Nutrition
Street address
Emam Reza hospital, Golgasht Str., Azadi Ave.
City
Tabriz
Province
East Azarbaijan
Postal code
5163995479
Phone
+98 41 3336 1928
Email
neda_dolatkhah@yahoo.com

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Undecided - It is not yet known if there will be a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Undecided - It is not yet known if there will be a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available
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