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维生素K2治疗老年人群夜间腿部痉挛的效果:一项随机、双盲、对照试验的研究方案

Effect of vitamin K2 in the treatment of nocturnal leg cramps in the older population: Study protocol of a randomized, double-blind, controlled trial.

作者信息

Li Ying, Zhu Rui, Wang Li, Tan Jing

机构信息

Department of Hematology, Chengdu Third People's Hospital, Chengdu, Sichuan, China.

School of Clinical Medicine, North Sichuan Medical College, Nanchong, Sichuan, China.

出版信息

Front Nutr. 2023 Feb 23;10:1119233. doi: 10.3389/fnut.2023.1119233. eCollection 2023.

Abstract

INTRODUCTION

Nocturnal leg cramps (NLCs) are sudden contractions of the leg muscles, usually in the posterior calf muscles at night, affecting sleep quality. Because the precise pathophysiology of NCLs is unclear, different interventions have been proposed. There is conflicting evidence regarding the efficacy of conventional interventions in preventing cramps. Thus, the present study aims to investigate the effects of vitamin K2 for NLCs in a prospective randomized, double-blind, controlled trial.

METHODS AND ANALYSIS

This multicenter, randomized, double-blind, placebo-controlled clinical study will enroll older age (≥65-year-old) with two or more documented episodes of NLCs during 2 weeks of screening. Participants will be randomized to receive vitamin K2 or a similar-looking placebo for 8 weeks in a 1:1 ratio. Follow-up visits will be scheduled each week at the beginning of 4-week intervention, then participants will be visited semimonthly. The primary outcome is the difference in the mean number of NLCs per week in the vitamin K2 and placebo arms. The secondary outcomes include the severity and duration of NLCs in the vitamin K2 and placebo arms. Two hundred patients will be needed, for this two-treatment parallel design study, to achieve a probability is 90% that the study will detect a treatment difference at a two-sided 0.04 significance level, if the difference between treatments is 3.6 (difference in means between treatment arms) NLC events.

DISCUSSION

Nocturnal Leg Cramps (NLCs) are a common musculoskeletal disorder in the general population, but effective and safe interventions have not been established. Our previous study has shown vitamin K2 was effective to reduce the frequency, severity, and duration of dialysis-related muscle cramps with a good safety profile. This randomized controlled trial (RCT) of rigorous methodological design will help to establish the effectiveness of vitamin K2 for the management of NLCs in older population. The findings of this RCT will encourage the studies of vitamin K2 in musculoskeletal disorders.

CLINICAL TRIAL REGISTRATION

www.ClinicalTrials.gov, identifier, NCT05547750.

摘要

引言

夜间腿部痉挛(NLCs)是腿部肌肉的突然收缩,通常发生在夜间小腿后侧肌肉,会影响睡眠质量。由于NLCs的确切病理生理学尚不清楚,因此人们提出了不同的干预措施。关于传统干预措施预防痉挛的疗效,证据相互矛盾。因此,本研究旨在通过一项前瞻性随机、双盲、对照试验,调查维生素K2对NLCs的影响。

方法与分析

这项多中心、随机、双盲、安慰剂对照的临床研究将招募年龄较大(≥65岁)且在2周筛查期间有两次或更多次记录在案的NLC发作的患者。参与者将按1:1的比例随机接受维生素K2或外观相似的安慰剂,为期8周。在为期4周的干预开始时,每周安排随访,之后参与者将每半月接受一次随访。主要结局是维生素K2组和安慰剂组每周NLC平均发作次数的差异。次要结局包括维生素K2组和安慰剂组NLC的严重程度和持续时间。对于这项双治疗平行设计研究,需要200名患者,以便在双侧0.04显著性水平下,若治疗差异为3.6(治疗组之间的均值差异)次NLC事件,该研究有90%的概率检测到治疗差异。

讨论

夜间腿部痉挛(NLCs)是普通人群中常见的肌肉骨骼疾病,但尚未确立有效且安全的干预措施。我们之前的研究表明,维生素K2能有效降低透析相关肌肉痉挛的频率、严重程度和持续时间,且安全性良好。这项方法设计严谨的随机对照试验(RCT)将有助于确立维生素K2在老年人群中治疗NLCs的有效性。该RCT的结果将鼓励对维生素K2在肌肉骨骼疾病方面的研究。

临床试验注册

www.ClinicalTrials.gov,标识符,NCT05547750。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8512/9996107/c370dab83121/fnut-10-1119233-g001.jpg

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