The Role of Migraine Prophylaxis Agent Topiramate in Treating Patients With Sudden Sensorineural Hearing Loss
Study Details
Study Description
Brief Summary
Migraine and sudden sensorineural hearing loss(SSNHL) are two related disorders. A systemic steroid is usually used to treat SSNHL but the role of migraine prophylaxis medication remained unknown. Mehdi Abouzari et al. found a better improvement when combining topiramate and nortriptyline with steroids in a retrospective study. However, a prospective study with randomization is needed to elucidate the efficacy of these agents.
This is a clinical study using medication approved and currently prescribed in the clinic. The included patients were those who came to the clinic and were diagnosed with SSNHL within 14 days of onset. Those patients were asked whether they agreed to participate in this clinical trial. Patients who were diagnosed with SSNHL but were later found to be other diseases such as Meniere's disease and cerebellopontine angle will be excluded from this study.
The involved patients were randomized divided into two groups. Both groups received systemic steroids with/without intratympanic steroids. The experimental group receives additional oral topiramate for 6 weeks.
Follow-up time is at least 3 months.
This study is multi-center. Location of the study is performed at Chang gung memorial hospital Linkou branch, Taipei branch, Taoyuan branch, and New Taipei Municipal Tucheng Hospital.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
Phase 2 |
Detailed Description
Once the patients were diagnosed with SSNHL, detailed information of the clinical trial will be introduced. If the patient agreed to participate, he/she will be randomized. The experimental group receives additional oral topiramate for 6 weeks.
Both groups follow up at the clinic for at least 3 months. The pure tone audiometry and speech audiometry will be measured at the initial and end of follow-up.
Patients who were later diagnosed with cerebellopontine angle tumors, stroke, or Meniere's disease, will be excluded from this study.
The audiometry and other hearing outcomes will be analyzed at the end of the study. The treatment efficacy, and prognostic factors will be analyzed and reported. Data regarding adverse effects and drop-out will also be collected and reported.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Topiramate arm The experimental group receives a systemic steroid with/without intratympanic steroids as the standard treatment of SSNHL. The experimental group receives additional oral topiramate for 6 weeks. The dosage of topiramate is 25 mg orally before bedtime with the weekly escalation of 25 mg up to 100 mg. The total duration of oral topiramate is 6 weeks. |
Drug: Topiramate
The topiramate arm receives additional oral topiramate for 6 weeks. The dose of topiramate is started from 25mg orally daily with the weekly escalation of 25mg to a maximum of 100mg.
Drug: Systemic Steroids
Both groups receive a systemic steroid with/without intratympanic steroids as the standard treatment of SSNHL.
|
| Active Comparator: Control arm The control arm receives a systemic steroid with/without intratympanic steroids as the standard treatment of SSNHL. |
Drug: Systemic Steroids
Both groups receive a systemic steroid with/without intratympanic steroids as the standard treatment of SSNHL.
|
Outcome Measures
Primary Outcome Measures
- Audiometry change [Baseline pure tone audiometry will be measured at the time of recruitment. The audiometry will be followed up 3 months after the initial recruitment. The audiometry change between two arms will be calculated and analyzed at the study completion.]
Change From Baseline on the pure tone audiometry and speech audiometry at 3 months
Secondary Outcome Measures
- Demography [The number of participants and demographic data will be analyzed at study completion.]
Number of Participants, Number of participants from each group, Number of Participants With Treatment-Related Adverse Events, Age and gender of participants, Number of drop-out from each group.
Eligibility Criteria
Criteria
Inclusion Criteria:
-
Age > 20
-
Confirmed diagnosis of unilateral sudden sensorineural hearing loss(SSNHL)
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Treatment started 14 days within onset of SSNHL
Exclusion Criteria:
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Previous SSNHL history
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Previous middle ear disorder such as chronic otitis media, or previous ear surgery
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Meniere's disease and fluctuating hearing loss patients
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Pregnancy or trying to become pregnant
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Leukemia, hemodialysis, and patients who received chemotherapy before.
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Previous head and neck radiotherapy
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cerebellopontine angle tumors such as vestibular schwannoma
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Patients with moderate to severe hepatic insufficiency
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Patients with major depression disorder or suicide attempt
-
Patients with glaucoma
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | New Taipei Municipal Tucheng Hospital | New Taipei City | Taiwan | 236 |
Sponsors and Collaborators
- Chang Gung Memorial Hospital
Investigators
- Study Chair: BANG-YAN ZHANG, MD., New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation)
Study Documents (Full-Text)
None provided.More Information
Publications
- 202200324A3