The ACTS Trial: N-acetylcysteine (NAC) and Night-splinting as a Non-operative Treatment for Carpal Tunnel Syndrome

Launched by EMILY KRAUSS · Jul 6, 2020

Keywords

ClinConnect Summary

The ACTS Trial is studying whether taking an oral medication called N-acetylcysteine (NAC) can help improve symptoms of carpal tunnel syndrome (CTS) when combined with wearing a night splint. CTS is a condition that causes pain, numbness, and weakness in the hand due to pressure on the median nerve in the wrist. This trial is looking for adults aged 18 and older who have been diagnosed with mild to moderate CTS and have had symptoms for at least six weeks. Participants will be randomly assigned to either take NAC or a placebo (a pill with no active ingredients) while using a night splint for eight weeks.

During the trial, participants will fill out questionnaires to share how their symptoms change over time. The goal is to see if NAC can make a real difference in reducing pain and improving hand function compared to just using a night splint. This research could lead to a safe and affordable treatment option for people with CTS, potentially reducing the need for more invasive procedures like surgery. If you're considering joining the study, it's important to know that certain medical conditions and past treatments may affect your eligibility.

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ALL

Eligibility criteria

• Inclusion Criteria:
• • 1. The patient has a confirmed diagnosis of mild to moderate idiopathic unilateral or bilateral CTS as determined by both clinical exam findings and electrodiagnostic nerve conduction studies (median nerve distal motor latency ≥ 4.3 milliseconds and/or median nerve sensory distal latency ≥ 3.5 milliseconds at the wrist) performed within the preceding year prior to enrollment
• • 2. Symptoms of CTS must have been present for ≥ 6 weeks
• • 3. The patient must be ≥ 18 years of age.
• Exclusion Criteria:
• • 1. Any previous carpal tunnel release procedure on the ipsilateral limb
• • 2. Any previous corticosteroid injection in the last 6 months on the ipsilateral limb
• • 3. Severe CTS/signs of median nerve denervation with axonal loss determined by constant wrist or hand pain, constant parasthesias in the median nerve distribution, or thenar muscle atrophy in the ipsilateral limb
• • 4. Any known or suspected allergy to NAC
• • 5. Any current medications which preclude use of NAC including antibiotics or nitroglycerin
• • 6. Breastfeeding patients or patients with nephrolithiasis
• • 7. Any history of proximal ipsilateral neck or proximal limb injury
• • 8. Secondary CTS related to pregnancy
• • 9. Unable for financial reasons to obtain a night splint (i.e. lack of insurance coverage or lack of financial means).