Noninvasive Neurostimulation of the Vagus Nerve for the Relief of Acute Bronchoconstriction Due to Asthma (BC-SA-01)
Primary Purpose
Asthma
Status
Terminated
Phase
Not Applicable
Locations
South Africa
Study Type
Interventional
Intervention
AlphaCore System
Sponsored by

About this trial
This is an interventional supportive care trial for Asthma
Eligibility Criteria
Inclusion Criteria:
- Is between the ages of 18 and 70 years.
- Has been admitted to an emergency care facility with a working diagnosis of bronchoconstriction due to asthma.
- Has an FEV1<60% predicted.
- Is available and willing to return for an office visit at 7 days and participate in a 30-day telephone call from time of discharge from the ED.
- Is able to give written Informed Consent, or his/her legally authorized representative is available to give written Informed Consent.
Exclusion Criteria:
- Has a history of lung cancer, chronic obstructive pulmonary disease (COPD), or other co-morbidity due to irreversible narrowing of the airways.
Is at risk of imminent respiratory collapse:
- Lung Function: FEV1 < 25% predicted
- Signs and symptoms of extreme respiratory distress at rest, such as accessory muscle use, chest retraction
- Consciousness State: Drowsy, confused
- Rapid deterioration in respiratory status (sudden change in respiratory rate, decrease in oxygen saturation, change in consciousness, etc).
- Has an abscess or other infection or lesion (including lymphadenopathy) at the therapy head placement site.
- Has known or suspected atherosclerotic cardiovascular disease, carotid artery disease (e.g. bruits or history of TIA or CVA) or congestive heart failure (CHF).
- Has suspected or confirmed sepsis.
- Has a clinically significant irregular heart rate or rhythm.
- Clinically significant changes in blood pressure or is receiving pressors to maintain blood pressure.
- Is currently implanted with an electrical and/or neurostimulator device, including but not limited to cardiac pacemaker, vagal neurostimulator, deep brain stimulator, spinal stimulator, bone growth stimulator, or cochlear implant.
- Has a history of carotid endarterectomy or vascular neck surgery on the right side.
- Has been implanted with metal cervical spine hardware.
- Has a condition that would interfere with VAS Dyspnea self-assessment.
- Is pregnant.
- Is participating in any other therapeutic clinical investigation or has participated in a clinical trial in the preceding 30 days.
- Belongs to a vulnerable population or has any condition such that his or her ability to provide informed consent, comply with follow-up requirements, or provide self-assessments is compromised (e.g., homeless, developmentally disabled, prisoner).
Sites / Locations
- Kuilsriver Hospital
- Panorama Mediclinic
- Life Vincent Pallotti Hospital
- Cape Gate Medi-Clinic Hospital
- Christiaan Barnard Memorial Hospital
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
AlphaCore System
Arm Description
non-invasive vagus nerve stimulation (nVNS) using the AlphaCore System
Outcomes
Primary Outcome Measures
Number of Participants With Adverse Events
Subjects were assessed for adverse events for the duration of procedure. Subjects were also seen at 7 days and had a phone call at 30 days from the date of the stimulation procedure.
Secondary Outcome Measures
Number of Participants With a Change in FEV1 (Forced Expiratory Volume at 1 Second) of 12% or More From Baseline to 30 Minutes
Improvement in FEV1 was defined as an increase of at least 12% compared with baseline (pre-first stimulation). The 30 minute measure was taken immediately after the second stimulation.
(FEV1 measured as a percentage of normal, where greater that 80% is normal and less than 40% is severe degree of obstruction.)
Improvement in Dyspnea Score of at Least 1.5 Points From Baseline to 30 Minutes
Improvement in dyspnea was defined as at least 1.5 point decrease on a 10 point Visual Analogue Scale (VAS) compared with baseline (pre-first stimulation). Where 0 = no dyspnea and 10 = very severe dyspnea. The 30 minute measure was taken immediately after the second stimulation.
Time to Discharge From the Emergency Department
Time to discharge from the emergency department post stimulation
Number of Participants With Requirement for Concomitant Medications
Requirement for concomitant medications. Medications administered in the emergency department pre and post stimulation
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT01385306
Brief Title
Noninvasive Neurostimulation of the Vagus Nerve for the Relief of Acute Bronchoconstriction Due to Asthma
Acronym
BC-SA-01
Official Title
Noninvasive Neurostimulation of the Vagus Nerve With the AlphaCore System for the Relief of Acute Bronchoconstriction Due to Asthma
Study Type
Interventional
2. Study Status
Record Verification Date
October 2018
Overall Recruitment Status
Terminated
Why Stopped
Slow enrollment
Study Start Date
June 2011 (undefined)
Primary Completion Date
May 2012 (Actual)
Study Completion Date
July 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
ElectroCore INC
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The objective of this feasibility research study is to gather preliminary clinical data regarding the safety and potential clinical benefit of noninvasive neurostimulation of the vagus nerve with the AlphaCore™ system for the relief of acute bronchoconstriction due to asthma.
Detailed Description
The purpose of the study was to collect initial safety and efficacy information of use of the AlphaCore System by clinicians in an emergency setting as an adjunctive treatment to standard of care for the relief of acute bronchoconstriction. After consent was obtained and screening completed, subjects were stimulated two times, 30 minutes apart, for 90 seconds each. Subjects were assessed prior to and immediately post the first stimulation and at 15, 30, 60, and 90 minutes; follow was also conducted at day 7 and day 30.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Asthma
7. Study Design
Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
6 (Actual)
8. Arms, Groups, and Interventions
Arm Title
AlphaCore System
Arm Type
Experimental
Arm Description
non-invasive vagus nerve stimulation (nVNS) using the AlphaCore System
Intervention Type
Device
Intervention Name(s)
AlphaCore System
Intervention Description
Non-invasive neurostimulation of the vagus nerve
Primary Outcome Measure Information:
Title
Number of Participants With Adverse Events
Description
Subjects were assessed for adverse events for the duration of procedure. Subjects were also seen at 7 days and had a phone call at 30 days from the date of the stimulation procedure.
Time Frame
30 days
Secondary Outcome Measure Information:
Title
Number of Participants With a Change in FEV1 (Forced Expiratory Volume at 1 Second) of 12% or More From Baseline to 30 Minutes
Description
Improvement in FEV1 was defined as an increase of at least 12% compared with baseline (pre-first stimulation). The 30 minute measure was taken immediately after the second stimulation.
(FEV1 measured as a percentage of normal, where greater that 80% is normal and less than 40% is severe degree of obstruction.)
Time Frame
30 minutes
Title
Improvement in Dyspnea Score of at Least 1.5 Points From Baseline to 30 Minutes
Description
Improvement in dyspnea was defined as at least 1.5 point decrease on a 10 point Visual Analogue Scale (VAS) compared with baseline (pre-first stimulation). Where 0 = no dyspnea and 10 = very severe dyspnea. The 30 minute measure was taken immediately after the second stimulation.
Time Frame
30 minutes
Title
Time to Discharge From the Emergency Department
Description
Time to discharge from the emergency department post stimulation
Time Frame
Duration of stay in emergency room - up to approximately 6 hours.
Title
Number of Participants With Requirement for Concomitant Medications
Description
Requirement for concomitant medications. Medications administered in the emergency department pre and post stimulation
Time Frame
Duration of stay in emergency room, up to approximately 6 hours
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Is between the ages of 18 and 70 years.
Has been admitted to an emergency care facility with a working diagnosis of bronchoconstriction due to asthma.
Has an FEV1<60% predicted.
Is available and willing to return for an office visit at 7 days and participate in a 30-day telephone call from time of discharge from the ED.
Is able to give written Informed Consent, or his/her legally authorized representative is available to give written Informed Consent.
Exclusion Criteria:
Has a history of lung cancer, chronic obstructive pulmonary disease (COPD), or other co-morbidity due to irreversible narrowing of the airways.
Is at risk of imminent respiratory collapse:
Lung Function: FEV1 < 25% predicted
Signs and symptoms of extreme respiratory distress at rest, such as accessory muscle use, chest retraction
Consciousness State: Drowsy, confused
Rapid deterioration in respiratory status (sudden change in respiratory rate, decrease in oxygen saturation, change in consciousness, etc).
Has an abscess or other infection or lesion (including lymphadenopathy) at the therapy head placement site.
Has known or suspected atherosclerotic cardiovascular disease, carotid artery disease (e.g. bruits or history of TIA or CVA) or congestive heart failure (CHF).
Has suspected or confirmed sepsis.
Has a clinically significant irregular heart rate or rhythm.
Clinically significant changes in blood pressure or is receiving pressors to maintain blood pressure.
Is currently implanted with an electrical and/or neurostimulator device, including but not limited to cardiac pacemaker, vagal neurostimulator, deep brain stimulator, spinal stimulator, bone growth stimulator, or cochlear implant.
Has a history of carotid endarterectomy or vascular neck surgery on the right side.
Has been implanted with metal cervical spine hardware.
Has a condition that would interfere with VAS Dyspnea self-assessment.
Is pregnant.
Is participating in any other therapeutic clinical investigation or has participated in a clinical trial in the preceding 30 days.
Belongs to a vulnerable population or has any condition such that his or her ability to provide informed consent, comply with follow-up requirements, or provide self-assessments is compromised (e.g., homeless, developmentally disabled, prisoner).
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Elmin Steyn, MD
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Zunaid Mohammed, MD
Organizational Affiliation
unafiliated
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Robert Johnson
Organizational Affiliation
unafiliated
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Dale Cilliers
Organizational Affiliation
unafiliated
Official's Role
Principal Investigator
Facility Information:
Facility Name
Kuilsriver Hospital
City
Kuils River
State/Province
Cape Town
ZIP/Postal Code
7580
Country
South Africa
Facility Name
Panorama Mediclinic
City
Panorama
State/Province
Cape Town
ZIP/Postal Code
7500
Country
South Africa
Facility Name
Life Vincent Pallotti Hospital
City
Pinelands
State/Province
Cape Town
ZIP/Postal Code
7405
Country
South Africa
Facility Name
Cape Gate Medi-Clinic Hospital
City
Stellenbosch
State/Province
Cape Town
ZIP/Postal Code
7600
Country
South Africa
Facility Name
Christiaan Barnard Memorial Hospital
City
Cape Town
ZIP/Postal Code
8001
Country
South Africa
12. IPD Sharing Statement
Citations:
PubMed Identifier
23510361
Citation
Steyn E, Mohamed Z, Husselman C. Non-invasive vagus nerve stimulation for the treatment of acute asthma exacerbations-results from an initial case series. Int J Emerg Med. 2013 Mar 19;6(1):7. doi: 10.1186/1865-1380-6-7.
Results Reference
derived
Learn more about this trial
Noninvasive Neurostimulation of the Vagus Nerve for the Relief of Acute Bronchoconstriction Due to Asthma
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