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Evaluation of Spinal Cord Stimulation Pulse Rate On Clinical Outcomes (PROCO)

Primary Purpose

Back Pain, Neuralgia

Status
Completed
Phase
Not Applicable
Locations
United Kingdom
Study Type
Interventional
Intervention
Boston Scientific PRECISION Spinal Cord Stimulator System
Sponsored by
Mid and South Essex NHS Foundation Trust
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Back Pain focused on measuring Spinal Cord Stimulation

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Complaint of persistent or recurrent low back pain, with or without equal or lesser leg pain, for at least 90 days prior to Screen.
  2. Received at least 90 days of documented pain management care to address the primary pain complaint, prior to Screening (e.g. medication, physical therapy.)
  3. No back surgery within 6 months prior to Screening.
  4. Average low back pain intensity, during the position/activity, which routinely causes worst pain, of 5 or greater on a 0-10 numerical rating scale during Baseline period based on eDiary.
  5. If taking prescription opioids for primary chronic pain complaint (low back and/or leg pain), must have been on a stable prescription (same drug(s) and dose(s)) 30 days prior to Screening to a total of less than 180 mg Oral Morphine equivalent
  6. Willing and able to comply with all protocol-required procedures and assessments/evaluations (e.g. willing to comply with opioid prescription lock from the Baseline visit through End of Rate Randomization and protocol required stimulation parameter locks, complete daily eDiary).
  7. 18 years of age or older when written informed consent is obtained.
  8. If female of childbearing potential: not pregnant, as evidenced by a negative pregnancy test at Screening.
  9. Subject signed a valid, IRB-approved informed consent form (ICF) provided in English.
  10. Baseline Oswestry Disability Index score ≥ 20 and ≤ 80.
  11. Received at least 30 per cent reduction in NRS of average low back pain intensity from Baseline during the end of Post Implant HF10 Sweet-Spot Search as recorded in the eDiary.

Exclusion Criteria:

  1. Average worst leg pain intensity is greater than average worst low back pain intensity as reported during Baseline period based on eDiary.
  2. Radiographic evidence of spinal instability requiring fusion.
  3. Primary pain complaint of vascular origin (e.g. peripheral vascular disease).
  4. Spinal pain secondary to neoplasm, infection, autoimmune disorder with spinal involvement, or a spinal metabolic disorder.
  5. Any pain-related diagnosis or medical/psychological condition that, in the clinician's best judgment might confound reporting of study outcomes (e.g. pelvic pain, angina pain, chronic migraine.
  6. Participating (or intends to participate) in another clinical study.
  7. Terminal illness with anticipated survival 1 year.
  8. Current condition associated with risk of immunocompromised that might increase risk of infection during study duration.
  9. Currently on any anticoagulant medications that cannot be discontinued during perioperative period.
  10. Are pregnant/lactating or not using adequate birth control.
  11. Have untreated major psychiatric comorbidity, serious drug related behaviour issues.

Sites / Locations

  • North Bristol NHS Trust
  • Orsett Hospital
  • South Tees NHS Foundation Trust

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Active Comparator

Active Comparator

Active Comparator

Active Comparator

Arm Label

Arm 1

Arm 2

Arm 3

Arm 4

Arm Description

Boston Scientific PRECISION Spinal Cord Stimulator System with MultiWave Technology programmed to A KHz

Boston Scientific PRECISION Spinal Cord Stimulator System with MultiWave Technology programmed to B KHz

Boston Scientific PRECISION Spinal Cord Stimulator System with MultiWave Technology programmed to C KHz

Boston Scientific PRECISION Spinal Cord Stimulator System with MultiWave Technology programmed to D KHz

Outcomes

Primary Outcome Measures

Back pain relief
Mean reported pain on Numerical Rating Scale (NRS)

Secondary Outcome Measures

Leg pain relief
Mean reported pain on Numerical Rating Scale (NRS)
Patient global impression of change at end of Long-Term Follow-up
Questionnaire
Change in quality of life (EQ-5D) from Baseline Visit to end of Long-Term Follow-up
Questionnaire
Change in activities of Daily Living related to back pain disability from Baseline visit to end of Long-Term Follow-up
Questionnaire

Full Information

First Posted
September 1, 2015
Last Updated
December 21, 2020
Sponsor
Mid and South Essex NHS Foundation Trust
Collaborators
North Bristol NHS Trust
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1. Study Identification

Unique Protocol Identification Number
NCT02549183
Brief Title
Evaluation of Spinal Cord Stimulation Pulse Rate On Clinical Outcomes
Acronym
PROCO
Official Title
Evaluation of Stimulation Pulse Rate on Clinical Outcomes in Patients Whose Pain is Controlled by 10KHz Frequency - a Feasibility Study
Study Type
Interventional

2. Study Status

Record Verification Date
December 2020
Overall Recruitment Status
Completed
Study Start Date
June 1, 2015 (Actual)
Primary Completion Date
July 13, 2017 (Actual)
Study Completion Date
July 13, 2017 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mid and South Essex NHS Foundation Trust
Collaborators
North Bristol NHS Trust

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
Clinical study to estimate the optimal frequency for stimulation of the spinal cord to achieve relief from back pain.
Detailed Description
This is a feasibility study to identify the optimal frequency for stimulation of the spinal cord to achieve maximum reduction in neuropathic back pain as measured by average Numerical rating Scale. Twenty patients who suffer from back more than leg pain will be recruited into the study once they have satisfactory pain relief from both low and high frequency stimulations. Each patient will then receive stimulation at four different frequencies for 2-3 weeks in a random and blinded order. Their pain scores and function will be assessed using a variety of different tools. The data will then be used to estimate the optimal frequency.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Back Pain, Neuralgia
Keywords
Spinal Cord Stimulation

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Masking
Participant
Allocation
Randomized
Enrollment
22 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Arm 1
Arm Type
Active Comparator
Arm Description
Boston Scientific PRECISION Spinal Cord Stimulator System with MultiWave Technology programmed to A KHz
Arm Title
Arm 2
Arm Type
Active Comparator
Arm Description
Boston Scientific PRECISION Spinal Cord Stimulator System with MultiWave Technology programmed to B KHz
Arm Title
Arm 3
Arm Type
Active Comparator
Arm Description
Boston Scientific PRECISION Spinal Cord Stimulator System with MultiWave Technology programmed to C KHz
Arm Title
Arm 4
Arm Type
Active Comparator
Arm Description
Boston Scientific PRECISION Spinal Cord Stimulator System with MultiWave Technology programmed to D KHz
Intervention Type
Device
Intervention Name(s)
Boston Scientific PRECISION Spinal Cord Stimulator System
Intervention Description
Spinal cord stimulation randomly programmed to KHz frequencies; A, B, C and D Kilo Hertz.
Primary Outcome Measure Information:
Title
Back pain relief
Description
Mean reported pain on Numerical Rating Scale (NRS)
Time Frame
Three months
Secondary Outcome Measure Information:
Title
Leg pain relief
Description
Mean reported pain on Numerical Rating Scale (NRS)
Time Frame
3-6 months
Title
Patient global impression of change at end of Long-Term Follow-up
Description
Questionnaire
Time Frame
6-9 months
Title
Change in quality of life (EQ-5D) from Baseline Visit to end of Long-Term Follow-up
Description
Questionnaire
Time Frame
6-9 months
Title
Change in activities of Daily Living related to back pain disability from Baseline visit to end of Long-Term Follow-up
Description
Questionnaire
Time Frame
6-9 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Complaint of persistent or recurrent low back pain, with or without equal or lesser leg pain, for at least 90 days prior to Screen. Received at least 90 days of documented pain management care to address the primary pain complaint, prior to Screening (e.g. medication, physical therapy.) No back surgery within 6 months prior to Screening. Average low back pain intensity, during the position/activity, which routinely causes worst pain, of 5 or greater on a 0-10 numerical rating scale during Baseline period based on eDiary. If taking prescription opioids for primary chronic pain complaint (low back and/or leg pain), must have been on a stable prescription (same drug(s) and dose(s)) 30 days prior to Screening to a total of less than 180 mg Oral Morphine equivalent Willing and able to comply with all protocol-required procedures and assessments/evaluations (e.g. willing to comply with opioid prescription lock from the Baseline visit through End of Rate Randomization and protocol required stimulation parameter locks, complete daily eDiary). 18 years of age or older when written informed consent is obtained. If female of childbearing potential: not pregnant, as evidenced by a negative pregnancy test at Screening. Subject signed a valid, IRB-approved informed consent form (ICF) provided in English. Baseline Oswestry Disability Index score ≥ 20 and ≤ 80. Received at least 30 per cent reduction in NRS of average low back pain intensity from Baseline during the end of Post Implant HF10 Sweet-Spot Search as recorded in the eDiary. Exclusion Criteria: Average worst leg pain intensity is greater than average worst low back pain intensity as reported during Baseline period based on eDiary. Radiographic evidence of spinal instability requiring fusion. Primary pain complaint of vascular origin (e.g. peripheral vascular disease). Spinal pain secondary to neoplasm, infection, autoimmune disorder with spinal involvement, or a spinal metabolic disorder. Any pain-related diagnosis or medical/psychological condition that, in the clinician's best judgment might confound reporting of study outcomes (e.g. pelvic pain, angina pain, chronic migraine. Participating (or intends to participate) in another clinical study. Terminal illness with anticipated survival 1 year. Current condition associated with risk of immunocompromised that might increase risk of infection during study duration. Currently on any anticoagulant medications that cannot be discontinued during perioperative period. Are pregnant/lactating or not using adequate birth control. Have untreated major psychiatric comorbidity, serious drug related behaviour issues.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Simon Thomson, MD
Organizational Affiliation
National Health Service, United Kingdom
Official's Role
Study Chair
Facility Information:
Facility Name
North Bristol NHS Trust
City
Bristol
State/Province
Avon
ZIP/Postal Code
BS10 5NB
Country
United Kingdom
Facility Name
Orsett Hospital
City
Orsett
State/Province
Essex
ZIP/Postal Code
RM16 3EU
Country
United Kingdom
Facility Name
South Tees NHS Foundation Trust
City
Middlesbrough
ZIP/Postal Code
TS4 3BW
Country
United Kingdom

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
29220121
Citation
Thomson SJ, Tavakkolizadeh M, Love-Jones S, Patel NK, Gu JW, Bains A, Doan Q, Moffitt M. Effects of Rate on Analgesia in Kilohertz Frequency Spinal Cord Stimulation: Results of the PROCO Randomized Controlled Trial. Neuromodulation. 2018 Jan;21(1):67-76. doi: 10.1111/ner.12746. Epub 2017 Dec 8.
Results Reference
result

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Evaluation of Spinal Cord Stimulation Pulse Rate On Clinical Outcomes

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