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Ultra Low Frequency Spinal Cord Stimulation for Chronic Low Back Pain

Primary Purpose

Chronic Pain, Chronic Low-back Pain

Status
Recruiting
Phase
Not Applicable
Locations
Australia
Study Type
Interventional
Intervention
ULF SCS
Sponsored by
Presidio Medical, Inc
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Pain focused on measuring Neuromodulation, Spinal Cord Stimulation

Eligibility Criteria

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

Inclusion Criteria: Diagnosed with chronic low back pain with/without leg pain (VAS ≥60mm for back pain for the past week), which has been refractory to conservative therapy for a minimum of 3 months. Be on no or stable pain medications, as determined by the investigator, for at least 28 days prior to the screening visit. Is currently considered medically stable as judged by investigator. Able to operate the SCS device (e.g., using remote control) and charge the device appropriately. Determined to be a good surgical candidate by the investigator. Willing to sign the Human Research Ethics Committee (HREC) approved informed consent and deemed capable of complying with the requirements of the study protocol. Willing to stay on stable medications until implantable pulse generator (IPG) activation (i.e., from IPG implant to IPG activation, except for usual postoperative medications required following IPG insertion). Able to comply with study requirements and attend all scheduled visits. Eighteen (18) years of age or older. Literate, able to speak English and able to complete questionnaires independently. Exclusion Criteria: Diagnosis of active disruptive psychological or psychiatric disorder or other known condition significant enough to impact perception of pain, compliance, intervention and/or ability to evaluate treatment outcome as assessed by a clinical psychologist or psychiatrist in a psychological assessment performed at Baseline. Chronic pain in any area other than back or legs, such that it precludes subject's ability to assess their pain for the primary indication of chronic low back pain as determined by Investigator. Previous experience with implantable neuromodulation devices (e.g., spinal cord stimulation, peripheral nerve stimulation, dorsal root ganglion stimulation). Opioid usage with average total daily morphine equivalent dose (MED) of >60 mg. A known need for an MRI or surgery within a 2-week period of the screening visit through the end of the study. Female candidates of childbearing potential that are pregnant (confirmed by positive urine/blood pregnancy test) or plan to get pregnant during the duration of the study. Subject is participating in another interventional clinical trial.

Sites / Locations

  • Genesis Research Services Pty LtdRecruiting
  • CerCare Pty LtdRecruiting
  • Metro Pain Research Institute

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ULF SCS

Arm Description

Participants with chronic low back pain that is refractory to conservative care will undergo temporary trial stimulation with the ULF SCS system. Those receiving at least 50% pain relief of their chronic back pain will be eligible for a permanent device implant and followed for 12 months.

Outcomes

Primary Outcome Measures

Back pain responder rate at 3 months as assessed using a visual analog scale (VAS)
A responder is defined as a participant that achieved at least 50% reduction in back pain at the follow-up compared to baseline. Responder rate is defined as the percentage of participants that were responders.

Secondary Outcome Measures

Change in back pain VAS at 3 months
The mean percentage change in VAS back pain intensity from baseline.
Change in back pain VAS at 6 months
The mean percentage change in VAS back pain intensity from baseline.
Change in back pain VAS at 12 months
The mean percentage change in VAS back pain intensity from baseline.
Change in leg pain VAS at 3 months
The mean percentage change in VAS leg pain intensity from baseline. Calculated only for participants who scored at least 40 out of 100mm for leg pain at baseline.
Change in leg pain VAS at 6 months
The mean percentage change in VAS leg pain intensity from baseline. Calculated only for participants who scored at least 40 out of 100mm for leg pain at baseline.
Change in leg pain VAS at 12 months
The mean percentage change in VAS leg pain intensity from baseline. Calculated only for participants who scored at least 40 out of 100mm for leg pain at baseline.
Proportion of participants with a minimal clinically important difference (MCID) as measured by Oswestry Disability Index (ODI) at 3 months
The MCID is defined as at least a 10-point improvement on ODI.
Proportion of participants with a MCID as measured by ODI at 6 months
The MCID is defined as at least a 10-point improvement on ODI.
Proportion of participants with a MCID as measured by ODI at 12 months
The MCID is defined as at least a 10-point improvement on ODI.
Change in EuroQol-5 Dimension (EQ-5D) quality of life index at 3 months
The mean change in EQ-5D index from baseline.
Change in EQ-5D quality of life index at 6 months
The mean change in EQ-5D index from baseline.
Change in EQ-5D quality of life index at 12 months
The mean change in EQ-5D index from baseline.
Proportion of participants with remission of low back pain as assessed by VAS at 6 months
Remission is defined as VAS score of 30mm or less for 6 consecutive months.
Proportion of participants with remission of low back pain as assessed by VAS at 9 months
Remission is defined as VAS score of 30mm or less for 6 consecutive months.
Proportion of participants with remission of low back pain as assessed by VAS at 12 months
Remission is defined as VAS score of 30mm or less for 6 consecutive months.
Change in sleep quality as assessed by Medical Outcomes Study Sleep Scale (MOS-SS) at 3 months
The mean change in MOS-SS index from baseline.
Change in sleep quality as assessed by MOS-SS at 6 months
The mean change in MOS-SS index from baseline.
Change in sleep quality as assessed by MOS-SS at 12 months
The mean change in MOS-SS index from baseline.

Full Information

First Posted
April 19, 2023
Last Updated
May 26, 2023
Sponsor
Presidio Medical, Inc
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1. Study Identification

Unique Protocol Identification Number
NCT05837234
Brief Title
Ultra Low Frequency Spinal Cord Stimulation for Chronic Low Back Pain
Official Title
A Prospective, Open-Label, Multi-Center Trial to Evaluate the Safety and Effectiveness of Ultra Low Frequency Spinal Cord Stimulation in Patients With Chronic Low Back Pain
Study Type
Interventional

2. Study Status

Record Verification Date
May 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 9, 2023 (Actual)
Primary Completion Date
September 2024 (Anticipated)
Study Completion Date
June 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Presidio Medical, Inc

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The Presidio Medical Ultra Low Frequency (ULF™) Spinal Cord Stimulation (SCS) System is intended to provide pain relief to participants who have been clinically diagnosed with chronic low back pain with or without leg pain.
Detailed Description
This is a prospective, open-label, multi-center clinical trial in which participants with chronic low back pain (CLBP) with/without leg pain will be invited to enroll and undergo treatment with the ULF SCS system. The purpose of this study is to evaluate the safety and effectiveness of ULF SCS over a 1-year period.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Pain, Chronic Low-back Pain
Keywords
Neuromodulation, Spinal Cord Stimulation

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
55 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ULF SCS
Arm Type
Experimental
Arm Description
Participants with chronic low back pain that is refractory to conservative care will undergo temporary trial stimulation with the ULF SCS system. Those receiving at least 50% pain relief of their chronic back pain will be eligible for a permanent device implant and followed for 12 months.
Intervention Type
Device
Intervention Name(s)
ULF SCS
Intervention Description
Ultra low frequency spinal cord stimulation
Primary Outcome Measure Information:
Title
Back pain responder rate at 3 months as assessed using a visual analog scale (VAS)
Description
A responder is defined as a participant that achieved at least 50% reduction in back pain at the follow-up compared to baseline. Responder rate is defined as the percentage of participants that were responders.
Time Frame
3 months
Secondary Outcome Measure Information:
Title
Change in back pain VAS at 3 months
Description
The mean percentage change in VAS back pain intensity from baseline.
Time Frame
3 months
Title
Change in back pain VAS at 6 months
Description
The mean percentage change in VAS back pain intensity from baseline.
Time Frame
6 months
Title
Change in back pain VAS at 12 months
Description
The mean percentage change in VAS back pain intensity from baseline.
Time Frame
12 months
Title
Change in leg pain VAS at 3 months
Description
The mean percentage change in VAS leg pain intensity from baseline. Calculated only for participants who scored at least 40 out of 100mm for leg pain at baseline.
Time Frame
3 months
Title
Change in leg pain VAS at 6 months
Description
The mean percentage change in VAS leg pain intensity from baseline. Calculated only for participants who scored at least 40 out of 100mm for leg pain at baseline.
Time Frame
6 months
Title
Change in leg pain VAS at 12 months
Description
The mean percentage change in VAS leg pain intensity from baseline. Calculated only for participants who scored at least 40 out of 100mm for leg pain at baseline.
Time Frame
12 months
Title
Proportion of participants with a minimal clinically important difference (MCID) as measured by Oswestry Disability Index (ODI) at 3 months
Description
The MCID is defined as at least a 10-point improvement on ODI.
Time Frame
3 months
Title
Proportion of participants with a MCID as measured by ODI at 6 months
Description
The MCID is defined as at least a 10-point improvement on ODI.
Time Frame
6 months
Title
Proportion of participants with a MCID as measured by ODI at 12 months
Description
The MCID is defined as at least a 10-point improvement on ODI.
Time Frame
12 months
Title
Change in EuroQol-5 Dimension (EQ-5D) quality of life index at 3 months
Description
The mean change in EQ-5D index from baseline.
Time Frame
3 months
Title
Change in EQ-5D quality of life index at 6 months
Description
The mean change in EQ-5D index from baseline.
Time Frame
6 months
Title
Change in EQ-5D quality of life index at 12 months
Description
The mean change in EQ-5D index from baseline.
Time Frame
12 months
Title
Proportion of participants with remission of low back pain as assessed by VAS at 6 months
Description
Remission is defined as VAS score of 30mm or less for 6 consecutive months.
Time Frame
6 months
Title
Proportion of participants with remission of low back pain as assessed by VAS at 9 months
Description
Remission is defined as VAS score of 30mm or less for 6 consecutive months.
Time Frame
9 months
Title
Proportion of participants with remission of low back pain as assessed by VAS at 12 months
Description
Remission is defined as VAS score of 30mm or less for 6 consecutive months.
Time Frame
12 months
Title
Change in sleep quality as assessed by Medical Outcomes Study Sleep Scale (MOS-SS) at 3 months
Description
The mean change in MOS-SS index from baseline.
Time Frame
3 months
Title
Change in sleep quality as assessed by MOS-SS at 6 months
Description
The mean change in MOS-SS index from baseline.
Time Frame
6 months
Title
Change in sleep quality as assessed by MOS-SS at 12 months
Description
The mean change in MOS-SS index from baseline.
Time Frame
12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosed with chronic low back pain with/without leg pain (VAS ≥60mm for back pain for the past week), which has been refractory to conservative therapy for a minimum of 3 months. Be on no or stable pain medications, as determined by the investigator, for at least 28 days prior to the screening visit. Is currently considered medically stable as judged by investigator. Able to operate the SCS device (e.g., using remote control) and charge the device appropriately. Determined to be a good surgical candidate by the investigator. Willing to sign the Human Research Ethics Committee (HREC) approved informed consent and deemed capable of complying with the requirements of the study protocol. Willing to stay on stable medications until implantable pulse generator (IPG) activation (i.e., from IPG implant to IPG activation, except for usual postoperative medications required following IPG insertion). Able to comply with study requirements and attend all scheduled visits. Eighteen (18) years of age or older. Literate, able to speak English and able to complete questionnaires independently. Exclusion Criteria: Diagnosis of active disruptive psychological or psychiatric disorder or other known condition significant enough to impact perception of pain, compliance, intervention and/or ability to evaluate treatment outcome as assessed by a clinical psychologist or psychiatrist in a psychological assessment performed at Baseline. Chronic pain in any area other than back or legs, such that it precludes subject's ability to assess their pain for the primary indication of chronic low back pain as determined by Investigator. Previous experience with implantable neuromodulation devices (e.g., spinal cord stimulation, peripheral nerve stimulation, dorsal root ganglion stimulation). Opioid usage with average total daily morphine equivalent dose (MED) of >60 mg. A known need for an MRI or surgery within a 2-week period of the screening visit through the end of the study. Female candidates of childbearing potential that are pregnant (confirmed by positive urine/blood pregnancy test) or plan to get pregnant during the duration of the study. Subject is participating in another interventional clinical trial.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Valerie Cimmarusti
Phone
+1 (626) 353-8667
Email
vcimmarusti@presidiomedical.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Willem Volschenk, MBCHB
Organizational Affiliation
Genesis Research Services
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Mattew Green, BMBS
Organizational Affiliation
CerCare
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Paul Verrills, MBBS
Organizational Affiliation
Metro Pain Research Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
Genesis Research Services Pty Ltd
City
Newcastle
State/Province
New South Wales
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Heather Macdonald
Phone
+61 2 4985 1841
Email
r.manager@genesisresearchservices.com
First Name & Middle Initial & Last Name & Degree
Willem Volschenk, MBCHB
Facility Name
CerCare Pty Ltd
City
Wayville
State/Province
South Australia
Country
Australia
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Helen Plummer
Phone
+61 8 8340 7733
Email
Helen@painmedsa.com
First Name & Middle Initial & Last Name & Degree
Matthew Green, BMBS
Facility Name
Metro Pain Research Institute
City
Clayton
State/Province
Victoria
ZIP/Postal Code
3168
Country
Australia
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Maja Green, PhD
Phone
+61 3 9595 6181
Email
mgreen@MPRI.com.au
First Name & Middle Initial & Last Name & Degree
Paul Verrills, MBBS

12. IPD Sharing Statement

Plan to Share IPD
No

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Ultra Low Frequency Spinal Cord Stimulation for Chronic Low Back Pain

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