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Rechargeable Implantable Vagus Nerve Stimulation System for Drug-Refractory Epilepsy

Primary Purpose

Drug-Refractory Epilepsy

Status
Recruiting
Phase
Not Applicable
Locations
China
Study Type
Interventional
Intervention
G114R VNS system
Sponsored by
Beijing Pins Medical Co., Ltd
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Drug-Refractory Epilepsy focused on measuring Vagus Nerve Stimulation

Eligibility Criteria

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

Inclusion Criteria: Age: ≥3 years old; gender is not limited; Patients with clinically diagnosed drug-resistant epilepsy, suitable for vagus nerve stimulation therapy; At least 6 seizures per month; Patients with a history of increased heart rate (tachycardia) associated with seizure onset based on clinical data obtained from medical history, admission/hospital charts, or prior neurophysiologic evaluations; When the patient is lying on the left side and in an upright position, from the proposed electrode position on the neck to the proposed pulse generator on the chest, the peak-peak R-wave of the ECG should be higher than 0.40mV; Patients who are willing to undergo EMU phase assessment and activate the automatic mode function during this period; Patients must be in good general health and ambulatory; Children and guardians must be willing and able to give informed consent; Patients and their families have good compliance and can cooperate with the completion of postoperative follow-up requirements. Exclusion Criteria: Patients have had a bilateral or left cervical vagotomy; One or both sides of the vagus nerve have lesions or damage; Patients have a history of VNS Therapy; Patients with a history of status epilepticus within 1 year prior to enrollment; Patients with a history of mental illness or pseudoepileptic seizures or epilepsy caused by intracranial space-occupying lesions; Patients currently use, or are expected to use, short-wave diathermy, microwave diathermy, or therapeutic ultrasound diathermy; Patients expected to require full body magnetic resonance imaging; VNS therapeutic system implants will bring unacceptable surgical or medical risks to patients (according to the judgment of the investigator); Patients with surgical contraindications identified by surgeons and anesthesiologists such as tumors, insulin-dependent diabetes mellitus or poor general condition; A record of clinically significant seizure-related bradycardia (heart rate below 50 bpm); Patients prescribed drugs specifically for a cardiac or autonomic disorder that in the investigator's opinion would affect heart rate response unless the patient has ictal tachycardia while taking said drugs. These include, but are not limited to, beta adrenergic antagonists ("beta blockers"); Patients with known clinically significant arrhythmias, and patients with clinically significant arrhythmias identified by 24-hour ambulatory ECG recordings obtained at the screening visit; Adult patients with severe mental illness, severe cognitive impairment, history of severe depression, or suicidal tendencies, which, in the judgment of the investigator, would pose an unacceptable risk to the patient or prevent the patient from successfully completing the study; Abusing alcohol or use narcotic drugs; Women who are pregnant. Women of childbearing age must take a pregnancy test; Patients currently enrolled in another investigational study; Those deemed unsuitable by the researcher.

Sites / Locations

  • Peking University First HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

G114R VNS system

Arm Description

Outcomes

Primary Outcome Measures

Sensitivity of epilepsy detection
Sensitivity is defined as the total number of seizures detected divided by the total number of seizures during the EMU stay.
False positives for epilepsy detection
A false positive event is defined when the IPG judged a seizure and triggered automatic mode stimulation ±2 minutes outside the time window of a actual seizure. The ratio of the total number of false positive events for all subjects to the monitoring time for all subjects during the EMU phase is defined as the false positive rate.

Secondary Outcome Measures

Changes in Seizure Frequency from Baseline
Seizure frequency is calculated at 2 and 3 month follow-up visits based on seizure diary information and compared to baseline estimates. Response rate is computed and summarized for seizure as the percentage of patients that achieved ≥50% seizure reduction per month from baseline by visit.
Change in seizure Severity
The Epilepsy Severity Scale (NHS3) will be completed at baseline,at the end of the EMU phase and during the follow-up period. The severity of epilepsy will be assessed based on seizure type. The range of NHS3 scale is 1-27 with 1 being the least severe and 27 being the most severe.
Change in Quality of Life
Quality of life data is collected using patient-completed QOLIE-31 scales and compared between baseline and follow-up visits. The range for QOLIE-31-P (all subscores) is 0-100 with higher scores reflecting greater well-being.
Heart rate recording accuracy
The total number and accuracy of heart rate detected by IPG are measured by ECG recording.
Duty cycle
The total percentage of time VNS is on for an individual patient is called the duty cycle. It's calculated as (ON time + X )/(ON time + OFF time), X depended on the setting of Soft start/stop.
Charging Equipment Satisfaction Evaluation
A questionnaire is used to evaluate the simplicity of the charging process and overall satisfaction.

Full Information

First Posted
July 28, 2023
Last Updated
September 11, 2023
Sponsor
Beijing Pins Medical Co., Ltd
Collaborators
Peking University First Hospital, Beijing Tiantan Hospital
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1. Study Identification

Unique Protocol Identification Number
NCT05993117
Brief Title
Rechargeable Implantable Vagus Nerve Stimulation System for Drug-Refractory Epilepsy
Official Title
Rechargeable Implantable Vagus Nerve Stimulation System for Drug-Refractory Epilepsy
Study Type
Interventional

2. Study Status

Record Verification Date
September 2023
Overall Recruitment Status
Recruiting
Study Start Date
September 1, 2021 (Actual)
Primary Completion Date
June 2024 (Anticipated)
Study Completion Date
December 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Beijing Pins Medical Co., Ltd
Collaborators
Peking University First Hospital, Beijing Tiantan Hospital

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
To evaluate the performance of automatic stimulation mode of a new rechargeable implantable vagus nerve stimulation system for drug-refractory epilepsy
Detailed Description
The study is a prospective, single-group, open-lable trial designed to collect data on patients implanted with a Model G114R VNS system (Beijing PINS Medical) from baseline through an EMU (epilepsy monitoring unit) stay of up to 5 days, and 3-mouth follow-up. The seizure burden and quality of life were evaluated. Adverse events were recorded during the trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Drug-Refractory Epilepsy
Keywords
Vagus Nerve 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
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
G114R VNS system
Arm Type
Experimental
Intervention Type
Device
Intervention Name(s)
G114R VNS system
Intervention Description
All patients treated with Rechargeable Implantable Vagus Nerve Stimulation System (G114R)
Primary Outcome Measure Information:
Title
Sensitivity of epilepsy detection
Description
Sensitivity is defined as the total number of seizures detected divided by the total number of seizures during the EMU stay.
Time Frame
2-4 weeks after implant
Title
False positives for epilepsy detection
Description
A false positive event is defined when the IPG judged a seizure and triggered automatic mode stimulation ±2 minutes outside the time window of a actual seizure. The ratio of the total number of false positive events for all subjects to the monitoring time for all subjects during the EMU phase is defined as the false positive rate.
Time Frame
2-4 weeks after implant
Secondary Outcome Measure Information:
Title
Changes in Seizure Frequency from Baseline
Description
Seizure frequency is calculated at 2 and 3 month follow-up visits based on seizure diary information and compared to baseline estimates. Response rate is computed and summarized for seizure as the percentage of patients that achieved ≥50% seizure reduction per month from baseline by visit.
Time Frame
up to 3 months Visit
Title
Change in seizure Severity
Description
The Epilepsy Severity Scale (NHS3) will be completed at baseline,at the end of the EMU phase and during the follow-up period. The severity of epilepsy will be assessed based on seizure type. The range of NHS3 scale is 1-27 with 1 being the least severe and 27 being the most severe.
Time Frame
up to 3 months Visit
Title
Change in Quality of Life
Description
Quality of life data is collected using patient-completed QOLIE-31 scales and compared between baseline and follow-up visits. The range for QOLIE-31-P (all subscores) is 0-100 with higher scores reflecting greater well-being.
Time Frame
up to 3 months Visit
Title
Heart rate recording accuracy
Description
The total number and accuracy of heart rate detected by IPG are measured by ECG recording.
Time Frame
1 to 2 weeks after implantation
Title
Duty cycle
Description
The total percentage of time VNS is on for an individual patient is called the duty cycle. It's calculated as (ON time + X )/(ON time + OFF time), X depended on the setting of Soft start/stop.
Time Frame
up to 3 months Visit
Title
Charging Equipment Satisfaction Evaluation
Description
A questionnaire is used to evaluate the simplicity of the charging process and overall satisfaction.
Time Frame
2-4 weeks after implant

10. Eligibility

Sex
All
Minimum Age & Unit of Time
3 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age: ≥3 years old; gender is not limited; Patients with clinically diagnosed drug-resistant epilepsy, suitable for vagus nerve stimulation therapy; At least 6 seizures per month; Patients with a history of increased heart rate (tachycardia) associated with seizure onset based on clinical data obtained from medical history, admission/hospital charts, or prior neurophysiologic evaluations; When the patient is lying on the left side and in an upright position, from the proposed electrode position on the neck to the proposed pulse generator on the chest, the peak-peak R-wave of the ECG should be higher than 0.40mV; Patients who are willing to undergo EMU phase assessment and activate the automatic mode function during this period; Patients must be in good general health and ambulatory; Children and guardians must be willing and able to give informed consent; Patients and their families have good compliance and can cooperate with the completion of postoperative follow-up requirements. Exclusion Criteria: Patients have had a bilateral or left cervical vagotomy; One or both sides of the vagus nerve have lesions or damage; Patients have a history of VNS Therapy; Patients with a history of status epilepticus within 1 year prior to enrollment; Patients with a history of mental illness or pseudoepileptic seizures or epilepsy caused by intracranial space-occupying lesions; Patients currently use, or are expected to use, short-wave diathermy, microwave diathermy, or therapeutic ultrasound diathermy; Patients expected to require full body magnetic resonance imaging; VNS therapeutic system implants will bring unacceptable surgical or medical risks to patients (according to the judgment of the investigator); Patients with surgical contraindications identified by surgeons and anesthesiologists such as tumors, insulin-dependent diabetes mellitus or poor general condition; A record of clinically significant seizure-related bradycardia (heart rate below 50 bpm); Patients prescribed drugs specifically for a cardiac or autonomic disorder that in the investigator's opinion would affect heart rate response unless the patient has ictal tachycardia while taking said drugs. These include, but are not limited to, beta adrenergic antagonists ("beta blockers"); Patients with known clinically significant arrhythmias, and patients with clinically significant arrhythmias identified by 24-hour ambulatory ECG recordings obtained at the screening visit; Adult patients with severe mental illness, severe cognitive impairment, history of severe depression, or suicidal tendencies, which, in the judgment of the investigator, would pose an unacceptable risk to the patient or prevent the patient from successfully completing the study; Abusing alcohol or use narcotic drugs; Women who are pregnant. Women of childbearing age must take a pregnancy test; Patients currently enrolled in another investigational study; Those deemed unsuitable by the researcher.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Jianguang Sun
Phone
010-60736388
Email
sunjianguang@pinsmedical.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ye Wu
Organizational Affiliation
Peking University First Hospital
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Jianguo Zhang
Organizational Affiliation
Beijing Tiantan Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Peking University First Hospital
City
Beijing
State/Province
Beijing
ZIP/Postal Code
100034
Country
China
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Ye Wu
Phone
010-66119025
Email
bdyyec@163.com

12. IPD Sharing Statement

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Rechargeable Implantable Vagus Nerve Stimulation System for Drug-Refractory Epilepsy

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