search
Back to results

Study of Wireless Nerve Stimulation in the Treatment of Chronic Migraine

Primary Purpose

Migraine

Status
Not yet recruiting
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
StimRelieve Halo System
Sponsored by
Stimwave Technologies
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Migraine

Eligibility Criteria

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

Inclusion Criteria:

  • Subject is ≥ 18 years but less than 65 years of age at time of informed consent;
  • Subject who developed chronic migraine before the age of 60 years old;
  • Subjects have been diagnosed with chronic migraine according to the International Classification of Headache Disorders-3 (ICHD-3) (2013) criteria;
  • No medication overuse and not attributed to another causative disorder;
  • Subjects have chronic migraine for at least 6 months prior to enrollment;
  • Are refractory to conventional pharmacological chronic migraine treatments as defined by the failure to respond, or the intolerance, to at least 3 prophylaxis therapies (of which one is topiramate if not contraindicated) as determined by the investigator;
  • Based on the medical opinion of the Principal Investigator, there is no evidence of anatomic abnormalities that could jeopardize the placement of the device or pose a hazard to the subject;
  • Subject is willing to undergo surgical implant procedure, attend visits as scheduled, and comply with the study requirements;
  • Based on the opinion of the Principal Investigator, subject is willing and able to operate the patient programmer, recharging equipment, and electronic diary equipment, and has the ability to undergo study assessments and provide accurate responses;
  • Based on the opinion of the implanter, subject is a good surgical candidate for the implant procedure;
  • Subject is male or non-pregnant female. If female of child-bearing potential, must have a negative pregnancy test at baseline visit, and if sexually active, must be using a medically acceptable method of contraception for the duration of their study participation; Subject is deemed to be neuropsychosocially appropriate for implantation therapies based of the assessment of a Clinical Psychologist, using face-to-face encounters and the psychological testing described in the measures.

Exclusion Criteria:

  • Subject has undergone botulinum toxin (BOTOX) injections of the head and/or neck in the last 3 months;
  • Subject is on prescribed opioid medication;
  • Subject has a history of trigeminal autonomic cephalalgias;
  • Subject has a history of other primary or secondary headache disorders;
  • Subject has a history of trigeminal neuralgia;
  • Subject has cranial postherpetic neuralgia (shingles);
  • Subject has an active systemic infection or is immunocompromised; Insulin-dependent diabetic who is not controlled through diet and/or medication (determined by the physician) or non-insulin dependent diabetic who is not well controlled through diet and/or medication;
  • Bleeding complications or coagulopathy issues;
  • A life expectancy of less than one year;
  • Any active implanted device whether turned off or on;
  • Conditions requiring Magnetic Resonance Imaging (MRI) evaluation or diathermy procedures.
  • Based on the medical opinion of the Principal Investigator, Psychologist and/or Psychiatrist, the subject has other psychological conditions (e.g., psychosis, suicidal ideation, borderline personality disorder, somatization, narcissism), other health conditions (e.g., substance abuse, another chronic condition requiring the regular use of opioid medication), or other legal concerns that would preclude his/her enrollment in the study or potentially confound the results of the study;
  • Subject is currently enrolled in or plans to enroll in any concurrent drug and/or device study while participating in this study;
  • Subject is currently involved in litigation regarding injury, or is receiving worker's compensation benefits;
  • Subject is currently being treated with repetitive transcranial magnetic stimulation r(TMS) or electro convulsion therapy (ECT).

Sites / Locations

    Arms of the Study

    Arm 1

    Arm 2

    Arm Type

    Active Comparator

    Experimental

    Arm Label

    Delayed Continuation Group

    Continued Stim Group

    Arm Description

    All Subjects will be implanted with the StimRelieve HALO System. Subjects randomized to the delayed continuation group will have their systems deactivated until their 3 months follow-up visit. After this visit the stimulation will be reactivated.

    All Subjects will be implanted with the StimRelieve HALO System. Subjects randomized to the continued stim group will continue with active stimulation and monitored at defined intervals for data collection and device reprogramming, if needed.

    Outcomes

    Primary Outcome Measures

    Headache Days
    The primary effectiveness endpoint is defined as a ≥ 30% reduction in headache days per month at 3 months post-trial with no increase in medication as compared to baseline.
    Adverse Events
    The primary safety endpoint is the incidence and severity of adverse events through 3 months post-trial.

    Secondary Outcome Measures

    Migraine Days
    Change in number of migraine days per month from baseline to 3 months post-trial
    Headache Days
    Change in number of headache days per month from baseline to 3 months post-trial
    Headache Impact Test (HIT) Score
    Change from baseline in total HIT-6 score to 3 months post-trial
    Pain Medication
    Change from baseline in frequency of acute headache pain medication intake (all categories) at 3 months post-trial

    Full Information

    First Posted
    March 29, 2016
    Last Updated
    October 31, 2022
    Sponsor
    Stimwave Technologies
    search

    1. Study Identification

    Unique Protocol Identification Number
    NCT02725554
    Brief Title
    Study of Wireless Nerve Stimulation in the Treatment of Chronic Migraine
    Official Title
    Prospective, Randomized, Controlled, Multi-Center Study of Wireless Nerve Stimulation in the Treatment of Chronic Migraine
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    October 2022
    Overall Recruitment Status
    Not yet recruiting
    Study Start Date
    December 2023 (Anticipated)
    Primary Completion Date
    July 2024 (Anticipated)
    Study Completion Date
    December 2026 (Anticipated)

    3. Sponsor/Collaborators

    Responsible Party, by Official Title
    Sponsor
    Name of the Sponsor
    Stimwave Technologies

    4. Oversight

    Studies a U.S. FDA-regulated Drug Product
    No
    Studies a U.S. FDA-regulated Device Product
    Yes
    Data Monitoring Committee
    Yes

    5. Study Description

    Brief Summary
    The purpose of this study is to illustrate the safety and effectiveness of the StimRelieve Halo Nerve Stimulator System in the treatment of chronic migraine. The StimRelieve Halo System utilizes a minimally invasive procedure to implant a neurostimulator. This technology includes an octopolar electrode array stimulator with an embedded receiver. The energy source is a small, external, rechargeable transmitter, which is worn by the patient. The StimRelieve Halo System eliminates the implantable pulse generator, which has been the most common reason for reoperation or discomfort with existing devices. For this study, all subjects will be randomized at enrollment into either a delayed or immediate continuation group. The immediate continuation group will immediately continue with the stimulation therapy after the 30-day trial period and will be monitored for a total of 12 months. The delayed activation group will have their device turned off after the 30-day trial period for the next 3-months. At the 3-month visit, both groups be evaluated and the delayed activation group will have their devices reactivated. All subjects will immediately receive the permanent stimulator(s). The permanent stimulators can easily be removed if non-responders are identified. The wireless technology eliminates the need for externalized extensions, IPG's and thus reoperation. Additionally the outcome is highly dependent on placement of the stimulators. By eliminating the need for a staged trial, infection rates and incidence of pocket pain will decrease. In this study, subjects will undergo a 30-day trial in order to demonstrate effectiveness. Immediate activation of all devices will be done in the post-op period based on sensory response and subject comfort. Subjects will be seen at 14-days post-implant to assess patient compliance with the device, assess clinical response and to adjust programming parameters if not responding. Subjects will be seen at 1 month post-implant and headache diaries and questionnaires will be reviewed. Subjects not responding to the therapy by at least a 30% reduction in headache days will be deemed non-responders and will be withdrawn from the study and can choose to have the device removed. After the trial period, all responders will follow their random assignment determined at enrollment (delayed or immediate continuation). All subjects will be monitored for a total of 13 months. Adverse events will be monitored throughout the study.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Migraine

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Parallel Assignment
    Masking
    None (Open Label)
    Allocation
    Randomized
    Enrollment
    144 (Anticipated)

    8. Arms, Groups, and Interventions

    Arm Title
    Delayed Continuation Group
    Arm Type
    Active Comparator
    Arm Description
    All Subjects will be implanted with the StimRelieve HALO System. Subjects randomized to the delayed continuation group will have their systems deactivated until their 3 months follow-up visit. After this visit the stimulation will be reactivated.
    Arm Title
    Continued Stim Group
    Arm Type
    Experimental
    Arm Description
    All Subjects will be implanted with the StimRelieve HALO System. Subjects randomized to the continued stim group will continue with active stimulation and monitored at defined intervals for data collection and device reprogramming, if needed.
    Intervention Type
    Device
    Intervention Name(s)
    StimRelieve Halo System
    Intervention Description
    The StimRelieve Halo System is intended as the sole mitigating agent, or as an adjunct to other modes of therapy used in a multidisciplinary approach for chronic migraine as defined by the Third edition of the International Classification of headache disorders (ICDH-3). The system provides treatment by delivering small controlled electrical pulses to the occipital and supraorbital nerves, as it has been shown that for chronic migraine headaches the response to combined systems appears to be substantially better than occipital nerves stimulation alone.
    Primary Outcome Measure Information:
    Title
    Headache Days
    Description
    The primary effectiveness endpoint is defined as a ≥ 30% reduction in headache days per month at 3 months post-trial with no increase in medication as compared to baseline.
    Time Frame
    3 Months
    Title
    Adverse Events
    Description
    The primary safety endpoint is the incidence and severity of adverse events through 3 months post-trial.
    Time Frame
    12 Months
    Secondary Outcome Measure Information:
    Title
    Migraine Days
    Description
    Change in number of migraine days per month from baseline to 3 months post-trial
    Time Frame
    3 Months
    Title
    Headache Days
    Description
    Change in number of headache days per month from baseline to 3 months post-trial
    Time Frame
    3 Months
    Title
    Headache Impact Test (HIT) Score
    Description
    Change from baseline in total HIT-6 score to 3 months post-trial
    Time Frame
    3 Months
    Title
    Pain Medication
    Description
    Change from baseline in frequency of acute headache pain medication intake (all categories) at 3 months post-trial
    Time Frame
    3 Months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    18 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: Subject is ≥ 18 years but less than 65 years of age at time of informed consent; Subject who developed chronic migraine before the age of 60 years old; Subjects have been diagnosed with chronic migraine according to the International Classification of Headache Disorders-3 (ICHD-3) (2013) criteria; No medication overuse and not attributed to another causative disorder; Subjects have chronic migraine for at least 6 months prior to enrollment; Are refractory to conventional pharmacological chronic migraine treatments as defined by the failure to respond, or the intolerance, to at least 3 prophylaxis therapies (of which one is topiramate if not contraindicated) as determined by the investigator; Based on the medical opinion of the Principal Investigator, there is no evidence of anatomic abnormalities that could jeopardize the placement of the device or pose a hazard to the subject; Subject is willing to undergo surgical implant procedure, attend visits as scheduled, and comply with the study requirements; Based on the opinion of the Principal Investigator, subject is willing and able to operate the patient programmer, recharging equipment, and electronic diary equipment, and has the ability to undergo study assessments and provide accurate responses; Based on the opinion of the implanter, subject is a good surgical candidate for the implant procedure; Subject is male or non-pregnant female. If female of child-bearing potential, must have a negative pregnancy test at baseline visit, and if sexually active, must be using a medically acceptable method of contraception for the duration of their study participation; Subject is deemed to be neuropsychosocially appropriate for implantation therapies based of the assessment of a Clinical Psychologist, using face-to-face encounters and the psychological testing described in the measures. Exclusion Criteria: Subject has undergone botulinum toxin (BOTOX) injections of the head and/or neck in the last 3 months; Subject is on prescribed opioid medication; Subject has a history of trigeminal autonomic cephalalgias; Subject has a history of other primary or secondary headache disorders; Subject has a history of trigeminal neuralgia; Subject has cranial postherpetic neuralgia (shingles); Subject has an active systemic infection or is immunocompromised; Insulin-dependent diabetic who is not controlled through diet and/or medication (determined by the physician) or non-insulin dependent diabetic who is not well controlled through diet and/or medication; Bleeding complications or coagulopathy issues; A life expectancy of less than one year; Any active implanted device whether turned off or on; Conditions requiring Magnetic Resonance Imaging (MRI) evaluation or diathermy procedures. Based on the medical opinion of the Principal Investigator, Psychologist and/or Psychiatrist, the subject has other psychological conditions (e.g., psychosis, suicidal ideation, borderline personality disorder, somatization, narcissism), other health conditions (e.g., substance abuse, another chronic condition requiring the regular use of opioid medication), or other legal concerns that would preclude his/her enrollment in the study or potentially confound the results of the study; Subject is currently enrolled in or plans to enroll in any concurrent drug and/or device study while participating in this study; Subject is currently involved in litigation regarding injury, or is receiving worker's compensation benefits; Subject is currently being treated with repetitive transcranial magnetic stimulation r(TMS) or electro convulsion therapy (ECT).

    12. IPD Sharing Statement

    Plan to Share IPD
    Yes
    IPD Sharing Plan Description
    Within 6 months of end of study, data will be published. All study subject data will be anonymous.

    Learn more about this trial

    Study of Wireless Nerve Stimulation in the Treatment of Chronic Migraine

    We'll reach out to this number within 24 hrs