Tsunami DRG High Frequency Stimulation Study
Primary Purpose
Chronic Back Pain, Chronic Back and Leg Pain
Status
Active
Phase
Not Applicable
Locations
Belgium
Study Type
Interventional
Intervention
Spinal Cord Stimulator HF
Spinal Cord Stimulator Sham
Sponsored by
About this trial
This is an interventional treatment trial for Chronic Back Pain
Eligibility Criteria
Inclusion criteria
- Subject is ≥ 18 years of age at time of informed consent;
- Subjects have been diagnosed with predominant, chronic, intractable back pain with a VAS > 50 mm (on a 100-mm scale);
- Subjects have been diagnosed with predominant, chronic, intractable back pain for at least 6 months before study participation;
- Based on the medical opinion of the Principal Investigator, subject has a stable pain medication regiment;
- 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;
- Subject is willing and able to operate the patient programmer, recharging 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;
- Subject is deemed to be neuro-psycho-socially appropriate for implantation therapies based of the assessment of a clinical psychologist and principal investigator, using face-to-face encounters and the psychological testing described in the measures;
- Patient is capable of giving informed consent.
Exclusion criteria
- Obvious mechanical instability related to pain (diagnosed by imaging taken within the past 6 months);
- Unresolved malignancies in the last six months;
- Subject has post-herpetic neuralgia (shingles);
- Subject has an active systemic infection or is immune-compromised;
- Based on the medical opinion of the Principal Investigator 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;
- 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;
- Pregnant/lactating or not using adequate birth control;
- A life expectancy of less than one year;
- Any active implanted device whether turned off or on;
- A previous SCS experience;
- Conditions requiring Magnetic Resonance Imaging (MRI) evaluation or diathermy procedures.
Sites / Locations
- GZA Sint-Augustinus
- AZ Delta
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Sham Comparator
Arm Label
High Frequency
Sham
Arm Description
Subjects receiving high frequency pulse rate treatment over T9 exiting nerve roots. Subjects and assessors blinded Randomization.
Subjects receiving Sham (non-active) treatment over T9 exiting nerve roots. Subjects and assessors blinded to randomization. Subjects and assessors to be unblinded if pain scores are 30 mms or higher with VAS after 1-month follow-up. Upon this moment subjects to receive active stimulation
Outcomes
Primary Outcome Measures
Responder rate
a > 50% reduction in back pain as measured by VAS with the Freedom SCS system in the HF (test) group as opposed to sham and conventional medical management
Secondary Outcome Measures
VAS back pain
Percentage change from baseline in VAS for back pain
VAS leg pain
Percentage change from baseline in VAS for leg pain
ODI
Change from baseline in functionality using the ODI score
Full Information
NCT ID
NCT03312010
First Posted
June 20, 2017
Last Updated
October 31, 2022
Sponsor
Stimwave Technologies
Collaborators
AZ Delta, GZA Ziekenhuizen Campus Sint-Augustinus
1. Study Identification
Unique Protocol Identification Number
NCT03312010
Brief Title
Tsunami DRG High Frequency Stimulation Study
Official Title
A European, Prospective, Multi-Center, Double-Blind, Randomized, Controlled, Clinical Trial Investigating the Effects of High Frequency Wireless Spinal Cord Stimulation (SCS) Over Exiting Nerve Roots in the Treatment of Chronic Back Pain
Study Type
Interventional
2. Study Status
Record Verification Date
October 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
March 1, 2018 (Actual)
Primary Completion Date
August 1, 2019 (Actual)
Study Completion Date
December 1, 2022 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Stimwave Technologies
Collaborators
AZ Delta, GZA Ziekenhuizen Campus Sint-Augustinus
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
Prospective, double blinded, randomized, clinical study investigating the effects of high frequency SCS over exiting nerve roots at T9 for the treatment of chronic back or back and leg pain.
Detailed Description
All subjects will have two permanent stimulators placed over the exiting nerve roots at T9 at the implant visit. The stimulators can easily be removed for non-responders. High frequency stimulation is typically programmed below sensory threshold. This type of stimulation lends itself to a placebo-controlled trial. For this study subjects will be randomized 1:1 at enrollment into a high frequency or sham group. Neither the subjects nor experimenters will be made aware of their randomization assignment for at least the first month of the trial. Subjects belonging to both groups will be unblinded to their assignment at the 1-month or a later visit (including unscheduled visit) if they have a VAS > 30 mms. Subjects belonging to the sham group will be reprogrammed with HF stimulation at this point. Subjects belonging to the HF stimulation group will keep stimulating with HF. Subjects reporting a VAS < 30 mms will continue to be blinded.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Back Pain, Chronic Back and Leg Pain
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Prospective, partially double-blinded, randomized
Masking
ParticipantInvestigatorOutcomes Assessor
Masking Description
Subjects and assessors randomized to HF blinded Subjects and assessors randomized to sham blinded
Allocation
Randomized
Enrollment
38 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
High Frequency
Arm Type
Experimental
Arm Description
Subjects receiving high frequency pulse rate treatment over T9 exiting nerve roots. Subjects and assessors blinded Randomization.
Arm Title
Sham
Arm Type
Sham Comparator
Arm Description
Subjects receiving Sham (non-active) treatment over T9 exiting nerve roots. Subjects and assessors blinded to randomization. Subjects and assessors to be unblinded if pain scores are 30 mms or higher with VAS after 1-month follow-up. Upon this moment subjects to receive active stimulation
Intervention Type
Device
Intervention Name(s)
Spinal Cord Stimulator HF
Intervention Description
A needle and catheter is carefully inserted near your spinal column. The stimulator is then placed through the catheter close to your spinal column. The proximal end of the stimulator is then sutured underneath the skin of your back to the fascia to prevent migration.
Intervention Type
Device
Intervention Name(s)
Spinal Cord Stimulator Sham
Intervention Description
A needle and catheter is carefully inserted near your spinal column. The stimulator is then placed through the catheter close to your spinal column. The proximal end of the stimulator is then sutured underneath the skin of your back to the fascia to prevent migration.
Primary Outcome Measure Information:
Title
Responder rate
Description
a > 50% reduction in back pain as measured by VAS with the Freedom SCS system in the HF (test) group as opposed to sham and conventional medical management
Time Frame
1 month post-implant
Secondary Outcome Measure Information:
Title
VAS back pain
Description
Percentage change from baseline in VAS for back pain
Time Frame
1, 3, 6, 9, 12 and 36 months
Title
VAS leg pain
Description
Percentage change from baseline in VAS for leg pain
Time Frame
1, 3, 6, 9, 12 and 36 months
Title
ODI
Description
Change from baseline in functionality using the ODI score
Time Frame
1, 3, 6, 9, 12 and 36 months
Other Pre-specified Outcome Measures:
Title
PGIC
Description
Subject satisfaction with the therapy as measured by the Patient Global Impression of Change (PGIC)
Time Frame
1, 3, 6, 9, 12 and 36 months
Title
EQ-5D-5L
Description
Changes from baseline in quality of life
Time Frame
1, 3, 6, 9, 12 and 36 months
Title
AE's
Description
Incidence of device related adverse events
Time Frame
1, 3, 6, 9, 12 and 36 months
Title
Opioid Pain Medication
Description
Prescribed opioid pain medications
Time Frame
1, 3, 6, 9, 12 and 36 months
Title
Non-opioid Pain Medication
Description
Prescribed non-opioid pain medication
Time Frame
1, 3, 6, 9, 12 and 36 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion criteria
Subject is ≥ 18 years of age at time of informed consent;
Subjects have been diagnosed with predominant, chronic, intractable back pain with a VAS > 50 mm (on a 100-mm scale);
Subjects have been diagnosed with predominant, chronic, intractable back pain for at least 6 months before study participation;
Based on the medical opinion of the Principal Investigator, subject has a stable pain medication regiment;
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;
Subject is willing and able to operate the patient programmer, recharging 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;
Subject is deemed to be neuro-psycho-socially appropriate for implantation therapies based of the assessment of a clinical psychologist and principal investigator, using face-to-face encounters and the psychological testing described in the measures;
Patient is capable of giving informed consent.
Exclusion criteria
Obvious mechanical instability related to pain (diagnosed by imaging taken within the past 6 months);
Unresolved malignancies in the last six months;
Subject has post-herpetic neuralgia (shingles);
Subject has an active systemic infection or is immune-compromised;
Based on the medical opinion of the Principal Investigator 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;
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;
Pregnant/lactating or not using adequate birth control;
A life expectancy of less than one year;
Any active implanted device whether turned off or on;
A previous SCS experience;
Conditions requiring Magnetic Resonance Imaging (MRI) evaluation or diathermy procedures.
Facility Information:
Facility Name
GZA Sint-Augustinus
City
Wilrijk
State/Province
Antwerpen
ZIP/Postal Code
2610
Country
Belgium
Facility Name
AZ Delta
City
Roeselare
ZIP/Postal Code
8800
Country
Belgium
12. IPD Sharing Statement
Plan to Share IPD
No
IPD Sharing Plan Description
Publication, Study outcomes
Citations:
PubMed Identifier
34854473
Citation
O'Connell NE, Ferraro MC, Gibson W, Rice AS, Vase L, Coyle D, Eccleston C. Implanted spinal neuromodulation interventions for chronic pain in adults. Cochrane Database Syst Rev. 2021 Dec 2;12(12):CD013756. doi: 10.1002/14651858.CD013756.pub2.
Results Reference
derived
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Tsunami DRG High Frequency Stimulation Study
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