Bioness® StimRouter™ Neuromodulation System for Chronic Pain Therapy

NCT ID: NCT01592344

Last Updated: 2016-04-11

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

94 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-04-30

Study Completion Date

2015-07-31

Brief Summary

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The purpose of this study is to investigate whether the StimRouter (SR) electrical stimulation therapy leads to clinically important pain relief in patients with chronic intractable pain of peripheral nerve origin after three months of treatment. At the same time, this study will gather information on side effects associated with the StimRouter electrical stimulation therapy.

Detailed Description

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Ninety (minimum) up to one hundred twenty-six (126) adult (≥ 22 years) subjects who have severe intractable chronic pain of peripheral nerve origin associated with post traumatic/post surgical neuralgia persisting for 3 months or longer and an average chronic pain level of at least 5 on a 0-10 numeric rating scale, where such pain is attributable to a lesion or disease of the somatosensory nervous system, will be recruited from U.S. outpatient physical medicine and rehabilitation clinics.

After screening, subjects who were confirmed to be eligible for the study and provided informed consent will have a pain level assessment period for approximately one week then come back for the Baseline/Implantation visit. Subjects will be trained on and required to complete a patient diary of pain intensity level for at least 7 consecutive days prior to baseline. The randomization and programming will take place approximately two weeks after implantation. Subjects in the treatment group will receive electrical stimulation and pain medication. In contrast, subjects in the parallel control group will receive control stimulation and pain medication.

The plan is to have the parallel portion of the study run for approximately 12 weeks (or 3 months) after randomization for efficacy analysis. Subjects in the control group will be allowed to cross over to the treatment group for nine months of electrical stimulation; the subjects in the treatment group will have nine additional months of stimulation treatment such that safety data will be collected throughout a full twelve month period on all available subjects. While the end of the study is approximately 12 months after randomization, as previously stated, the efficacy analyses will be based on the data collected at the end of the 3-month follow-up evaluation.

Conditions

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Chronic Pain

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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StimRouter - active stimulation

StimRouter- active electrical stimulation is applied transdermally to a targeted peripheral nerve. This is accomplished via a fully implanted StimRouter lead that receives energy from a rechargeable programmed external pulse transmitter (EPT) with attached gel electrodes. The EPT receives radio frequency (RF) commands from a Patient Programmer. A StimRouter Clinician Programmer is used to program the StimRouter EPT and Patient Programmer. Up to eight stimulation programs may be saved on a Patient Programmer for on-demand selection by the study patient.

Group Type EXPERIMENTAL

StimRouter - active stimulation

Intervention Type DEVICE

The stimulation program settings for this arm are as follows:

Stim Settings

* Waveform: Symmetric or Asymmetric
* Phase Duration: 100-250 µsec
* Pulse Rate: 50-100 Hz
* Intensity: 0-30mA Time Settings
* Constant Stim: On
* Total Time: 6 hour

StimRouter - Control

StimRouter- Electrical stimulation is withheld from the targeted peripheral nerve after fully implanting the StimRouter lead. The rechargeable programmed external pulse transmitter (EPT) with attached gel electrodes is placed for transdermal stimulation but no stimulation is delivered. The EPT which normally receives radio frequency (RF) commands from a Patient Programmer is not activated. A StimRouter Clinician Programmer is used to program the StimRouter EPT and Patient Programmer such that no stimulation occurs in the Control Arm of the study.

Group Type SHAM_COMPARATOR

StimRouter - Control

Intervention Type DEVICE

The stimulation program settings for this arm are as follows:

Stim Settings

* Waveform: Symmetric or Asymmetric
* Phase Duration: 200 µsec
* Pulse Rate: 1 Hz
* Intensity: 0 mA Time Settings
* Constant Stim: On
* Total Time: 6 hour

Interventions

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StimRouter - active stimulation

The stimulation program settings for this arm are as follows:

Stim Settings

* Waveform: Symmetric or Asymmetric
* Phase Duration: 100-250 µsec
* Pulse Rate: 50-100 Hz
* Intensity: 0-30mA Time Settings
* Constant Stim: On
* Total Time: 6 hour

Intervention Type DEVICE

StimRouter - Control

The stimulation program settings for this arm are as follows:

Stim Settings

* Waveform: Symmetric or Asymmetric
* Phase Duration: 200 µsec
* Pulse Rate: 1 Hz
* Intensity: 0 mA Time Settings
* Constant Stim: On
* Total Time: 6 hour

Intervention Type DEVICE

Other Intervention Names

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Bioness® StimRouter™ Neuromodulation System Bioness® StimRouter™ Neuromodulation System

Eligibility Criteria

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Inclusion Criteria

1. Adults (≥ 22 years) suitable for an implanted electrode for pain relief.
2. Subjects who are able to give informed consent and to understand and comply with study requirements.
3. Subjects who have severe intractable chronic pain of peripheral nerve origin associated with post traumatic/post surgical neuralgia for ≥ 3 months (i.e., intractable to pain medication).
4. Subjects who are able to tolerate skin surface stimulation (TENS).
5. Subjects who have a worst chronic pain level in the last 24 hours ≥ 5/10 (on 0-10 NRS) where such pain is attributable to a lesion or disease of the somatosensory nervous system.
6. Subjects who are on a stable dose of pain medications for at least four weeks prior to screening and willing and able to maintain an equivalent dosage of their current pain medications from randomization to 3-month follow-up.

Exclusion Criteria

1. Subjects who are not willing and able to maintain stable dosages of their pain medications from randomization to 3-month follow-up.
2. Subjects with a pain condition that could be confused with their peripheral neuropathic pain or that is more severe than their peripheral neuropathic pain.
3. Subjects who, for implantation in the trunk, have an implanted demand-type cardiac pacemaker or defibrillator.
4. Subjects who have a metal implant in the area for StimRouter implantation without Sponsor approval. Maintain a minimum separation distance of 6 inches (15 cm) between the StimRouter system and all other active implanted devices and metallic implants.
5. Subjects who require, or are likely to require, diathermy at the implant site.
6. Subjects who require, or are likely to require, therapeutic ultrasound at the implant site.
7. Subjects who have a cancerous lesion present near the target stimulation point or near to where the StimRouter user patch will adhere.
8. Subjects who are known or suspected to have a nickel allergy.
9. Subjects with bleeding disorders or active anticoagulation that cannot be stopped for a few days close to the time of the surgical procedure.
10. Subjects who decline to provide written consent or follow-up.
11. Subjects who are pregnant, plan on becoming pregnant, or are breastfeeding during the study period. Subjects who are 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 the study participation.
12. Subjects who have an active systemic infection or are immunocompromised.
13. Subjects who have an active or existing skin disorder or irritation, which, at the physician's discretion, precludes the use of skin gel electrodes.
14. Subjects who currently require or are likely to require Magnetic Resonance Imaging (MRI) within the MRI exclusion zone: the entire StimRouter lead must be at least 50 cm from the center of the MR system's bore (the iso-center) and at least 16 cm outside of the MR coil measured from the edge of the MR coil.
15. Subjects who have a history of adverse reactions to local anesthetic (e.g., lidocaine).
16. Subjects who are participating in any other study that could affect the outcome of the StimRouter study, such as a spinal stimulation study, without Sponsor approval.
17. Subjects who are in litigation or who have pending or an active worker's compensation claim.
18. Subjects with less than one year of life expectancy.
Minimum Eligible Age

22 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Bioness Inc

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Linh Nguyen, MS

Role: STUDY_DIRECTOR

Bioness Inc

Ramsin Benyamin, M.D.

Role: PRINCIPAL_INVESTIGATOR

Millennium Pain Center

Timothy Deer, M.D.

Role: STUDY_CHAIR

Center for Pain Relief, St. Francis Hospital

Locations

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Arizona Pain Specialists

Scottsdale, Arizona, United States

Site Status

Neurovations

Napa, California, United States

Site Status

Neuro-Therapeutics, Inc.

Pasadena, California, United States

Site Status

The Spine Institute, Center for Spinal Restoration

Santa Monica, California, United States

Site Status

Holy Cross Orthopedic Institute

Fort Lauderdale, Florida, United States

Site Status

Shands Jacksonville Medical Center, Dept of Neurology Research

Jacksonville, Florida, United States

Site Status

Millennium Pain Center

Bloomington, Illinois, United States

Site Status

Premier Pain Centers, LLC

Shrewsbury, New Jersey, United States

Site Status

The Center for Clinical Research

Winston-Salem, North Carolina, United States

Site Status

Cleveland Clinic

Cleveland, Ohio, United States

Site Status

Virginia Mason Medical Center

Seattle, Washington, United States

Site Status

Center for Pain Relief, St. Francis Hospital

Charleston, West Virginia, United States

Site Status

The Center for Pain Relief at St. Mary's Medical Center

Huntington, West Virginia, United States

Site Status

Countries

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United States

Related Links

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Other Identifiers

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CP-STMR11-001

Identifier Type: -

Identifier Source: org_study_id

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