Trial Outcomes & Findings for Subcutaneous Nerve Stimulation for Failed Back Surgery Syndrome (FBSS) Patients (NCT NCT01818297)

NCT ID: NCT01818297

Last Updated: 2017-09-21

Results Overview

Number of responders in Treatment and Control groups. Subjects reported typical back pain (0=no pain, 10=worst pain) during the Baseline (BL) and Blinded Phase (M3) periods. Percentage reduction in average back pain was calculated as (BL-M3)/BL. Subjects with at least a 50% reduction in average back pain between Baseline and Month 3, with no increase in prescribed pain medications, were considered responders.

Recruitment status

TERMINATED

Study phase

NA

Target enrollment

137 participants

Primary outcome timeframe

Baseline to 3 months

Results posted on

2017-09-21

Participant Flow

This study enrolled adult patients with chronic, intractable post-surgical back pain. First enrollment was in April 2013. Enrollment was suspended in September 2014 due to slow enrollment. The last subject visit was in March 2016. The planned enrollment was 323 subjects, with 218 randomized. Actual enrollment was 137 subjects with 62 randomized.

Of the 137 enrolled subjects, 62 were implanted and randomized. Of the 75 subjects who discontinued from the study prior to randomization, 54 did not meet inclusion/exclusion criteria, 12 withdrew consent or declined device implant, 3 discontinued due to study suspension, and 6 discontinued for other reasons.

Participant milestones

Participant milestones
Measure
Treatment
Treatment settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Control
Control settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Blinded Phase (Randomization - 3 Months)
STARTED
32
30
Blinded Phase (Randomization - 3 Months)
Week 1
32
30
Blinded Phase (Randomization - 3 Months)
Week 6
32
29
Blinded Phase (Randomization - 3 Months)
COMPLETED
32
29
Blinded Phase (Randomization - 3 Months)
NOT COMPLETED
0
1
Open Label Phase (3-12 Months)
STARTED
32
29
Open Label Phase (3-12 Months)
COMPLETED
14
19
Open Label Phase (3-12 Months)
NOT COMPLETED
18
10

Reasons for withdrawal

Reasons for withdrawal
Measure
Treatment
Treatment settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Control
Control settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Blinded Phase (Randomization - 3 Months)
Adverse Event
0
1
Open Label Phase (3-12 Months)
Physician Decision
1
0
Open Label Phase (3-12 Months)
Early study closure
17
10

Baseline Characteristics

Subcutaneous Nerve Stimulation for Failed Back Surgery Syndrome (FBSS) Patients

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treatment
n=32 Participants
Treatment settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Control
n=30 Participants
Control settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Total
n=62 Participants
Total of all reporting groups
Age, Continuous
60.6 years
STANDARD_DEVIATION 13.1 • n=93 Participants
59.8 years
STANDARD_DEVIATION 13.7 • n=4 Participants
60.2 years
STANDARD_DEVIATION 13.3 • n=27 Participants
Sex: Female, Male
Female
18 Participants
n=93 Participants
16 Participants
n=4 Participants
34 Participants
n=27 Participants
Sex: Female, Male
Male
14 Participants
n=93 Participants
14 Participants
n=4 Participants
28 Participants
n=27 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=93 Participants
1 Participants
n=4 Participants
1 Participants
n=27 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
32 Participants
n=93 Participants
29 Participants
n=4 Participants
61 Participants
n=27 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Asian
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=93 Participants
0 Participants
n=4 Participants
2 Participants
n=27 Participants
Race (NIH/OMB)
White
30 Participants
n=93 Participants
28 Participants
n=4 Participants
58 Participants
n=27 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=93 Participants
2 Participants
n=4 Participants
2 Participants
n=27 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Region of Enrollment
United States
32 participants
n=93 Participants
30 participants
n=4 Participants
62 participants
n=27 Participants
Back pain
6.77 units on a scale
STANDARD_DEVIATION 1.25 • n=93 Participants
6.66 units on a scale
STANDARD_DEVIATION 0.88 • n=4 Participants
6.71 units on a scale
STANDARD_DEVIATION 1.08 • n=27 Participants

PRIMARY outcome

Timeframe: Baseline to 3 months

Number of responders in Treatment and Control groups. Subjects reported typical back pain (0=no pain, 10=worst pain) during the Baseline (BL) and Blinded Phase (M3) periods. Percentage reduction in average back pain was calculated as (BL-M3)/BL. Subjects with at least a 50% reduction in average back pain between Baseline and Month 3, with no increase in prescribed pain medications, were considered responders.

Outcome measures

Outcome measures
Measure
Treatment
n=32 Participants
Treatment settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Control
n=30 Participants
Control settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Number of Back Pain Responders (Subjects Who Achieve at Least a 50% Reduction in Average Back Pain With no Increase in Prescription Pain Medications) From Baseline to Month 3 Post-device Activation.
9 Participants
5 Participants

SECONDARY outcome

Timeframe: Baseline to 3 months

Compare the difference in average improvement in disability (as measured by Oswestry Disability Index (ODI)) from Baseline to Month 3 between the Treatment and Control groups. ODI ranges from 0% (no disability) -100% (greatest disability). Change is calculated as Baseline - Month 3 with a positive change indicating improvement in disability. Subjects with missing Baseline and/or Month 3 ODI assessments were counted as no change (Baseline - Month 3 = 0).

Outcome measures

Outcome measures
Measure
Treatment
n=32 Participants
Treatment settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Control
n=30 Participants
Control settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Functional Disability
9.8 units on a scale
Standard Deviation 14.3
10.0 units on a scale
Standard Deviation 12.1

SECONDARY outcome

Timeframe: 3 months

Population: The analysis population includes all randomized subjects, with the exception of one subject in the Control group who did not have a satisfaction value. This subject was excluded from the analysis.

Compare difference in number of subjects satisfied with therapy between the Treatment and Control groups at Month 3. Subjects who reported they were very or somewhat satisfied with the therapy were counted as satisfied. Subjects with no satisfaction response were excluded from the analysis.

Outcome measures

Outcome measures
Measure
Treatment
n=32 Participants
Treatment settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Control
n=29 Participants
Control settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Subject Satisfaction
25 Participants
22 Participants

SECONDARY outcome

Timeframe: Baseline to 3 months

Compare the average change in quality of life (as measured by Short Form Health Survey (SF36 v2): Physical component score (PCS)) from Baseline to Month 3 between subjects in the Treatment and Control groups. The PCS ranges from 0 (worst possible physicial quality of life) to 100 (best possible physical quality of life). Change was calculated as Month 3 - Baseline, with a positive difference indicating improvement in physical quality of life. Subjects with missing Baseline and/or Month 3 SF-36: PCS assessments were counted as no change (Month 3 - Baseline = 0).

Outcome measures

Outcome measures
Measure
Treatment
n=32 Participants
Treatment settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Control
n=30 Participants
Control settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Quality of Life: Physical
3.6 units on a scale
Standard Deviation 8.6
3.1 units on a scale
Standard Deviation 7.1

SECONDARY outcome

Timeframe: Baseline to 3 months

Compare the average change in quality of life (as measured by Short Form Health Survey (SF36 v2): Mental component score (MCS)) from Baseline to Month 3 between subjects in the Treatment and Control groups. The MCS ranges from 0 (worst possible mental quality of life) to 100 (best possible mental quality of life). Change was calculated as Month 3 - Baseline, with a positive difference indicating improvement in mental quality of life. Subjects with missing Baseline and/or Month 3 SF-36: MCS assessments were counted as no change (Month 3 - Baseline = 0).

Outcome measures

Outcome measures
Measure
Treatment
n=32 Participants
Treatment settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Control
n=30 Participants
Control settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Quality of Life: Mental
1.9 units on a scale
Standard Deviation 10.0
1.4 units on a scale
Standard Deviation 9.6

SECONDARY outcome

Timeframe: Baseline to 3 months

Compare the average improvement in worst back pain from Baseline to Month 3 between the Treatment and Control groups. Subjects reported worst back pain (0 (no pain) - 10 (worst pain)) during the Baseline and Blinded Phase (Month 3) periods. Change was calculated as Baseline - Month 3, with a positive change indicating improvement in worst back pain.

Outcome measures

Outcome measures
Measure
Treatment
n=32 Participants
Treatment settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Control
n=30 Participants
Control settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Worst Back Pain
2.7 units on a scale
Standard Deviation 2.6
1.6 units on a scale
Standard Deviation 1.9

Adverse Events

Treatment

Serious events: 2 serious events
Other events: 11 other events
Deaths: 0 deaths

Control

Serious events: 0 serious events
Other events: 8 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Treatment
n=32 participants at risk
Treatment settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Control
n=30 participants at risk
Control settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Infections and infestations
Implant site infection
3.1%
1/32 • Number of events 1 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
0.00%
0/30 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
3.1%
1/32 • Number of events 1 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
0.00%
0/30 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.

Other adverse events

Other adverse events
Measure
Treatment
n=32 participants at risk
Treatment settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Control
n=30 participants at risk
Control settings of Medtronic PrimeAdvanced® neurostimulator system implant PrimeAdvanced® neurostimulator system: Neurostimulator and associated components
Musculoskeletal and connective tissue disorders
Back pain
12.5%
4/32 • Number of events 4 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
6.7%
2/30 • Number of events 2 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
General disorders
Implant site pain
9.4%
3/32 • Number of events 3 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
6.7%
2/30 • Number of events 2 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
Musculoskeletal and connective tissue disorders
Pain in extremity
6.2%
2/32 • Number of events 2 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
3.3%
1/30 • Number of events 1 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
Musculoskeletal and connective tissue disorders
Spinal osteoarthritis
0.00%
0/32 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
10.0%
3/30 • Number of events 3 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
Gastrointestinal disorders
Nausea
0.00%
0/32 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
6.7%
2/30 • Number of events 2 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
Nervous system disorders
Burning sensation
6.2%
2/32 • Number of events 2 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.
0.00%
0/30 • The adverse events summarized by treatment arm are all adverse events that were collected during the Blinded Phase of the study (from Randomization through the Month 3 visit).
There were 175.6 total months of subject follow-up during this time: 94.2 months in the Treatment group and 81.4 months in the Control group.

Additional Information

Neuro Clinical Trials

Medtronic Neuromodulation

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