Trial Outcomes & Findings for Vectors Post Market: A Study to Assess Pain Relief Using Spinal Cord Stimulation (NCT NCT03345472)

NCT ID: NCT03345472

Last Updated: 2020-11-03

Results Overview

Demonstrate a significant improvement in overall pain intensity as measured by the Visual Analog Scale (VAS). The VAS ranges from 0 (no pain) to 100 (worst pain imaginable). The change in overall pain intensity is calculated as the Baseline VAS minus the 3-month VAS, where a positive value indicates an improvement (ie, reduction) in pain from Baseline to 3 months. Higher values represent a larger reduction (ie, greater improvement) in pain. The change in overall pain intensity as measured by the VAS can range from -100 (worsening in pain from 0 at baseline to 100 at 3 months) to 100 (improvement in pain from 100 at baseline to 0 at 3 months). It should be noted that while the change in VAS can range from -100 to 100, no subjects had a VAS of 0 at baseline, as the presence of pain was required for eligibility for inclusion in the study.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

175 participants

Primary outcome timeframe

Baseline to 3 months

Results posted on

2020-11-03

Participant Flow

175 subjects were enrolled. 32 exited before the spinal cord stimulation trial. 143 subjects started the trial and 12 exited during the trial. 131 subjects completed the trial: 117 had a successful high dose (HD) trial; the 14 with unsuccessful HD trial were exited. Of the 117, 14 exited before implant and 103 were implanted (Treated Arm).

Participant milestones

Participant milestones
Measure
Treated
Enrolled subjects who are implanted with a spinal cord stimulation system that is activated. Spinal Cord Stimulation System: Implanted neurostimulation system (neurostimulator and leads) with high dose stimulation parameters.
Implant to 3 Months
STARTED
103
Implant to 3 Months
COMPLETED
99
Implant to 3 Months
NOT COMPLETED
4
3 Months to 12 Months
STARTED
99
3 Months to 12 Months
COMPLETED
91
3 Months to 12 Months
NOT COMPLETED
8

Reasons for withdrawal

Reasons for withdrawal
Measure
Treated
Enrolled subjects who are implanted with a spinal cord stimulation system that is activated. Spinal Cord Stimulation System: Implanted neurostimulation system (neurostimulator and leads) with high dose stimulation parameters.
Implant to 3 Months
Withdrawal by Subject
2
Implant to 3 Months
Physician Decision
1
Implant to 3 Months
Adverse Event
1
3 Months to 12 Months
Physician Decision
3
3 Months to 12 Months
Lost to Follow-up
2
3 Months to 12 Months
Withdrawal by Subject
1
3 Months to 12 Months
Adverse Event
1
3 Months to 12 Months
Death
1

Baseline Characteristics

Vectors Post Market: A Study to Assess Pain Relief Using Spinal Cord Stimulation

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Treated
n=103 Participants
Enrolled subjects who are implanted with a spinal cord stimulation system that is activated. Spinal Cord Stimulation System: Implanted neurostimulation system (neurostimulator and leads) with high dose stimulation parameters.
Age, Continuous
60.8 years
STANDARD_DEVIATION 13.4 • n=93 Participants
Sex: Female, Male
Female
56 Participants
n=93 Participants
Sex: Female, Male
Male
47 Participants
n=93 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants
n=93 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
93 Participants
n=93 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
6 Participants
n=93 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=93 Participants
Race (NIH/OMB)
Asian
0 Participants
n=93 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants
Race (NIH/OMB)
Black or African American
10 Participants
n=93 Participants
Race (NIH/OMB)
White
92 Participants
n=93 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=93 Participants
Race (NIH/OMB)
Unknown or Not Reported
1 Participants
n=93 Participants
Region of Enrollment
United States
103 participants
n=93 Participants
Years from pain onset to enrollment
12.9 years
STANDARD_DEVIATION 11.1 • n=93 Participants

PRIMARY outcome

Timeframe: Baseline to 3 months

Demonstrate a significant improvement in overall pain intensity as measured by the Visual Analog Scale (VAS). The VAS ranges from 0 (no pain) to 100 (worst pain imaginable). The change in overall pain intensity is calculated as the Baseline VAS minus the 3-month VAS, where a positive value indicates an improvement (ie, reduction) in pain from Baseline to 3 months. Higher values represent a larger reduction (ie, greater improvement) in pain. The change in overall pain intensity as measured by the VAS can range from -100 (worsening in pain from 0 at baseline to 100 at 3 months) to 100 (improvement in pain from 100 at baseline to 0 at 3 months). It should be noted that while the change in VAS can range from -100 to 100, no subjects had a VAS of 0 at baseline, as the presence of pain was required for eligibility for inclusion in the study.

Outcome measures

Outcome measures
Measure
Treated
n=103 Participants
Enrolled subjects who are implanted with a spinal cord stimulation system that is activated. Spinal Cord Stimulation System: Implanted neurostimulation system (neurostimulator and leads) with high dose stimulation parameters.
Change in Overall Pain Intensity on the Visual Analog Scale (0-100)
45.4 units on a scale
Standard Error 2.6

SECONDARY outcome

Timeframe: Baseline to 3 months

Characterize the overall pain efficacy responder rate, where the responder rate is the percentage of subjects who experience at least a 50% improvement in overall pain, as measured by the Visual Analog Scale (VAS). The VAS ranges from 0 (no pain) to 100 (worst pain imaginable). The percent improvement for each subject was calculated as \[100\*(Baseline VAS - 3-month VAS)/Baseline VAS\], where a positive number represents an improvement, and the larger the number the greater the percent improvement. If the percent improvement from baseline to 3 months was at least 50%, the subject was considered a responder. The percentage of subjects who experience at least a 50% improvement in overall pain can range from 0% (no responders) to 100% (all responders).

Outcome measures

Outcome measures
Measure
Treated
n=103 Participants
Enrolled subjects who are implanted with a spinal cord stimulation system that is activated. Spinal Cord Stimulation System: Implanted neurostimulation system (neurostimulator and leads) with high dose stimulation parameters.
Overall Pain Efficacy Responder Rate
68.3 percent of subjects who are responder
Interval 59.0 to 77.5

SECONDARY outcome

Timeframe: Baseline to 3 months

Characterize the low back pain efficacy responder rate, where the responder rate is the percentage of subjects who experience at least a 50% improvement in low back pain, as measured by the Visual Analog Scale (VAS). The VAS ranges from 0 (no pain) to 100 (worst pain imaginable). The percent improvement for each subject was calculated as \[100\*(Baseline VAS - 3-month VAS)/Baseline VAS\], where a positive number represents an improvement, and the larger the number the greater the percent improvement. If the percent improvement from baseline to 3 months was at least 50%, the subject was considered a responder. The percentage of subjects who experience at least a 50% improvement in low back pain can range from 0% (no responders) to 100% (all responders).

Outcome measures

Outcome measures
Measure
Treated
n=103 Participants
Enrolled subjects who are implanted with a spinal cord stimulation system that is activated. Spinal Cord Stimulation System: Implanted neurostimulation system (neurostimulator and leads) with high dose stimulation parameters.
Low Back Pain Efficacy Responder Rate
59.8 percent of subjects who are responders
Interval 49.9 to 69.7

SECONDARY outcome

Timeframe: Baseline to 3 months

Characterize the leg pain efficacy responder rate, where the responder rate is the percentage of subjects who experience at least a 50% improvement in leg pain, as measured by the Visual Analog Scale (VAS). The VAS ranges from 0 (no pain) to 100 (worst pain imaginable). The percent improvement for each subject was calculated as \[100\*(Baseline VAS - 3-month VAS)/Baseline VAS\], where a positive number represents an improvement, and the larger the number the greater the percent improvement. If the percent improvement from baseline to 3 months was at least 50%, the subject was considered a responder. The percentage of subjects who experience at least a 50% improvement in leg pain can range from 0% (no responders) to 100% (all responders).

Outcome measures

Outcome measures
Measure
Treated
n=103 Participants
Enrolled subjects who are implanted with a spinal cord stimulation system that is activated. Spinal Cord Stimulation System: Implanted neurostimulation system (neurostimulator and leads) with high dose stimulation parameters.
Leg Pain Efficacy Responder Rate
77.4 percent of subjects who are responders
Interval 69.1 to 85.7

Adverse Events

Treated

Serious events: 1 serious events
Other events: 36 other events
Deaths: 1 deaths

Serious adverse events

Serious adverse events
Measure
Treated
n=103 participants at risk
Enrolled subjects who are implanted with a spinal cord stimulation system that is activated. Spinal Cord Stimulation System: Implanted neurostimulation system (neurostimulator and leads) with high dose stimulation parameters.
Musculoskeletal and connective tissue disorders
Back pain
0.97%
1/103 • Number of events 1 • 12 months post-device activation
Adverse events related to the implanted spinal cord stimulation system, accessories, surgical procedures, and therapy were collected. The sum of subjects affected within each individual event may not add to the total number of subjects affected, as subjects may have experienced more than 1 type of event.

Other adverse events

Other adverse events
Measure
Treated
n=103 participants at risk
Enrolled subjects who are implanted with a spinal cord stimulation system that is activated. Spinal Cord Stimulation System: Implanted neurostimulation system (neurostimulator and leads) with high dose stimulation parameters.
Nervous system disorders
Paraesthesia
18.4%
19/103 • Number of events 25 • 12 months post-device activation
Adverse events related to the implanted spinal cord stimulation system, accessories, surgical procedures, and therapy were collected. The sum of subjects affected within each individual event may not add to the total number of subjects affected, as subjects may have experienced more than 1 type of event.
Product Issues
Device stimulation issue
10.7%
11/103 • Number of events 14 • 12 months post-device activation
Adverse events related to the implanted spinal cord stimulation system, accessories, surgical procedures, and therapy were collected. The sum of subjects affected within each individual event may not add to the total number of subjects affected, as subjects may have experienced more than 1 type of event.
Musculoskeletal and connective tissue disorders
Back pain
8.7%
9/103 • Number of events 10 • 12 months post-device activation
Adverse events related to the implanted spinal cord stimulation system, accessories, surgical procedures, and therapy were collected. The sum of subjects affected within each individual event may not add to the total number of subjects affected, as subjects may have experienced more than 1 type of event.

Additional Information

Stacie Hallaway/Senior Clinical Research Specialist

Medtronic Restorative Therapies Group, Spinal Cord Stimulation

Phone: 763-526-3844

Results disclosure agreements

  • Principal investigator is a sponsor employee Per the Clinical Investigation Plan, all proposed publications must be reviewed and approved by Medtronic prior to publication.
  • Publication restrictions are in place

Restriction type: OTHER