Dual Field PEMF Therapy in Lower Extremity Painful Diabetic Distal Symmetric Peripheral Neuropathy

NCT ID: NCT03455543

Last Updated: 2020-07-15

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 182 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-03-26
• Study Completion Date: 2019-07-18

Brief Summary

Part A of this trial is a multi-center, prospective, double-blinded, sham-controlled, randomized clinical trial. Part A will evaluate PEMF treatment compared to sham treatment in patients with painful diabetic distal symmetric peripheral neuropathy (DSPN) when treatment is administered 30 minutes twice daily through a 120-day period (4 months). Part B is a 8-month open-label active treatment extension period designed to collect longer-term data on pain, medication use, quality of life and safety (Part B).Part B of this trial is a an extension period upon completion of Part A.

Detailed Description

Eligible subjects will be entered into a 14-day ePRO diary run-in period to collect average baseline pain scores related to their diabetic neuropathy in the lower extremities, diary compliance, and analgesic consumption (maintenance and prn prescribed peripheral neuropathic pain medication pill counts). Subjects will collect electronic patient-reported outcome (ePRO) data each morning around the same time during the run-in period.

Subjects will return to the clinic at Baseline (Day 0) for review of eligibility, diary compliance, average baseline diabetic neuropathic pain score of ≥4 and <9, and review of stable analgesic pain consumption profile during the 14-day run-in period. Qualified subjects based on diary compliance and average pain score will be randomized 1:1 (active: sham) and will be instructed to self-treat twice daily for 120 days. Subjects will record electronic patient-reported outcome (ePRO) data following each morning treatment for 120 days. Subjects consenting to distal thigh and distal leg skin biopsies during the Screening visit will have biopsies collected and sent to the central laboratory for assessment. All subjects will have baseline assessments conducted.

Subjects will receive a telephone call at Day 7 to ensure compliance to treatment and diary completion, provide follow-up information on the biopsy sites (if applicable), complete a blinding assessment as well as be assessed for safety and concomitant medication changes.

At Month 1 subjects will return to the clinic for evaluation of safety, concomitant medication changes, review device usage and ePRO diary completion, and Patient Global Impression (PGI). Treatment satisfaction will also be assessed.

At Month 2 subjects will return to the clinic for evaluation of safety, concomitant medication changes, treatment satisfaction, review of device usage (reports will be supplied to the site) and ePRO diary completion, quality of life outcomes (WPAIQ and NeuroQoL), Patient Global Impression (PGI), and interim visit measurements of SPP.

At Month 3, subjects will return to the clinic for evaluation of safety, concomitant medication changes, review device usage (reports will be supplied to the site) and ePRO diary completion, and Patient Global Impression (PGI). Treatment satisfaction will also be assessed.

At Month 4 (end of Part A / start of Part B), subjects will return to the clinic for evaluation of safety, treatment satisfaction, review of device usage (reports will be supplied to the site), HbA1c, concomitant medication changes, weight, quality of life outcomes (WPAIQ and NeuroQoL), PGI, final measurements of SPP, NCS, QST and be assessed to determine their Toronto Clinical Neuropathy Score. Those subjects who consented and had biopsies collected at the Enrollment visit, will have their end of study biopsies during this visit and samples sent directly to the central laboratory for assessment. Subjects will return the study device and complete a blinding assessment.

Subjects that complete Part A will continue into the open-label extension period (Part B). All subjects will be reconsented if not completed at a prior visit and given an open-label active device. Subjects will record ePRO data for one week prior to the Month 6, 8, 10, and 12 visits following each morning treatment. Subjects will be reminded of the150-day (Month 5) phone call.

At Month 5, subjects will receive a telephone call to ensure compliance to treatment, and to be assessed for safety and concomitant medication changes.

At Month 6, subjects will receive a telephone call to ensure treatment compliance and collection of diary data, and to assess safety and concomitant medication changes.

At Month 7, subjects will receive a telephone call to ensure treatment compliance, and to assess safety and concomitant medication changes.

At Month 8, subjects will return to the clinic for evaluation of safety, measure QST, treatment satisfaction, review of device usage and collection of diary data, concomitant medication changes, quality of life outcomes (NeuroQoL), and PGI.

At Month 9, subjects will receive a telephone call to ensure treatment compliance, and to assess safety and concomitant medication changes.

At Month 10, subjects will receive a telephone call to ensure treatment compliance and collection of diary data, and to assess safety and concomitant medication changes.

At Month 11, subjects will receive a telephone call to ensure treatment compliance, and to assess safety and concomitant medication changes.

At Month 12 (end of open-label treatment extension), subjects will return to the clinic for evaluation of safety, weight, QST, NCS, TCNSS, PGI, treatment satisfaction, review of device usage and collection of diary data, concomitant medication changes, quality of life outcomes (NeuroQoL), and will return the study device. Subjects who consented and had biopsies collected at the 4 Month visit, will have their end of study biopsies performed during this visit.

Conditions

Diabetic Neuropathy Peripheral

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: QUADRUPLE

Study Groups

Active Group

Treatment with active Provant Therapy System

Group Type: EXPERIMENTAL

Active Provant Therapy System

Intervention Type: DEVICE

Treatment with active Provant Therapy System

Sham Group

Treatment with in-active (sham) Provant Therapy System

Group Type: SHAM_COMPARATOR

Inactive (sham) Provant Therapy System

Intervention Type: DEVICE

Treatment with inactive Provant Therapy System

Interventions

Active Provant Therapy System

Treatment with active Provant Therapy System

Intervention Type: DEVICE

Inactive (sham) Provant Therapy System

Treatment with inactive Provant Therapy System

Intervention Type: DEVICE

Eligibility Criteria

Inclusion Criteria

• Type 1 or Type 2 diabetes
• Pain attributed to symmetrical lower extremity diabetic peripheral neuropathy for at least 6 months
• DPN pain over the preceding 24 hours is ≥4 and <9 based on the 11-point NPRS (0-10)
• 22 to 80 years of age
• On stable diabetes treatment
• HbA1c less than or equal to 10%
• No recent changes to analgesic prescriptions
• ABI of ≥0.8 to ≤1.3
• Walks independently
• Willing and able to give consent
• If female, must be post-menopausal, surgically sterile, abstinent or practicing an effective method of birth control
• Can access an internet browser or smart phone

To be randomized after the 14-day run-in period, average pain (NPRS) must be ≥ 4 and < 9 over preceding 7 days and subject must be 70% compliant with ePRO assessments (electronic diary)

Exclusion Criteria

• Active, open ulcer on either extremity
• Significant peripheral vascular disease
• Venous insufficiency
• History of solid organ transplant or severe renal disease
• Diagnosed with a non-diabetic cause of chronic neuropathy
• Previous or current history of primary or tertiary hyperparathyroidism, hypercalcemia, psychiatric disorder, alcohol dependency, Hepatitis B or C, or HIV infection
• Significant cardiovascular disease
• Uncontrolled medical illness
• Requires or anticipates the need for surgery during the study
• Total foot depth of >8 cm
• Has received any investigational drug or device within 30 days
• Has used systemic corticosteroids within 3 months
• History of malignancy within 5 years in treatment area
• A psychiatric disorder of sufficient severity
• Receiving prn narcotic medications
• History of drug or alcohol abuse within 1 year
• Implanted pacemaker, defibrillator, neurostimulator, spinal cord stimulator, bone stimulator, cochlear implant, or other implanted device with an implanted metal lead(s0
• Pregnant or planning to become pregnant
• Previous treatment with Provant Therapy
• Unwilling to follow instructions or comply with study instructions
• Pain from any other source that could confuse DPN pain assessment
• Clinically significant foot deformity
• Skin condition that could alter peripheral sensations
• Previous surgery to the spine or lower extremity with residual symptoms of pain or difficulty with movement.
• Clinically significant arthropathy

• Minimum Eligible Age: 22 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

Regenesis Biomedical, Inc.

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Physician's Research Group

Mesa, Arizona, United States

Valley Clinical Research

Northridge, California, United States

Northern California Research

Sacramento, California, United States

Diabetes Research Center

Tustin, California, United States

Mountain View Clinical Research

Denver, Colorado, United States

Lake Internal Medicine Associates

Eustis, Florida, United States

Clinical Physiology Associates

Fort Myers, Florida, United States

Spotlight Research Center

Miami, Florida, United States

Clinical Research of Central Florida

Winter Haven, Florida, United States

River Birch Research Alliance, LLC

Blue Ridge, Georgia, United States

MediSphere Medical Research Center, LLC

Evansville, Indiana, United States

Heartland Research Associate, LLC

Wichita, Kansas, United States

Healthcare Research Network

Hazelwood, Missouri, United States

The Center for Pharmaceutical Research, LLC

Kansas City, Missouri, United States

Palm Research Center

Las Vegas, Nevada, United States

Great Lakes Medical Resarch

Westfield, New York, United States

Wake Family Medicine, PC

Cary, North Carolina, United States

Rainier Clinical Research

Renton, Washington, United States

Countries

United States

Provided Documents

Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Other Identifiers

RBI.2017.002

Identifier Type: -

Identifier Source: org_study_id