Trial Outcomes & Findings for Noninvasive Peripheral Nerve Stimulation for Medication-Refractory Primary RLS (The RESTFUL Study) (NCT NCT04874155)

NCT ID: NCT04874155

Last Updated: 2024-10-08

Results Overview

Responder rate is defined as the proportion of responses of "Much Improved" or "Very Much Improved" relative to baseline on the investigator-rated 7-point CGI-I scale.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

133 participants

Primary outcome timeframe

Week 4

Results posted on

2024-10-08

Participant Flow

Subjects must have received a medical diagnosis of primary restless legs syndrome (RLS), have moderate-severe RLS and be refractory to RLS medication.

Participant milestones

Participant milestones
Measure
TOMAC Group
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver active stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Sham Control Group
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver SHAM stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Overall Study
STARTED
68
65
Overall Study
COMPLETED
65
62
Overall Study
NOT COMPLETED
3
3

Reasons for withdrawal

Reasons for withdrawal
Measure
TOMAC Group
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver active stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Sham Control Group
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver SHAM stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Overall Study
Lost to Follow-up
1
1
Overall Study
Withdrawal by Subject
2
2

Baseline Characteristics

Noninvasive Peripheral Nerve Stimulation for Medication-Refractory Primary RLS (The RESTFUL Study)

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
TOMAC Group
n=68 Participants
Noninvasive peripheral nerve stimulation device programmed to deliver active stimulation - Phase 1 NTX100 Neuromodulation System - Active: Noninvasive peripheral nerve stimulation device programmed to active mode.
Sham Control Group
n=65 Participants
Noninvasive peripheral nerve stimulation device programmed to deliver non-therapeutic (sham) stimulation - Phase 1 NTX100 Neuromodulation System - Sham: Noninvasive peripheral nerve stimulation device programmed to sham mode.
Total
n=133 Participants
Total of all reporting groups
Ethnicity (NIH/OMB)
Hispanic or Latino
4 Participants
n=5 Participants
4 Participants
n=7 Participants
8 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
64 Participants
n=5 Participants
61 Participants
n=7 Participants
125 Participants
n=5 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=5 Participants
0 Participants
n=7 Participants
2 Participants
n=5 Participants
Race (NIH/OMB)
White
64 Participants
n=5 Participants
65 Participants
n=7 Participants
129 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
IRLS Total Score at Baseline
25.2 Units on a scale
STANDARD_DEVIATION 5.3 • n=5 Participants
25.4 Units on a scale
STANDARD_DEVIATION 5.3 • n=7 Participants
25.3 Units on a scale
STANDARD_DEVIATION 5.3 • n=5 Participants
Age, Customized
56.3 years
STANDARD_DEVIATION 10.96 • n=5 Participants
58.6 years
STANDARD_DEVIATION 11.81 • n=7 Participants
57.46 years
STANDARD_DEVIATION 11.39 • n=5 Participants
Sex: Female, Male
Female
39 Participants
n=5 Participants
41 Participants
n=7 Participants
80 Participants
n=5 Participants
Sex: Female, Male
Male
29 Participants
n=5 Participants
24 Participants
n=7 Participants
53 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Week 4

Population: Primary Efficacy Endpoint (CGI-I Responder Rate at Week 4) - (ITT Population)

Responder rate is defined as the proportion of responses of "Much Improved" or "Very Much Improved" relative to baseline on the investigator-rated 7-point CGI-I scale.

Outcome measures

Outcome measures
Measure
TOMAC Group
n=68 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver active stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Sham Control Group
n=65 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver SHAM stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Number of Subjects for Which the Clinician Reported "Much Improved" or "Very Much Improved" on the Clinical Global Impressions-Improvement (CGI-I) Scale for TOMAC Compared to Sham
29 Participants
10 Participants

SECONDARY outcome

Timeframe: Week 4

Population: Key Secondary Efficacy Endpoints (ITT Population)

Responder rate is defined as the proportion of responses of "Much Improved" or "Very Much Improved" relative to baseline on the participant-rated 7-point PGI-I scale.

Outcome measures

Outcome measures
Measure
TOMAC Group
n=68 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver active stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Sham Control Group
n=65 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver SHAM stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Responder Rate on Patient Global Impressions-Improvement (PGI-I) Scale
33 Participants
12 Participants

SECONDARY outcome

Timeframe: Week 4

Population: Key Secondary Efficacy Endpoints (ITT Population)

IRLS is a participant-rated questionnaire that rates RLS severity from 0-40, where 40 is the most severe.

Outcome measures

Outcome measures
Measure
TOMAC Group
n=68 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver active stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Sham Control Group
n=65 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver SHAM stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Mean Change From Baseline in International Restless Legs Syndrome Study Group Rating Scale (IRLS) Score
-7.2 score on a scale
Standard Deviation 6.2
-3.8 score on a scale
Standard Deviation 5.9

SECONDARY outcome

Timeframe: Week 4

Population: Key Secondary Efficacy Endpoints (ITT Population)

MOS-II is a subscale of the participant-rated MOS questionnaire that measures subjective sleep quality. The MOS-I (6-items) and MOS-II (9-items) are the two validated subscales of the 12-item MOS Sleep Scale. Both are scored from 0 to 100, where 100 corresponds to the worst possible sleep problems and 0 corresponds to no sleep problems. See https://labs.dgsom.ucla.edu/hays/files/view/docs/surveys/sleep/sleepman-112603.pdf for more information.

Outcome measures

Outcome measures
Measure
TOMAC Group
n=68 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver active stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Sham Control Group
n=65 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver SHAM stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Mean Change From Baseline in Medical Outcomes Study Sleep Problems Index II (MOS-II) Score
-13.7 score on a scale
Standard Deviation 14.9
-4.0 score on a scale
Standard Deviation 14.8

SECONDARY outcome

Timeframe: Week 4

MOS-I is a subscale of the participant-rated MOS questionnaire that measures subjective sleep quality. The MOS-I (6-items) and MOS-II (9-items) are the two validated subscales of the 12-item MOS Sleep Scale. Both are scored from 0 to 100, where 100 corresponds to the worst possible sleep problems and 0 corresponds to no sleep problems. See https://labs.dgsom.ucla.edu/hays/files/view/docs/surveys/sleep/sleepman-112603.pdf for more information.

Outcome measures

Outcome measures
Measure
TOMAC Group
n=68 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver active stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Sham Control Group
n=65 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver SHAM stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Mean Change From Baseline in Medical Outcomes Study Sleep Problems Index I (MOS-I) Score
-11.8 score on a scale
Standard Deviation 14.7
-2.8 score on a scale
Standard Deviation 14.9

SECONDARY outcome

Timeframe: Week 4

Mean rating on the investigator-rated 7-point Likert CGI-I scale, where lower scores indicate improvement. Possible choices (followed by scale value) are: Very much improved (1), Much improved (2), Minimally improved (3), No change (4), Minimally worse (5), Much worse (6), Very Much Worse (7).

Outcome measures

Outcome measures
Measure
TOMAC Group
n=68 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver active stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Sham Control Group
n=65 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver SHAM stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Mean Clinical Global Impressions-Improvement (CGI-I) Scale Rating
2.6 score on a scale
Standard Deviation 1.1
3.5 score on a scale
Standard Deviation 0.9

SECONDARY outcome

Timeframe: Week 8

Population: Key Secondary Efficacy Endpoints (ITT Population)

Question #7 of the IRLS assesses the participant-rated frequency (days/week) of RLS symptoms on a scale from 0 to 4, where lower scores indicate less frequent symptoms

Outcome measures

Outcome measures
Measure
TOMAC Group
n=68 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver active stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Sham Control Group
n=65 Participants
Stage 1 (4 weeks): Double-blind, Noninvasive peripheral nerve stimulation device programmed to deliver SHAM stimulation Stage 2 (4 weeks): Open-label, noninvasive peripheral nerve stimulation device programmed to active mode.
Score for Question #7 of the International Restless Legs Syndrome Study Group Rating Scale (IRLS)
-0.9 Days per Week
Standard Deviation 1.07
-0.6 Days per Week
Standard Deviation 1.2

Adverse Events

TOMAC Group

Serious events: 0 serious events
Other events: 28 other events
Deaths: 0 deaths

Sham Control Group

Serious events: 0 serious events
Other events: 23 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
TOMAC Group
n=68 participants at risk
Treatment group
Sham Control Group
n=65 participants at risk
Control group
Skin and subcutaneous tissue disorders
Administration site discomfort
32.4%
22/68 • Number of events 22 • 8 weeks
Descriptive analyses of adverse events for both study arms, classified and tabulated by seriousness, relationship to the device, and severity.
24.6%
16/65 • Number of events 16 • 8 weeks
Descriptive analyses of adverse events for both study arms, classified and tabulated by seriousness, relationship to the device, and severity.
Skin and subcutaneous tissue disorders
Administration site irritation
8.8%
6/68 • Number of events 6 • 8 weeks
Descriptive analyses of adverse events for both study arms, classified and tabulated by seriousness, relationship to the device, and severity.
10.8%
7/65 • Number of events 7 • 8 weeks
Descriptive analyses of adverse events for both study arms, classified and tabulated by seriousness, relationship to the device, and severity.

Additional Information

Jonathan Charlesworth, PhD

Noctrix Health, Inc.

Phone: 804-683-4279

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place