Real-world Data Analysis of REN Treatment in Migraine Patients

NCT ID: NCT04992897

Last Updated: 2024-11-22

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Total Enrollment

12151 participants

Study Classification

OBSERVATIONAL

Study Start Date

2021-06-15

Study Completion Date

2021-08-10

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Data analysis concerning four sets of metrics: A. Per-treatment patterns of REN use as a standalone treatment vs. in combination with medications. B. Per-user Intra-individual consistency of efficacy across multiple treatments (consistency defined as a response to treatment in at least 50% of treatments). C. Distribution of treatment intensity among users (the electroceutical equivalent to treatment dose). D. Prevalence and severity of adverse events.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

The REN device The REN device is a wearable device applied to the upper arm and stimulates C and Aδ noxious fibers using a modulated, symmetrical, biphasic, square pulse with a pulse width of 400 μs, modulated frequency of 100-120 Hz, and up to 40 mA output current which can be adjusted by the patient.

Data collection As part of the sign-up process to the Nerivio app, all patients accept the terms of use which specify that providing personal information is done of their own free will, and that their de-identified data may be used for research purposes. Users were not obligated to provide personal information and could treat without providing any feedback. The app includes a secured, personal migraine diary, which enables patients to record and track their migraines and other headaches. At the beginning of each treatment, and again 2 hours after the start of treatment, patients are prompted to record their symptoms, including pain level (none, mild, moderate, severe), functional disability ('No limitation, 'Some limitation', 'Moderate limitation, 'Severe limitation), and indication of which medications, if any, were taken within that 2-hour time window.

Dataset Real-world data of REN treatments collected from patients across the United States who used the REN device.

'Treatment' defined as a REN treatment of at least 20 minutes (the nominal duration is 45 minutes).

'Evaluable treatment' defined as a treatment in which pain levels were reported at baseline and post 2 hours.

Inclusion criteria for each of the different metrics:

A. REN-medication combinations: all evaluable treatments. B. Consistent efficacy: all users that performed at least 2 evaluable treatments. In order to isolate the effect of REN treatments, this dataset considered only treatments where REN was used as a standalone treatment.

C. Intensity stability: all treatments. D. Safety: all reported adverse events (AEs) within the time period.

Outcome measures

Respectively, outcome measures:

A. REN-Medication combinations (prevalence \& efficacy):

Medication intake outcomes calculated based on the 2h post-treatment report and comprised of the percentage of treatments in which no rescue medications were used, treatments in which OTC medications were taken, treatments in which triptans were taken, treatments in which other prescription medications were taken, and treatments in which medication intake status was not reported. OTC included acetaminophen, NSAIDs, and combinations of the two, with or without caffeine.

Efficacy outcomes calculated based on the baseline and post-2h reports and comprised of:

(i) consistency of pain relief (decrease in headache from moderate or severe at baseline to mild or no pain); (ii) consistency of pain-freedom (decrease in headache from mild, moderate, or severe at baseline to no pain); (iii) Consistency of improvement in function (improvement in at least one grade between baseline and 2 hours); and (iv) consistency of return to normal function (no functional disability at 2 hours).

B. Consistent efficacy:

Consistency defined as a response of a patient to the treatment in at least 50% of their treated attacks, and calculated for the four efficacy outcomes: (i) consistency of pain relief (ii) consistency of pain-freedom (iii) consistency of improvement in function; and (iv) consistency of return to normal function.

C. Treatment intensity:

The mean intensity of the stimulation collected for all treatments that were 20 minutes or longer, which were performed within the study's time window.

D. Safety:

All adverse events that were reported within the study's period, the following information provided: number of device-related AEs, percentage of the device-related AEs that were mild, moderate, and severe, and percentage of AEs that were serious vs. not serious.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Migraine

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

REN-Medication combinations

all evaluable treatments.

'Treatment' defined as a REN treatment of at least 20 minutes (the nominal duration is 45 minutes).

'Evaluable treatment' defined as a treatment in which pain levels were reported at baseline and post 2 hours.

Remote Electrical Neuromodulation (REN)

Intervention Type DEVICE

Acute migraine treament

Consistent efficacy

all users that performed at least 2 evaluable treatments. In order to isolate the effect of REN treatments, this dataset considered only treatments where REN was used as a standalone treatment.

'Treatment' defined as a REN treatment of at least 20 minutes (the nominal duration is 45 minutes).

'Evaluable treatment' defined as a treatment in which pain levels were reported at baseline and post 2 hours.

Remote Electrical Neuromodulation (REN)

Intervention Type DEVICE

Acute migraine treament

Treatment intensity distribution

all treatments.

'Treatment' defined as a REN treatment of at least 20 minutes (the nominal duration is 45 minutes).

Remote Electrical Neuromodulation (REN)

Intervention Type DEVICE

Acute migraine treament

Safety

all reported treatment/device-related adverse events (AEs) within the time period.

Remote Electrical Neuromodulation (REN)

Intervention Type DEVICE

Acute migraine treament

Interventions

Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.

Remote Electrical Neuromodulation (REN)

Acute migraine treament

Intervention Type DEVICE

Other Intervention Names

Discover alternative or legacy names that may be used to describe the listed interventions across different sources.

Nerivio

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

REN users in the U.S.

Exclusion Criteria

Cohort 1 REN treatments that were shorter than 20 minutes or did not have a report of pain level.

Cohort 2 Treatments in which medications were taken within 2 hours from REN treatment. Users that had less than 2 REN treatments.

Cohort 3 REN treatments that were shorter than 20 minutes

Cohort 4 All REN sessions, regardless of duration or medication intake.
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

Georgetown University

OTHER

Sponsor Role collaborator

Mayo Clinic

OTHER

Sponsor Role collaborator

Theranica

INDUSTRY

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Responsibility Role SPONSOR

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Theranica USA Inc

Bridgewater, New Jersey, United States

Site Status

Theranica Bio-Electronics

Netanya, , Israel

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States Israel

References

Explore related publications, articles, or registry entries linked to this study.

Yarnitsky D, Dodick DW, Grosberg BM, Burstein R, Ironi A, Harris D, Lin T, Silberstein SD. Remote Electrical Neuromodulation (REN) Relieves Acute Migraine: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial. Headache. 2019 Sep;59(8):1240-1252. doi: 10.1111/head.13551. Epub 2019 May 9.

Reference Type BACKGROUND
PMID: 31074005 (View on PubMed)

Tepper SJ, Lin T, Montal T, Ironi A, Dougherty C. Real-world Experience with Remote Electrical Neuromodulation in the Acute Treatment of Migraine. Pain Med. 2020 Dec 25;21(12):3522-3529. doi: 10.1093/pm/pnaa299.

Reference Type BACKGROUND
PMID: 32935848 (View on PubMed)

Hershey AD, Lin T, Gruper Y, Harris D, Ironi A, Berk T, Szperka CL, Berenson F. Remote electrical neuromodulation for acute treatment of migraine in adolescents. Headache. 2021 Feb;61(2):310-317. doi: 10.1111/head.14042. Epub 2020 Dec 21.

Reference Type BACKGROUND
PMID: 33349920 (View on PubMed)

Nierenburg H, Vieira JR, Lev N, Lin T, Harris D, Vizel M, Ironi A, Lewis B, Wright P. Remote Electrical Neuromodulation for the Acute Treatment of Migraine in Patients with Chronic Migraine: An Open-Label Pilot Study. Pain Ther. 2020 Dec;9(2):531-543. doi: 10.1007/s40122-020-00185-1. Epub 2020 Jul 9.

Reference Type BACKGROUND
PMID: 32648205 (View on PubMed)

Rapoport AM, Lin T. Device profile of the Nerivio for acute migraine treatment: overview of its efficacy and safety. Expert Rev Med Devices. 2019 Dec;16(12):1017-1023. doi: 10.1080/17434440.2019.1695599. Epub 2019 Nov 25.

Reference Type BACKGROUND
PMID: 31747304 (View on PubMed)

Marmura MJ, Lin T, Harris D, Ironi A, Rosen NL. Incorporating Remote Electrical Neuromodulation (REN) Into Usual Care Reduces Acute Migraine Medication Use: An Open-Label Extension Study. Front Neurol. 2020 Apr 7;11:226. doi: 10.3389/fneur.2020.00226. eCollection 2020.

Reference Type BACKGROUND
PMID: 32318014 (View on PubMed)

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

RW002

Identifier Type: -

Identifier Source: org_study_id

More Related Trials

Additional clinical trials that may be relevant based on similarity analysis.

Nerivio Efficacy Under High-Frequency Use
NCT07336056 ACTIVE_NOT_RECRUITING PHASE4
Migraine in Adolescents
NCT05654012 RECRUITING NA