At-home Ultrasound Localized Therapy for Rheumatoid Arthritis Study [At-home ULTRA Study]

NCT ID: NCT07163221

Last Updated: 2025-12-26

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

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-11-03

Study Completion Date

2026-11-30

Brief Summary

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The At-Home ULTRA Study will evaluate performance of the MINI system as indicated for the treatment of adults with active, moderate to severe rheumatoid arthritis who are inadequate responders or are intolerant to conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), biologic DMARDs (bDMARDs), or targeted synthetic DMARDs (tsDMARDs). The non-invasive study device delivers ultrasound stimulation to the spleen to reduce inflammation. The study will enroll at least 60 participants at up to 8 sites. There will be three arms consisting of two active stimulation groups (treatment) and one non-active stimulation group (sham-control). After completing the double-blinded primary endpoint assessment period at Week 12, there will be a one-way crossover of control participants to active stimulation and an additional 12 week follow-up with all participants to evaluate long-term outcomes.

Detailed Description

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Conditions

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Rheumatoid Arthritis (RA)

Keywords

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RA SecondWave Systems SecondWave Rheumatoid Arthritis Neuromodulation Ultrasound Splenic Ultrasound Spleen Spleen stimulation Ultrasound Stimulation Immunomodulation spleen stimulating device drug refractory noninvasive non-invasive

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

A 2-stage, randomized, double-blind, sham-controlled, multicenter study. Participants will be randomized into three groups, where one group is the standard of care control and the other two groups are standard of care plus differing stimulation settings of the SecondWave MINI therapy. Participants assigned to the treatment group will receive active stimulation for 20 min once per day, and those assigned to the control group will receive sham-stimulation for 20 min once per day.
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
All subjects, investigators, joint evaluators and outcome assessors will be blinded. Blinding of subjects will be assessed at Week 12.

Study Groups

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Control

Non-active Sham Stimulation

Group Type SHAM_COMPARATOR

Sham ultrasound stimulation (control)

Intervention Type DEVICE

Sham ultrasound stimulation for 20 minutes once per day

Conventional Synthetic DMARD

Intervention Type DRUG

All subjects will take at least one type of conventional synthetic DMARD at the same stable dose for at least 8 weeks prior to the treatment period and continuing through study close out

Treatment Setting 1

Subjects will receive daily noninvasive ultrasound stimulation of the spleen using Ultrasound Treatment Setting 1 for 20 minutes once per day

Group Type EXPERIMENTAL

Non-invasive ultrasound stimulation of the spleen - Treatment Setting 1

Intervention Type DEVICE

Subjects will receive daily noninvasive ultrasound stimulation of the spleen using Ultrasound Treatment Setting 1 for 20 minutes once per day

Conventional Synthetic DMARD

Intervention Type DRUG

All subjects will take at least one type of conventional synthetic DMARD at the same stable dose for at least 8 weeks prior to the treatment period and continuing through study close out

Treatment Setting 2

Subjects will receive daily noninvasive ultrasound stimulation of the spleen using Ultrasound Treatment Setting 2 for 20 minutes once per day

Group Type EXPERIMENTAL

Non-invasive ultrasound stimulation of the spleen - Treatment Setting 2

Intervention Type DEVICE

Subjects will receive daily noninvasive ultrasound stimulation of the spleen using Ultrasound Treatment Setting 2 for 20 minutes once per day

Conventional Synthetic DMARD

Intervention Type DRUG

All subjects will take at least one type of conventional synthetic DMARD at the same stable dose for at least 8 weeks prior to the treatment period and continuing through study close out

Interventions

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Non-invasive ultrasound stimulation of the spleen - Treatment Setting 1

Subjects will receive daily noninvasive ultrasound stimulation of the spleen using Ultrasound Treatment Setting 1 for 20 minutes once per day

Intervention Type DEVICE

Non-invasive ultrasound stimulation of the spleen - Treatment Setting 2

Subjects will receive daily noninvasive ultrasound stimulation of the spleen using Ultrasound Treatment Setting 2 for 20 minutes once per day

Intervention Type DEVICE

Sham ultrasound stimulation (control)

Sham ultrasound stimulation for 20 minutes once per day

Intervention Type DEVICE

Conventional Synthetic DMARD

All subjects will take at least one type of conventional synthetic DMARD at the same stable dose for at least 8 weeks prior to the treatment period and continuing through study close out

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Males and females ages 18 and above
2. Active moderate to severe seropositive RA
3. At least 6 total tender and/or swollen joints counted on a 28 joint assessment during screening and at Week 0 (a joint that is both tender and swollen will be counted as "2")
4. Demonstrated an inadequate response to, or loss of response to standard csDMARD treatment (e.g., methotrexate) or up to three total bDMARDs and tsDMARDs
5. Receiving stable background treatment with a csDMARD prior to start of the treatment period at Week 0. Methotrexate (if chosen as background treatment) must be maintained at a stable dose for at least 4 weeks prior to Week 0, while all other csDMARDs (if chosen as background treatment) must be maintained at a stable dose for at least 8 weeks prior to Week 0. Participants must be willing to maintain their background medication regimen throughout the 28-week study period.
6. For participants that have previously undergone treatment with bDMARDs or tsDMARDs therapy, those treatments must be discontinued at least 4 weeks prior to start of the treatment period at Week 0 and may not be resumed until after the Week 24 Closeout Visit
7. For participants that have previously undergone treatment with Golimumab or Infliximab, those treatments must be discontinued at least 8 weeks prior to start of the treatment period at Week 0 and may not be resumed until after the Week 24 Closeout Visit
8. Participants may receive up to 10 mg of daily prednisone as part of their background treatment but must have maintained a stable dose for a minimum of 6 weeks prior to start of the treatment period at Week 0, and must be willing to maintain the stable dose until after the Week 24 Closeout Visit
9. Torso circumference at the belly button and sternum level must both be in the range of 25 to 50 inches
10. Participants with an immunomodulation device must be willing and able to turn the device off at least 4 weeks prior to start of the treatment period at Week 0 and may not be resumed until after the Week 24 Closeout Visit
11. Participants must be willing not to initiate any new treatments with expected immune modulating effects during the study period, and any existing immune modulating treatments must be stabilized by Week 0

Exclusion Criteria

1. Active bacterial or viral infection
2. Pregnant women or those trying to become pregnant
3. Receiving active chemotherapy or immunotherapy to treat malignancy within 30 days prior to enrollment
4. Having received more than a total of three bDMARDs and tsDMARDs
5. Having received Rituximab monoclonal antibody medication
6. Presence of an implanted device or other solid object in the vicinity of the spleen that can interfere with or absorb the ultrasound beam
7. History of asplenia
8. History of splenomegaly
9. History of ascites
10. Recent abdominal surgery
11. Currently participating in an investigational drug or device study
12. Open wound/sores that would make performing study procedures too difficult
13. Inability to perform minimal daily self-cares associated with feeding or dressing, such as lifting a cup of water to the mouth or putting on clothing.
14. Refusal or inability to regularly attend the scheduled on-site visits and at-home visits, or perform the remote video observation sessions
15. Cannot speak English
16. Any other clinical reasons deemed by the investigators of the study in which the patient would not be an appropriate candidate for the study
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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SecondWave Systems Inc.

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Daniel Zachs

Role: STUDY_DIRECTOR

SecondWave Systems Inc.

Locations

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Arizona Arthritis and Rheumatology Associates P.C.

Glendale, Arizona, United States

Site Status RECRUITING

Medvin Clinical Research

Covina, California, United States

Site Status RECRUITING

Southland Arthritis & Osteoporosis Medical Center

Temecula, California, United States

Site Status RECRUITING

University of Colorado

Aurora, Colorado, United States

Site Status RECRUITING

University of Minnesota Medical School, Division of Rheumatic and Autoimmune Diseases

Minneapolis, Minnesota, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Daniel Zachs

Role: CONTACT

Phone: 612-444-6264

Email: [email protected]

Facility Contacts

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Nathaly Navarro, BS

Role: primary

Rosalia Tanory, MBBS

Role: primary

Adam Ramos

Role: backup

Ana Roup

Role: primary

Chong Pedrick, RN

Role: primary

Panida Khuansanguan, MS

Role: backup

Erik Peterson, M.D.

Role: primary

Other Identifiers

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Pro00087265

Identifier Type: -

Identifier Source: org_study_id