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The ARTISAN-SNM study is designed to evaluate the safety and effectiveness of the Axonics Sacral Neuromodulation System as an aid in the treatment of the symptoms of urinary urgency incontinence (UUI) in patients who have failed or could not tolerate more conservative treatments.
The ARTISAN-SNM Trial which was a single-arm, prospective study that included 29 centers and enrolled 129 participants. The primary aim of the study was to evaluate the safety and efficacy of the Axonics SNM System for the treatment of UUI symptoms. Primary outcome was improvement in UUI episodes on a 3-day bladder diary. Secondary outcomes included quality of life using the ICIQ-OABqol questionnaire, patient satisfaction, and bowel symptoms captured using the Cleveland Clinic Florida Fecal Incontinence Score (CCF-FIS). Participants were followed out to 2 years and data was reported at 6 months, 1 year and 2 years
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment group | Experimental | Urinary Urgency Incontinence |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Axonics Sacral Neuromodulation System (SNM) System | Device | Axonics Sacral Neuromodulation System (SNM) System |
|
| Measure | Description | Time Frame |
|---|---|---|
| Proportion of Responders | Responders are defined as patients with greater than or equal to 50% reduction in symptoms | 2 years |
| Measure | Description | Time Frame |
|---|---|---|
| ICIQ-OAB-qol | International Consultation on Incontinence Modular Questionnaire (ICIQ)- Overactive Bladder (OAB), Quality of Life (qol). Score range of 0-100, with greater values indicating better quality of life. | 2 years |
| Daily Number of Urgency Leaks |
| Measure | Description | Time Frame |
|---|---|---|
| Change in CCF-FIS Score for Participants With a CCF-FIS Score ≥6 at Baseline | Change in CCF-FIS score at follow-up compared to baseline. Cleveland Clinic Florida - Fecal Incontinence Score (CCF-FIS): includes 5 items (solid, liquid, gas, wears pad and lifestyle alteration) and 5 frequencies (never = 0, rarely = 1, sometimes = 2, usually = 3, always = 4). Scores range from 0 for full continence to 20 for complete incontinence. A higher score indicates more severe FI symptoms and a score ≥ 6 indicates moderate to severe FI symptoms. |
Primary Inclusion Criteria:
Primary Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Howard Goldman, MD FACS | The Cleveland Clinic | Principal Investigator |
| Felicia Lane, MD | UC Irvine Health | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UC Irvine Health | Irvine | California | 95134 | United States | ||
| Cleveland Clinic |
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| ID | Title | Description |
|---|---|---|
| FG000 | Treatment Group | Urinary Urgency Incontinence Axonics Sacral Neuromodulation System (SNM) System: Axonics Sacral Neuromodulation System (SNM) System |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Treatment Group | Urinary Urgency Incontinence Axonics Sacral Neuromodulation System (SNM) System: Axonics Sacral Neuromodulation System (SNM) System |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Proportion of Responders | Responders are defined as patients with greater than or equal to 50% reduction in symptoms | Completers | Posted | Count of Participants | Participants | 2 years |
|
|
2 years
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Treatment Group | Urinary Urgency Incontinence Axonics Sacral Neuromodulation System (SNM) System: Axonics Sacral Neuromodulation System (SNM) System |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Atrial fibrillation | Cardiac disorders | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Proctalgia | Gastrointestinal disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Gita Ghadimi | Axonics, Inc. | 9497516412 | gita.ghadimi@axonics.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Feb 11, 2019 | Feb 3, 2022 | Prot_SAP_000.pdf |
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| ID | Term |
|---|---|
| D053202 | Urinary Incontinence, Urge |
| ID | Term |
|---|---|
| D014549 | Urinary Incontinence |
| D014555 | Urination Disorders |
| D014570 | Urologic Diseases |
| D052776 | Female Urogenital Diseases |
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| ID | Term |
|---|---|
| D016503 | Drug Delivery Systems |
| ID | Term |
|---|---|
| D004358 | Drug Therapy |
| D013812 | Therapeutics |
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The daily number of urgency leaks is measured by a bladder diary |
| 2 years |
| Voids | Measured by a bladder diary | 2 years |
| Baseline, 2-years |
| Participant Satisfaction for Treatment of UUI Symptoms | The subject satisfaction questionnaire was designed to provide information on subjective satisfaction with r-SNM therapy and the recharging experience. Participants indicated satisfaction with r-SNM therapy for treatment of their UUI symptoms based on a 7-point Likert scale ranging from "Very satisfied" to "Very dissatisfied". Results are presented as the number of participants who reported "Very, moderately, or slightly satisfied" with r-SNM therapy for treatment of their UUI symptoms. | 2-year |
| Cleveland |
| Ohio |
| 44106 |
| United States |
| Maastricht University Medical Center | Maastricht | Netherlands |
| UCLH | London | United Kingdom |
| Participants |
|
| Age, Continuous | Mean | Full Range | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Ethnicity (NIH/OMB) | Count of Participants | Participants |
|
| Race (NIH/OMB) | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
|
| Secondary | ICIQ-OAB-qol | International Consultation on Incontinence Modular Questionnaire (ICIQ)- Overactive Bladder (OAB), Quality of Life (qol). Score range of 0-100, with greater values indicating better quality of life. | Completers | Posted | Mean | Standard Deviation | score on a scale | 2 years |
|
|
|
| Secondary | Daily Number of Urgency Leaks | The daily number of urgency leaks is measured by a bladder diary | Completers | Posted | Mean | Standard Deviation | Daily number of UUI episodes | 2 years |
|
|
|
| Secondary | Voids | Measured by a bladder diary | Completers | Posted | Mean | Standard Error | Voids | 2 years |
|
|
|
| Other Pre-specified | Change in CCF-FIS Score for Participants With a CCF-FIS Score ≥6 at Baseline | Change in CCF-FIS score at follow-up compared to baseline. Cleveland Clinic Florida - Fecal Incontinence Score (CCF-FIS): includes 5 items (solid, liquid, gas, wears pad and lifestyle alteration) and 5 frequencies (never = 0, rarely = 1, sometimes = 2, usually = 3, always = 4). Scores range from 0 for full continence to 20 for complete incontinence. A higher score indicates more severe FI symptoms and a score ≥ 6 indicates moderate to severe FI symptoms. | Completers | Posted | Mean | Standard Deviation | score on a scale | Baseline, 2-years |
|
|
|
| Other Pre-specified | Participant Satisfaction for Treatment of UUI Symptoms | The subject satisfaction questionnaire was designed to provide information on subjective satisfaction with r-SNM therapy and the recharging experience. Participants indicated satisfaction with r-SNM therapy for treatment of their UUI symptoms based on a 7-point Likert scale ranging from "Very satisfied" to "Very dissatisfied". Results are presented as the number of participants who reported "Very, moderately, or slightly satisfied" with r-SNM therapy for treatment of their UUI symptoms. | Completers | Posted | Count of Participants | Participants | 2-year |
|
|
|
| 1 |
| 129 |
| 19 |
| 129 |
| 20 |
| 129 |
| Abdominal pain | Gastrointestinal disorders | Systematic Assessment |
|
| Appendicitis | Gastrointestinal disorders | Systematic Assessment |
|
| Large intestine perforation | Gastrointestinal disorders | Systematic Assessment |
|
| Colitis | Gastrointestinal disorders | Systematic Assessment |
|
| Chest pain | General disorders | Systematic Assessment |
|
| Non-cardiac chest pain | General disorders | Systematic Assessment |
|
| Influenza like illness | General disorders | Systematic Assessment |
|
| Bilary sepsis | Infections and infestations | Systematic Assessment |
|
| Chlostridium difficile infection | Infections and infestations | Systematic Assessment |
|
| Cellulitis | Infections and infestations | Systematic Assessment |
|
| Sepsis | Infections and infestations | Systematic Assessment |
|
| Pneumonia | Infections and infestations | Systematic Assessment |
|
| Urosepsis | Infections and infestations | Systematic Assessment |
|
| Incision site infection | Infections and infestations | Systematic Assessment |
|
| Joint dislocation | Injury, poisoning and procedural complications | Systematic Assessment |
|
| Hip fracture | Injury, poisoning and procedural complications | Systematic Assessment |
|
| Fall | Injury, poisoning and procedural complications | Systematic Assessment |
|
| Ankle fracture | Injury, poisoning and procedural complications | Systematic Assessment |
|
| Blood creatinine increased | Investigations | Systematic Assessment |
|
| Hyponatraemia | Metabolism and nutrition disorders | Systematic Assessment |
|
| Arthalgia | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Paresis | Nervous system disorders | Systematic Assessment |
|
| Loss of consciousness | Nervous system disorders | Systematic Assessment |
|
| Rash generalized | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
| Implant site coldness | General disorders | Systematic Assessment |
|
| Medical device site pain | General disorders | Systematic Assessment |
|
| Medical device discomfort | General disorders | Systematic Assessment |
|
| Implant site pain | General disorders | Systematic Assessment |
|
| Incision site infection | Infections and infestations | Systematic Assessment |
|
| Implant site infection | Infections and infestations | Systematic Assessment |
|
| Groin pain | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Pain in extremity | Musculoskeletal and connective tissue disorders | Systematic Assessment |
|
| Paraesthesia | Nervous system disorders | Systematic Assessment |
|
| Lead dislodgement | Product Issues | Systematic Assessment |
|
| Device power source issue | Product Issues | Systematic Assessment |
|
| Device breakage | Product Issues | Systematic Assessment |
|
| Vulvovaginal pain | Reproductive system and breast disorders | Systematic Assessment |
|
| Vulvovaginal discomfort | Reproductive system and breast disorders | Systematic Assessment |
|
| Medical device change | Surgical and medical procedures | Systematic Assessment |
|
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| D005261 |
| Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D052801 | Male Urogenital Diseases |
| D059411 | Lower Urinary Tract Symptoms |
| D020924 | Urological Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |