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A BIOTRONIK wearable stimulator will be utilized in order to investigate the effects of two study spinal cord stimulation (SCS) therapies on subject reported pain and paresthesia perception observed over 12 days of study stimulation testing following the conclusion of a successful SCS commercial trial.
The study population will consist of patients with chronic low back and/or leg pain who have been identified as candidates for trial testing of a commercially available SCS system including percutaneous SCS trial lead(s), but have not yet undergone trial lead implant. The commercial trial test period will be conducted independently from the study according to standard of care. The commercial trial period is referred to as the "trial" and the BENEFIT-02 interventional study stimulation period is referred to as the "study".
Potential subjects will be identified by the investigator from their general patient population and must meet all of the study inclusion and none of the study exclusion criteria evaluated at the time of enrollment. Once study eligibility is confirmed, written informed consent is obtained, after which enrollment visit data will be collected. Subjects will be considered fully enrolled after being randomly assigned to receive one of two study SCS therapies.
To participate in this study, subjects must be willing to undergo an extended 14 day testing period following the conclusion of their commercial trial, where their existing SCS trial lead(s) will be connected to a BIOTRONIK study stimulator and one of two randomly assigned study SCS therapies will be administered for an additional 12 days after a two day washout period. After completion of the 12 day study testing period, the subject's participation in the study ends, the study stimulator will be disconnected, and the commercial SCS trial lead(s) will be removed according to the standard clinical routine.
This feasibility study includes the assessment of two primary endpoints and two secondary endpoints that are designed to provide preliminary information regarding the effectiveness and safety of the two study SCS therapies under investigation in the study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Therapy A Spinal Cord Stimulation Parameter Set | Experimental |
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| Therapy B Spinal Cord Stimulation Parameter Set | Experimental |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Therapy A spinal cord stimulation parameter set using BIO-RNA system and associated components | Device | Therapy A stimulation patterns |
|
| Measure | Description | Time Frame |
|---|---|---|
| Change Since Baseline in Numerical Rating Scale (NRS) for Pain (Overall) Evaluated Separately for Each Study SCS Therapy | The purpose of primary endpoint 1 is to evaluate the change since baseline in Numerical Rating Scale (NRS) for pain (overall) for each study SCS therapy. The evaluation of primary endpoint 1 is based on the NRS for pain (overall) obtained at the final study testing visit compared with the baseline measurement obtained prior to initiation of the commercial trial period, for subjects randomized to each study SCS therapy. Numerical Rating Scale (NRS) was collected for overall pain experienced over the past 24 hours on a scale of 0-10, with 0 being No Pain and 10 being Worst Possible Pain. | Baseline and in-office visit 3, average of 21 days |
| Inter-therapy Comparison of Change Since Baseline in Numerical Rating Scale (NRS) for Pain (Overall) | The purpose of primary endpoint 2 is to provide an inter-therapy comparison of change since baseline in Numerical Rating Scale (NRS) for pain (overall). Primary endpoint 2 analyses includes all participants included in primary endpoint 1 analyses. Numerical Rating Scale (NRS) was collected for overall pain experienced over the past 24 hours on a scale of 0-10, with 0 being No Pain and 10 being Worst Possible Pain. | Baseline and in-office visit 3, average of 21 days |
| Measure | Description | Time Frame |
|---|---|---|
| Change Since Conclusion of Commercial Trial in Numerical Rating Scale (NRS) for Pain (Overall) Evaluated Separately for Each Study SCS Therapy | The evaluation of secondary endpoint 1 will be based on Numerical Rating Scale (NRS) for overall pain experienced over the past 24 hours (scale of 0-10, with 0 being No Pain and 10 being Worst Possible Pain) obtained at conclusion of commercial trial compared to NRS for overall pain at the final study testing visit |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Leonardo Kapural, MD | Carolinas Pain Institute | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hope Research Institute | Peoria | Arizona | 85381 | United States | ||
| Arizona Pain |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37589641 | Derived | Kapural L, Patterson DG, Li S, Hatheway J, Hunter C, Rosen S, Fishman M, Gupta M, Sayed D, Christopher A, Burgher A, McJunkin T, Ross EL, Provenzano D, Amirdelfan K. Multiphase Spinal Cord Stimulation in Participants With Chronic Back or Leg Pain: Results of the BENEFIT-02 Randomized Clinical Trial. Neuromodulation. 2023 Oct;26(7):1400-1411. doi: 10.1016/j.neurom.2023.05.006. Epub 2023 Aug 16. |
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Of 136 provisionally enrolled participants, 77 met the criteria to be randomized to treatment.
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| ID | Title | Description |
|---|---|---|
| FG000 | Therapy A Spinal Cord Stimulation Parameter Set | Therapy A (~600-1500Hz) spinal cord stimulation parameter set using BIO-RNA system and associated components. |
| FG001 | Therapy B Spinal Cord Stimulation Parameter Set |
| Title | Milestones | Reasons Not Completed | |||||
|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Apr 19, 2019 | Mar 9, 2023 |
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| Therapy B spinal cord stimulation parameter set using BIO-RNA system and associated components | Device | Therapy B stimulation patterns |
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| In-office visit 1 at approximately 7 days and in-office visit 3 at approximately 21 days, average of 14 days |
| Investigational Device-related Adverse Event-free Rate | The evaluation of secondary endpoint 2 will be based on the number of subjects free from investigational device-related adverse events assessed at in-office visit 1 (randomization visit) through in-office visit 3 (study completion). The investigational device-related adverse event-free rate was pre-defined within the protocol as the overall rate from all implanted Prospera SCS devices, regardless of randomized therapy output setting (Therapy A or Therapy B). | Baseline and in-office visit 3, average of 21 days |
| Scottsdale |
| Arizona |
| 85258 |
| United States |
| Integrated Pain Management (IPM) Medical Group | Walnut Creek | California | 94598 | United States |
| Center for Interventional Pain and Spine | Wilmington | Delaware | 19711 | United States |
| Coastal Orthopedics | Bradenton | Florida | 34209 | United States |
| Pain Care, LLC | Stockbridge | Georgia | 30281 | United States |
| Kansas University Medical Center | Kansas City | Kansas | 66160 | United States |
| Neuroscience Research Center DBA Kansas Pain Management | Overland Park | Kansas | 66210 | United States |
| Brigham and Women's Hospital | Chestnut Hill | Massachusetts | 02467 | United States |
| St. Louis Pain Consultants | Chesterfield | Missouri | 63017 | United States |
| KC Pain Centers | Lee's Summit | Missouri | 64086 | United States |
| Nevada Advanced Pain Specialists | Reno | Nevada | 89511 | United States |
| Premier Pain Centers | Shrewsbury | New Jersey | 07702 | United States |
| Ainsworth Institute of Pain Management | New York | New York | 10022 | United States |
| The Center for Clinical Research | Winston-Salem | North Carolina | 27103 | United States |
| Integrated Pain Solutions | Columbus | Ohio | 43240 | United States |
| Delaware Valley Pain and Spine Institute | Trevose | Pennsylvania | 19053 | United States |
| Northwest Pain Care, Inc. | Spokane | Washington | 99201 | United States |
Therapy B (~300-600Hz) spinal cord stimulation parameter set using BIO-RNA system and associated components.
| COMPLETED |
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| NOT COMPLETED |
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| ID | Title | Description |
|---|---|---|
| BG000 | Enrolled But Not Randomized | Subjects selected for participation from the investigator's patient population who have signed the Informed Consent Form, have confirmation of the initial enrollment criteria, and have completed baseline measurements, but did not meet criteria to be randomized at office visit 1. |
| BG001 | Therapy A | Subjects meeting all eligibility criteria at office visit 1 and are subsequently randomized to Therapy A (~600-1500Hz) spinal cord stimulation parameter set. |
| BG002 | Therapy B | Subjects meeting all eligibility criteria at office visit 1 and are subsequently randomized to Therapy B (~300-600Hz) spinal cord stimulation parameter set. |
| BG003 | Total | Total of all reporting groups |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean | Standard Deviation | Years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Ethnicity (NIH/OMB) | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Clinical Characteristics - Primary Pain Diagnosis | Subject medical history characteristics collected for the study at time of enrollment. | Count of Participants | Participants |
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| Clinical Characteristics - Previous Back Surgery | Count of Participants | Participants |
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| Clinical Characteristics - Taking Opioid Analgesics | Count of Participants | Participants |
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| 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 | Change Since Baseline in Numerical Rating Scale (NRS) for Pain (Overall) Evaluated Separately for Each Study SCS Therapy | The purpose of primary endpoint 1 is to evaluate the change since baseline in Numerical Rating Scale (NRS) for pain (overall) for each study SCS therapy. The evaluation of primary endpoint 1 is based on the NRS for pain (overall) obtained at the final study testing visit compared with the baseline measurement obtained prior to initiation of the commercial trial period, for subjects randomized to each study SCS therapy. Numerical Rating Scale (NRS) was collected for overall pain experienced over the past 24 hours on a scale of 0-10, with 0 being No Pain and 10 being Worst Possible Pain. | Only patients with valid NRS for pain (overall) at both baseline and at in-office visit 3 were evaluated for this endpoint. | Posted | Mean | Standard Deviation | Score on a scale | Baseline and in-office visit 3, average of 21 days |
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| Primary | Inter-therapy Comparison of Change Since Baseline in Numerical Rating Scale (NRS) for Pain (Overall) | The purpose of primary endpoint 2 is to provide an inter-therapy comparison of change since baseline in Numerical Rating Scale (NRS) for pain (overall). Primary endpoint 2 analyses includes all participants included in primary endpoint 1 analyses. Numerical Rating Scale (NRS) was collected for overall pain experienced over the past 24 hours on a scale of 0-10, with 0 being No Pain and 10 being Worst Possible Pain. | Only patients with valid NRS for pain (overall) at both baseline and at in-office visit 3 were evaluated for this endpoint. | Posted | Mean | Standard Deviation | Score on a scale | Baseline and in-office visit 3, average of 21 days |
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| Secondary | Change Since Conclusion of Commercial Trial in Numerical Rating Scale (NRS) for Pain (Overall) Evaluated Separately for Each Study SCS Therapy | The evaluation of secondary endpoint 1 will be based on Numerical Rating Scale (NRS) for overall pain experienced over the past 24 hours (scale of 0-10, with 0 being No Pain and 10 being Worst Possible Pain) obtained at conclusion of commercial trial compared to NRS for overall pain at the final study testing visit | Only patients with valid NRS for pain (overall) at both in-office visit 1 and in-office visit 3 were evaluated for this endpoint. | Posted | Mean | Standard Deviation | Score on a scale | In-office visit 1 at approximately 7 days and in-office visit 3 at approximately 21 days, average of 14 days |
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| Secondary | Investigational Device-related Adverse Event-free Rate | The evaluation of secondary endpoint 2 will be based on the number of subjects free from investigational device-related adverse events assessed at in-office visit 1 (randomization visit) through in-office visit 3 (study completion). The investigational device-related adverse event-free rate was pre-defined within the protocol as the overall rate from all implanted Prospera SCS devices, regardless of randomized therapy output setting (Therapy A or Therapy B). | Evaluable subjects for secondary endpoint 2 will include all subjects who undergo randomization and have the investigational stimulation system connected to their SCS trial leads. The investigational device-related adverse event-free rate was pre-defined within the protocol as the overall rate from all implanted Prospera SCS devices, regardless of randomized therapy output setting (Therapy A or Therapy B). Therefore, data for Therapy A and Therapy B are combined for this outcome measure. | Posted | Count of Participants | Participants | Baseline and in-office visit 3, average of 21 days |
|
21 days
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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 | Enrolled But Not Randomized | Subjects selected for participation from the investigator's patient population who have signed the Informed Consent Form and have confirmation of the initial enrollment criteria but have not yet been randomized. | 0 | 59 | 0 | 59 | 2 | 59 |
| EG001 | Therapy A | Subjects meeting all eligibility criteria who have been randomized to the Therapy A (~600-1500Hz) spinal cord stimulation parameter set. | 0 | 38 | 0 | 38 | 3 | 38 |
| EG002 | Therapy B | Subjects meeting all eligibility criteria who have been randomized to the Therapy B (~300-600Hz) spinal cord stimulation parameter set. | 0 | 39 | 0 | 39 | 3 | 39 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Irritation from wound dressing | Skin and subcutaneous tissue disorders | Systematic Assessment | SCS Trial Lead Implant Procedure-Related |
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| Lead migration | Surgical and medical procedures | Systematic Assessment | SCS Trial Lead Implant Procedure-Related |
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| Reaction from wound dressing | Skin and subcutaneous tissue disorders | Systematic Assessment | SCS Trial Lead Implant Procedure-Related |
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| Persistent post-surgical site pain | Surgical and medical procedures | Systematic Assessment | Commercial Trial Period Related |
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| Reaction from wound dressing | Skin and subcutaneous tissue disorders | Systematic Assessment | Commercial Trial Period Related |
| |
| Urinary incontinence | Renal and urinary disorders | Systematic Assessment | Commercial Trial Period Related |
| |
| Neurostimulator device entered "safe mode" | Product Issues | Systematic Assessment | Unknown Relationship to the Investigational Device |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Crystal Miller | BiotronikUS | 503-475-4984 | crystal.miller@biotronik.com |
| Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | May 28, 2020 | Mar 9, 2023 | SAP_001.pdf |
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| Male |
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| Not Hispanic or Latino |
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| Unknown or Not Reported |
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| Asian |
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| Native Hawaiian or Other Pacific Islander |
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| Black or African American |
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| White |
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| More than one race |
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| Unknown or Not Reported |
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| Radiculopathy |
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| Complex regional pain syndrome |
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| Chronic pain syndrome |
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| Degenerative disc disease |
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| Spinal stenosis |
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| Low back pain |
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| Dorsalgia |
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| Spondylosis |
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| Other primary pain diagnosis |
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| Unknown primary pain diagnosis |
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| No |
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| Unknown |
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| No |
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| Unknown |
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| Other |
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| Participants |
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| Units | Counts |
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| Participants |
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