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Decision was taken to consider other opportunities for collecting sham-controlled data for BurstDR SCS.
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The purpose of this prospective, multi-center, randomized, triple-blind, sham-controlled study with parallel economic evaluation is to test the analgesic superiority of BurstDR-SCS compared to sham stimulation using both traditional patient-reported pain outcome measures and objective physiologic data collected from patient-worn biosensors. The endpoints associated with these objectives will be studied across a follow-up period of 6 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| BurstDR-SCS | Experimental | Subjects implanted with BurstDR-SCS will be included in BurstDR-SCS arm. |
|
| Sham control arm | Experimental | Subjects implanted with the BurstDR-SCS system will be included in the Sham control arm |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| BurstDR-SCS | Device | Spinal Cord Stimulation with a BurstDR-SCS system. |
| |
| Measure | Description | Time Frame |
|---|---|---|
| Change in overall back pain severity (NRS) at 6 months compared to sham arm | The pain severity endpoint is based on a review of previous RCTs of SCS and a consideration of IMMPACT (Initiative on Methods, Measurement and Pain Assessment in Clinical Trials) and COMET recommendations | At 6 Months |
| Change in a composite of physiologic and behavioral features compared to sham arm leading up to 6 months post-permanent implant | Ability to use composite of physiologic and behavioral features (including data from biosensors) to identify treatment responders and physiological data collected from patient-worn biosensors. | At 6 Months |
| Measure | Description | Time Frame |
|---|---|---|
| Change in percentage of patients reporting 50% or more reduction in backpain severity (NRS) at 6 months in treatment vs. sham | At 6 Months | |
| Change in cumulative proportion of responders for back pain (NRS) in treatment vs. sham | At 6 Months |
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General Inclusion Criteria:
General Exclusion Criteria:
Protocol-Specific Screening Exclusion Criteria:
1. Urine pregnancy test.
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| Name | Affiliation | Role |
|---|---|---|
| Dr. Stefano Palmisani | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Comprehensive Integrated Pain Program - Interventional Pain Service (CIPP-IPS) (Toronto Western Hospital) | Toronto | Canada | ||||
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| BurstDR-SCS |
| Device |
BurstDR-SCS system turned off. |
|
| Change in pain-related catastrophizing (Pain Catastrophizing Scale) in treatment vs. sham | The Pain Catastrophizing Scale questionnaire will be completed during selected clinical site visits via the electronic data acquisition portal. These questionnaires will be used for the assessment of study endpoints. The questionnaire includes thirteen statements describing different thoughts and feelings that may be associated with pain. Using the scale 0-4 (0- not at all; 1- to a slight degree; 2- to a moderate degree; 3- to a great degree; and 4- all the time), the patients are expected to indicate the degree to which they have these thoughts and feelings when they're experiencing pain. | At 6 Months |
| Change in functional disability (Oswestry Disability Index) in treatment vs. sham | The Oswestry Disability Index questionnaire will be completed during selected clinical site visits via the electronic data acquisition portal. These questionnaires will be used for the assessment of study endpoints. An interpretation of 0% to 20% means minimal disability; 21% to 40% means moderate disability; 41% to 60% means severe disability; 61% to 80% means crippled; and 81%-100% means bed-bound patients. | At 6 Months |
| Change in patient satisfaction (Patient Global Impression of Change) in treatment vs. sham | The Patient Global Impression of Change questionnaire will be completed during selected clinical site visits via the electronic data acquisition portal. These questionnaires will be used for the assessment of study endpoints. The scale ranges include:
| At 6 Months |
| Change in health-related quality of life (EQ5D-5L) in treatment vs. sham | The EQ5D-5L questionnaire will be completed during selected clinical site visits via the electronic data acquisition portal. These questionnaires will be used for the assessment of study endpoints and to estimate health-related quality of life and quality-adjusted life years. It is a 5-level version of the EQ5D. The descriptive system comprises five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems and extreme problems. | At 6 Months |
| Change in health-related quality of life (PROMIS-29+2) in treatment vs. sham | The PROMIS-29+2 questionnaire will be completed during selected clinical site visits via the electronic data acquisition portal. These questionnaires will be used for the assessment of study endpoints. The patients' answers to the PROMIS-29 are scored from 1-5 (with the exception of the NRS). The sum of the PROMIS results in the raw score, which lies between 4 and 20. There is no total score, but each axis forms its own score. | At 6 Months |
| Change in emotional functioning improvement (Patient Health Questionnaire-9) in treatment vs. sham | The Patient Health Questionnaire-9 will be completed during selected clinical site visits via the electronic data acquisition portal. These questionnaires will be used for the assessment of study endpoints. The Patient Health Questionnaire is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. It is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). | At 6 Months |
| Change in pain interference PROMIS-29+2 domain in treatment vs. sham | The PROMIS-29+2 questionnaire will be completed during selected clinical site visits via the electronic data acquisition portal. These questionnaires will be used for the assessment of study endpoints. The patients' answers to the PROMIS-29 are scored from 1-5 (with the exception of the NRS). The sum of the PROMIS results in the raw score, which lies between 4 and 20. There is no total score, but each axis forms its own score. | At 6 Months |
| Change in social roles and activities PROMIS-29+2 domain in treatment vs. sham | The PROMIS-29+2 questionnaire will be completed during selected clinical site visits via the electronic data acquisition portal. These questionnaires will be used for the assessment of study endpoints. The patients' answers to the PROMIS-29 are scored from 1-5 (with the exception of the NRS). The sum of the PROMIS results in the raw score, which lies between 4 and 20. There is no total score, but each axis forms its own score. | At 6 Months |
| Change in sleep disturbance PROMIS-29+2 domain in treatment vs. sham | The PROMIS-29+2 questionnaire will be completed during selected clinical site visits via the electronic data acquisition portal. These questionnaires will be used for the assessment of study endpoints. The patients' answers to the PROMIS-29 are scored from 1-5 (with the exception of the NRS). The sum of the PROMIS results in the raw score, which lies between 4 and 20. There is no total score, but each axis forms its own score. | At 6 Months |
| Change in on concomitant pain-related medication usage in treatment vs. sham | Importance of keeping pain-related treatments stable (per agreement with physician), including medications, physical therapy, psychotherapy, pain-related treatments (invasive or non-invasive) and interventions. | At 6 Months |
| Change in overall leg pain severity (NRS) at 6 months compared to sham arm in patients who reported baseline chronic leg pain | At 6 Months |
| Change in percentage of patients reporting 50% or more reduction in leg pain severity (NRS) at 6 months in treatment vs. sham in patients who reported baseline chronic leg pain | At 6 Months |
| Change in cumulative proportion of responders for leg pain (NRS) in treatment vs. sham in patients who reported baseline chronic leg pain | At 6 Months |
| Seacroft Hospital |
| Leeds |
| United Kingdom |
| The Walton Centre | Liverpool | United Kingdom |
| Guy's and St. Thomas Hospital | London | United Kingdom |
| St. Bartholomew Hospital | London | United Kingdom |