CClinicalTrials.gg
CompletedNCT03266107Updated Dec 22, 2020Results posted

Study of Basivertebral Nerve Ablation Treatment of Chronic Low Back Pain

An interventional study of Intracept in Chronic Low Back Pain, sponsored by Relievant Medsystems, Inc.. Completed at 2 sites in United States. Open to participants aged 25 Years to 70 Years. Per ClinicalTrials.gov, last updated 2020-12-22.

Sponsored by Relievant Medsystems, Inc. · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
50
Allocation
Not applicable
Ages
25 Years to 70 Years
Sex
All
01

Study summary

Prospective, single arm, open label, multi-center study to evaluated the effectiveness of intraosseous basivertebral nerve radiofrequency ablation using the Intracept System.

Read the detailed description

This is a prospective, open-label, single-arm study of patients diagnosed with vertebrogenic low back pain for a minimum of 6 months with conservative care. Participants will receive the Intracept System procedure to ablate the basivertebral nerve within the vertebral body. Treatment is performed on all vertebral bodies with Modic type 1 or type 2 changes on MRI from L3-S1.

02

Conditions studied

  • Chronic Low Back Pain

Keywords

  • Vertebrogenic Low Back Pain
03

Who can participate

Ages eligible
25 Years to 70 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Skeletally mature subjects at least 25 years of age
  • Chronic low back pain for at least 6 months
  • Failure to respond to at least 6 months of non-operative conservative management
  • Oswestry Disability Index (ODI) at least 30 points
  • Modic changes Type 1 or 2

Exclusion criteria

Exclusion Criteria:

  • Current or history of vertebral cancer or spinal metastasis
  • History of a fragility fracture
  • Any back pathology related to trauma, evidence of vertebral compression fracture or other spinal pathology that could affect assessment of response to back pain
  • Disc extrusion or protrusion
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
50 participants (actual)

Study arms

  • Experimental
    Treatment

    BVN Ablation

    Device: Intracept

Interventions

  • DeviceIntracept

    Radiofrequency ablation of the basivertebral nerve using the Intracept System

05

What researchers measure

Primary outcomes

  1. Oswestry Disability Index (ODI) - 3 Months

    Change in mean Oswestry Disability Index (ODI) total score from baseline to 3 months post-treatment. ODI total score scale of 0 (no disability) to 100 (complete disability), with categories of 0-20 (minimal disability), 21-40 (moderate disability), 41-60 (severe disability), 61-80 (crippling back pain), and 81-100 (bed-bound or exaggerating). The minimally clinically important difference in ODI from baseline is considered to be a 10 points reduction from baseline.

    Time frame: 3 months

Secondary outcomes

  1. Visual Analog Scale (VAS) - 3 Months

    Change in the mean visual analog scale (VAS) low back pain from baseline to 3 months post treatment. VAS is a 10 point numeric scale with 0 being no pain and 10 being worst imaginable pain. The minimal clinically important difference is a 2 point reduction from baseline.

    Time frame: 3 Months

  2. ODI Responder Rate - 3-Month

    Number \& percent of patients with greater than or equal to 15 point reduction in Oswestry Disability Index (ODI) from baseline to 3 months post treatment. ODI is scored on a scale of 0 (no disability) to 100 (complete disability), with categories of 0-20 (minimal disability), 21-40 (moderate disability), 41-60 (severe disability), 61-80 (crippling back pain), and 81-100 (bed-bound or exaggerating). The minimally clinically important difference for this tool is considered to be 10 points.

    Time frame: 3 Months

  3. VAS Responder Rate - 3 Month

    Number and percentage of participants with a greater than or equal to 2 point reduction from baseline in visual analog scale (VAS) for low back pain at 3 months post treatment. VAS is a patient-reported 10 point numeric pain scale with 0 being no pain and 10 being worst imaginable pain. The minimal clinically important difference in VAS from baseline is a 2 point reduction.

    Time frame: 3 Months

  4. ODI -12 Months

    Change in mean Oswestry Disability Index (ODI) total score from baseline to 12 months post treatment. ODI total score is on a scale of 0 (no disability) to 100 (complete disability), with categories of 0-20 (minimal disability), 21-40 (moderate disability), 41-60 (severe disability), 61-80 (crippling back pain), and 81-100 (bed-bound or exaggerating). The minimally clinically important difference for this tool is considered to be 10 point reduction in ODI.

    Time frame: 12 Months

  5. VAS - 12 Month

    Change in mean visual analog scale (VAS) for low back pain score from baseline at 12 months. VAS is a patient-reported 10 point numeric pain scale with 0 being no pain and 10 being worst imaginable pain. The minimal clinically important difference in VAS from baseline is a 2 point reduction.

    Time frame: 12 Months

  6. ODI Responder Rate - 12-Month

    Number and percent of patients with greater than or equal to 15 point reduction in Oswestry Disability Index (ODI) total score from baseline to 12 months post treatment. ODI total score scale of 0 (no disability) to 100 (complete disability), with categories of 0-20 (minimal disability), 21-40 (moderate disability), 41-60 (severe disability), 61-80 (crippling back pain), and 81-100 (bed-bound or exaggerating). The minimally clinically important difference for this tool is considered to be 10 points.

    Time frame: 12 Months

  7. VAS Responder Rate - 12 Months

    Number and percent of participants with a reduction of greater than or equal to 2 points of the visual analog scale (VAS) at 12 months post treatment. VAS is a patient-reported 10 point numeric pain scale with 0 being no pain and 10 being worst imaginable pain. The minimal clinically important difference in VAS from baseline is a 2 point reduction in score.

    Time frame: 12 Months

  8. VAS Reduction 50% or More - 12 Month

    Number and percent of participants that reported a 50% or greater reduction in Visual Analog Scale (VAS) from baseline to 12 months.

    Time frame: 12 Months

06

Results

Posted Dec 22, 2020

Participant flow

Patients for the study were drawn from current low back pain clinic populations, referrals, and patient self-referral at two investigative sites in the U.S. from February 2018 to February 2019. Consecutively identified patients were screened for medical history and review of MRI for Modic/endplate changes and any excluded pain sources.

Enrollment to Procedure
Participant flow — Enrollment to Procedure
MilestoneTreatment
Started50
Completed47
Not completed3
Withdrew: Failure to access due to hardened bone1
Withdrew: Study stopped prior to procedure2
3-Month Follow-up Visit
Participant flow — 3-Month Follow-up Visit
MilestoneTreatment
Started47
Completed46
Not completed1
Withdrew: Lost to follow-up1
12-Month Follow-up Visit
Participant flow — 12-Month Follow-up Visit
MilestoneTreatment
Started46
Completed45
Not completed1
Withdrew: Lost to follow-up1

Outcome measures

PrimaryOswestry Disability Index (ODI) - 3 Months

Change in mean Oswestry Disability Index (ODI) total score from baseline to 3 months post-treatment. ODI total score scale of 0 (no disability) to 100 (complete disability), with categories of 0-20 (minimal disability), 21-40 (moderate disability), 41-60 (severe disability), 61-80 (crippling back pain), and 81-100 (bed-bound or exaggerating). The minimally clinically important difference in ODI from baseline is considered to be a 10 points reduction from baseline.

Time frame:
3 months
Reported as:
Mean · units on a scale
Oswestry Disability Index (ODI) - 3 Months
units on a scaleTreatment
Oswestry Disability Index (ODI) - 3 Months-30.33 ± 12.71
Statistical analysis
  • Treatment · t-test, 1 sided · p = <0.001
SecondaryVisual Analog Scale (VAS) - 3 Months

Change in the mean visual analog scale (VAS) low back pain from baseline to 3 months post treatment. VAS is a 10 point numeric scale with 0 being no pain and 10 being worst imaginable pain. The minimal clinically important difference is a 2 point reduction from baseline.

Time frame:
3 Months
Reported as:
Mean · units on a scale
Visual Analog Scale (VAS) - 3 Months
units on a scaleTreatment
Visual Analog Scale (VAS) - 3 Months-3.79 ± 2.2
Statistical analysis
  • Treatment · t-test, 1 sided · p = <0.001
SecondaryODI Responder Rate - 3-Month

Number \& percent of patients with greater than or equal to 15 point reduction in Oswestry Disability Index (ODI) from baseline to 3 months post treatment. ODI is scored on a scale of 0 (no disability) to 100 (complete disability), with categories of 0-20 (minimal disability), 21-40 (moderate disability), 41-60 (severe disability), 61-80 (crippling back pain), and 81-100 (bed-bound or exaggerating). The minimally clinically important difference for this tool is considered to be 10 points.

Time frame:
3 Months
Reported as:
Count of participants · Participants
ODI Responder Rate - 3-Month
ParticipantsTreatment
ODI Responder Rate - 3-Month42
SecondaryVAS Responder Rate - 3 Month

Number and percentage of participants with a greater than or equal to 2 point reduction from baseline in visual analog scale (VAS) for low back pain at 3 months post treatment. VAS is a patient-reported 10 point numeric pain scale with 0 being no pain and 10 being worst imaginable pain. The minimal clinically important difference in VAS from baseline is a 2 point reduction.

Time frame:
3 Months
Reported as:
Count of participants · Participants
VAS Responder Rate - 3 Month
ParticipantsTreatment
VAS Responder Rate - 3 Month36
SecondaryODI -12 Months

Change in mean Oswestry Disability Index (ODI) total score from baseline to 12 months post treatment. ODI total score is on a scale of 0 (no disability) to 100 (complete disability), with categories of 0-20 (minimal disability), 21-40 (moderate disability), 41-60 (severe disability), 61-80 (crippling back pain), and 81-100 (bed-bound or exaggerating). The minimally clinically important difference for this tool is considered to be 10 point reduction in ODI.

Time frame:
12 Months
Reported as:
Mean · units on a scale
ODI -12 Months
units on a scaleTreatment
ODI -12 Months-32.31 ± 14.07
Statistical analysis
  • Treatment · t-test, 1 sided · p = <0.001
SecondaryVAS - 12 Month

Change in mean visual analog scale (VAS) for low back pain score from baseline at 12 months. VAS is a patient-reported 10 point numeric pain scale with 0 being no pain and 10 being worst imaginable pain. The minimal clinically important difference in VAS from baseline is a 2 point reduction.

Time frame:
12 Months
Reported as:
Mean · units on a scale
VAS - 12 Month
units on a scaleTreatment
VAS - 12 Month-4.31 ± 2.51
SecondaryODI Responder Rate - 12-Month

Number and percent of patients with greater than or equal to 15 point reduction in Oswestry Disability Index (ODI) total score from baseline to 12 months post treatment. ODI total score scale of 0 (no disability) to 100 (complete disability), with categories of 0-20 (minimal disability), 21-40 (moderate disability), 41-60 (severe disability), 61-80 (crippling back pain), and 81-100 (bed-bound or exaggerating). The minimally clinically important difference for this tool is considered to be 10 points.

Time frame:
12 Months
Reported as:
Count of participants · Participants
ODI Responder Rate - 12-Month
ParticipantsTreatment
ODI Responder Rate - 12-Month40
SecondaryVAS Responder Rate - 12 Months

Number and percent of participants with a reduction of greater than or equal to 2 points of the visual analog scale (VAS) at 12 months post treatment. VAS is a patient-reported 10 point numeric pain scale with 0 being no pain and 10 being worst imaginable pain. The minimal clinically important difference in VAS from baseline is a 2 point reduction in score.

Time frame:
12 Months
Reported as:
Count of participants · Participants
VAS Responder Rate - 12 Months
ParticipantsTreatment
VAS Responder Rate - 12 Months36
SecondaryVAS Reduction 50% or More - 12 Month

Number and percent of participants that reported a 50% or greater reduction in Visual Analog Scale (VAS) from baseline to 12 months.

Time frame:
12 Months
Reported as:
Count of participants · Participants
VAS Reduction 50% or More - 12 Month
ParticipantsTreatment
VAS Reduction 50% or More - 12 Month31

Adverse events

Collected over 12 months. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Treatment0/47 (0%)0/47 (0%)2/47 (4.3%)
Most frequent other events
Most frequent other events
EventTreatment
RadiculitisMusculoskeletal and connective tissue disorders2/47

Baseline characteristics

Intracept treated population

Age, Continuous
Age, Continuous(years)Treatment
Mean44.47 ± 8.6
Sex: Female, Male
Sex: Female, Male(Participants)Treatment
Female25
Male22
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Treatment
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American1
White46
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(participants)Treatment
United States47
Baseline Oswestry Disability Index (ODI)
Baseline Oswestry Disability Index (ODI)(Total score on a scale of 0 to 100)Treatment
Mean47.13 ± 9.87
Baseline Visual Analog Scale (VAS) for Low Back Pain
Baseline Visual Analog Scale (VAS) for Low Back Pain(Scale 0 to 10)Treatment
Mean6.82 ± 1.03
07

Study locations

2 sites
  • Indiana Spine Group
    Carmel, Indiana 46032, United States
  • Seton Spine and Scoliosis Center
    Austin, Texas 78731, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Nov 15, 2018

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — Results

Supporting information: Study protocol, Icf, Csr, Analytic code

09

Registry details

Key details

Study ID
NCT03266107
Lead sponsor
Relievant Medsystems, Inc.
Responsible party
Sponsor
First posted
Aug 29, 2017
Start date
Feb 14, 2018
Primary completion
Feb 17, 2020
Completion
Feb 17, 2020
Results posted
Dec 22, 2020
Last update
Dec 22, 2020

Study contacts

Eeric Truumees, MD
principal investigator · Independent
Kevin Macadaeg, MD
principal investigator · Independent

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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