Performance and Long-term Safety of FlowOx2.0™, Multiple Sclerosis, Spasticity and Pain

February 21, 2023 updated by: Otivio AS

An Open 6-month Investigation, to Evaluate the Performance and Long-term Safety of FlowOx2.0™ in Patients With Multiple Sclerosis (Optional Continuation From NCT05562453)

This study is based on a 4-week double-blind, randomized, controlled, parallel design investigation to investigate the impact of intermittent negative pressure on spasticity and pain in people with multiple sclerosis (pwMS) (NCT05562453). The investigational device (FlowOx2.0™) is composed of a Pressure Chamber and a Control Unit (and disposable parts). All subjects will receive the same pressure chamber but be randomized to either a Control Unit that generates intermittent negative pressure (INP) of - (minus) 40 mmHg or a Control Unit that generates INP of - 10 mmHg. FlowOx2.0™ generating -40 mmHg is the investigational device, and FlowOx2.0™ generating -10 mmHg, is the comparator device. After the initial 4-week double-blind period (NCT05562453), all participants will be offered the -40mmHg control unit to be used during a 6-months optional extension part. The participants who volunteer to continue in the 6-months optional extension part will be included in this study.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Enrolling by invitation

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Detailed Description

FlowOx2.0™ is a commercially available device for home treatment of peripheral arterial disease. It is designed to be used at home by patients and has been shown to cause rapid changes in blood flow velocity in the treated leg. Recently, individuals with multiple sclerosis have reported a positive impact on their self-perceived spasticity and pain levels. The study will recruit patients from Norway, Sweden, and Denmark. All subjects will be instructed to treat the most affected leg for 60 minutes per day, preferentially in the evening. The same leg should be treated throughout the study period. A 4-week double-blind part (NCT05562453) is followed by this open investigation in which all randomized subjects that have completed the main part are offered to continue for an additional 6 months using the active device (INP of - 40 mmHg).

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Anticipated)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
60

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Norway
      • Bergen, Norway, 5839
        • Dept. of Neurology Haukeland Univ. Hospital & Dept. of Clin. Med., Univ. of Bergen, Bergen, Norway

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

18 years to 70 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

The subjects must meet all the following criteria to be eligible to participate in the clinical investigation:

  1. Diagnosed MS according to revised McDonald criteria.
  2. Give written informed consent.
  3. Age 18-70 years.
  4. Stable MS disease without attack within the last three months.

  5. Ability to perform the walk tests:

    1. 2-minute walk test, and
    2. 25-Foot walk.
  6. Self-reported spasticity in the most affected leg that would be subject to treatment at baseline with a score of ≥ 4, scored using the numeric rating scale (NRS) during the last 24 hours.
  7. Pain and/or discomfort related to the spasticity described in inclusion criteria 6., over the last 7 days using the numeric rating scale (NRS).
  8. Stable and unchanged treatment of spasticity and pain the last month, as judged by the Investigator.
  9. Stable and unchanged disease-modulating treatment for MS last 6 months, as judged by the Investigator.
  10. Can self-manage study equipment.
  11. Willingness and ability to comply with study procedures, visit schedules, and requirements.
  12. Conducted the 4-week double-blind part of the study (NCT05562453).

Exclusion Criteria:

Subjects meeting any of the following criteria will not be permitted to participate in the clinical investigation:

  1. Have spasticity due to a disease other than MS.
  2. Pregnancy or planned pregnancy within the upcoming study period, up to 7 months (includes the optional extension part).
  3. Have an ongoing infection that subjectively affects their MS state, as judged by the Investigator.
  4. Have received botulinum toxin injection for spasticity within the last 4 months.
  5. Have symptoms or illness that make it difficult to participate in the study, as judged by the Investigator.
  6. Having planned surgery or other treatment within the coming study period of up to 7 months that makes it difficult to participate in the study, as judged by the Investigator.
  7. Subjects with uncontrolled wound infections or infections in the skin of the treated leg.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Investigational device
FlowOx 2.0 (-40mmHg intermittent negative pressure)
Device: FlowOx 2.0
-40mmHg intermittent negative pressure for 60 minutes per day

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Change in self-reported spasticity using Numeric Rating Scale (NRS)
Time Frame: 6 months
Numerical Rating Scale The minimum and maximum values: 0, 10 Higher scores mean a worse outcome the last 24 hours. The scale scores spasticity from 0-10, where 0 is no spasticity, and 10 is worst imaginable spasticity. The scoring should be done at roughly the same time of day and not during or immediately after treatment.
6 months

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Change in self-reported pain using NRS for subjects with a baseline NRS ≥4.
Time Frame: 6 months
Pain is scored using the NRS which describes the average score of pain over the last 24 hours. The scale scores pain from 0-10, where 0 is no pain, and 10 is worst imaginable pain. The scoring is done each day of the study. The scoring should be done roughly at the same time and not during or immediately after treatment.
6 months
Frequency of adverse events
Time Frame: 6 months
All incidences of adverse events (AEs) and device deficiencies (DDs) will be documented and reported during the clinical investigation. At visits and phone calls, study staff will ask whether the subject has experienced any AEs/DDs since the last call/visit. Staff will also follow-up any previous AEs during visits and calls, i.e., are AEs resolved or still ongoing. The subjects will also be encouraged to call and report between visits and calls.
6 months
Change in timed 25-foot walk (T25-FW)
Time Frame: 6 months
The Timed 25-Foot Walk (T25-FW). The T25-FW is a quantitative mobility and leg function performance test based on a timed 25-Foot Walk. The subject is directed to one end of a clearly marked 25-foot course and is instructed to walk 25 feet as quickly as possible, but safely. The time is calculated from the initiation of the instruction to start and ends when the subject has reached the 25-foot mark. The task is immediately administered again by having the patient walk back the same distance. The "score" is the average of these two walks. Subjects may use assistive devices when doing this task. Staff record the average T25-FW score in seconds.
6 months
Change in 2-minute walking tests
Time Frame: 6 months
The 2-min walk test, should be tested in a hallway free of obstacles. Subject instruction will be: "Cover as much ground as possible over 2 minutes. Walk continuously, if possible, but do not be concerned if you need to slow down or stop to rest. The goal is to feel at the end of the test that more ground could not have been covered in the 2 minutes.
6 months
Change in health-related quality of life measured by Multiple sclerosis impact scale (MSIS-29)
Time Frame: 6 minths
The MSIS-29 is a measure of the physical and psychological impact of multiple sclerosis (MS) from the patients' perspective. Twenty-nine (29) questions are responded by the subject by circling the number that best describes the subject's situation (graded 1-5, where 1 is "not at all" and 5 is extremely). It captures the subject's views about the impact of MS on his/her day-to-day life during the past two weeks.
6 minths
Change in health-related quality of life measured by EQ-5D-5L
Time Frame: 6 months
The EQ-5D-5L is a self-assessed, health related, quality of life questionnaire. The scale measures quality of life on a 5-component scale including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The EQ-5D-5L essentially consists of 2 pages: the EQ-5D descriptive system and the EQ visual analogue scale (EQ VAS).
6 months
Change in Hospital Anxiety and Depression Scale (HADS)
Time Frame: 6 months
The Hospital Anxiety and Depression Scale (HADS) is a 14-item measure designed to assess anxiety and depression symptoms in medical patients, with emphasis on reducing the impact of physical illness on the total score. Items are rated on a 4-point severity scale. The HADS produces two scales, one for anxiety (HADS-A) and one for depression (HADS-D), differentiating the two states.
6 months

Other Outcome Measures

Other Outcome Measures

For clinical trials, a planned measurement described in the protocol that is used to determine the effect of an intervention/treatment on participants. For observational studies, a measurement or observation that is used to describe patterns of diseases or traits, or associations with exposures, risk factors, or treatment. Types of outcome measures include primary outcome measure and secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
The proportion of subjects with ≥ 30% improvement in self-reported pain using NRS
Time Frame: 6 months
The endpoint will be assessed as described under the primary endpoint
6 months
Mean daily treatment time
Time Frame: 6 months
The control unit records daily use, frequency of use per day and errors (periods without predefined pressure generated). The data will be compiled and used to ensure compliance.
6 months
Proportion of subjects who wish to continue treatment with FlowOx2.0 beyond 4 weeks
Time Frame: 6 months
The number of individuals interested in continuing treatment is expected to reflect a potential benefit. The information will be tabled.
6 months
Change in medication use for spasticity and pain
Time Frame: 6 months
During the enrolment visit, medication use for spasticity and pain will be registered. The same will be recorded at subsequent visits.
6 months
Change of self-reported sleep quality using the NRS
Time Frame: 6 months
Sleep quality is scored using the NRS which describes the average score of sleep over the last 24 hours. The scale scores sleep quality from 0-10, where 0 is the best possible sleep, and 10 is the worst imaginable sleep. The scoring should be done roughly at the same time during the day.
6 months
Change in fatigue using the NRS
Time Frame: 6 months
Fatigue is scored using the NRS which describes the average score of fatigue over the last 24 hours. The scale scores fatigue from 0-10, where 0 is no fatigue, and 10 is the worst imaginable fatigue. The scoring should be done roughly at the same time during the day.
6 months
Change in Modified Ashworth Scale from baseline
Time Frame: 6 months
During the enrolment visit, Modified Ashworth Scale is assessed. The same will be recorded at month 6.
6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Otivio AS

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Principal Investigator: Kjell-Morten Myhr, MD, PhD, Dept. of Neurology Haukeland Univ. Hosp. & Dept. of Clin. Med, Univ. of Bergen, Norway
  • Principal Investigator: Peter Vestergaard Rasmussen, MD, PhD, Department of Clinical Medicine - The Department of Neurology, Aarhus University
  • Principal Investigator: Sara Haghighi Mobarhan Smith, MD, PhD, Linköping University, Linköping, Sweden

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
November 4, 2022

Primary Completion (Anticipated)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
June 30, 2023

Study Completion (Anticipated)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 31, 2023

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
October 25, 2022

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
October 25, 2022

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
October 28, 2022

Study Record Updates

Last Update Posted (Estimate)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
February 23, 2023

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 21, 2023

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
February 1, 2023

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • FO-NP002

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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