- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03783689
The SNAP Trial: SPRINT® Peripheral Nerve Stimulation for the Treatment of Neuropathic Post-Amputation Pain (SNAP)
November 3, 2023 updated by: SPR Therapeutics, Inc.
The SNAP Trial: SPRINT® Peripheral Nerve Stimulation for the Treatment of Neuropathic Post-Amputation Pain in a Randomized, Double-blinded, Placebo-controlled, Multicenter Trial
The purpose of this study is to determine if pain can be relieved by delivering small amounts of electricity (called "electrical stimulation") to the nerves in an individual's amputated leg.This study will involve the use of a Peripheral Nerve Stimulation (PNS) System that is made by SPR Therapeutics (the sponsor of the study).
The PNS System was cleared by the FDA for up to 60 days of use for the management of chronic pain, including extremity (leg) pain.
Study Overview
Status
Terminated
Conditions
Intervention / Treatment
Study Type
Interventional
Enrollment (Actual)
38
Phase
- 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
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Arizona
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Phoenix, Arizona, United States, 85018
- Pain Center of Arizona - Hope Research Institute
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California
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La Jolla, California, United States, 92093
- University of California San Diego
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Florida
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Orlando, Florida, United States, 32827
- Lake Nona Medical Arts
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Tampa, Florida, United States, 33612
- James A. Haley Veterans' Hospital
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Georgia
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Newnan, Georgia, United States, 30265
- Better Health Clinical Research
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Illinois
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Chicago, Illinois, United States, 60611
- Northwestern University
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Kansas
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Overland Park, Kansas, United States, 66210
- NeuroScience Research Center, LLC
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Kentucky
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Edgewood, Kentucky, United States, 41017
- OtriMed Clinical Research Center
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Massachusetts
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Waltham, Massachusetts, United States, 02451
- MedVadis Research
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New Jersey
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Shrewsbury, New Jersey, United States, 07702
- Premier Pain Centers
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Voorhees, New Jersey, United States, 08043
- Pain Management Center
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North Carolina
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Durham, North Carolina, United States, 27710
- Duke University
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Winston-Salem, North Carolina, United States, 27103
- Center for Clinical Research
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Texas
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San Antonio, Texas, United States, 78229
- The University of Texas Health Science Center at San Antonio
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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
Ages Eligible for Study
21 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Key Inclusion Criteria:
- At least 21 years old
- Lower extremity amputation
- Experiencing residual limb (stump) and/or phantom limb pain
- Healed amputation and healthy residual limb based upon the investigator's evaluation
Key Exclusion Criteria:
- Conditions with increased risk of infection (e.g., compromised immune system or history of recurrent skin infections)
- Implanted electronic device
- Pregnancy
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: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: Group 1 (Treatment)
Subjects in Group 1 will have Leads placed in the residual limb in the upper leg.
These subjects will then use the SPRINT Peripheral Nerve Stimulation (PNS) System and will receive electrical stimulation for 8 weeks.
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The SPRINT System delivers mild electrical stimulation to nerves in the residual limb.
The SPRINT System includes two small wires (called "Leads") that are placed through the skin in the upper leg.
It also includes a device worn on the body that delivers stimulation (called the SPRINT Stimulator).
Other Names:
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Sham Comparator: Group 2 (Control)
Subjects in Group 2 will have Leads placed in the residual limb in the upper leg.
These subjects will then use the SPRINT Peripheral Nerve Stimulation (PNS) System and receive 8 weeks of sham stimulation.
Subjects will then have the option to crossover and receive stimulation therapy.
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The SPRINT System delivers mild electrical stimulation to nerves in the residual limb.
The SPRINT System includes two small wires (called "Leads") that are placed through the skin in the upper leg.
It also includes a device worn on the body that delivers stimulation (called the SPRINT Stimulator).
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number of Subjects With ≥50% Reduction in Average Post-Amputation Pain (Residual Limb Pain [RLP] and/or Phantom Limb Pain [PLP])
Time Frame: Baseline and 5 to 8 weeks post-start of treatment (SOT)
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All subjects were asked to complete daily diaries to record their average residual limb pain and/or phantom pain intensities during the past 24 hours on each day of a 7-day period using an 11-point numerical rating scale where 0 represents "No Pain" and 10 represents "Pain as bad as you can imagine."
The average pain scores were calculated across the 7-day period for each region of pain at baseline and across weeks 5 to 8 post-start of treatment.
Percent reduction was then calculated for each subject's qualifying region of pain (residual limb and/or phantom limb pain with qualifying average pain intensity at baseline).
To be considered a success, subjects must have experienced ≥ 50% reduction in all qualifying regions of pain compared to their 7-day baseline diary average pain score(s).
The number of successes is presented.
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Baseline and 5 to 8 weeks post-start of treatment (SOT)
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Number of Subjects That Experienced at Least One Study-Related Adverse Event
Time Frame: Up to 14 months for each Group 1 subject and up to 18 months for each Group 2 subject (time from baseline to last study visit)
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At each study visit following the baseline assessment at Visit 1, subjects were questioned if any changes in their medical status or condition have occurred since their previous visit.
If the subject experienced a change that was a study-related adverse event, an Adverse Event Form was completed by the site.
The number of subjects that experienced at least one study-related adverse event is reported here.
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Up to 14 months for each Group 1 subject and up to 18 months for each Group 2 subject (time from baseline to last study visit)
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Pain Interference
Time Frame: Visit 1 (Baseline), Visit 7 (4-weeks post-start of treatment [SOT]), Visit 11 (8-weeks post-SOT), Visit 13 (3-months post-SOT), Visit 14 (6-months post-SOT), and Visit 16 (12-months post-SOT)
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Question 9 of the Brief Pain Inventory-Short Form (BPI-9) is a 7-part question that assesses the level of interference that subjects experience in their daily lives due to pain.
The 7 categories are general activity, mood, walking ability, normal work, relations with other people, sleep, and enjoyment of life.
Subjects were asked to rate how much their post-amputation residual and/or phantom limb pains interfere with each aspect on an 11-point numerical scale where 0 represents "Does Not Interfere" and 10 represents "Completely Interferes."
The average of these 7 scores was calculated for each subject at each time point.
Percent reduction was then calculated for each subject's qualifying region of pain (residual limb and/or phantom limb pain with qualifying average pain intensity at baseline).
To be considered a success, subjects must have experienced ≥ 50% reduction in all qualifying regions of pain compared to baseline.
The number of successes is presented.
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Visit 1 (Baseline), Visit 7 (4-weeks post-start of treatment [SOT]), Visit 11 (8-weeks post-SOT), Visit 13 (3-months post-SOT), Visit 14 (6-months post-SOT), and Visit 16 (12-months post-SOT)
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Pain Disability Index (PDI)
Time Frame: Visit 1 (Baseline), Visit 7 (4-weeks post-start of treatment [SOT]), Visit 11 (8-weeks post-SOT), Visit 13 (3-months post-SOT), Visit 14 (6-months post-SOT), and Visit 16 (12-months post-SOT)
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The Pain Disability Index (PDI) is a validated survey measuring the degree to which pain disrupts 7 categories of life activities on a scale from 0 to 10, with higher scores indicating greater disability.
The 7 scores were summed for each subject to provide an overall pain disability score ranging from 0 to 70.
A score of 0 indicates no disability while a score of 70 signifies that all of the activities in which the individual would normally be involved have been totally disrupted or prevented by pain.
To be considered a success, subjects must have a ≥ 10-point reduction in their total PDI score at each time point compared to their baseline score.
The number of subjects successful at each time point is reported.
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Visit 1 (Baseline), Visit 7 (4-weeks post-start of treatment [SOT]), Visit 11 (8-weeks post-SOT), Visit 13 (3-months post-SOT), Visit 14 (6-months post-SOT), and Visit 16 (12-months post-SOT)
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Patient Global Impression of Change (PGIC) Survey
Time Frame: Visit 7 (4-weeks post-Start of Therapy [SOT]), Visit 11 (8-weeks post-SOT), Visit 13 (3-months post-SOT), Visit 14 (6-months post-SOT), and Visit 16 (12-months post-SOT)
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The Patient Global Impression of Change (PGIC) Survey asks subjects to rate their improvement with treatment on a 7-point scale ranging from -3 to 0 to +3, where -3 represents "very much worse," 0 is "no change," and +3 represents "very much improved" as compared to before stimulation treatment.
The subjects combine all the components of their experience into one overall score.
The mean rank score of each group was calculated for each time frame.
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Visit 7 (4-weeks post-Start of Therapy [SOT]), Visit 11 (8-weeks post-SOT), Visit 13 (3-months post-SOT), Visit 14 (6-months post-SOT), and Visit 16 (12-months post-SOT)
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Pain Catastrophizing Scale (PCS)
Time Frame: Visit 1 (Baseline), Visit 7 (4-weeks post-Start of Treatment [SOT]), and Visit 11 (8-weeks post-SOT)
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The Pain Catastrophizing Scale (PCS) questionnaire has 13 questions that assess rumination, magnification, and helplessness.
Subjects are asked to think back on painful experiences in the past and reflect on how often they had specific thoughts or feelings.
Each of the 13 questions is scored on a 5-point scale where 0 represents "not at all," and 4 represents "all the time."
The scores from each question were summed for each subject to provide a total PCS score, with a possible range from 0 to 52 with higher scores indicating a greater tendency to catastrophize pain (i.e. a higher score indicates a worse outcome).
The mean score for each time point is presented.
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Visit 1 (Baseline), Visit 7 (4-weeks post-Start of Treatment [SOT]), and Visit 11 (8-weeks post-SOT)
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Pain Medication Usage
Time Frame: Baseline, 1 to 4 weeks post-start of treatment (SOT), 5 to 8 weeks post-SOT, 3 months post-SOT, 6 months post-SOT, and 12 months post-SOT
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Subjects completed 7-day diaries in which they tracked their daily use of analgesic medications.
Opioid analgesic usage was converted into a morphine equivalent dosage (MED), which is measured in units of morphine milligram equivalents (MME), for subjects who were using opioid analgesics at baseline.
The average MED was calculated for each subject at each time point.
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Baseline, 1 to 4 weeks post-start of treatment (SOT), 5 to 8 weeks post-SOT, 3 months post-SOT, 6 months post-SOT, and 12 months post-SOT
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Number of Subjects With ≥ 50% Reduction in Average Post-Amputation Pain (Residual Limb Pain [RLP] and/or Phantom Limb Pain [PLP]) 1 to 4 Weeks After Start of Treatment
Time Frame: Baseline and 1 to 4 weeks post-start of treatment (SOT)
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All subjects were asked to complete daily diaries to record their average residual limb pain and/or phantom pain intensities during the past 24 hours on each day of a 7-day period using an 11-point numerical rating scale where 0 represents "No Pain" and 10 represents "Pain as bad as you can imagine."
The average pain scores were calculated across the 7-day period for each region of pain at baseline and across weeks 1 to 4 post-start of treatment (i.e., the first half of the 8-week treatment period).
Percent reduction was then calculated for each subject's qualifying region of pain (residual limb and/or phantom limb pain with qualifying average pain intensity at baseline).
To be considered a success, subjects must have experienced ≥ 50% reduction in all qualifying regions of pain compared to their 7-day baseline diary average pain score(s).
The number of successes is presented.
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Baseline and 1 to 4 weeks post-start of treatment (SOT)
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Number of Subjects With ≥ 50% Reduction in Average Residual Limb Pain (RLP) 5 to 8 Weeks After Start of Treatment
Time Frame: Baseline and 5 to 8 weeks post-start of treatment (SOT)
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All subjects were asked to complete daily diaries to record their average residual limb pain and/or phantom pain intensities during the past 24 hours on each day of a 7-day period using an 11-point numerical rating scale where 0 represents "No Pain" and 10 represents "Pain as bad as you can imagine."
The average residual limb pain scores were calculated across the 7-day period at baseline and for weeks 5 to 8 post-start of treatment (for subjects with qualifying residual limb average pain intensity at baseline).
Percent reduction from baseline was then calculated, and the number of subjects that experienced ≥ 50% reduction in residual limb pain are reported.
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Baseline and 5 to 8 weeks post-start of treatment (SOT)
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Number of Subjects With ≥ 50% Reduction in Average Phantom Limb Pain (PLP) 5 to 8 Weeks After Start of Treatment
Time Frame: Baseline and 5 to 8 weeks post-start of treatment (SOT)
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All subjects were asked to complete daily diaries to record their average residual limb pain and/or phantom pain intensities during the past 24 hours on each day of a 7-day period using an 11-point numerical rating scale where 0 represents "No Pain" and 10 represents "Pain as bad as you can imagine."
The average phantom limb pain scores were calculated across the 7-day period at baseline and for weeks 5 to 8 post-start of treatment (for subjects with qualifying phantom limb average pain intensity at baseline).
Percent reduction from baseline was then calculated, and the number of subjects that experienced ≥ 50% reduction in phantom limb pain are reported.
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Baseline and 5 to 8 weeks post-start of treatment (SOT)
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Durability of Treatment Effect on Average Post-Amputation Pain Intensity (Residual Limb Pain [RLP] and/or Phantom Limb Pain [PLP])
Time Frame: Baseline, 3-months post-Start of Treatment (SOT), 6-months post-SOT, and 12-months post-SOT
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All subjects were asked to complete daily diaries to record their average residual limb pain and/or phantom limb pain intensities during the past 24 hours on each day of a 7-day period using an 11-point numerical rating scale where 0 represents "No Pain" and 10 represents "Pain as bad as you can imagine."
The average pain scores were calculated across the 7-day period for each region of pain at baseline and at 3, 6, and 12 months post-start of treatment.
Percent reduction was then calculated for each subject's qualifying region of pain (residual limb and/or phantom limb pain with qualifying average pain intensity at baseline) at each time point.
To be considered a success, subjects must have experienced ≥ 50% reduction in all qualifying regions of pain compared to their 7-day baseline diary average pain score(s).
The number of successes is presented.
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Baseline, 3-months post-Start of Treatment (SOT), 6-months post-SOT, and 12-months post-SOT
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
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)
December 18, 2018
Primary Completion (Actual)
September 22, 2022
Study Completion (Actual)
September 22, 2022
Study Registration Dates
First Submitted
December 19, 2018
First Submitted That Met QC Criteria
December 19, 2018
First Posted (Actual)
December 21, 2018
Study Record Updates
Last Update Posted (Actual)
November 29, 2023
Last Update Submitted That Met QC Criteria
November 3, 2023
Last Verified
November 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- 0147-CSP-000
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
Yes
product manufactured in and exported from the U.S.
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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