Differential Target Multiplexed Spinal Cord Stimulation (DTM-SCS®) Real World Outcomes

The UPGRADE Study: Real World Outcomes® of Differential Target Multiplexed (DTM-SCS®) Stimulation in Existing and New Medtronic Implants

The UPGRADE registry will capture long-term, real-world outcomes to understand the effect of Differential Target Multiplexed (DTM®) programming in the Spinal Cord Stimulation (SCS) implanted population on the management of chronic pain, primarily on its use for trunk and/or limb pain. The clinical study is sponsored by Celéri Health and is funded through a financial grant from Medtronic's External Research Program. The registry study will be conducted across approximately 25 centers in the United States with up to 600 participants enrolled.

Study Overview

• Status: Completed
• Conditions: Chronic Pain
• Intervention / Treatment: Device: Medtronic Intellis™ and Vanta™

Detailed Description

This clinical investigation is a prospective, observational, open-label, non-randomized, multi-center study. It is designed to collect clinical follow-up data on Differential Target Multiplexed (DTM®) programming that is available in Medtronic's Intellis™ and Vanta™ spinal cord stimulators, which has shown superiority to conventional programming parameters in a randomized controlled trial (NCT03606187).

Participants currently implanted with a permanent neurostimulation system, whom are planned for conversion to DTM® programming as well as newly identified participants planned to undergo a trial of neurostimulation using DTM® will be eligible to participate in this study. Data will be collected at baseline prior to DTM® programming exposure.

Participants who continue to meet eligibility criteria and have had their implanted DTM programming activated will enter a follow-up period for up to 24 months, where participant self-reported questionnaires will be assessed each month with study visits to occur at months 12 and 24.

Throughout the study, objective functional data will be collected automatically as part of the Medtronic device interrogation.

• Study Type: Observational
• Enrollment (Actual): 255

Contacts and Locations

Study Locations

• United States
  • Alaska
    • Anchorage, Alaska, United States, 99508
      • Neuroversion
  • Arizona
    • Oro Valley, Arizona, United States, 85755
      • Desert Sky Spine & Sports Medicine
    • Sierra Vista, Arizona, United States, 85635
      • Desert Sky Spine & Sports Medicine
  • California
    • Buena Park, California, United States, 90621
      • NuVation Pain Group - Buena Park
    • Los Angeles, California, United States, 90020
      • NuVation Pain Group - Los Angeles
    • Orange, California, United States, 92801
      • Spine and Sports Specialty Medical Group
    • Roseville, California, United States, 95661
      • Spine & Nerve Diagnostic Center - Roseville
  • Florida
    • Brandon, Florida, United States, 33511
      • Florida Pain Medicine - Brandon
    • Fleming Island, Florida, United States, 32003
      • Jax Spine & Pain Centers - Fleming Island
    • Jacksonville, Florida, United States, 32218
      • Jax Spine & Pain Centers - UF North
    • Jacksonville, Florida, United States, 32256
      • Jax Spine & Pain Centers - Jacksonville
    • Riverview, Florida, United States, 33569
      • Florida Spine & Pain Specialists
    • Saint Augustine, Florida, United States, 32080
      • Jax Spine & Pain Centers -St. Augustine
    • Wesley Chapel, Florida, United States, 33544
      • Florida Pain Medicine - Wesley Chapel
    • Winter Park, Florida, United States, 32789
      • National Spine and Pain Centers - Winter Park, FL
  • Georgia
    • Waycross, Georgia, United States, 31501
      • Centurion Spine & Pain Centers (Jax Spine)
  • Illinois
    • Bloomington, Illinois, United States, 61704
      • Millennium Pain Center (National Spine and Pain Centers - Bloomington, IL)
  • Maryland
    • Oxon Hill, Maryland, United States, 20745
      • National Spine and Pain Centers - National Harbor (Oxon Hill)
    • Pikesville, Maryland, United States, 21208
      • National Spine and Pain Centers - Pikesville, MD
  • Nevada
    • Henderson, Nevada, United States, 89052
      • Comprehensive and Interventional Pain Management
  • New Jersey
    • Voorhees, New Jersey, United States, 08043
      • National Spine and Pain Centers - The Pain Management Center - Voorhees
  • North Carolina
    • Charlotte, North Carolina, United States, 28262
      • Carolinas Research Institute - Mallard Creek
    • Huntersville, North Carolina, United States, 28078
      • Carolinas Research Institute - Huntersville
  • Ohio
    • Hillsboro, Ohio, United States, 45133
      • Premier Pain Treatment Institute - Hillsboro
    • Loveland, Ohio, United States, 45140
      • Premier Pain Treatment Institute - Loveland
    • Mount Orab, Ohio, United States, 45154
      • Premier Pain Treatment Institute - Mt. Orab
  • Oklahoma
    • Norman, Oklahoma, United States, 73072
      • Oklahoma Pain Physicians - Norman
    • Oklahoma City, Oklahoma, United States, 73120
      • Oklahoma Pain Physicians - Oklahoma City
    • Purcell, Oklahoma, United States, 73080
      • Oklahoma Pain Physicians - Purcell
  • Texas
    • Fort Worth, Texas, United States, 76244
      • North Texas Orthopedics & Spine Center- Keller/Alliance
    • Grapevine, Texas, United States, 76051
      • North Texas Orthopedics & Spine Center - Grapevine
    • Tyler, Texas, United States, 75701
      • Precision Spine Care
  • Virginia
    • Winchester, Virginia, United States, 22601
      • Valley Pain Consultants
  • Washington
    • Spokane, Washington, United States, 99201
      • Northwest Pain Care

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Participant has a permanent Medtronic Intellis™ neurostimulation system implanted or is planning to be implanted with a Medtronic Intellis™ or Vanta™ neurostimulation system and is a candidate for Differential Target Multiplexed (DTM®) programming for the management of chronic pain, primarily on its use for trunk and/or limb pain.

Description

Inclusion Criteria:

1. Participant must provide written informed consent prior to any clinical study-related procedure.
2. Participant is at least 18 years (or the minimum age required by local law to consent for participation in a clinical investigation) or older at the time of enrollment.
3. Participant has a permanent Medtronic Intellis™ neurostimulation system implanted or is planning to be implanted with a Medtronic Intellis™ or Vanta™ neurostimulation system.
4. Participant has access to an iPhone or Android capable device and/or computer with regular internet access for the purposes of electronically completing web-based participant self-reported questionnaires via SMS text or email.

Exclusion Criteria:

1. Participant is unable to provide written informed consent or to comply with study-related requirements, procedures, and visits.
2. Participant is a profound responder for all pain areas to existing neurostimulation therapy (≥80% reported relief).
3. Participant is enrolled, or intends to participate, in a clinical drug and/or device study (investigational device, investigational drug, new indication for a device or drug, or additional testing beyond standard of care procedures) which could confound the results of this trial as determined by the investigator.
4. Presence of other anatomic or comorbid conditions, or other medical, social, or psychological conditions that, in the investigator's opinion, could limit the participant's ability to participate in the clinical investigation or to comply with follow-up requirements.
5. Participant is pregnant or nursing.

Study Plan

How is the study designed?

Design Details

• Observational Models: Other
• Time Perspectives: Prospective

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
To evaluate the Pain Impact Score as measured by the PROMIS-29 before and after introduction of Differential Target Multiplexed (DTM®) stimulation programming in a real-world population.	24 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
To characterize the responder rate for pain by pain area per Percent Pain Relief for DTM-SCS® compared to participant baseline treatment.		24 months
To characterize the responder rate for pain by pain area per Numeric Rating Scale for DTM-SCS® compared to participant baseline treatment.		24 months
To evaluate the longitudinal characterization of objective posture and activity measures.	Time spent in each activity/position (Intellis™ device data)	24 months
To characterize Patient Global Impression of Change (PGIC) with neurostimulation.		24 months
To evaluate the performance of the DTM® pre-programming questionnaire in predicting outcome of DTM-SCS® programming.		24 months
To characterize the neuropathic pain quality using PROMIS-Neuropathic Pain Quality (PROMIS-PQ-Neuro) before and after treatment.		24 months

Collaborators and Investigators

• Sponsor: Celéri Health, Inc.
• Collaborators: Medtronic
• Investigators: Study Director: Michael Fishman, MD, Chief Medical Officer

Publications and helpful links

Helpful Links

• Sponsor Website

Study record dates

Study Major Dates

• Study Start (Actual): January 29, 2021
• Primary Completion (Actual): July 1, 2023
• Study Completion (Actual): July 1, 2023

Study Registration Dates

• First Submitted: January 19, 2021
• First Submitted That Met QC Criteria: January 21, 2021
• First Posted (Actual): January 27, 2021

Study Record Updates

• Last Update Posted (Actual): August 21, 2024
• Last Update Submitted That Met QC Criteria: August 20, 2024
• Last Verified: August 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Chronic Pain
• Other Study ID Numbers: UPGRADE

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