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- Essai clinique NCT07725419
Transcutaneous Pulsed Radiofrequency for the Treatment of Diabetic Peripheral Neuropathy Pain
Can a Non-interventional Pulsed Radiofrequency Device Relieve Pain and Improve Function in Patients With Diabetic Neuropathy That Are Refractory to Medication? A Single Blind Randomized Placebo-controlled Trial
The purpose of this study is to determine if a non-invasive, electrical pulsed radio frequency (PRF) device can relieve pain and improve function in patients suffering from diabetic nerve pain in their feet, known as pedal diabetic peripheral neuropathy. Patients with this condition often experience severe pain, burning sensations, numbness, and tingling. Current medications for diabetic nerve pain often have unwanted side effects or do not provide sufficient relief.
In this single-blind, randomized trial, participants are assigned to receive either an active PRF treatment or a placebo (sham) treatment. Both treatments involve placing the device safely behind the knee (targeting the sciatic nerve) for 10 minutes, once a week for 3 weeks. The main question this study aims to answer is whether the active PRF treatment reduces nerve pain and symptoms significantly more than the placebo, measured by standard symptom questionnaires over a 6-month period.
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Diabetic peripheral neuropathy (DPN) is a common complication of diabetes, often presenting as a chronic, symmetrical, length-dependent sensorimotor polyneuropathy. Patients frequently experience neuropathic pain, hyperalgesia, allodynia, and paraesthesia in the lower extremities. Because pharmacological treatments for painful DPN are often ineffective and complicated by adverse side effects, there is a significant unmet clinical need for alternative, non-pharmacological therapies. This single-blind, randomized, placebo-controlled clinical trial evaluates the efficacy of a transcutaneous electrical pulsed radio frequency (PRF) device in alleviating the pain and sensory symptoms associated with pedal DPN.
Patients diagnosed with pedal DPN who scored 4 or higher on the DN4 neuropathic pain diagnostic test were randomized into two parallel groups: an active treatment group and a placebo group. To ensure successful patient blinding, participants were advised that they might not feel a physical sensation during the treatment, which aligns with the natural sensory loss (numbness/paraesthesia) commonly experienced by this patient population. Care providers and investigators administering the interventions were unblinded.
The treatment protocol involved mapping the sciatic nerve in the popliteal fossa posteriorly at the knee. The active or placebo device was then applied bilaterally at this site for 10 minutes. Interventions were administered once weekly for three consecutive weeks.
Clinical efficacy was assessed using validated patient-reported outcome measures. The primary outcome evaluated changes in neuropathic pain and symptoms using the DN4 test, while the secondary outcome measured pain severity and interference with daily life using the Brief Pain Inventory-Short Form (BPI-SF). Data was collected at baseline, immediately following the third treatment, and at subsequent follow-up visits at 1, 3, and 6 months to evaluate both immediate and sustained therapeutic effects.
Type d'étude
Inscription (Réel)
Phase
- N'est pas applicable
Contacts et emplacements
Lieux d'étude
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Gauteng
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Johannesburg, Gauteng, Afrique du Sud
- Centre for Diabetes and Endocrinology (CDE), Houghton
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Johannesburg, Gauteng, Afrique du Sud
- Clinical Sites - West Johannesburg
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Johannesburg, Gauteng, Afrique du Sud
- Diabetic Clinic at the Charlotte Maxeke Hospital
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Krugersdorp, Gauteng, Afrique du Sud
- Clinical Sites - Krugersdorp
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Pretoria, Gauteng, Afrique du Sud
- CDE / Clinical Sites - Pretoria
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Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
- Diagnosis of pedal Diabetic Peripheral Neuropathy.
- A score of 4 or greater than 4/10 on the DN4 Test.
- Naive to (no previous experience with) the electrical pulsed radio frequency current treatment.
Exclusion Criteria:
- Current pregnancy.
- Presence of a pacemaker.
- Presence of a peripheral or spinal cord stimulator.
- Presence of metal implants in the knee and/or hip.
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: Group A: Active Transcutaneous Pulsed Radio Frequency
Patients in this group received the active electrical pulsed radiofrequency current treatment.
The device was applied bilaterally at the sciatic nerve in the popliteal fossa.
Each treatment session lasted for 10 minutes.
The intervention was administered once weekly for three consecutive weeks.
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Active transcutaneous electrical pulsed radio frequency stimulation.
The device is applied bilaterally at the sciatic nerve in the popliteal fossa for 10 minutes, once weekly for 3 consecutive weeks.
Autres noms:
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Comparateur factice: Group B: Placebo / Sham Device
Patients in this group received a placebo (sham) treatment designed to mimic the active device.
The placebo device was applied bilaterally at the sciatic nerve in the popliteal fossa.
Each placebo session lasted for 10 minutes.
The sham intervention was administered once weekly for three consecutive weeks.
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A sham device designed to look and operate like the active device but delivering no therapeutic current.
It is applied bilaterally at the sciatic nerve in the popliteal fossa for 10 minutes, once weekly for 3 consecutive weeks to mimic the active treatment.
Autres noms:
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change in Neuropathic Pain and Symptoms as Measured by the DN4 Test
Délai: Baseline, prior to the third treatment (Week 3), and at 1, 3, and 6 months after the last treatment.
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The DN4 (Douleur Neuropathique 4) questionnaire is a screening tool used to identify neuropathic pain and symptoms.
It consists of 7 subjective questions regarding sensory symptoms (e.g., burning, painful cold, electric shocks, tingling, pins and needles, numbness) and 3 objective tests (hypoesthesia to touch, pinprick, and tactile allodynia).
The maximum score is 10 points.
A score of 4 or greater out of 10 represents a positive diagnosis of neuropathic pain.
Higher scores indicate a greater severity of neuropathic pain and symptoms.
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Baseline, prior to the third treatment (Week 3), and at 1, 3, and 6 months after the last treatment.
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Change in Pain Severity as Measured by the Brief Pain Inventory-Short Form (BPI-SF)
Délai: Baseline, after the first treatment (Week 1), second treatment (Week 2), third treatment (post-treatment at Week 3), and at 1, 3, and 6 months after the last treatment.
|
The BPI-SF is a validated patient-reported questionnaire that evaluates pain.
This outcome focuses on the Pain Severity subscale, which assesses worst, least, average, and present pain using an 11-point numerical rating scale.
Scores range from 0 to 10, where 0 equals "no pain" and 10 equals "pain as bad as you can imagine".
Higher scores indicate greater pain severity.
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Baseline, after the first treatment (Week 1), second treatment (Week 2), third treatment (post-treatment at Week 3), and at 1, 3, and 6 months after the last treatment.
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Change in Pain Interference as Measured by the Brief Pain Inventory-Short Form (BPI-SF)
Délai: Baseline, after the first treatment (Week 1), second treatment (Week 2), third treatment (post-treatment at Week 3), and at 1, 3, and 6 months after the last treatment.
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The BPI-SF also evaluates how much pain interferes with various aspects of the patient's daily life.
This includes general activities, work, sleep, walking ability, mood, relations with other people, and overall quality of life.
Interference is measured using an 11-point numerical rating scale ranging from 0 to 10, where 0 equals "does not interfere" and 10 equals "completely interferes".
Higher scores indicate greater interference with daily functioning.
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Baseline, after the first treatment (Week 1), second treatment (Week 2), third treatment (post-treatment at Week 3), and at 1, 3, and 6 months after the last treatment.
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Collaborateurs et enquêteurs
Parrainer
Collaborateurs
Les enquêteurs
- Chercheur principal: Phyllis P Berger, Faculty: University of the Witwatersrand
- Directeur d'études: Stanley S Landau, Centre for Diabetes and Endocrinology (CDE)
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Réel)
Achèvement primaire (Réel)
Achèvement de l'étude (Réel)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Mots clés
Termes MeSH pertinents supplémentaires
- La douleur
- Manifestations neurologiques
- Maladies du système endocrinien
- Maladies du système nerveux
- Maladies vasculaires
- Maladies cardiovasculaires
- Maladies neuromusculaires
- Maladies du système nerveux périphérique
- Diabète sucré
- Angiopathies diabétiques
- Complications du diabète
- Maladies de la peau
- Ulcère de la peau
- Ulcère de jambe
- Neuropathies diabétiques
- Ulcère du pied
- Conditions pathologiques, signes et symptômes
- Maladies de la peau et du tissu conjonctif
- Signes et symptômes
- Névralgie
- Pied diabétique
Autres numéros d'identification d'étude
- M161037
Plan pour les données individuelles des participants (IPD)
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Description du régime IPD
Informations sur les médicaments et les dispositifs, documents d'étude
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