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Transcutaneous Auricular Vagal Neuromodulation Therapy (AVNT™) in Chronic Kidney Disease Autonomic Dysfunction

4 november 2026 bijgewerkt door: NYU Langone Health

Feasibility and Preliminary Efficacy of Transcutaneous Auricular Vagal Neuromodulation Therapy (AVNT™) in Chronic Kidney Disease Autonomic Dysfunction: A Randomized, Sham-Controlled Pilot Trial (Parasym-CKD)

The purpose of this pilot study is to establish the feasibility of home-based Auricular Vagal Neuromodulation Therapy (AVNT™) in Chronic Kidney Disease (CKD) patients, generate preliminary efficacy data on autonomic function outcomes, and explore whether timing variation influences treatment response.

Studie Overzicht

Toestand

Nog niet aan het werven

Conditie

Interventie / Behandeling

Studietype

Ingrijpend

Inschrijving (Geschat)

30

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

Studie Locaties

    • New York
      • New York, New York, Verenigde Staten, 10016
        • NYU Langone Health

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

18 jaar en ouder (Volwassen, Oudere volwassene)

Accepteert gezonde vrijwilligers

Nee

Geslachten die in aanmerking komen voor studie

Allemaal

Beschrijving

Inclusion Criteria:

  1. Age ≥18 years at time of informed consent
  2. Documented Chronic Kidney Disease (CKD) stage G3-G5 (estimated Glomerular Filtration Rate (eGFR) 15-59 mL/min/1.73 m²), not on maintenance dialysis, based on eGFR or clinical documentation
  3. Patients at New York University (NYU) clinics who meet criteria
  4. Non NYU patients reaching out study team via iConnect
  5. Clinically stable: No hospitalization, acute kidney injury, or acute illness requiring medical intervention within prior 4 weeks
  6. Stable dosing of autonomically active medications: participants taking beta-blockers, other rate-controlling agents, anticholinergics, or sympathomimetics must be on a stable dose for ≥4 weeks before baseline with no anticipated changes during the study. Use of these agents is recorded and included as a covariate in analyses of heart-rate-based endpoints. Autonomically active medications: agents that materially affect heart rate, blood pressure, or autonomic tone - beta-blockers, non-dihydropyridine calcium-channel blockers, alpha-blockers, central sympatholytics (e.g., clonidine), midodrine, fludrocortisone, anticholinergics, sympathomimetics/stimulants, serotonin-norepinephrine reuptake inhibitors (SNRIs)/selective serotonin reuptake inhibitors (SSRIs), and diuretics are recorded with agent, dose, and timing, must be stable for ≥4 weeks before baseline with no anticipated change during the study, and are included as covariates. Home measurements are taken at a consistent time relative to the participant's usual dosing.

Exclusion Criteria:

  1. Implantable cardioverter-defibrillator (ICD) or other implanted cardiac device

  2. Known severe coronary disease (≥70% stenosis in major vessel) or myocardial infarction within past 5 years

  3. Hospitalized within 4 weeks

  4. Syncope or unexplained loss of consciousness within past 12 months

  5. Uncontrolled arrhythmia (atrial fibrillation with resting heart rate >110 bpm, recent runs of sustained ventricular tachycardia or supraventricular tachycardia) within 3 months.

  6. Severe bradycardia (<40 bpm at rest, symptomatic) , or second- or third-degree atrioventricular (AV) block without a functioning pacemaker

  7. Neurological/Anatomical Exclusions:

  8. History of vagotomy (surgical cutting of vagus nerve)

  9. Trigeminal neuralgia within 1 year

  10. Epilepsy or seizure disorder (unless well-controlled defined as seizure free with stable dose of medication for ≥2 years)

  11. Dementia or cognitive impairment preventing informed consent or study compliance

    Renal/General Medical Exclusions:

  12. End-stage kidney disease (ESKD) on maintenance hemodialysis or peritoneal dialysis

  13. Pregnancy or breastfeeding

  14. Active malignancy (except non-melanoma skin cancer)

  15. Severe hepatic disease (Child-Pugh Class C cirrhosis)

  16. Immunosuppression (within 8 weeks of enrollment) or active immunosuppressive therapy

    Skin/Electrode-Related Exclusions:

  17. Active infection or severe lesions at tragus preventing electrode placement

  18. Known allergy to gold or electrode materials

  19. Implanted device at <2 cm proximity to ear tragus (e.g., cochlear implant, cerebral shunt, invasive Vagus Nerve Stimulation (VNS))

    Substance Use/Other:

  20. Active substance uses disorder (within 1 year) or alcohol use >14 drinks/week

  21. Participation in another clinical trial within 30 days

  22. Any condition that, in the investigator's judgment, would make participation unsafe or preclude compliance

  23. Prisoners

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Behandeling
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Faculteitstoewijzing
  • Masker: Dubbele

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Sham-vergelijker: Sham-AM

Participants will use the sham-device for 1 hr/day at 7:00 AM.

The device is equipped with a "ramp-down sham mode". In this mode, no electrical stimulation will occur for the remainder of the session and participant intensity adjustments are disabled. Participants will use the sham-device at home once daily for 60 minutes either in the morning at 7am or in the evening at 7pm.

Sham-vergelijker: Sham-PM

Participants will use the sham-device for 1 hr/day at 7:00 PM.

The device is equipped with a "ramp-down sham mode". In this mode, no electrical stimulation will occur for the remainder of the session and participant intensity adjustments are disabled. Participants will use the sham-device at home once daily for 60 minutes either in the morning at 7am or in the evening at 7pm.

Experimenteel: Active-AM

Participants will use the active AVNT device for 1 hr/day at 7:00 AM.

The device consists of a handheld stimulation unit (~2 inches) connected to a tragus earpiece electrode (worn like an in-ear headphone, removed after each session). Participants will undergo AVNT™ at home once daily for 60 minutes either in the morning at 7am or in the evening at 7pm at a pulse width of 250 μs, frequency of 20 Hz, and comfortable, patient-titrated intensity based on personalized perceptual thresholds.

Andere namen:
  • Nurosym
Experimenteel: Active-PM

Participants will use the active AVNT device for 1 hr/day at 7:00 PM.

The device consists of a handheld stimulation unit (~2 inches) connected to a tragus earpiece electrode (worn like an in-ear headphone, removed after each session). Participants will undergo AVNT™ at home once daily for 60 minutes either in the morning at 7am or in the evening at 7pm at a pulse width of 250 μs, frequency of 20 Hz, and comfortable, patient-titrated intensity based on personalized perceptual thresholds.

Andere namen:
  • Nurosym

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in Orthostatic Heart Rate Response
Tijdsspanne: Week 0, Week 2

Difference in standing heart rate at 1 minute minus baseline seated heart rate, averaged across daily home measurements in Week 0 (baseline) and last 3-5 days of Week 2 (post-intervention).

Week 0, Week 2

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Change in high-sensitivity C-reactive protein (hs-CRP) (pg/mL)
Tijdsspanne: Week 0, Week 2
Week 0, Week 2
Change in Interleukin-6 (IL-6) (pg/mL)
Tijdsspanne: Week 0, Week 2
Week 0, Week 2
Change in Urine Albumin-Creatinine Ratio (UACR) (mg/g creatinine)
Tijdsspanne: Week 0, Week 2
Week 0, Week 2
Change in Composite Autonomic Symptom Score-31 (COMPASS-31)
Tijdsspanne: Week 0, Week 2

The COMPASS-31 is a 31-item, self-administered clinical questionnaire used to measure the severity and distribution of autonomic nervous system symptoms (dysautonomia). Scores range from 0 to 100, where higher scores indicate worse autonomic dysfunction.

Week 0, Week 2
Percentage of participants who achieved ≥85% prescribed minutes (714 of 840 min)
Tijdsspanne: Week 2
Week 2
Percentage of patients that completed ≥70% of scheduled autonomic measurements
Tijdsspanne: Week 2
Week 2

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Onderzoekers

  • Hoofdonderzoeker: Qandeel Soomro, MD, MS, NYU Langone Health

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Geschat)

1 november 2026

Primaire voltooiing (Geschat)

1 januari 2028

Studie voltooiing (Geschat)

1 januari 2028

Studieregistratiedata

Eerst ingediend

4 november 2026

Eerst ingediend dat voldeed aan de QC-criteria

4 november 2026

Eerst geplaatst (Werkelijk)

10 november 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

10 november 2026

Laatste update ingediend die voldeed aan QC-criteria

4 november 2026

Laatst geverifieerd

1 oktober 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • 26-00938

Plan Individuele Deelnemersgegevens (IPD)

Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?

JA

Beschrijving IPD-plan

The de-identified participant data from the final research dataset will be shared upon reasonable request beginning 9 to 36 months after publication or as required by a condition of awards or supporting agreements, provided the requesting investigator executes a data use agreement with NYU Langone Health. This instance of data sharing will also require separate IRB review as well as review from NYU Langone's Data Sharing Strategy Board (DSSB). Requests should be directed to: Qandeel.Soomro@nyulangone.org. The protocol and statistical analysis plan will be posted on Clinicaltrials.gov only as required by federal regulation or supporting awards and agreements.

IPD-tijdsbestek voor delen

Beginning 9 months and ending 36 months following article publication or as required by a condition of awards and agreements supporting the research.

IPD-toegangscriteria voor delen

The investigator who proposed to use the data will be granted access upon reasonable request. Requests should be directed to Qandeel.Soomro@nyulangone.org. To gain access, data requestors will need to sign a data access agreement. This instance of data sharing will also require separate IRB review as well as review from NYU Langone's DSSB.

IPD delen Ondersteunend informatietype

  • LEERPROTOCOOL
  • SAP

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Ja

product vervaardigd in en geëxporteerd uit de V.S.

Nee

Deze informatie is zonder wijzigingen rechtstreeks van de website clinicaltrials.gov gehaald. Als u verzoeken heeft om uw onderzoeksgegevens te wijzigen, te verwijderen of bij te werken, neem dan contact op met register@clinicaltrials.gov. Zodra er een wijziging wordt doorgevoerd op clinicaltrials.gov, wordt deze ook automatisch bijgewerkt op onze website .