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Diabetic Neuropathy PeripheralRELIEFNCT03455543

Dual Field PEMF Therapy in Lower Extremity Painful Diabetic Distal Symmetric Peripheral Neuropathy

A study testing Active Provant Therapy System in people with Diabetic Neuropathy Peripheral, run by Regenesis Biomedical, Inc. at 18 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Part A of this trial is a multi-center, prospective, double-blinded, sham-controlled, randomized clinical trial. Part A will evaluate PEMF treatment compared to sham treatment in patients with painful diabetic distal symmetric peripheral neuropathy (DSPN) when treatment is administered 30 minutes twice daily through a… Read more about this study

Who is it for?
Ages 22 to 80 years
Conditions the study is for
Diabetic Neuropathy Peripheral
What is being tested?
Active Provant Therapy System
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
182 participants
Where
18 sitesUnited States
Study dates
26 Mar 2018to 18 Jul 2019
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 22 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Type 1 or Type 2 diabetes
  • Pain attributed to symmetrical lower extremity diabetic peripheral neuropathy for at least 6 months
  • DPN pain over the preceding 24 hours is ≥4 and <9 based on the 11-point NPRS (0-10)
  • 22 to 80 years of age
  • On stable diabetes treatment
  • HbA1c less than or equal to 10%
Show all 13Show fewer
  • No recent changes to analgesic prescriptions
  • ABI of ≥0.8 to ≤1.3
  • Walks independently
  • Willing and able to give consent
  • If female, must be post-menopausal, surgically sterile, abstinent or practicing an effective method of birth control
  • Can access an internet browser or smart phone
  • To be randomized after the 14-day run-in period, average pain (NPRS) must be ≥ 4 and < 9 over preceding 7 days and subject must be 70% compliant with ePRO assessments (electronic diary)

Who cannot join

  • Active, open ulcer on either extremity
  • Significant peripheral vascular disease
  • Venous insufficiency
  • History of solid organ transplant or severe renal disease
  • Diagnosed with a non-diabetic cause of chronic neuropathy
  • Previous or current history of primary or tertiary hyperparathyroidism, hypercalcemia, psychiatric disorder, alcohol dependency, Hepatitis B or C, or HIV infection
Show all 25Show fewer
  • Significant cardiovascular disease
  • Uncontrolled medical illness
  • Requires or anticipates the need for surgery during the study
  • Total foot depth of >8 cm
  • Has received any investigational drug or device within 30 days
  • Has used systemic corticosteroids within 3 months
  • History of malignancy within 5 years in treatment area
  • A psychiatric disorder of sufficient severity
  • Receiving prn narcotic medications
  • History of drug or alcohol abuse within 1 year
  • Implanted pacemaker, defibrillator, neurostimulator, spinal cord stimulator, bone stimulator, cochlear implant, or other implanted device with an implanted metal lead(s0
  • Pregnant or planning to become pregnant
  • Previous treatment with Provant Therapy
  • Unwilling to follow instructions or comply with study instructions
  • Pain from any other source that could confuse DPN pain assessment
  • Clinically significant foot deformity
  • Skin condition that could alter peripheral sensations
  • Previous surgery to the spine or lower extremity with residual symptoms of pain or difficulty with movement.
  • Clinically significant arthropathy

Trial locations and contacts

18 sites in 1 country.

18 sites in 1 country

United States18 sites
  • River Birch Research Alliance, LLC

    Blue Ridge, Georgia, 30514

  • Wake Family Medicine, PC

    Cary, North Carolina, 27513

  • Mountain View Clinical Research

    Denver, Colorado, 80209

  • Lake Internal Medicine Associates

    Eustis, Florida, 32726

  • MediSphere Medical Research Center, LLC

    Evansville, Indiana, 47714

  • Clinical Physiology Associates

    Fort Myers, Florida, 33912

  • Healthcare Research Network

    Hazelwood, Missouri, 63042

  • The Center for Pharmaceutical Research, LLC

    Kansas City, Missouri, 64114

  • Palm Research Center

    Las Vegas, Nevada, 89128

  • Physician's Research Group

    Mesa, Arizona, 85206

  • Spotlight Research Center

    Miami, Florida, 33176

  • Valley Clinical Research

    Northridge, California, 91325

  • Rainier Clinical Research

    Renton, Washington, 98057

  • Northern California Research

    Sacramento, California, 95821

  • Diabetes Research Center

    Tustin, California, 92780

  • Great Lakes Medical Resarch

    Westfield, New York, 14787

  • Heartland Research Associate, LLC

    Wichita, Kansas, 67207

  • Clinical Research of Central Florida

    Winter Haven, Florida, 33880

Other trials in United States

About this study

Official title: A Multi-Center, Double-Blind, Sham-Controlled, Randomized Trial of Dual Field PEMF Therapy [Provant® Therapy System] in Lower Extremity Painful Diabetic Distal Symmetric Peripheral Neuropathy (DSPN) (The RELIEF Trial)

Part A of this trial is a multi-center, prospective, double-blinded, sham-controlled, randomized clinical trial. Part A will evaluate PEMF treatment compared to sham treatment in patients with painful diabetic distal symmetric peripheral neuropathy (DSPN) when treatment is administered 30 minutes twice daily through a 120-day period (4 months). Part B is a 8-month open-label active treatment extension period designed to collect longer-term data on pain, medication use, quality of life and safety (Part B).Part B of this trial is a an extension period upon completion of Part A.

Read the detailed description

Eligible subjects will be entered into a 14-day ePRO diary run-in period to collect average baseline pain scores related to their diabetic neuropathy in the lower extremities, diary compliance, and analgesic consumption (maintenance and prn prescribed peripheral neuropathic pain medication pill counts). Subjects will collect electronic patient-reported outcome (ePRO) data each morning around the same time during the run-in period.

Subjects will return to the clinic at Baseline (Day 0) for review of eligibility, diary compliance, average baseline diabetic neuropathic pain score of ≥4 and <9, and review of stable analgesic pain consumption profile during the 14-day run-in period. Qualified subjects based on diary compliance and average pain score will be randomized 1:1 (active: sham) and will be instructed to self-treat twice daily for 120 days. Subjects will record electronic patient-reported outcome (ePRO) data following each morning treatment for 120 days. Subjects consenting to distal thigh and distal leg skin biopsies during the Screening visit will have biopsies collected and sent to the central laboratory for assessment. All subjects will have baseline assessments conducted.

Subjects will receive a telephone call at Day 7 to ensure compliance to treatment and diary completion, provide follow-up information on the biopsy sites (if applicable), complete a blinding assessment as well as be assessed for safety and concomitant medication changes.

At Month 1 subjects will return to the clinic for evaluation of safety, concomitant medication changes, review device usage and ePRO diary completion, and Patient Global Impression (PGI). Treatment satisfaction will also be assessed.

At Month 2 subjects will return to the clinic for evaluation of safety, concomitant medication changes, treatment satisfaction, review of device usage (reports will be supplied to the site) and ePRO diary completion, quality of life outcomes (WPAIQ and NeuroQoL), Patient Global Impression (PGI), and interim visit measurements of SPP.

At Month 3, subjects will return to the clinic for evaluation of safety, concomitant medication changes, review device usage (reports will be supplied to the site) and ePRO diary completion, and Patient Global Impression (PGI). Treatment satisfaction will also be assessed.

At Month 4 (end of Part A / start of Part B), subjects will return to the clinic for evaluation of safety, treatment satisfaction, review of device usage (reports will be supplied to the site), HbA1c, concomitant medication changes, weight, quality of life outcomes (WPAIQ and NeuroQoL), PGI, final measurements of SPP, NCS, QST and be assessed to determine their Toronto Clinical Neuropathy Score. Those subjects who consented and had biopsies collected at the Enrollment visit, will have their end of study biopsies during this visit and samples sent directly to the central laboratory for assessment. Subjects will return the study device and complete a blinding assessment.

Subjects that complete Part A will continue into the open-label extension period (Part B). All subjects will be reconsented if not completed at a prior visit and given an open-label active device. Subjects will record ePRO data for one week prior to the Month 6, 8, 10, and 12 visits following each morning treatment. Subjects will be reminded of the150-day (Month 5) phone call.

At Month 5, subjects will receive a telephone call to ensure compliance to treatment, and to be assessed for safety and concomitant medication changes.

At Month 6, subjects will receive a telephone call to ensure treatment compliance and collection of diary data, and to assess safety and concomitant medication changes.

At Month 7, subjects will receive a telephone call to ensure treatment compliance, and to assess safety and concomitant medication changes.

At Month 8, subjects will return to the clinic for evaluation of safety, measure QST, treatment satisfaction, review of device usage and collection of diary data, concomitant medication changes, quality of life outcomes (NeuroQoL), and PGI.

At Month 9, subjects will receive a telephone call to ensure treatment compliance, and to assess safety and concomitant medication changes.

At Month 10, subjects will receive a telephone call to ensure treatment compliance and collection of diary data, and to assess safety and concomitant medication changes.

At Month 11, subjects will receive a telephone call to ensure treatment compliance, and to assess safety and concomitant medication changes.

At Month 12 (end of open-label treatment extension), subjects will return to the clinic for evaluation of safety, weight, QST, NCS, TCNSS, PGI, treatment satisfaction, review of device usage and collection of diary data, concomitant medication changes, quality of life outcomes (NeuroQoL), and will return the study device. Subjects who consented and had biopsies collected at the 4 Month visit, will have their end of study biopsies performed during this visit.

Being tested
Active Provant Therapy System, Inactive (sham) Provant Therapy System

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Active Provant Therapy SystemDevice

    Treatment with active Provant Therapy System

  • Inactive (sham) Provant Therapy SystemDevice

    Treatment with inactive Provant Therapy System

Study groups in NCT03455543
Study groupRoleWhat they receive
Active GroupExperimentalTreatment with active Provant Therapy System
Receives: Device: Active Provant Therapy System
Sham GroupSham comparatorTreatment with in-active (sham) Provant Therapy System
Receives: Device: Inactive (sham) Provant Therapy System

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Pain Intensity

    Absolute change in pain intensity as measured by the 11-point, numerical pain rating scale (NPRS) (0-10; where 0=no pain, to 10=worst possible pain).

    Measured: Baseline through 4 months

Secondary outcomes (8)
  1. Patients With 2 Point or 30% Reduction in Pain at 4 Months

    Percentage of patients who have either a 2 point or 30% reduction in (pain) NPRS at 4 Months.

    Absolute change in pain intensity as measured by the 11-point, numerical pain rating scale (NPRS) (0-10; where 0=no pain, to 10=worst possible pain).

    Measured: Baseline to 4 months

  2. Patient Global Impression at 4 Months

    Patient Global Impression at 4 Months. The question assesses change since the start of the study on a 7-point scale ("Since the start of the study, how has your diabetic neuropathy in your legs changed?"), and to score it as either very much worse, much worse, minimally worse, no change, minimally improved, much improved or very much improved.

    Measured: Baseline through 4 months.

  3. Time to 30% or 2-point Reduction in NPRS, Whichever Comes First, Through 4 Months

    Absolute change in pain intensity as measured by the 11-point, numerical pain rating scale (NPRS) (0-10; where 0=no pain, to 10=worst possible pain). Number of participants achieving a 30% or 2-point reduction at or prior to weeks 1, 4, 8, 12 and 17 are displayed below.

    Measured: Through 4 months

  4. Change in Neuropathy Related Quality of Life (NeuroQoL) Between Baseline and End of Treatment at 4 Months.

    A validated set of health-related quality of life measures that are domain specific.Subjects will completed 6 domains: (1) Pain, (2) Lost/Reduced Feeling, (3) Diffuse Sensory Motor Symptoms, (4) Restrictions in Activities of Daily Living, (5) Disruptions in Social Relationships, and (6) Emotional Distress.The short forms were completed by the subject at the Enrollment Visit and end of study visit (Day 121). Each question in the domain was rated on a symptom scale from 1 (never) to 5 (all the time) and a bothersome scale from 1 (none) to 3 (very much).

    The total score for the domain was calculated by multiplying the symptom score by the bothersome score. The scale range is from 1 to 15 where the minimum (best/least symptomatic) score is 1 and the maximum (worst/most symptomatic) score is 15. The mean change from Baseline to month 4 is displayed below.

    Measured: Baseline to 4 months

  5. Change is Skin Perfusion Pressure (SPP) for Baseline to End of Treatment at 4 Months

    SPP was measured at two locations on each foot (dorsal right and left and plantar right and left). Mean change displayed from Baseline to 4-months displayed below.

    SPP measures pressure in mmHg; an increase in pressure is favorable.

    • Normal SPP: 50 mmHg to 100 mmHg
    • Marginal Ischemia SPP: 30 mmHg to 50 mmHg
    • Critical Limb Ischemia / PAD SPP: < 30 mmHg

    Measured: Baseline to 4 months

  6. Changes in Nerve Conduction Studies of Velocity Between Baseline and End of Treatment at 4 Months.

    Using the NC-stat DPNCheck, the sural nerve conduction velocity was recorded on the right and left legs. An increase in velocity would suggest DPN improvement. The mean change from Baseline to 4-months is displayed below.

    Measured: Baseline to 4 Months

  7. Changes in Quantitative Sensory Testing (QST) Between Baseline and End of Treatment at 4 Months.

    Contact thermal stimulation will be delivered using the Medoc Ltd. Q-Sense system to assess cool sensation threshold, warm sensation threshold and heat pain threshold modalities using the method of limits. Within the cool and warm sensation modalities, the trial is repeated 4 times on each foot and 3 times on each foot for heat pain threshold modality. The cool thermal testing will be conducted prior to the warm and heat pain thermal testing.

    Mean change from baseline to 4-months displayed below.

    Measured: Baseline to 4 months

  8. Changes in Nerve Conduction Studies of Amplitude Between Baseline and End of Treatment at 4 Months.

    Using the NC-stat DPNCheck, the sural nerve conduction amplitude was recorded on the right and left legs. An increase in amplitude would suggest DPN improvement. The mean change from Baseline to 4-months is displayed below.

    Measured: Baseline to 4 Months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted6 Mar 2018
  2. Study start26 Mar 2018
  3. Primary completion14 Nov 2018
  4. Study completion18 Jul 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Two parallel groups, active device group versus sham device group. Subjects will be randomized 1:1 at baseline and treat with active PEMF or sham for 4 months.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
182 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03455543
Sponsor's protocol ID
RBI.2017.002
Acronym
RELIEF
Status last verified
Jul 2020
First submitted
28 Feb 2018
Last updated
15 Jul 2020
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Tassone EE, Page JC, Slepian MJ. Assessing the Effects of Pulsed Electromagnetic Therapy on Painful Diabetic Distal Symmetric Peripheral Neuropathy: A Double-Blind Randomized Controlled Trial. J Diabetes Sci Technol. 2025 Mar;19(2):361-369. doi: 10.1177/19322968231190413. Epub 2023 Aug 4.

    PubMed 37542366

Questions about this trial

What is this clinical trial studying?

A study testing Active Provant Therapy System in people with Diabetic Neuropathy Peripheral, run by Regenesis Biomedical, Inc. at 18 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 13 inclusion and 25 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Jul 2020. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 18 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 9 Mar 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Pain Intensity (time frame: Baseline through 4 months). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03455543, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jul 2020.

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