RNS® System LTT Study

Phase 4

Completed

Conditions: Epilepsy

Interventions: Device: RNS® System

Registration Number: NCT00572195

Lead Sponsor: NeuroPace

Brief Summary: The RNS® System LTT study is designed to assess the ongoing safety and to evaluate the long-term efficacy of the RNS® System as an adjunctive therapy in reducing the frequency of seizures in individuals 18 years of age or older with partial onset seizures that are refractory to two or more antiepileptic medications. Candidates will continue to receive their epilepsy medications while participating in the trial.

Detailed Description: NeuroPace, Inc. is sponsoring an investigational device study of the RNS® System, the first closed loop responsive brain stimulator designed to treat refractory epilepsy. The RNS® System LTT study is an open-label multi-center prospective 7-year clinical investigation which follows completion of the RNS® System Pivotal or Feasibility study. Data regarding safety and efficacy are collected at 6-month intervals, and data regarding quality of life are collected at yearly intervals.

The study is designed to assess the ongoing safety and to evaluate the long-term efficacy of the RNS® System as an adjunctive therapy in reducing the frequency of medically uncontrolled and disabling partial onset seizures that start from one or two areas of the brain.

The RNS® System LTT study will provide additional data on the safety and efficacy of the RNS® System for 7 years following a subject's completion of the RNS® System Feasibility or Pivotal studies. Data from the RNS® System LTT study will be combined with data collected during the RNS® System Feasibility and Pivotal studies, resulting in 9 total years of post-implant follow-up data. These data will be used to calculate long-term SAE rate, percent change in seizure frequency (from pre-implant baseline), as well as the frequency of sudden unexplained death in epilepsy (SUDEP).

The RNS® Neurostimulator (a pacemaker-like device) and NeuroPace® Leads (tiny wires with electrodes) are implanted in the head. The Neurostimulator is a battery powered, microprocessor controlled device that detects and stores records of electrographic patterns (such as epileptiform, or seizure-like, activity) from the Leads within the brain. When the device detects an electrographic pattern, it responds by sending electrical stimulation through the Leads to a small part of the patient's brain to interrupt the electrographic pattern. This type of treatment is called responsive stimulation, but it is not yet known if it will work for the treatment of epilepsy. Direct brain stimulation therapy has already received approval in the United States, Europe, Canada, and Australia for the treatment of Essential Tremor and Parkinson's disease. Direct brain stimulation is not approved for the treatment of epilepsy.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 230

Inclusion Criteria

Subject has completed either the RNS® System Pivotal or Feasibility study
Subject has an implanted RNS® System
Subject has elected to continue to receive responsive neurostimulation therapy after completion of the RNS® System Pivotal or Feasibility study
Subject is able to attend scheduled appointments for the RNS® System LTT study

Exclusion Criteria

Subject has active psychiatric or medical illness that makes it inadvisable for the subject to continue to receive responsive neurostimulation therapy with the RNS® System
Subject has been diagnosed with psychogenic or non-epileptic seizures, or primarily generalized seizures during the RNS® System Pivotal or Feasibility study
Subject has been noncompliant with scheduled appointments during the RNS® System Pivotal or Feasibility study
Subject has been noncompliant with maintaining seizure diaries during the RNS® System Pivotal or Feasibility study
Informed consent cannot be obtained from subject or caregiver

Study & Design

Study Type: INTERVENTIONAL

Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Evaluation Group (stimulation ON)	RNS® System	Group of subjects that have an RNS® System implanted, completed the RNS® System Pivotal or Feasibility study, and elected to continue to receive RNS® System responsive stimulation for the long term.

Primary Outcome Measures

Name	Time	Method
Number of Participants With Serious Adverse Events (SAE)	2 years post-implant through 9 years post-implant (7 years)	The number of subjects having an SAE during the RNS® System LTT study.
Percentage Change From Baseline in Seizure Frequency	6 months post-implant through 9 years post-implant (8.5 years)	The average percentage change in the mean frequency of total disabling seizures relative to pre-implant baseline. The percent change will be calculated for each subject over 6-month intervals beginning 6 months after RNS® System implant and continuing through completion of the RNS® System LTT study.

Secondary Outcome Measures

Name	Time	Method
Responder Rate	6 months post-implant through 9 years post-implant (8.5 years)	The proportion of subjects with greater than or equal to 50% reduction in total disabling seizures compared to pre-implant baseline.
QOLIE (Quality of Life in Epilepsy)	1 year post-implant through 9 years post-implant (8 years)	QOLIE 89 (for English-speaking subjects) or QOLIE 31 P (for Spanish speaking subjects) scores collected at each year of follow-up after implantation of the RNS® System compared to the QOLIE 89 / QOLIE 31 P at pre-implant baseline. A QOLIE overall score was obtained using a weighted average of multi-item scale scores. The QOLIE overall score was converted to a T-score, a normally distributed scale with a mean score of 50 and standard deviation (SD) of 10. Higher scores reflect a better quality of life.
Adverse Event Rate	6 months post-implant through 9 years post-implant (8.5 years)	The rate of occurrence of any adverse event (AE) observed during the Long-term Treatment Investigation.

Trial Locations

Locations (33): University of Southern California
🇺🇸
Los Angeles, California, United States
Saint Barnabas Medical Center
🇺🇸
Livingston, New Jersey, United States
Johns Hopkins University School of Medicine
🇺🇸
Baltimore, Maryland, United States
University of Rochester
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Rochester, New York, United States
Wake Forest University Health Sciences
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Winston-Salem, North Carolina, United States
Dartmouth-Hitchcock Medical Center
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Lebanon, New Hampshire, United States
Baylor College of Medicine
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Houston, Texas, United States
University of Virginia
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Charlottesville, Virginia, United States
Mayo Clinic - Arizona
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Phoenix, Arizona, United States
Medical College of Georgia / Georgia Regents University
🇺🇸
Augusta, Georgia, United States
California Pacific Medical Center
🇺🇸
San Francisco, California, United States
Yale University School of Medicine
🇺🇸
New Haven, Connecticut, United States
Medical University of South Carolina
🇺🇸
Charleston, South Carolina, United States
Massachusetts General Hospital
🇺🇸
Boston, Massachusetts, United States
Louisiana State University Epilepsy Center of Excellence
🇺🇸
New Orleans, Louisiana, United States
Mayo Clinic - Jacksonville
🇺🇸
Jacksonville, Florida, United States
Swedish Medical Center
🇺🇸
Seattle, Washington, United States
Emory University
🇺🇸
Atlanta, Georgia, United States
Miami Children's Hospital
🇺🇸
Miami, Florida, United States
University of Texas Southwestern Medical Center
🇺🇸
Dallas, Texas, United States
Weill Medical College of Cornell University
🇺🇸
New York, New York, United States
Indiana University
🇺🇸
Indianapolis, Indiana, United States
Cleveland Clinic Foundation
🇺🇸
Cleveland, Ohio, United States
Henry Ford Hospital
🇺🇸
Detroit, Michigan, United States
Via Christi Comprehensive Epilepsy Center
🇺🇸
Wichita, Kansas, United States
Mayo Clinic - Rochester
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Rochester, Minnesota, United States
Oregon Health & Science University
🇺🇸
Portland, Oregon, United States
Columbia University / Columbia Presbyterian Medical Center
🇺🇸
New York, New York, United States
University of Florida at Gainesville
🇺🇸
Gainesville, Florida, United States
George Washington University
🇺🇸
Washington, District of Columbia, United States
University of Wisconsin Hospital and Clinics
🇺🇸
Madison, Wisconsin, United States
Rush University Medical Center / Epilepsy Center
🇺🇸
Chicago, Illinois, United States
Thomas Jefferson University
🇺🇸
Philadelphia, Pennsylvania, United States