St Jude Medical has announced data from the ACCURATE study shows that stimulation of the dorsal root ganglion (DRG) with the company’s Axium neurostimulator system is associated with superior pain relief over traditional spinal cord stimulation (SCS) for the treatment of chronic pain of the lower limbs.
St Jude Medical says that the ACCURATE study, designed to support US approval of DRG stimulation, represents the medical device industry’s largest study to date to evaluate patients suffering from chronic lower limb pain associated with complex regional pain syndrome (CRPS) or peripheral causalgia (nerve damage)—two of the many chronic pain conditions currently underserved by traditional SCS therapy. A total of 152 patients were enrolled in the trial at 22 centres across the USA.
Patients in the study were randomised to receive either DRG stimulation delivered by the Axium system or traditional SCS therapy delivered by a competitor’s system. After three months, investigators from the ACCURATE study found the trial had met its primary endpoints for both non-inferiority and superiority over traditional SCS. Specifically, data from the ACCURATE study shows DRG stimulation delivered:
- Superior pain relief: Significantly more patients receiving DRG stimulation achieved significant pain relief and greater treatment success when compared to patients receiving traditional SCS (81.2% vs 55.7%).
- Consistent therapy: Patients receiving DRG stimulation reported no differences in paraesthesia intensity due to changes in body position (postural effects) when compared to traditional SCS. A statistically significant result was found between the two groups studied. Postural effects can be a common challenge associated with traditional SCS therapy.
- Precise anatomical coverage: Patients in the Axium group were significantly less likely to report feeling stimulation outside their area of pain, compared to the control group.
“Data from the ACCURATE study are exciting because they demonstrate that DRG stimulation can offer meaningful improvement over traditional spinal cord stimulation for patients suffering from chronic pain conditions that have historically been challenging to treat,” said Mark Carlson, chief medical officer at St Jude Medical. “We look forward to continuing to develop DRG stimulation therapy to expand availability for patients currently underserved by traditional chronic pain therapy options.”
According to the Institute of Medicine, chronic pain affects more than 100 million Americans, an incidence rate which outpaces heart disease, cancer and diabetes combined. Research suggests that, in total, the condition costs the American population an estimated 515 million workdays annually and generates upwards of 40 million visits to physicians each year.
Stimulation of the DRG with Axium targets nerves within the DRG, a spinal structure packed with sensory nerves that transmit information to the spinal cord, which then conducts those signals to the brain. By targeting the DRG, stimulation with the Axium system has been shown in international research to be effective in treating conditions currently underserved by traditional SCS. St Jude Medical plans to explore potential pathways to further expand the availability of DRG stimulation for other hard-to-treat chronic pain conditions.