{"id":42213,"date":"2018-05-29T10:57:11","date_gmt":"2018-05-29T09:57:11","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=42213"},"modified":"2018-05-29T10:57:11","modified_gmt":"2018-05-29T09:57:11","slug":"unreported-clinical-trial-of-the-week-scrambler-therapy-in-the-treatment-of-chronic-chemotherapy-induced-peripheral-neuropathy-nct02111174","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2018\/05\/29\/unreported-clinical-trial-of-the-week-scrambler-therapy-in-the-treatment-of-chronic-chemotherapy-induced-peripheral-neuropathy-nct02111174\/","title":{"rendered":"Unreported clinical trial of the week: Scrambler therapy in the treatment of chronic chemotherapy-induced peripheral neuropathy (NCT02111174)"},"content":{"rendered":"<p><strong>Nick DeVito and Ben Goldacre<\/strong><\/p>\n<p><strong>Background<\/strong><\/p>\n<div>The US FDA Amendments Act (FDAAA 2007) requires certain clinical trials to report their results onto <a href=\"http:\/\/clinicaltrials.gov\/\" target=\"_blank\" rel=\"noopener\">ClinicalTrials.gov<\/a> within one year of completion. Our <a href=\"https:\/\/fdaaa.trialstracker.net\/\" target=\"_blank\" rel=\"noopener\">FDAAA TrialsTracker<\/a> shows all individual trials that <a href=\"https:\/\/www.biorxiv.org\/content\/early\/2018\/03\/12\/266452.full.pdf\" target=\"_blank\" rel=\"noopener\">breach<\/a> this legal requirement. Once a week, we write about one unreported clinical trial: you can read more background <a href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/03\/29\/it-is-time-to-fix-the-problem-of-unreported-clinical-trials\/\" target=\"_blank\" rel=\"noopener\">here<\/a>.<\/div>\n<div><\/div>\n<div>\n<p><strong>Trial NCT02111174<\/strong><\/p>\n<\/div>\n<div>\n<p>This week\u2019s unreported trial is titled: \u201cA Pilot Randomized Sham-Controlled Trial of MC5-A Calmare Therapy (Scrambler Therapy) in the Treatment of Chronic Chemotherapy-Induced Peripheral Neuropathy (CIPN)\u201d (<a href=\"https:\/\/clinicaltrials.gov\/ct2\/show\/NCT02111174\" target=\"_blank\" rel=\"noopener\">NCT02111174<\/a>). The trial enrolled 30 adult participants experiencing CIPN pain. The intervention group received treatment with a scrambler therapy device; the control group received a sham version of the treatment. The study was blinded for participants, care providers, and outcome assessors. The primary outcome was change in pain at 28 days as measured by Modified Brief Pain Index score. The secondary outcomes were changes in pain measured by the Brief Pain Inventory, changes in patient reported outcomes and changes in pain drug use.<\/p>\n<\/div>\n<div>\n<p><strong>Clinical Discussion<\/strong><\/p>\n<\/div>\n<div>\n<p><a href=\"https:\/\/www.nhs.uk\/conditions\/peripheral-neuropathy\/\" target=\"_blank\" rel=\"noopener\">Peripheral neuropathy<\/a> occurs when \u201cnerves in the body&#8217;s extremities\u2014such as the hands, feet and arms\u2014are damaged\u201d which can cause pain and discomfort. While this is a common condition in the elderly, it can also occur as a side effect of chemotherapy. A 2014 <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/25261162?dopt=Abstract\" target=\"_blank\" rel=\"noopener\">systematic review<\/a> found that the prevalence of CIPN was 68.1% in the first month following chemotherapy. <a href=\"http:\/\/www.gotoper.com\/publications\/ajho\/2015\/2015Jan\/Management-of-Chemotherapy-Induced-Peripheral-Neuropathy\" target=\"_blank\" rel=\"noopener\">If CIPN in severe enough<\/a>, it could interfere with the patient\u2019s chemotherapy regimen as well as have major impacts on patient quality of life. Scrambler therapy, in which electrodes are placed onto affected areas and <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4973603\/\" target=\"_blank\" rel=\"noopener\">deliver<\/a> \u201celectrical stimulation of pain fibers with the intent of re-organizing maladaptive signaling pathways\u201d may be a way to treat CIPN. A 2016 <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4973603\/\" target=\"_blank\" rel=\"noopener\">review<\/a> found largely positive findings on the effectiveness of scrambler therapy in CIPN. Additional trials and <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29137098\" target=\"_blank\" rel=\"noopener\">case studies<\/a>, including some by the <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/27330020\" target=\"_blank\" rel=\"noopener\">PI of this study<\/a>, continue to be published showing the promise of this device in the treatment of <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29630779\" target=\"_blank\" rel=\"noopener\">peripheral neuropathy<\/a> and <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/29293482\" target=\"_blank\" rel=\"noopener\">other forms<\/a> <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5857462\/\" target=\"_blank\" rel=\"noopener\">of pain<\/a>. As <a href=\"https:\/\/doi.org\/10.1080\/14737140.2017.1374856\" target=\"_blank\" rel=\"noopener\">experts demand more progress<\/a> in the treatment of CIPN, it is important that this study be reported to add to this growing evidence base for this promising new therapy option.<\/p>\n<\/div>\n<div>\n<p><strong>Legislative Discussion<\/strong><\/p>\n<\/div>\n<div>\n<p>We intend that this series should occasionally shed light on interesting issues around transparency rules, and how registry data is used. You can read some general background about the FDA Amendments Act 2007\u2014and why a trial is considered \u201cdue\u201d<a href=\"https:\/\/www.biorxiv.org\/content\/early\/2018\/03\/12\/266452\" target=\"_blank\" rel=\"noopener\">\u2014here<\/a> and <a href=\"https:\/\/ebmdatalab.net\/why-is-this-trial-due-to-report\/\" target=\"_blank\" rel=\"noopener\">here<\/a>.<\/p>\n<\/div>\n<div>\n<p>Last week\u2019s Unreported Clinical Trial of the Week covered the first non-drug treatment of the series. This week we present the first unreported trial on a medical device. Medical devices are important treatment options for millions of people. Some registries, such as the EUCTR, do not cover trials of medical devices; however the FDAAA 2007 requires applicable device trials to register and report results onto <a href=\"http:\/\/clinicaltrials.gov\/\" target=\"_blank\" rel=\"noopener\">ClinicalTrials.gov<\/a>.<\/p>\n<\/div>\n<p><strong>Conclusion<\/strong><\/p>\n<p>This unreported trial was sponsored by the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins. The study PI is Dr. Thomas J. Smith. Johns Hopkins provides guidelines for staff on responsibilities related to trial registration and reporting <a href=\"https:\/\/www.hopkinsmedicine.org\/institutional_review_board\/guidelines_policies\/guidelines\/clinical_trials.html#What%20requirements%20for%20posting\" target=\"_blank\" rel=\"noopener\">here<\/a>. As of 29 May 2018, this trial is 66 days overdue to report. We hope the investigators will share the results of this trial soon.<\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/ben_goldacre.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-41742\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/ben_goldacre.jpg\" alt=\"\" width=\"160\" height=\"160\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/ben_goldacre.jpg 160w, https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/ben_goldacre-150x150.jpg 150w\" sizes=\"auto, (max-width: 160px) 100vw, 160px\" \/><\/a><\/p>\n<p dir=\"ltr\"><em><strong>Ben Goldacre<\/strong> is a doctor, author, and director of the EBM DataLab at the University of Oxford. He co-founded the AllTrials campaign for trials transparency.<\/em><\/p>\n<p dir=\"ltr\"><em><strong>Competing interests<\/strong>: BG has received research funding from the Laura and John Arnold Foundation, the Wellcome Trust, the Oxford Biomedical Research Centre, the NHS National Institute for Health Research School of Primary Care Research, the Health Foundation, and the World Health Organization; he also receives personal income from speaking and writing for lay audiences on the misuse of science.<\/em><\/p>\n<p><a href=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/nick_de_vito.png\"><img loading=\"lazy\" decoding=\"async\" class=\"alignleft size-full wp-image-41743\" src=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/nick_de_vito.png\" alt=\"\" width=\"160\" height=\"160\" srcset=\"https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/nick_de_vito.png 160w, https:\/\/blogs.bmj.com\/bmj\/files\/2018\/03\/nick_de_vito-150x150.png 150w\" sizes=\"auto, (max-width: 160px) 100vw, 160px\" \/><\/a><\/p>\n<p><em><strong>Nicholas J DeVito<\/strong> is a researcher at the EBM Datalab at the University of Oxford.<\/em><\/p>\n<p><em><strong>Competing interests<\/strong>: ND is employed on BG\u2019s LJAF grant.<b>\u00a0<\/b><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Nick DeVito and Ben Goldacre Background The US FDA Amendments Act (FDAAA 2007) requires certain clinical trials to report their results onto ClinicalTrials.gov within one year of completion. Our FDAAA [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/05\/29\/unreported-clinical-trial-of-the-week-scrambler-therapy-in-the-treatment-of-chronic-chemotherapy-induced-peripheral-neuropathy-nct02111174\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":42163,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18897],"tags":[],"class_list":["post-42213","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-unreported-trial-of-the-week"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Unreported clinical trial of the week: Scrambler therapy in the treatment of chronic chemotherapy-induced peripheral neuropathy (NCT02111174) - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2018\/05\/29\/unreported-clinical-trial-of-the-week-scrambler-therapy-in-the-treatment-of-chronic-chemotherapy-induced-peripheral-neuropathy-nct02111174\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Unreported clinical trial of the week: Scrambler therapy in the treatment of chronic chemotherapy-induced peripheral neuropathy (NCT02111174) - The BMJ\" \/>\n<meta property=\"og:description\" content=\"Nick DeVito and Ben Goldacre Background The US FDA Amendments Act (FDAAA 2007) requires certain clinical trials to report their results onto ClinicalTrials.gov within one year of completion. 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