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Kryoneurolyse bei schmerzhafter diabetischer Neuropathie des Fußes

Offene Rekrutierung
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Die klinische Studie NCT06646731 ist eine interventionsstudie zur Untersuchung von Painful Diabetic Peripheral Neuropathy (PDPN) und hat den Status offene rekrutierung. Die Studie startete am 25. August 2025 und soll 30 Teilnehmer aufnehmen. Durchgeführt von Universität von Kalifornien, San Diego ist der Abschluss für 1. Juni 2026 geplant. Die Daten von ClinicalTrials.gov wurden zuletzt am 5. September 2025 aktualisiert.
Kurzbeschreibung
The study is a single-center, randomized, participant- and observer-masked, human-subjects, post-market clinical pilot study to investigate the use of ultrasound-guided percutaneous cryoneurolysis to treat diabetic neuropathy of the foot. A prolonged nerve block may be provided by freezing the nerve using a technique called "cryoneurolysis". With cryoneurolysis and ultrasound machines, a small needle-like "probe" may be placed through anesthetized skin and guided to the target nerve to allow freezing. The procedure takes about 6 minutes for each nerve, involves little discomfort, has no systemic side effects, and cannot be misused or become addictive. Participants will be randomly allocated to one of two possible treatments groups: cryoneurolysis (experimental) or sham (control). The primary outcome measure is the change in pain on the neuropathic pain scale from baseline 1 month following the procedure.
Ausführliche Beschreibung
The study is a single-center, randomized, participant- and observer-masked, human-subjects, post-market clinical pilot study to investigate the use of ultrasound-guided percutaneous cryoneurolysis to treat diabetic neuropathy of the foot. A prolonged nerve block may be provided by freezing the nerve using a technique called "cryoneurolysis". With cryoneurolysis and ultrasound machines, a small needle-like "probe" may be placed through anesthetized skin and guided to the target nerve to allow freezing. The procedure takes about 6 minutes for each nerve, involves little discomfort, has no systemic side effects, and cannot be misused or become addictive. After 2-3 months, the nerve returns to normal functioning. Participants will be randomly allocated to one of two possible treatments groups: cryoneurolysis (experimental) or sham (control). The primary outcome measure is the change in pain on the neuropathic pain scale from baseline 1 month following the procedure.

Our objective is to investigate the therapeutic benefits of cryoneurolysis for research participants with painful diabetic neuropathy of the feet via a pilot study of 30 research participants. We hypothesize that ultrasound-guided cryoneurolysis of the superficial peroneal nerve will improve pain outcomes in research participants with painful diabetic neuropathy of the foot. The aims of this study will be to:

Primary Specific Aim. Demonstrate the potential efficacy of ultrasound-guided percutaneous cryoneurolysis of the superficial peroneal nerve, sural, distal saphenous, and/or deep peroneal nerve to treat painful diabetic neuropathy of the foot in reducing neuropathic pain 1 month after the procedure compared to baseline. This will be performed as a pilot study and executed as a randomized sham-controlled clinical trial of 30 subjects.

Hypothesis 1: Diabetic neuropathic pain intensity will be decreased relative to baseline 1 month following a cryoneurolysis procedure (as measured by the Neuropathic Pain Scale).

Secondary Specific Aim: To test the influence of a cryoanalgesia treatment as compared to sham/placebo on the long term measurements related to pain, quality of life, and analgesic usage.

Hypothesis 2a: Perception of well-being will be improved 1 month following one cryoneurolysis procedure (as measured with the Patient Global Impression of Change Scale).

Hypothesis 2b: Physical and emotional functioning will be improved relative to baseline 1 month following one cryoneurolysis procedure (as measured with the Interference Subscale of the Brief Pain Inventory).

Hypothesis 2c: Pain and opioid consumption will be reduced in the cryoneurolysis group compare to sham at multiple post-procedure time points, including 1 week, 1 month, 3 months, and 6 months after.

Offizieller Titel

Ultrasound-guided Percutaneous Cryoneurolysis for Management of Chronic Painful Diabetic Neuropathy: A Randomized Sham-controlled Pilot Study

Erkrankungen
Painful Diabetic Peripheral Neuropathy (PDPN)
Publikationen
Wissenschaftliche Artikel und Forschungspapiere zu dieser klinischen Studie:
Weitere Studien-IDs
  • 811212
NCT-Nummer
Studienbeginn (tatsächlich)
2025-08-25
Zuletzt aktualisiert
2025-09-05
Studienende (vorauss.)
2026-06
Geplante Rekrutierung
30
Studientyp
Interventionsstudie
PHASE
Nicht zutreffend
Status
Offene Rekrutierung
Stichwörter
Cryoneurolysis
Diabetic Peripheral Neuropathy of the Foot
Chronic Pain
Ultrasound-Guided Percutaneous Cryoneurolysis
Primäres Ziel
Behandlung
Zuteilungsmethode
Randomisiert
Interventionsmodell
Parallel
Verblindung
Doppelt verblindet
Studienarme/Interventionen
Teilnehmergruppe/StudienarmIntervention/Behandlung
Aktives VergleichspräparatCryoneurolysis
For participants randomized to active treatment, the probe placed in the research participant will be triggered and the nitrous oxide passed through the probe and then back into the machine, and finally vented out from the console. This will result in a freeze-thaw cycle. This may be repeated, as necessary, to ensure the entire cross-section of each nerve is fully treated.
Kryoneurolyse
Peripheral nerve cryoneurolysis of the foot
Schein-VergleichspräparatSham
Patients in this arm will also receive a diagnostic block with local anesthetic. If pain relief is satisfactory, the patients in this arm will undergo the procedure but the cryo probe will simply not be activated.
Sham Cryoneurolysis
a sham probe will be placed percutaneously proximal to target nerves. No cryoneurolysis will be given.
Hauptergebnismessungen
ErgebnismessungBeschreibung der MessungZeitrahmen
Pain Intensity
Change in pain intensity compared to baseline due to diabetic neuropathy of the foot as measured by the score of the Neuropathic Pain Scale. The primary outcome will be at 1 month following the study procedure. The primary statistic will be comparing the median change in the neuropathic pain scale score between both cohorts.
1 month
Nebenergebnismessungen
ErgebnismessungBeschreibung der MessungZeitrahmen
Perception of Well-Being
Perception of well-being will be improved 1 month following one cryoneurolysis procedure (as measured with the Patient Global Impression of Change Scale).
1 month
Physical and Emotional Functioning
Physical and emotional functioning will be improved relative to baseline 1 month following one cryoneurolysis procedure (as measured with the Interference Subscale of the Brief Pain Inventory).
1 month
Pain intensity - 1 month
Pain intensity as measured by Brief Pain Inventory
1 month
Pain Intensity - 1 week
Pain intensity as measured by Neuropathic Pain Scale and Brief Pain Inventory)
1 week
Pain Intensity - 3 months
Pain intensity as measured by the Brief Pain Inventory and Neuropathic Pain Scale
3 months
Pain Intensity - 6 months
Pain intensity as measured by the Brief Pain Inventory and Neuropathic Pain Scale
6 months
Opioid consumption - 1 week
opioid consumption as measured by the Quantitative Analgesic Questionnaire
1 week
Opioid consumption - 1 month
opioid consumption as measured by the Quantitative Analgesic Questionnaire
1 month
Opioid consumption - 3 months
opioid consumption as measured by the Quantitative Analgesic Questionnaire
3 months
Opioid consumption - 6 months
opioid consumption as measured by the Quantitative Analgesic Questionnaire
6 months
Eignungskriterien

Zugelassene Altersgruppen
Erwachsene, Ältere Erwachsene
Mindestalter
18 Years
Zugelassene Geschlechter
Alle
  • Research participants with diabetes mellitus and painful diabetic neuropathy of the foot (unilateral or bilateral)
  • HgbA1c <10 (to avoid any increased risk of site infection)
  • Adult patients of at least 18 years of age
  • Experiencing at least moderate diabetic neuropathic pain in the foot - defined as 3 or higher on the numeric rating scale (NRS; 0-10, 0=no pain; 10=worse imaginable pain) - at least daily for the previous 2 months.

  • Diabetic neuropathy not in the distribution of the superficial peroneal nerve, sural nerve, deep peroneal, and/or distal saphenous nerve.
  • Comorbidities that are contraindication to cryoneurolysis (e.g., Reynaud syndrome, cryoglobulinemia, cold urticaria)
  • Allergy to local anesthetic
  • Pregnancy
  • Incarceration
  • Inability to communicate to investigators due to lack of capacity
  • Local infection in the foot/ankle where cryoneurolysis will be performed
University of California, San Diego logoUniversität von Kalifornien, San Diego339 aktive klinische Studien zum Erkunden
Verantwortliche Partei
Rodney Gabriel, Hauptprüfer, Associate Professor, University of California, San Diego
Zentrale Studienkontakte
Kontakt: Rodney A Gabriel, MD, MAS, 858-663-7747, [email protected]
Kontakt: Kyle Norton, MD, 702-209-9532, [email protected]
1 Studienstandorte in 1 Ländern

California

University of California, San Diego, La Jolla, California, 92129, United States
Rodney A Gabriel, MD, MAS, Kontakt, 858-663-7747, [email protected]
Kyle Norton, MD, Kontakt, 702-209-9532, [email protected]
Rodney A Gabriel, MD, MAS, Hauptprüfer
Offene Rekrutierung