First Patient in Study to Assess Pain Control and Oral Opioid Elimination with Targeted Drug Delivery

Medtronic plc says a first patient has been enrolled in the Embrace TDD (targeted drug delivery) clinical study. The aim is to evaluate the use of the SynchroMed™ II intrathecal drug delivery system (“Medtronic pain pump”) as an alternative to oral opioids for patients with chronic intractable non-malignant primary back pain with or without leg pain.

Background

While oral opioids are widely used to treat pain, there is limited evidence on the effectiveness and benefits of long-term oral opioid therapy. There’s also an opioid epidemic and ongoing pain management crisis. In the face of these factors, there is a need to better understand solutions that effectively address chronic pain and support the elimination of oral opioids. Evidence suggests that oral opioid tapering and elimination may improve pain relief and allow for treatment with a lower effective dose of intrathecal medication compared to a combination of oral and intrathecal treatment. The Embrace TDD study was designed to further understand the impact of an opioid-free period prior to TDD treatment on patient outcomes.

The Medtronic pain pump and catheter are implanted under the skin and deliver medication into the intrathecal space, enabling clinicians to prescribe reduced doses compared to systemically delivered medications and tailor drug delivery to patient needs. It provides effective pain relief at a fraction of the oral dose with fewer side effects and may help reduce or eliminate the use of oral opioids.

The Embrace TDD study will follow patients who wean completely from all oral opioids and have a successful intrathecal drug trial. It is a prospective, multi-center, post-market study that will enroll approximately 100 patients with chronic intractable non-malignant primary back pain with or without leg pain at up to 15 sites in the U.S. Patients will wean from all oral opioids prior to initiating intrathecal therapy. The study will assess pain control and opioid-related side effects at six months following a route of delivery change to intrathecal preservative-free morphine sulfate. Patients taking a daily systemic opioid dose of ≤ 120 Morphine Milligram Equivalents (MME), who are candidates for TDD, are eligible. Patients will be followed for 12 months.

Clinician comments

The first patient was enrolled by John A. Hatheway, M.D., in Spokane, Wash., who stated; “There are several strategies to approach weaning prior to or following TDD treatment. The Embrace TDD study is important because it will evaluate the impact of weaning patients completely off oral opioids before treating them with intrathecal therapy using the Medtronic pain pump.

“My goal is to provide patients with effective pain relief and help them eliminate long-term oral opioid use. Understanding the effect of being opioid free prior to TDD treatment may be clinically relevant as clinicians seek to optimize the use of long-term alternatives to oral opioids.”

Company comments

“As part of our commitment to helping address the opioid crisis, Medtronic is investing in clinical research and tools that can increase understanding of how to use proven alternative treatments, like TDD, for patients with uncontrolled chronic pain,” said Charlie Covert, vice president and general manager, Targeted Drug Delivery, Medtronic Pain Therapies. “We hope the Embrace TDD study will provide valuable insights about how to best optimize use of the Medtronic pain pump and enable clinicians to help more patients with chronic pain, which has a significant personal and societal impact.”

Source: Medtronic plc

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