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经皮传入模式刺激治疗原发性震颤:长期随访的真实世界证据。

Transcutaneous Afferent Patterned Stimulation for Essential Tremor: Real-World Evidence with Long Term Follow-Up.

机构信息

Cala Health Inc, San Mateo, CA, USA.

Stanford University School of Medicine, Stanford, CA, USA.

出版信息

Tremor Other Hyperkinet Mov (N Y). 2023 Aug 29;13:29. doi: 10.5334/tohm.775. eCollection 2023.

Abstract

BACKGROUND

Transcutaneous afferent patterned stimulation (TAPS) is a non-invasive neuromodulation therapy for the treatment of hand tremor in patients with essential tremor (ET). This retrospective post-market analysis evaluated the usage, effectiveness, and safety of TAPS in patients using TAPS beyond a 90-day trial period in a real-world setting.

METHODS

Study personnel screened a manufacturer's database for TAPS devices that had been prescribed for the treatment of ET and used beyond a 90-day trial period between August 2019 and January 2023. The device logs were collected to extract the therapy usage, accelerometry measurements, and on-board ratings of tremor improvement. Study personnel also evaluated results of a voluntary survey requested by the manufacturer after the 90-day trial period. Adverse events were assessed from patients' complaints reported to the manufacturer.

RESULTS

A total of 1,223 patients in the manufacturer's database met the study criteria. The patients had used therapy between 90 and 1,233 days, with average usage of 5.6 sessions per week. Accelerometry data indicated 89% of patients experienced tremor improvement, with an average 64% improvement. 63% of patients rated at least half of their sessions as improved. No significant habituation was observed in patients who used therapy for more than one year. Approximately 62% of survey respondents either had reduced medication or planned to consult physicians about their medication usage. No serious safety events were reported, and 10% of patients reported minor safety complaints.

DISCUSSION

The analysis demonstrates the real-world effectiveness and safety of TAPS beyond a 90-day trial period over a longer timeframe and in a larger population size than previously published evidence.

摘要

背景

经皮传入模式刺激(TAPS)是一种非侵入性神经调节疗法,用于治疗特发性震颤(ET)患者的手部震颤。本回顾性上市后分析评估了在真实环境中,TAPS 超过 90 天试验期的情况下,患者对 TAPS 的使用、疗效和安全性。

方法

研究人员筛查了制造商的数据库,以寻找在 2019 年 8 月至 2023 年 1 月期间,用于治疗 ET 并超过 90 天试验期的 TAPS 设备的处方。从设备日志中提取治疗使用情况、加速度计测量值和船上震颤改善评分。研究人员还评估了制造商在 90 天试验期后要求进行的自愿调查的结果。从向制造商报告的患者投诉中评估不良事件。

结果

制造商数据库中共有 1223 名患者符合研究标准。这些患者的治疗使用时间为 90 至 1233 天,平均每周使用 5.6 次。加速度计数据表明,89%的患者出现震颤改善,平均改善 64%。63%的患者至少有一半的疗程评为改善。在使用治疗超过一年的患者中,未观察到明显的习惯化。大约 62%的调查受访者要么减少了药物使用,要么计划咨询医生有关他们的药物使用情况。未报告严重安全事件,10%的患者报告了轻微的安全投诉。

讨论

与以前发表的证据相比,该分析表明,在更长的时间内和更大的患者群体中,TAPS 在超过 90 天的试验期后具有真实世界的有效性和安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/460a/10473165/96478128d401/tohm-13-1-775-g1.jpg

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