Clinical study of a micro-implantable pulse generator for the treatment of peripheral neuropathic pain: 3-month and 6-month results from the COMFORT-randomised controlled trial

Reg Anesth Pain Med. 2025 Jul 4;50(7):561-567. doi: 10.1136/rapm-2023-105264.

Abstract

Background: We report the results from the first large, postmarket, multicentre, randomised controlled trial (RCT) evaluating peripheral nerve stimulation (PNS) for the treatment of chronic peripheral pain with a micro-implantable pulse generator (micro-IPG).

Methods: Subjects meeting eligibility were randomised (2:1) to either the active arm receiving PNS and conventional medical management (CMM) or the control arm receiving CMM alone. Treatments were limited to the following areas: lower back, shoulder, knee and foot/ankle.

Results: At 6 months, the active arm achieved an 88% responder rate with a 70% average reduction in pain. At the 3-month primary endpoint, the active arm achieved an 84% responder rate with an average pain reduction of 67% compared with the control arm, which achieved a 3% responder rate with an average pain reduction of 6%. Both responder rate and pain reduction in the active arm were significantly better than in the control arm (p<0.001). A majority of patient-reported outcomes also reached statistical significance. There have been no reports of pocket pain and no serious adverse device effects. 81% of subjects found the external wearable component of the PNS system to be comfortable.

Conclusions: This study successfully reached its primary endpoint-the active arm achieved a statistically significant superior responder rate as compared with the control arm at 3 months. These RCT results demonstrated that PNS, with this micro-IPG, is efficacious and safe. This ongoing study will follow subjects for 3 years, the results of which will be reported as they become available.

Keywords: CHRONIC PAIN; Neuralgia; Pain Management; Peripheral Nerve Injuries.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Chronic Pain* / diagnosis
  • Chronic Pain* / therapy
  • Electric Stimulation Therapy* / instrumentation
  • Electric Stimulation Therapy* / methods
  • Electrodes, Implanted*
  • Female
  • Humans
  • Implantable Neurostimulators*
  • Male
  • Middle Aged
  • Neuralgia* / diagnosis
  • Neuralgia* / physiopathology
  • Neuralgia* / therapy
  • Pain Management* / instrumentation
  • Pain Management* / methods
  • Pain Measurement / methods
  • Time Factors
  • Treatment Outcome