20 Participants Needed

Tulavi Allay Nerve Cap for Neuroma

AB
JF
Overseen ByJohn Fitzhenry, BA
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: Massachusetts General Hospital
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

What You Need to Know Before You Apply

What is the purpose of this trial?

In 2016, one in five individuals in the United States (US) experienced chronic pain, and approximately 40% of them suffered from neuropathic pain. The physical and emotional burden on patients results in costs of billions of dollars annually. Digital amputations affect over 23,000 people each year in the US and may lead to neuropathic pain and neuroma formation in the transected nerves. Previous studies have reported a 6.6% incidence of symptomatic neuroma, and more than 60% of these patients require surgery to reduce the negative impact on their daily living activities.To minimize neuroma formation after digital amputation, various techniques have been described, such as traction neurectomies (TN) and dorsal transpositions (DT), with and without nerve coaptation. However, it remains unclear whether these techniques improve patient-reported outcome measures in individuals undergoing this type of procedure. Previously published studies are descriptive in nature, focus on a single surgical technique, or include patients with established symptomatic neuromas. The only prospective trial on this topic was published in 2000 and compared two conventional techniques that have since been modified to better minimize neuroma formation or to reduce mechanical pressure by transposing the nerve ends to the dorsal aspect of the hand. However, that study used different scales to measure outcomes and did not incorporate aspects of pain that affect patients' emotional and social well-being.Currently, two randomized controlled trials are enrolling patients. One compares surgical techniques for the treatment of neuroma rather than its prevention. The other excludes digits with injuries located distal to the interphalangeal joints. Both studies focus on more complex surgical techniques.Given the extent of this problem, there has been recent innovation aimed at preventing neuroma formation. One promising product is the Tulavi Allay™ Nerve Cap, which has demonstrated encouraging results in basic science studies and anecdotally in early clinical use cases. In this study, the investigators have designed a prospective trial to assess the efficacy of the Tulavi Allay™ Nerve Cap when used to prevent symptomatic digital nerve neuroma following traumatic digital amputation.

Do I need to stop my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications.

How does the Tulavi Allay Nerve Cap treatment differ from other treatments for neuroma?

The Tulavi Allay Nerve Cap treatment is unique because it involves capping the nerve stump to prevent painful neuroma formation, similar to other nerve cap techniques that use materials like silicone or porcine small intestine submucosa. This approach helps guide nerve regeneration and acts as a barrier to external stimuli, reducing pain and neuroma recurrence.12345

Are You a Good Fit for This Trial?

This trial is for individuals who have undergone digital amputation and are at risk of developing nerve pain or neuromas. It's not clear what the exclusion criteria are, as they were not provided.

Inclusion Criteria

English-speaking
I am having one of my fingers or toes amputated due to injury at MGB.

Exclusion Criteria

Patients who are pregnant and/or breastfeeding
I am willing and able to participate in a trial study.
I am younger than 22 years old.
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Surgery and Initial Treatment

Participants undergo digital amputation surgery with the application of the Tulavi Allay™ Nerve Cap

1 day
1 visit (in-person)

Post-operative Monitoring

Participants are monitored post-operatively with questionnaires administered at multiple time points to assess pain and neuroma prevention

12 months
5 visits (in-person or virtual)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

  • Tulavi allay Nerve Cap
Trial Overview The study tests the Tulavi allay™ Nerve Cap's effectiveness in preventing neuropathic pain and neuroma formation after finger amputations. This prospective trial aims to improve patient outcomes by using this innovative device.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Tulavi allay Nerve CapExperimental Treatment1 Intervention
Arm 1 will include patients who satisfy the inclusion criteria and consent to the study enrollment and procedure. Surgeons will perform the procedure per their standard practice, but will use the allay™ Nerve Cap per the manufacturer's instructions to prevent potential symptomatic neuroma. Inclusion Criteria: * Patients undergoing traumatic amputation of a single digit at MGB * English-speaking Exclusion Criteria: * Patients undergoing revision amputation or non-traumatic amputation * Patients under 22 years old * Patients who are pregnant and/or breastfeeding * Unable or unwilling to participate in a trial study All adult patients, satisfying the above inclusion and exclusion criteria, are eligible for enrollment in this study regardless of sex, race, or ethnicity. Vulnerable populations will not be recruited.

Find a Clinic Near You

Who Is Running the Clinical Trial?

Massachusetts General Hospital

Lead Sponsor

Trials
3,066
Recruited
13,430,000+

Tulavi Therapeutics, Inc

Collaborator

Published Research Related to This Trial

In a study involving 10 rabbits, silicone capping of amputated nerves effectively prevented neuroma formation when the cap's length-to-diameter ratio was maintained between 5:1 and 10:1, indicating a specific design is crucial for success.
In a clinical trial with 18 patients suffering from traumatic neuromas, 15 patients experienced relief from pain after silicone capping, although some required revision surgery, highlighting the treatment's potential effectiveness but also the need for careful monitoring and follow-up.
The prevention and treatment of amputation neuromata by silicone capping.Swanson, AB., Boeve, NR., Lumsden, RM.[2022]

Citations

The prevention and treatment of amputation neuromata by silicone capping. [2022]
Management of Painful Recurrent Intermetatarsal Neuroma Using Processed Porcine Extracellular Matrix Material: A Case Report. [2017]
Application of a Porcine Small Intestine Submucosa Nerve Cap for Prevention of Neuromas and Associated Pain. [2021]
Painful Neuroma Treatment of the Supraorbital Nerve and Forehead Neurotization Using Human Cadaveric Nerve Allograft. [2018]
Neurocap Use for the Treatment of Iatrogenic Neuropathic Pain: Preliminary Operative Results in 3 Patients. [2021]
Unbiased ResultsWe believe in providing patients with all the options.
Your Data Stays Your DataWe only share your information with the clinical trials you're trying to access.
Verified Trials OnlyAll of our trials are run by licensed doctors, researchers, and healthcare companies.
Back to top
Terms of Service·Privacy Policy·Cookies·Security