A Study to Investigate the Efficacy of Pain Reduction With Cryoneurolysis Compared With Sham-treatment in Adults With Trigeminal Neuralgia

NCT06213155 | Recruiting DMC

• 1 other identifier: 630286
• Study Type: interventional
• Target: 24
• Locations: 1 country
• Sites: 1

Brief Summary

The CryoGem Trial is a research study that tests a freezing technique called cryoneurolysis to see if it helps relieve pain in adults with trigeminal neuralgia. Trigeminal neuralgia is a condition that causes severe facial pain. In this study, we want to find out if the freezing technique is effective and safe. We will do this by comparing two groups of adults with trigeminal neuralgia. One group will receive the actual treatment, while the other group will receive a fake treatment called a sham. Neither the participants nor the assessors will know which group they are in (this is called a blinded study). For the next four weeks, participants in both groups will continue recording their headaches without knowing which treatment they are receiving. After this initial period, there will be an extension period where all participants can receive treatment as needed for up to two years. The results of this study will help us decide if the freezing technique is a viable treatment option for trigeminal neuralgia. Our main goal is to see how many people in each group have a significant reduction in pain (at least 75% less pain). We will also record other important information about the participants. We are looking to recruit up to 24 adults with trigeminal neuralgia to take part in this study. All participants will keep a daily diary for two weeks to track their headaches before starting the treatment. Then, they will be randomly assigned to either the treatment group or the sham group.

Conditions

Trigeminal Neuralgia

Outcome Measures

Primary Outcomes (2)

• Average daily pain

  Difference in number of treatment responders (≥ 75% reduction in the mean average daily pain intensity on a NRS score) at weeks 3 - 4 post-intervention for paroxysmal pain corresponding to the treated branch compared to baseline in the treatment versus the sham group.

  Weeks 3 - 4 post-intervention compared to baseline

• Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]

  Occurrence of treatment-emergent adverse events and serious adverse events.

  Week 1-4

Secondary Outcomes (7)

• 50% responders

  Weeks 3 - 4 post-intervention compared to baseline

• 100% responders

  Weeks 3 - 4 post-intervention compared to baseline

• Patient Global Impression of Change (PGI-C) scale responders (a PGI- C responder is defined as having a response of "much improved" or "very much improved" at week 4.)

  Week 4

• Barrow Institute of (BNI- P) responders (a clinically significant response is defined as having BNI I - BNI IIIb at week 4).

  Week 4 in the active arm versus sham arm.

• Barrow Institute of (BNI- P) excellent responders (excellent response is defined as having BNI I - BNI II at week 4).

  Weeks 3 - 4 post-intervention compared to baseline

Study Arms (2)

Cryoneurolysis

EXPERIMENTAL

Device: Cryoneurolysis

Stimulation

SHAM COMPARATOR

Device: Stimulation

Interventions

Cryoneurolysis DEVICE

Cryoneurolysis

Cryoneurolysis

Stimulation DEVICE

Stimulation

Stimulation

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Participant must be 18 years at the time of signing the informed consent
• A diagnosis of primary (classic and idiopathic) trigeminal neuralgia affecting the mandibular and/or maxillary division, verified by a neurologist
• Ability to subclassify the trigeminal neuralgia according to the The International Classification of Headache Disorders, 3rd edition, i.e. sufficient magnetic resonance (MR) evaluation is mandatory
• History of minimum mean of three trigeminal neuralgia related pain paroxysms per day last 4 weeks
• History of minimum average daily pain intensity NRS score (ADP) of 4 to10 last 4 weeks
• In baseline minimum average daily pain intensity NRS score (ADP) of 4 to 10
• In baseline minimum mean of three trigeminal neuralgia related pain paroxysms per day
• Treatment refractory as defined in this study as failure to respond, pending an adequate trial in the opinion of the investigator, contraindications or intractable side effect to one of two medications:
• Carbamazepine
• Oxcarbazepine
• Unaltered prophylactic TN medication regime 2 weeks prior to baseline, and be willing to keep regime unaltered during the baseline and the blinded study period.
• Be an appropriate candidate for the study intervention required in this study on the basis of the clinical judgment of the investigator
• Capable of giving signed informed consent as which includes compliance with the requirements and restrictions listed in the informed consent form (ICF) and in this protocol.

You may not qualify if:

• Diagnosed with demyelinating inflammatory disorders such as e.g. multiple sclerosis.
• Other pain conditions, not intended to be treated in this study, that in the opinion of the investigator could interfere with study procedures, accurate pain reporting, and/or confound evaluation of study endpoints.
• High probability of neurological deterioration due to other medical conditions, that in the opinion of the investigator may confound outcome assessment.
• Patients exhibiting a high degree of comorbidity and/or frailty associated with reduced life expectancy or high likelihood of hospitalization, at the discretion of the investigator.
• Other coexisting current medical conditions, including, but not limited to, bleeding diathesis and thrombophilia, that presents excess procedural risk, in the opinion of the investigator.
• Have within 6 months of enrollment a significant untreated addiction to dependency- producing medications, alcohol, or illicit drugs.
• Abnormal pain behavior, inappropriate medication use and/or unresolved psychiatric illness, that in the opinion of the investigator are significant enough to impact perception of pain, compliance with intervention and/or ability to evaluate treatment outcome.
• Subject has had previous radiofrequency ablation (including non-lesional pulsed radiofrequency), balloon compression, gamma knife, or chemical denervation (e.g. glycerol treatments) of the Gasserian ganglion.
• Subject has had previous radiofrequency ablation (including non-lesional pulsed radiofrequency), balloon compression, gamma knife, or chemical denervation (e.g. glycerol treatments) of a division or branch of the trigeminal nerve being targeted in this study.
• Facial anomaly or trauma which renders the planned procedure difficult.
• Subject currently has an active oral or dental abscess or a local infection at the site of injection based on present symptoms.
• Subject has been diagnosed with any major infectious processes such as osteomyelitis, or primary or secondary malignancies involving the face that have been active or required treatment in the past 6 months.
• Current participation in another treatment study
• Sensory deficits and/or pain configuration supporting, in the opinion of the neurologist, trigeminal neuropathy as more likely diagnosis.
• Patients with any kind of conductive implant with contraindication for nerve stimulation according to study innervation.

Sponsors & Collaborators

• St. Olavs Hospital: lead

Study Sites (1)

St. Olavs University Hospital

Trondheim, Norway

RECRUITING

MeSH Terms

Conditions

Trigeminal Neuralgia

Condition Hierarchy (Ancestors)

Trigeminal Nerve Diseases; Facial Neuralgia; Facial Nerve Diseases; Mouth Diseases; Stomatognathic Diseases; Cranial Nerve Diseases; Nervous System Diseases

Central Study Contacts

Irina Aschehoug

CONTACT

+47 72820972; irina.aschehoug@ntnu.no

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: TRIPLE
• Who Masked: PARTICIPANT, INVESTIGATOR, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 9, 2024
• First Posted: January 19, 2024
• Study Start: February 29, 2024
• Primary Completion: December 31, 2025
• Study Completion (Estimated): December 1, 2026
• Last Updated: June 19, 2025

Record last verified: 2025-06

Locations

NO (1)