Clinical Study of a Micro-Implantable Pulse Generator for the Treatment of Peripheral Neuropathic Pain (COMFORT 2)

Last updated: March 2, 2026
Sponsor: Nalu Medical, Inc.
Overall Status: Active - Not Recruiting

Phase

N/A

Condition

Pain (Pediatric)

Peripheral Neuropathy

Chronic Pain

Treatment

Conventional Medical Management

Nalu Neurostimulation System for PNS

Clinical Study ID

NCT05870124
NAL-01-2023-US
  • Ages 18-80
  • All Genders

Study Summary

This post market study is being conducted to document the comparative effectiveness and safety of peripheral nerve stimulation plus conventional medical management versus conventional medical management alone in the treatment of chronic, intractable peripheral neuralgia of post-traumatic or postsurgical origin. This is a prospective, minimal risk, multi-center, randomized control trial.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  1. Subject is between 18 to 80 years of age at the time of enrollment.

  2. Subject would have been prescribed PNS therapy regardless of participation in thisstudy; the use of the Nalu device must be on-label.

  3. Subject has been diagnosed with one or more of the conditions listed below in thelow back, shoulder, knee, or foot (including ankle):

  • Post-surgical/post-traumatic peripheral neuralgia including but not limited topain due to peripheral nerve injury, post-surgical scar formation, nerveentrapment

  • Mononeuropathy, specified or unspecified or in diseases classified elsewhere

  • Other neuralgia or neuropathic pain

  • Osteoarthritic pain

  1. Subject has chronic (defined as at least 6 months duration), intractable peripheralneuropathic pain, exclusive of the craniofacial region; any nociceptive pain must beless prominent than the neuropathic pain. Pain should have a predominant neuropathiccomponent as per the investigator's clinical assessment.

  2. Subject should have a pain score of at least 6, in the target area of pain, asrecorded on the BPI-Q5 (NRS) at screening.

  3. Subject is willing to cooperate with the study requirements including, compliancewith the study procedures and completion of all study visits.

  4. Subject reported stable pain (non-escalating) for 60 days prior to signing informedconsent.

  5. Subject is currently receiving CMM and has had stable pain medication use and dosagefor 30 days prior to signing informed consent.

  6. Subject is psychologically qualified to receive a peripheral nerve stimulator as perthe clinician's standard clinical practice and judgment and does not have clinicallyrelevant psychological condition(s) that would interfere with their ability toaccurately report outcomes or complete study procedures.

  7. Subject has demonstrated the ability to appropriately place the adhesive clip in thelocation where the IPG is most likely to be implanted. Alternatively, subject isable to appropriately use the relief belt and/or limb cuff to keep the Therapy Discin place.

Exclusion

Exclusion Criteria:

Subject currently has an active implantable medical device such as a drug pump, spinal cord stimulator, peripheral nerve stimulator, sacral nerve stimulator, deep brain stimulator, and/or cardiac pacemaker.

  1. Subject has previously failed PNS or Spinal Cord Stimulation (SCS) or Dorsal Root Ganglion (DRG) therapy (trial or permanent implant). See note below.

  2. Pain is completely absent at rest. 4. Patient has clinical evidence of complex regional pain syndrome (CRPS), peripheral neuralgia of metabolic origin, post-herpetic neuralgia, biochemical evidence of a metabolic or genetic neuropathy (e.g., Charcot'- Marie- Tooth Disease) or mixed motor/sensory polyneuropathy.

  3. Subject has a medical condition that would prevent them from participating in the current study per investigator's or medical monitor's judgment.

  4. Subject has had a successful (≥ 50% pain relief) interventional procedure within the past 3 months to treat the same pain condition(s) being examined in this study including, nerve blocks.

  5. Uncontrolled depression or uncontrolled psychiatric disorders 8. Subject is currently participating in another clinical investigation with an active treatment arm.

  6. Subject is allergic or sensitive to materials used in the device components including, skin adhesives or does not tolerate the wearable aspect of the device.

  7. Subject has pending or ongoing legal issues (including unresolved worker's compensation claims or equivalent) or other conflicting secondary gain issues related to their chronic pain condition.

  8. Subject has a current diagnosis of a coagulation disorder, bleeding diathesis, or progressive peripheral vascular disease that has not been medically corrected.

  9. Subject has an active systemic infection. 13. Subject is unable to read and/or write in English or give informed consent. 14. Subject has a life expectancy of less than 1 year. 15. Subject has an active malignant neoplasm (metastatic or local) or evidence of paraneoplastic syndrome.

  10. Subject with uncontrolled diabetes mellitus, showing signs of diabetic neuropathy, as evidenced by a neurological exam and a HbA1c test.

  11. Subject has evidence of an alcohol or drug dependency within the last 6 months prior to enrollment.

  12. Subject is pregnant (if female and sexually active, subject must be using a reliable form of birth control, be surgically sterile or be at least 1 year post-menopausal).

  13. Subject is nursing/breastfeeding. 20. Subject is on ≥90 mg-morphine equivalents per 24 hours. 21. Subject has undergone an ablative treatment of the target peripheral nerve, or proximal nerve trunk giving rise to the target nerve, or dorsal roots (and DRGs) that ultimately make up the target nerve. No ablative procedures directed at the spinal cord, dorsal roots, or peripheral nerve(s) being treated in the study. To note, subjects who have undergone RF ablation of the dorsal rami, cool pulsed RF of the facet innervation may be considered for enrollment.

Study Design

Total Participants: 185
Treatment Group(s): 2
Primary Treatment: Conventional Medical Management
Phase:
Study Start date:
April 27, 2023
Estimated Completion Date:
December 31, 2027

Study Description

Multi-center, prospective, open-label, randomized controlled trial (RCT) comparing PNS plus CMM with CMM alone. Subjects will be randomized to receive:

Arm 1: Nalu Neurostimulation System for PNS plus CMM Arm 2: CMM alone Consented subjects will receive a baseline evaluation and then be randomized 2:1 into one of two arms: 1) PNS+CMM arm or 2) CMM arm. Subjects assigned to Arm 1 will undergo a trial implant period using best clinical practices. Those subjects who pass the trial implant will receive the permanent implant. At the 3-month end point, subjects in Arm 2 will be given the option to crossover into Arm 1 beginning with a trial implant. All Arm 1 patients receiving a permanent implant will be followed for a total of 36 months after permanent implantation.Arm 2 patients who do not crossover will be followed for a total of 36 months from randomization.

Connect with a study center

  • The Pain Institute of Southern Arizona

    Tucson, Arizona 85710
    United States

    Site Not Available

  • Comprehensive Spine & Pain Physicians

    Burbank, California 91505
    United States

    Site Not Available

  • Pain Management and Injury Relief

    Thousand Oaks, California 91320
    United States

    Site Not Available

  • DBPS Research LLC

    Denver, Colorado 80111
    United States

    Site Not Available

  • International Spine, Pain & Performance Center

    Washington D.C., District of Columbia 20037
    United States

    Site Not Available

  • Coastal Spine & Pain Center

    Jacksonville, Florida 23305
    United States

    Site Not Available

  • University of Kansas Health System, Bell Hospital Marc A. Asher Comprehensive Spine Center

    Kansas City, Kansas 66160
    United States

    Site Not Available

  • Insight Research Institute

    Flint, Michigan 48507
    United States

    Site Not Available

  • NeuroInterventional Pain Management

    Monroe, Michigan 48161
    United States

    Site Not Available

  • Michigan Neurology & Spine Center

    Port Huron, Michigan 48060
    United States

    Site Not Available

  • Advanced Orthopedics and Sports Medicine Institute

    Freehold, New Jersey 07728
    United States

    Site Not Available

  • The Center for Clinical Research

    Winston-Salem, North Carolina 27103
    United States

    Site Not Available

  • Pacific Sports and Spine

    Eugene, Oregon 97401
    United States

    Site Not Available

  • Columbia Pain Management

    Milwaukie, Oregon 97222
    United States

    Site Not Available

  • Pain Specialists of America

    Austin, Texas 78745
    United States

    Site Not Available

  • Institute of Precision Pain Medicine

    Corpus Christi, Texas 78414
    United States

    Site Not Available

  • Anesis Spine and Pain Care

    Spokane, Washington 99216
    United States

    Site Not Available

  • Northwest Pain Care

    Spokane, Washington 99201
    United States

    Site Not Available

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