Vagus Nerve Stimulation + PEPC for Fibromyalgia and PTSD

(SWIFT-RELIEVE Trial)

SA
AW
Overseen ByAnna Woodbury, MD
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: VA Office of Research and Development
Must be taking: Psychotropic medications
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

Fibromyalgia (FM) pain and PTSD are highly prevalent and comorbid with associated increased risk of negative physical and mental health outcomes, including higher risk for opioid use and suicide. This project is designed to determine the effects of a 4 week trial of a device for pain management \[transauricular vagus nerve stimulation (taVNS)\] on pain interference and intensity \[Pain, Enjoyment, and Activity General Scale (PEG)\] and PTSD. The investigators will also examine how this impacts the Veterans by examining heart rate variability (HRV) as a stress response related biomarker. The investigators plan to randomize 180 Veterans (estimate up to 360 enrolled) with co-morbid FM and PTSD across pain integrated care and PTSD sites in this prospective study and compare: 1) active taVNS for pain + Prolonged Exposure in Primary Care (PE-PC) and 2) sham taVNS + PE-PC. Study includes 4 weeks of randomized treatment and 4 weeks of voluntary open label treatment. Veterans are assessed (self report \& interview measures, heart rate variability by wearable device) at Intake, Baseline/Post Run-In, Week 2, Week 4, Week 8 and 4 month follow-up. The investigators plan to retain data after the study for potential future use in research.

Who Is on the Research Team?

AW

Anna Woodbury, MD

Principal Investigator

Atlanta VA Medical and Rehab Center, Decatur, GA

SA

Sheila A.M. Rauch, PhD

Principal Investigator

Atlanta VA Medical and Rehab Center, Decatur, GA

Are You a Good Fit for This Trial?

This trial is for English-speaking Veterans with both fibromyalgia and PTSD, confirmed by specific questionnaires and pain scores. Participants must have stable medication use, not be pregnant or breastfeeding, and cannot have severe mental health issues, recent substance abuse, or other major medical problems.

Inclusion Criteria

Subjects must speak English
I am a Veteran with fibromyalgia and PTSD symptoms, and ongoing pain for at least 3 months.
I have been on the same dose of my psychiatric medication for at least 2 weeks and will not change it until after the 4-month follow-up.

Exclusion Criteria

Subjects must not be currently pregnant or lactating given risk of pre-term labor and interference of oxytocin with VNS effects
Subjects must not have a level of suicide risk that requires intervention as determined by item 9 on PHQ-9 with follow-up risk assessment by study staff
Subjects must not have unmanaged psychosis or bipolar disorder
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Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 visit (in-person)

Treatment

Participants receive either active or sham transauricular vagus nerve stimulation (taVNS) combined with Prolonged Exposure in Primary Care (PE-PC) for 4 weeks

4 weeks
6 visits (in-person or telehealth)

Open-label extension

Participants may opt into continuation of active taVNS treatment for an additional 4 weeks

4 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment, including assessments of pain and PTSD symptoms

4 months
2 visits (in-person or virtual)

What Are the Treatments Tested in This Trial?

Interventions

  • Prolonged Exposure in Primary Care (PE-PC)
  • Transauricular Vagus Nerve Stimulation (taVNS)

Trial Overview

The study compares a device that stimulates the vagus nerve through the ear (taVNS) plus talk therapy (PE-PC) to a sham (inactive) device plus the same therapy. Treatment lasts 4 weeks with follow-up assessments up to 4 months.

How Is the Trial Designed?

2

Treatment groups

Experimental Treatment

Placebo Group

Group I: taVNS plus PEPCExperimental Treatment1 Intervention
Group II: Sham plus PEPCPlacebo Group1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials
1,691
Recruited
3,759,000+