A digital software developed by Finnish
drugmaker Orion is aiming to address chronic pain conditions using virtual
reality (VR) devices that provide an immersive gamified therapeutic treatment
program.
The therapy uses a VR headset to guide
people with chronic pain through a series of cognitive behavioural therapy
(CBT) exercises that are designed to help them overcome the fear of movement –
also known as Kinesiophobia, and then re-engage in an active life. The modules
are presented in a gamified, personalised mode that can be tailored to the
patient’s needs.
Orion developed the software in close
collaboration with Professor Christopher Eccleston, a pain specialist from the
University of Bath, and technology group Healthware.
“There were a number
of people at Orion who had an interest in digital therapeutics, but also an
understanding that future solutions to chronic pain are not going to be just
delivered by pharmacology,” Eccleston tells pharmaphorum.
“As you start to think
more about chronic pain, you realise that chronic pain is really about function
and disability; it’s less about altering the sensation of pain and more about
altering behaviour.”
After developing the technology, the team
ran a feasibility study for six-months to determine its response and
tolerability. Due to encouraging results, a pilot study was opened to the
public last year in Helsinki, Finland.
The prospective, randomised, double-blind,
3-arm parallel group compared the digital therapy for pain with a control group
and an open standard care arm over 6-8 weeks. Patients were provided with the
devices at home and received technical support remotely.
“There’s such an unmet
need for chronic pain management that people came forward really quickly to
join the trial,” says Eccleston.
“I think
rehabilitation in chronic pain has been overdue a major change. There is
absolutely no reason why we should still be doing it in a rather old-fashioned
Victorian way of visiting a specialist’s office. It needs to be taken outside
the clinical setting and into the home; it needs to be made active!”
“As you start to think
more about chronic pain, you realise that chronic pain is really about function
and disability; it’s less about altering the sensation of pain and more about
altering behaviour”
Clinical trial success
In June, Orion announced the clinical trial
results showing the software had a statistically significant benefit over
placebo and standard care interventions for fear of movement, patient clinical
global impression of change and quality of life in adult patients with chronic
low back pain.
Results from the ‘VIRPI’ study in patients
with chronic pain showed that the TSK score (Tampa Scale for Kinesiophobia
assessing fear of movement) was significantly reduced at the
end-of-intervention.
According to Eccleston, the results
highlight the potential for digital therapeutics to expand treatment options.
“What digital
therapeutics will be really very good at is improving access to treatments that
people wouldn’t necessarily have access to otherwise,” he says. “Unfortunately,
the healthcare system is often dependent on the skills and expertise of
individual practitioners delivering treatment. With automated, remote
technology such as this we can provide solutions in a home environment,
tailored to individual needs.”
As patients received positive results in
the trial without specialist intervention, there is an opportunity to scale the
treatment up. Patients will also benefit from having a sense of control over
their treatment.
“We’re interested in
people being active and engaging with the world, moving in that world, and
getting involved with what matters to the,” says Eccleston.
“There are so many
aspects to virtual reality that are useful in pain management: principally, it
allows immersion far beyond what is possible by instruction, it creates
emotionally rich teachable experiences that take time to do face to face, and
it is portable The remote technologies enable people to try things out safely
and for their behaviour to be modified in a way they wouldn’t necessarily be
able to achieve in the ‘real world.’
Following the announcement of its pilot
study results, Orion is looking for partners to further develop and
commercialise the software. And as digital solutions become more widespread in
healthcare due to COVID-19, Eccleston is optimistic the therapy is here to
stay.
“I think we are seeing
a rapid reappraisal of the way we organise healthcare in long-term conditions.
The pandemic has been an accelerator and created much needed disruption in the
way in which we think about delivery of healthcare. I’m excited to see what the
future holds! If we get this right we can put evidence based interventions into
the hand of the many not just the few.”
