Marc Russo on running clinical trials in Australia and the INS

Dr Marc Russo is the president of the International Neuromodulation Society which is a nonprofit group of clinicians, scientists and engineers dedicated to the scientific development and awareness of neuromodulation. Dr Russo runs a large multidisciplinary pain clinic in Australia. He has conducted a number of first-in-man studies of novel neuromodulation implants as well as designing unique leads and waveforms in spinal cord stimulation (SCS).

Top 3 Takeaways:

• "Over more than a 20 year journey now we understand that these patients are best treated early rather than later. The best traded with as close to zero levels of opioids. And that doses higher than 40 milligrams per day, actually worsen outcomes for spinal cord stimulation,"

• "High dose exogenous opioid prescription can actually induce epigenetic change in the genome of a patient so that even if you remove something such as opioids after five years, the body doesn't return to its former expression of proteins and then maybe actually permanent changes that may have worse outcome."
• "What's in a book is not sacrosanct and that you need to not just blindly apply something that you read in a book and think that it was, descended from the tablets of Moses. You actually need to think of what are you doing and does that apply to this particular patient?"

0:45 "And do you want to introduce yourself?"

1:45 "What changes have you seen?"

3:45 "In bioelectronic medicine it's beneficial to have a combination of drugs and stimulation, but you're saying that's the opposite in pain? Is it something like a numbing effect or what's the justification that you found for this?"

5:45 "Is opioid something that lingers?"

7:30 "What are some other trends that you've noticed along your 20 years of working in the field?"

10:00 "So the stimulation is not something that's there forever that they're going to have to manage forever?"

11:30 What's it like running a clinical trials unit?

13:30 "What's the pain clinic, like what's the makeup of this and do hospitals send people to you or how does it work?"

15:15 "What would be the advantage of doing a clinical trial in Australia?"

16:30 "What's that process like, a clinical trial, and how long, how many patients are involved?"

19:00 "What would be a good clinical trial versus a bad clinical trial?"

24:00 "Is there anything that we didn't talk about that you wanted to mention?"