Medtronic announced the first patient implants in the Titan 2 pivotal study that will evaluate the safety and efficacy of Medtronic's investigational implantable tibial neuromodulation (TNM) device in people with overactive bladder (OAB). The minimally invasive technology stimulates the posterior tibial nerve near the ankle, transmitting electrical impulses that regulate neural activity of the bladder.

"Implantable TNM has the potential to offer relief to millions who suffer from bladder incontinence through a new approach that will provide greater convenience and more options for physicians and patients," said Una Lee, M.D., FPMRS, urology specialist at Virginia Mason Medical Center and national principal investigator for the TITAN 2 study. "The first patient implants in the Titan 2 study marks the beginning of what may be an important part of the future for better bladder control."

Implantable TNM aims to expand access to therapies for incontinence for more physicians and their patients. More than 37 million adults in the U.S. — almost one in six — suffer from OAB. Of those, 4.5 million are candidates for an advanced therapy, yet only 5% receive treatment. Medtronic currently offers percutaneous tibial neuromodulation (PTNM) therapy through its Nuro system, but PTNM requires patients visit a clinic setting to receive therapy and return for repeat treatments. An implantable TNM device would reduce the burden on patients and physicians by delivering ongoing treatments without the need for additional clinic visits. Additionally, the procedure is less invasive than sacral neuromodulation, the current standard of care.

The Titan 2 study is a prospective, multicenter, pivotal study to examine the safety and efficacy of the implantable TNM device in people with OAB. The study will include up to 130 patients from up to 30 sites in the U.S. The primary endpoint for the study is six months, and patients will be followed for 24 months.

Launched in April 2021, the Titan 1 feasibility study characterized the procedure for the implantable TNM device in subjects with bladder incontinence. Upon successful completion of Titan 2, Medtronic will prepare its submission to the U.S. Food and Drug Administration (FDA) for approval.

"Medtronic's decades of experience with implantable neuromodulation, existing proprietary technology platforms and the proven effectiveness of our PTNM therapy uniquely positions us to bring implantable TNM to the market. We're confident this new option will truly meet the needs of physicians and patients," said Mira Sahney, president of the Pelvic Health business, which is part of the Neuroscience Portfolio at Medtronic. "Titan 2 demonstrates our commitment to investing in the future and expanding access to advanced therapies for the treatment of incontinence."