David Shprecher, DO
Essential tremor is one of the most common movement disorders. Some studies suggest that as many as 5% of individuals aged 65 years and older have essential tremor. This prevalence rises above 10% among those aged 85 years and older.
Cala Trio had been shown to be effective in two small, single-session, placebo-controlled trials, leading to FDA clearance of the device. The primary goal of this study was to determine if Cala Trio improved tremor severity over a 3-month period. Based on clinician and patient ratings, most patients with severe or moderate tremor severity improved to mild or slight.
There are several essential tremor treatment options currently available. The first — pills and capsules — have been around a long time, but they are not always effective or well-tolerated. A second option, adaptive devices, include Liftware, which has a fork, spoon or knife attachment that will move against the tremor. However, patients often must pay out-of-pocket for therapies like this. A third option, surgery, involves deep brain stimulation or doing a radiosurgery (ultrasound or gamma knife) ablation of the ventral intermediate nucleus of the thalamus. This approach is more invasive and is associated with complication risks.
Cala Trio is noninvasive and does not have the side effects of oral medications, nor the complication risks of invasive procedures. What remains to be seen is whether it will be made broadly available and affordable. My experience with similar other devices for movement disorders is that it can take a long time after the FDA gives approval before insurance starts to cover them and/or the cost of treatment becomes affordable to most patients.
David Shprecher, DO
Director of Movement Disorders
Banner Sun Health Research Institute, Sun City, Ariz.
Disclosures: Shprecher reports receiving grant and/or research support from AbbVie, Acadia, the Arizona Alzheimer’s Consortium, Axovant, Biogen, Eisai, Eli Lilly, Enterin, Michael J. Fox Foundation, Neurocrine, the NIH, Nuvelution and Teva; speaker’s and/or consultant fees from Acorda, Amneal, Forensis, Neurocrine, Sunovion, Teva and US WorldMeds.
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