Uno studio per valutare l'efficacia della IDCT (terapia cellulare intradiscale) in soggetti con malattia degenerativa del disco lombare sintomatica da lieve a moderata a un livello (IDCT)
Uno studio prospettico, randomizzato, in doppio cieco, controllato con sham, multicentrico per valutare la sicurezza e l'efficacia di IDCT in soggetti con degenerazione del disco intervertebrale lombare sintomatica, lieve a moderata, a livello singolo
This is a Phase III, randomized, double-blinded, Sham-controlled, multi-center study in subjects with single-level, symptomatic lumbar (L3- S1) intervertebral disc degeneration. The study will have a 52-week primary period followed by 52 week Follow-up Period (total of 104 weeks).
The study protocol will be approved by the Institutional Review Board (IRB) or Independent Ethics Committee (IEC), and the study will be conducted in accordance with Good Clinical Practice (GCP). All subjects will provide written informed consent prior to Screening.
Approximately 162 subjects will be enrolled in the study. Up to 45 days prior to treatment, subjects will be screened for study inclusion, which includes obtaining baseline MRI and X-ray imaging. Imaging results for subjects initially eligible for study participation will be sent to a central imaging vendor for review and confirmation of eligibility, including the number of levels with degeneration. Subjects meeting all inclusion/exclusion criteria will be assigned to the corresponding treatment arm group and subsequently randomized to IDCT or Sham.
Randomization will occur approximately 7 to 14 days prior to the scheduled treatment administration date.
Overall, 162 subjects will be enrolled and randomized to IDCT or Sham in a 2:1 ratio.
- IDCT (n=108)
- Sham (n=54)
Panoramica dello studio
Stato
Stato
Condizioni
Condizioni
Intervento / Trattamento
Intervento / Trattamento
Descrizione dettagliata
Adult subjects with a diagnosis of single-level, mild to moderate, symptomatic lumbar (L3-S1) intervertebral disc degeneration that give consent and meet all the inclusion criteria and none of the exclusion criteria will be enrolled in this study. The disease, single-level disc will be known as the 'target disc' and will be either L3/L4, L4/L5, or L5/S1.
Tipo di studio
Tipo di studio
Iscrizione (Stimato)
Iscrizione
Fase
Fase
- Fase 3
Contatti e Sedi
Luoghi di studio
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Alabama
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Birmingham, Alabama, Stati Uniti, 35235
- Reclutamento
- Alabama Clinical Therapeutics
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Investigatore principale:
- Brad 205-833-2228, MD
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Contatto:
- Bailey Luster
- Numero di telefono: 205-833-2228
- Email: bailey.murphy@actstudy.net
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Arizona
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Phoenix, Arizona, Stati Uniti, 85054
- Reclutamento
- Mayo Clinic (AZ)
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Investigatore principale:
- John Freeman, MD
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Contatto:
- Debbie Ryan
- Numero di telefono: 480-342-1208
- Email: Ryan.Debra29@mayo.edu
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Scottsdale, Arizona, Stati Uniti, 85251
- Reclutamento
- HonorHealth
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Investigatore principale:
- Luis Tumialan, MD
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Contatto:
- Helen Riahi
- Numero di telefono: 602-258-2863
- Email: hriahi@honorhealth.com
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Arkansas
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Little Rock, Arkansas, Stati Uniti, 72205
- Reclutamento
- University of Arkansas for Medical Sciences
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Contatto:
- Lisa Richardson
- Numero di telefono: 501-526-7664
- Email: Lrichardson3@uams.edu
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Investigatore principale:
- Erica Petersen, MD
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California
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San Diego, California, Stati Uniti, 92111
- Reclutamento
- Solaris Research Institute
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Investigatore principale:
- Krishnan Chakravarthy, MD
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Contatto:
- Michelle Yi
- Numero di telefono: 858-251-6420
- Email: myi@solarisresearchinstitute.com
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Santa Monica, California, Stati Uniti, 90403
- Reclutamento
- Source Healthcare
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Investigatore principale:
- Timothy Davis, MD
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Contatto:
- Nidhi Thati
- Numero di telefono: 310-574-2777
- Email: nidhi@sourcehealthcare.com
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Thousand Oaks, California, Stati Uniti, 91320
- Reclutamento
- Pain Management and Injury Relief
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Contatto:
- Yvonne Avila
- Numero di telefono: 877-972-7576
- Email: yvonne.avila@sclamanagement.com
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Investigatore principale:
- Alexander Hersel, MD
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District of Columbia
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Washington D.C., District of Columbia, Stati Uniti, 20006
- Reclutamento
- International Spine, Pain and Performance Center
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Investigatore principale:
- Mehul Desai, MD
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Contatto:
- Sydney Sheridan
- Numero di telefono: 202-808-8295
- Email: ssheridan@isppcenter.com
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Florida
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Jacksonville, Florida, Stati Uniti, 32224
- Reclutamento
- Mayo Clinic (FL)
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Contatto:
- Katie Siebenlar
- Numero di telefono: 904-953-4915
- Email: siebenaler.katie@mayo.edu
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Investigatore principale:
- Wenchun Qu, MD
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Miami, Florida, Stati Uniti, 33136
- Reclutamento
- University of Miami Health System
-
Contatto:
- Yamilet Nieves Nieves
- Numero di telefono: 305-243-3048
- Email: yxn176@med.miami.edu
-
Investigatore principale:
- Barth Green, MD
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Orlando, Florida, Stati Uniti, 32832
- Reclutamento
- Conquest Research
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Investigatore principale:
- Gilbert Mbeo, MD
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Contatto:
- Kendra Tandeski
- Numero di telefono: 689-488-9112
- Email: kendra.tandeski@conquestresearch.com
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St. Petersburg, Florida, Stati Uniti, 33709
- Reclutamento
- Vantage Clinical Trials
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Investigatore principale:
- Robert Guirguis, MD
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Contatto:
- Civahn Robinson
- Numero di telefono: 727-471-6226
- Email: crobinson@vantagetrials.com
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Tampa, Florida, Stati Uniti, 33709
- Reclutamento
- Vantage Clinical Trials
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Investigatore principale:
- Jorge Leal, MD
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Contatto:
- Yiset Sanchez
- Numero di telefono: 813-549-5262
- Email: ysanchez@vantagetrials.com
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Idaho
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Boise, Idaho, Stati Uniti, 83709
- Terminato
- Injury Care Family Care Research
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Post Falls, Idaho, Stati Uniti, 83854
- Reclutamento
- Axis Spine Center
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Investigatore principale:
- Jessica Jameson, MD
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Contatto:
- Study Coordinator
- Numero di telefono: 208-457-4208
- Email: elisa.maples@nwsh.com
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Contatto:
- Email: Katelyn.Chemodurow@NWSH.com
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Illinois
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Chicago, Illinois, Stati Uniti, 60612
- Reclutamento
- Rush University Medical Center
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Investigatore principale:
- John O'Toole, MD
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Contatto:
- Reehan Malhance
- Numero di telefono: 312.942.0512
- Email: Reehan_T_Malhance@rush.edu
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Indiana
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Carmel, Indiana, Stati Uniti, 46032
- Reclutamento
- Indiana Spine Group
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Contatto:
- Sheetal Vinayek
- Numero di telefono: 317-715-5897
- Email: svinayek@indianaspinegroup.com
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Investigatore principale:
- Kevin Macadaeg, MD
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Kentucky
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Louisville, Kentucky, Stati Uniti, 40202
- Reclutamento
- Norton Leatherman Spine Center
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Contatto:
- Morgan Brown
- Numero di telefono: 502-584-7525
- Email: morgan.brown2@nortonhealthcare.org
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Investigatore principale:
- Steven Glassman, MD
-
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Louisiana
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New Orleans, Louisiana, Stati Uniti, 70121
- Reclutamento
- Ochsner Health System
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Investigatore principale:
- Maged Guirguis, MD
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Contatto:
- Raquel Walker
- Numero di telefono: 504-703-6091
- Email: raquel.walker@ochsner.org
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Minnesota
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Rochester, Minnesota, Stati Uniti, 55905
- Reclutamento
- Mayo Clinic (MN)
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Investigatore principale:
- Ryan D'Souza, MD
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Contatto:
- Rose Decker
- Numero di telefono: 507-422-0584
- Email: decker.rose@mayo.edu
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Missouri
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St Louis, Missouri, Stati Uniti, 63141
- Reclutamento
- The Orthopedic Center of St. Louis
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Contatto:
- Study Coordinator
- Numero di telefono: 314-738-4822
- Email: fschranck@spirittresearch.com
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Investigatore principale:
- Matthew Gornet, MD
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New York
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New York, New York, Stati Uniti, 10022
- Reclutamento
- Weill Cornell Medicine for Comprehensive Spine Care
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Contatto:
- Jeffery Tan
- Numero di telefono: 888-922-2257
- Email: jet4014@med.cornell.edu
-
Investigatore principale:
- Prabhav Deo, MD
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North Carolina
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Wilmington, North Carolina, Stati Uniti, 28403
- Reclutamento
- Wake Research
-
Investigatore principale:
- Jeremy Hoff, MD
-
Contatto:
- Study Coordinator
- Numero di telefono: 919-645-9212
- Email: dmyers@wakeresearch.com
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Winston-Salem, North Carolina, Stati Uniti, 27103
- Reclutamento
- Carolinas Pain Institute/ Center For Clinical Research
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Investigatore principale:
- Christopher Gilmore, MD
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Contatto:
- Study Coordinator
- Numero di telefono: ext 146 336-765-6181
- Email: jbrewer@ccrpain.com
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Ohio
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Cleveland, Ohio, Stati Uniti, 10524
- Reclutamento
- Cleveland Clinic
-
Contatto:
- Heather Rogers
- Numero di telefono: 216-444-1292
- Email: ROGERSH3@ccf.org
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Investigatore principale:
- Jijun Xu, MD
-
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Oregon
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Eugene, Oregon, Stati Uniti, 97404
- Reclutamento
- Pacific Sports and Spine
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Investigatore principale:
- Gregory Moore, MD
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Contatto:
- Ashley Hamann
- Numero di telefono: 541-780-0355
- Email: ahamann@pacificsportsandspine.com
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Pennsylvania
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King of Prussia, Pennsylvania, Stati Uniti, 19406
- Reclutamento
- Main Line Spine
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Investigatore principale:
- Scott Davidoff, MD
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Contatto:
- Cheryl Pugh
- Numero di telefono: 610-337-3111
- Email: cherylp@mainlinespine.com
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Tennessee
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Memphis, Tennessee, Stati Uniti, 38120
- Reclutamento
- Semmes Murphey Neurological Clinic
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Contatto:
- Numero di telefono: 901-259-5319
- Email: jarnold@semmes-murphey.com
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Investigatore principale:
- Michael LaBagnara, MD
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Contatto:
- Study Coordinator
- Numero di telefono: 901-260-6111
- Email: cberryman@semmes-murphey.com
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Texas
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Austin, Texas, Stati Uniti, 78745
- Reclutamento
- Pain Specialists of America
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Investigatore principale:
- Genaro Gutierrez, MD
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Contatto:
- Sheila Nardelli
- Numero di telefono: 949-922-5785
- Email: sheila@researchtex.com
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Utah
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Salt Lake City, Utah, Stati Uniti, 84108
- Reclutamento
- University of Utah
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Investigatore principale:
- Zachary McCormick, MD
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Contatto:
- Tou Xiong
- Numero di telefono: 801-587-5341
- Email: Tou.Xiong@hsc.utah.edu
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Virginia
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Richmond, Virginia, Stati Uniti, 23238
- Reclutamento
- Virginia iSpine Physicians
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Investigatore principale:
- Michael DePalma, MD
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Contatto:
- Devon Withers
- Numero di telefono: 804-330-2611
- Email: crc2@vaispine.com
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Criteri di partecipazione
Criteri di ammissibilità
Criteri di ammissibilità
Età idonea allo studio
Accetta volontari sani
Sessi ammissibili allo studio
Descrizione
Inclusion Criteria:
-
Has a diagnosis of mild to moderate, symptomatic, single-level degenerative disc disease (DDD) from L3-S1.
-
Has a target disc that meets Modified Pfirrmann Grade 3-7, as determined by a central radiologist.
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Is ≥18 and ≤75 years of age, skeletally mature, and has a body mass index (BMI) ≥18 kg/m2 and ≤38 kg/m2 at Screening.
-
Has been experiencing chronic low back pain for at least 6 months prior to Screening.
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Has had low back pain that is unresponsive to at least 3 months of conservative care (nonoperative treatment) to include at least one non-pharmacological intervention which may include physical therapy, acupuncture, chiropractic manipulation, massage, and at home medically supervised exercise program and two pharmacological interventions which may include NSAIDs, acetaminophen, duloxetine, and/or injectable therapy.
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Has pre-treatment low back pain score of 45 to 90 on VAS (Visual Analogue Scale) for low back pain at Screening and Day 1.
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Has pre-treatment ODI score of 35 to 90 at Screening and Day 1.
-
Is willing to voluntarily sign the informed consent form and agrees to the release of previous medical history for purposes of this study (i.e., HIPAA authorization) at Screening.
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Is physically and mentally able to comply with the protocol, able to understand and complete the required forms, and willing and able to adhere to the requirements of the protocol in the opinion of the Investigator.
-
Female-born subjects of childbearing potential must agree to and comply with using highly effective methods of birth control for the duration of the study (e.g., oral contraceptive, implant, injectable, indwelling intrauterine device, sexual abstinence, condoms, or a vasectomized partner).-
Exclusion Criteria:
Physical/ Medical History Exclusion Criteria
-
Has low back pain that in the Investigator's opinion is predominately myofascial in nature.
-
Has constant, unchanging low back pain that is not improved in any spinal position.
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Has radiculopathy resulting from nerve compression.
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Has non-radicular unilateral or bilateral leg pain with intensity greater than 50% of the intensity of the low-back pain, as measured by VAS.
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Leg pain that is of radicular origin, i.e., due to stimulation of nerve roots or dorsal root ganglion of a spinal nerve by compressive forces.
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Has frequent leg pain that extends below the knee.
-
Has severe unilateral or bilateral osteoarthritis of the knee or hip.
-
Severe spinal arthritis
-
Has cauda equina syndrome.
-
Has had previous lumbar spine surgery.
-
Has had previous disc invasive treatment procedures (i.e., intradiscal electrothermal therapy, intradiscal radiofrequency thermocoagulation) or intradiscal injections (i.e., injection of corticosteroids, methylene blue, dextrose, or glucosamine and chondroitin sulfate) or diagnostic discography at L3-S1 within the 3 months prior to Screening.
-
Subjects who have had basivertebral nerve ablation at L3-S1.
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Has clinical suspicion of facet pain as the primary pain generator.
-
Has current infection at the planned procedure site, active systemic infection, or current or prior history of lumbar spinal infection (i.e., discitis, septic arthritis, epidural abscess).
-
Has a history of fibromyalgia.
-
Has tested positive for Hepatitis B virus (HBV), Hepatitis C virus (HCV), or Human Immunodeficiency Virus (HIV).
-
Has presence of an active malignancy or tumor, or a prior history of malignancy within the last five years (except for basal cell carcinoma of the skin).
-
Has presence or prior history of a spinal malignancy.
-
Has significant systemic disease, such as unstable angina or autoimmune disease, such as rheumatoid arthritis. Has a history of congenital or acquired coagulopathy or thrombocytopenia.
31. Is currently taking anticoagulant, antiplatelet, or thrombolytic medications (except for aspirin or nonsteroidal anti-inflammatory drugs [NSAIDS]) and at the Investigator's medical discernment and discretion is unable to withhold medications for the time required per site standard or care, prior to the IDCT injection or is taking antineoplastic medications.
32. Is at higher risk for post-surgical infection (e.g., taking immunosuppressants), has a severe infection or a history of serious infection.
33. Has concomitant conditions requiring daily oral steroid usage for more than 30 days in the preceding 90 days before Screening.
34. Is taking opioids greater than 20 MME per day on an intermittent (as needed) basis OR is taking 20 MME or greater daily for more than 3 months prior to Screening
35. Has a history of unexplained, easy, or persistent bruising or bleeding, bleeding from the gums, or bleeding problems experienced in previous surgical procedures.
36. Has a history of hypersensitivity or anaphylactic reaction to bovine products, sodium hyaluronate/ hyaluronan/ hyaluronic acid, gentamicin, amphotericin b, dimethyl sulfoxide (DMSO), crustaceous/ shellfish, or porcine products.
37. Has an uncontrolled psychiatric condition or substance/alcohol abuse that would potentially interfere with the subject's participation in the study within 2 years prior to Screening in the opinion of the Investigator.
38. Has positive serum pregnancy test or nursing at time of Screening or has plans to become pregnant within the planned length of the study (2 years).
39. Has a body habitus that precludes adequate fluoroscopic visualization for the procedure or the procedure is physically impossible.
40. Has or requires an implantable electronic defibrillator, pacemaker, or has other contraindication to MRI scanning or cannot tolerate MRI scanning. Subjects who are expected to require a defibrillator or pacemaker, as determined by the Investigator should be excluded.
41. Has participated in another clinical study within the 6 months prior to Screening.
42. Has been a recipient or plans to be a recipient during trial participation of stem cell product to treat the lumbar spine.
43. Has participated in a prior IDCT clinical study.
44. Has pending litigation against a health care professional, except where required by the insurer as a condition of coverage.
45. A person who would not be available for the entire planned length of the trial.
46. Has active or pending worker's compensation claims. 47. In the Investigators opinion, the subject is not suitable for participation in the clinical trial.
Imaging Exclusion Criteria:
48. Three discs (L3-S1) that have a Modified Pfirrmann Grade 4-7.
49. Has evidence of prior lumbar vertebral body fracture at L3-S1.
50. Has scoliosis with curvature > 10 degrees.
51. Has congenital spinal irregularities such as segmentation.
52. Has an acute fracture of the spine at the time of enrollment in the study. Clinically compromised vertebral bodies within L3-S1 due to current or past trauma, e.g., sustained pathological fracture or multiple fractures of vertebrae.
53. Has evidence of dynamic instability on lumbar flexion extension per screening radiographs as indicated by >4.5 mm of translational motion at L3-S1; >15° of angular motion at L3/-L4; >20° of angular motion at L4-L/5; or >25° angular motion at L5/-S1.
54. Has Grade 2 or higher spondylolisthesis at L3-S1, as assessed by Meyerding classification.
55. Has lumbar spondylitis or other undifferentiated spondyloarthropathy.
56. Has Modic Type III Changes at L3-S1.
57. Has radiographic evidence or suspicion of a full thickness annular tear at L3-S1.
58. Has evidence of abnormal disc morphology defined as an extrusion or sequestration according to Fardon classification at L3- S1.
59. Has herniation > 3 mm in AP dimension that is associated with nerve root compression.
Piano di studio
Come è strutturato lo studio?
Dettagli di progettazione
- Scopo principale: Trattamento
- Assegnazione: Randomizzato
- Modello interventistico: Assegnazione parallela
- Mascheramento: Doppio
Numero di armi
Armi e interventi
Gruppo di partecipanti / ArmGruppo di partecipanti / Arm |
Intervento / TrattamentoIntervento / Trattamento |
|---|---|
|
Sperimentale: IDCT (n=108); Intradiscal injection of IDCT in a single target disc
1 mL intradiscal injection of 9,000,000 cells/mL |
Single intradiscal injection of 1 mL of 9,000,000 cells/mL IDCT in a single target disc. |
|
Comparatore fittizio: Sham (n=54);
Needle insertion up to the annulus of a single target disc. |
Single Sham needle insertion up to the annulus of a single target disc. |
Cosa sta misurando lo studio?
Misure di risultato primarie
Misure di risultato primarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Visual Analogue Scale (VAS) for low back pain
Lasso di tempo: Week 52
|
VAS is a sliding visual scale of 0 being "no pain" and 100 being "worst pain Imaginable' to assess changesfrom baseline in low back pain compared to Sham |
Week 52
|
|
Oswestry Disability Index (ODI)
Lasso di tempo: Week 52
|
ODI is a 10-item questionnaire used to measure functional disability in people with low back pain. It is a self-administered tool that assesses how back pain affects daily activities like walking, sleeping, and personal hygiene, with scores ranging from 0% (no disability) to 100% (maximum disability). |
Week 52
|
|
Adverse Events
Lasso di tempo: Day 1 to Week 52 in each treatment group.
|
Incidence of grade 2 (moderate) or greater AEs and SAEs |
Day 1 to Week 52 in each treatment group.
|
|
Adverse events of special interest
Lasso di tempo: Day 1 to Week 52 in each treatment group
|
Incidence of Adverse Events of Special Interest (AESI) to include any symptomatic injury of the target disc including annular tear, disc herniation/extrusion/prolapse as well as discitis. |
Day 1 to Week 52 in each treatment group
|
Misure di risultato secondarie
Misure di risultato secondarie
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
Visual Analogue Scale (VAS)
Lasso di tempo: Week 4, 12 and 26, 78 and 104
|
VAS is a sliding visual scale of 0 being "no pain" and 100 being "worst pain Imaginable' to assess changes from baseline in low back pain |
Week 4, 12 and 26, 78 and 104
|
|
Oswestry Disability Index (ODI)
Lasso di tempo: Week 4, 12 and 26, 78 and 105
|
ODI is a 10-item questionnaire used to measure functional disability in people with low back pain. It is a self-administered tool that assesses how back pain affects daily activities like walking, sleeping, and personal hygiene, with scores ranging from 0% (no disability) to 100% (maximum disability). |
Week 4, 12 and 26, 78 and 105
|
|
EQ-5D
Lasso di tempo: Enrollment through Week 104
|
EQ-5D is a validated too consisting of a set of questions covering five dimensions, with each dimension having a different severity level.
|
Enrollment through Week 104
|
|
Disc Volume
Lasso di tempo: Day 1 to Week 104
|
MRI assessment of Disc Volume though Week 104 |
Day 1 to Week 104
|
|
Pain Medication Use
Lasso di tempo: Enrollment to Week 104
|
Concomitant pain medication use for low back pain related to the target disc |
Enrollment to Week 104
|
|
Concomitant Therapy
Lasso di tempo: Enrollment to Week 104
|
Concomitant medical therapy for low back pain (physical therapy, acupuncture, chiropractic manipulation, massage, and at-home, medically supervised exercise program etc.) use for low back pain |
Enrollment to Week 104
|
|
Treatment Failure Rate
Lasso di tempo: Enrollment to week 104
|
Treatment failure rate (defined as an invasive non-surgical or surgical intervention) directly related to the target disc. |
Enrollment to week 104
|
|
Adverse Events
Lasso di tempo: Enrollment to Week 104
|
The incidence of grade 2 (moderate) or greater AEs and SAEs |
Enrollment to Week 104
|
|
Adverse Events of Special Interest (AESI)
Lasso di tempo: Enrollment to Week 104
|
The incidence of Adverse Events of Special Interest (AESI) observed defined as any one of the followings symptomatic injury of the target disc including annular tear, disc, herniation/extrusion/prolapse or any case of discitis. |
Enrollment to Week 104
|
Altre misure di risultato
Altre misure di risultato
Misura del risultato |
Misura Descrizione |
Lasso di tempo |
|---|---|---|
|
MRI Based evaluations
Lasso di tempo: Enrollment through Week 104
|
MRI Evaluation of the lumbar spine will be reported as an aggregate in one report to assess of disc height, Modified Pfirrmann grade, Modic changes, annular tears/fissures, endplate integrity, herniation, and any additional noteworthy observations at 12, 26, 52, 78, and 104. |
Enrollment through Week 104
|
|
X-ray evaluation of the lumbar spine
Lasso di tempo: Screening through Week 104
|
X-ray evaluation of flexion/extension will be assessed and measure in degrees of angles. |
Screening through Week 104
|
Collaboratori e investigatori
Sponsor
Sponsor
Investigatori
Investigatori
- Direttore dello studio: Lisa Flood, DiscGenics, Inc.
Studiare le date dei record
Studia le date principali
Inizio studio (Effettivo)
Inizio studio
Completamento primario (Stimato)
Completamento primario
Completamento dello studio (Stimato)
Completamento dello studio
Date di iscrizione allo studio
Primo inviato
Primo inviato
Primo inviato che soddisfa i criteri di controllo qualità
Primo inviato che soddisfa i criteri di controllo qualità
Primo Inserito (Effettivo)
Primo Inserito
Aggiornamenti dei record di studio
Ultimo aggiornamento pubblicato (Effettivo)
Ultimo aggiornamento pubblicato
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo aggiornamento inviato che soddisfa i criteri QC
Ultimo verificato
Ultimo verificato
Maggiori informazioni
Termini relativi a questo studio
Parole chiave
Termini MeSH pertinenti aggiuntivi
Altri numeri di identificazione dello studio
Altri numeri di identificazione dello studio
- DGX-A02
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Informazioni su farmaci e dispositivi, documenti di studio
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