アルキメデスの生分解性胆道および膵臓ステントの安全性と臨床性能を評価するための前向き多施設単一アームの市販後観察研究 (Registry)
Significant experience with biodegradable materials has been reported in the orthopedic literature; in particular; biodegradable stents have been used in the endovascular and urologic epithelium. Stents are typically made from polymeric materials including Polylactic Acid (PLA), Polyglycolide (PGA), Polydioxanone (PDO), Polyethyleneglycol (PEG), Polycaprolactone (PCL), etc., which have been cleared or approved by the FDA and CE-marked as drug carriers, sutures, and bone fixatives. The material is degraded by hydrolysis in, e.g., lactic acid, which is removed from the body by normal metabolic pathways. In the field of gastroenterology, these stents were first introduced in patients with an esophageal stenosis with encouraging results, although esophageal hyperplasia was a frequently encountered complication.
For biliary applications, biodegradable stents have been evaluated in several in-vitro and animal studies that demonstrated that the stents were safe and well tolerated. These stents provided an adequate radial force and resulted in complete stricture resolution within several months. The stents did not show any signs of biliary hyperplasia or integration in the epithelium. Moreover, they seem to have a self-clearing effect on attached biofilm as the outer layer sloughs during the degradation process similarly to the exfoliation of human skin. Also, the stent could be removed from the bile duct, thus offering the possibility of extraction if necessary at various times after implantation.
In 2010, Petryl was the first to use a biodegradable stent in the human bile duct. A stent was successfully placed using percutaneous transhepatic cholangiograpy in two patients with a postsurgical intrahepatic biliary stricture. Transient cholangitis was the only complication encountered and during the two years of follow-up, the bile duct remained patent.
Later, Mauri et al. presented in 2013 and 2016 results of a 107 patient study on a polydioxanone biodegradable biliary stent. The results have been published in the Journal of the European Society of Radiology. The authors concluded that percutaneous placement of a biodegradable biliary stent is a feasible and safe strategy to treat benign biliary strictures refractory to standard bilioplasty, with promising results in the mid-term period.
Prior to this study, the ARCHIMEDES device was assessed in the ARCHIMEDES Investigational study which has completed enrolment with 53 patients included, and the results are not yet published. In this study approximately half the stents were deployed in the bile duct (53%) and half in the pancreatic duct. All 53 patients have either completed, exited, or no longer have the study device. No patient remains in the study with a stent in place during the time of the last patient follow-ups. The study concluded without any device-related SAE. Bilirubin was reduced by 25.6%, which exceeded the >20% clinical success criterion, quality of life score improved from 3.7 to 7.9, procedural success was rated 1.4 (good to excellent), and technical success was achieved in all 53 patients.
Data from the ARCHIMEDES Investigational study was used for CE Mark approval, which was obtained in June 2018.
調査の概要
状態
状態
条件
条件
介入・治療
介入・治療
研究の種類
研究の種類
入学 (推定)
入学
連絡先と場所
研究連絡先
研究連絡先
- 名前:NIta Gondaliya
- 電話番号:+49 1716578285
- メール:ngondaliya@q3medical.com
研究連絡先のバックアップ
- 名前:Manfred Guelcher
- 電話番号:+4941716578200
- メール:mguelcher@q3medical.com
研究場所
-
-
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Afula、イスラエル、1834111
- 完了
- Emek Medical Center
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-
-
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Forlì、イタリア、47121
- 完了
- AUSL Romagna Ospedale Morgagni - Pierantoni
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Pavia、イタリア、27100
- 積極的、募集していない
- Gastroenterology and Digestive Endoscopy Unit Fondazione I.R.C.C.S. Policlinico San Matteo
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Roma、イタリア、00128
- 積極的、募集していない
- UCBM - Campus Bio-Medico University
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Milano
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Rozzano、Milano、イタリア、20089
- 積極的、募集していない
- Endoscopy Unit, Humanitas Research Hospital
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Singapore、シンガポール、308433
- 完了
- Tan Tock Seng Hospital Pte Ltd,
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Salamanca、スペイン、37007
- 募集
- Hospital Universitario de Salamanca
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コンタクト:
- Solorzano Garcia Ignacio
- 電話番号:55400 +34 679441022
- メール:isolorzano.ibsal@saludcastillayleon.es
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主任研究者:
- Dr. Alberto Álvarez Delgado, MD, PhD
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-
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Ljubljana、スロベニア、1000
- 募集
- University Medical Center Ljubljana
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コンタクト:
- Karin Pulevic, VS
- 電話番号:+38615228515
- メール:karin.pulevic@kclj.si
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コンタクト:
- Dr. Martina Jaklič, MD
- 電話番号:+38615222037
- メール:martina.jaklic@kclj.si
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主任研究者:
- Dr Samo Plut, MD
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-
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Düsseldorf、ドイツ、40217
- 募集
- Evangelisches Krankenhaus Düsseldorf
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コンタクト:
- Biljana Dimitrijevic, PhD
- 電話番号:+49 (0)211919483 601
- メール:Biljana.Dimitrijevic@evk-duesseldorf.de
-
コンタクト:
- Carina Friesl
- メール:carina.friesl@evk-duesseldorf.de
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主任研究者:
- Dr. Thomas Veiser, PhD
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Helsinki、フィンランド、00290
- 完了
- HUS Helsinki University Hospital
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Paris、フランス、75015
- 積極的、募集していない
- Hôpital Européen Georges-Pompidou HEGP Service d'Hépato-gastro-entérologie et endoscopies digestives
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参加基準
適格基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
サンプリング方法
調査対象母集団
Patients that will respect the inlcusion criteria will be enrolled in the study.
説明
Inclusion Criteria:
- Patient eligible for implantation of a pancreatic or billiary stent prior to participate in the study and according to current guidelines
- Patient has provided a signed and dated informed consent (according to the laws and regualtions of the country in which the observational study is conducted)
Exclusion Criteria:
- Age < 18 y
- Inability to understand the purpose of the study or refusal to cooperate
- Not available for routine follow-up visits
- Pregnancy
- Currently participating in a confounding trial before reaching first endpoint.
研究計画
研究はどのように設計されていますか?
デザインの詳細
- 観測モデル:COHORT
- 時間の展望:PROSPECTIVE
グループ/コホートの数
コホートと介入
グループ/コホートグループ/コホート |
介入・治療介入・治療 |
|---|---|
|
Patients will treated with ARCHIMEDES Biodegradable Biliary and Pancreatic Stent in routine practice
Participants receiving commercially available ARCHIMEDES Biodegradable Biliary and Pancreatic as part of standard care. Safety outcomes are collected for post-marketing surveillance |
Patients will treated with ARCHIMEDES Biodegradable Biliary and Pancreatic Stent in routine clinical practice |
この研究は何を測定していますか?
主要な結果の測定
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Primary Safety endpoint
時間枠:From enrollment to the end of treatment, as per the standard of care.
|
Proportion of subjects experiencing procedure- or device-related complications within 30 days including Post-ERCP pancreatitis, Bleeding, Perforation (biliary/pancreatic/duodenal), Stent misplacement, Stent migration, Biliary occlusion, Cholangitis, Severe pain, All-cause death Within 30 days of the index procedure |
From enrollment to the end of treatment, as per the standard of care.
|
二次結果の測定
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Secondary endpoints are defined as:
時間枠:Technical and Procedural success on the Procedure day and clinical success as per the Standard of Care
|
Clinical success: patency rate as defined by the rate of freedom of stent replacements at follow-up time points defined by investigators definition of SOC (standard of care) or until planned bridge surgery (defined as no need of stent replacement). Technical success: Accurate stent deployment across the target stricture as evaluated by fluoroscopy and endoscopy. Procedural success will be quantified (using a dedicated score system, Excellence=1, Good=2, Fair=3, Poor=4) by the endoscopist post procedure using the following components:
|
Technical and Procedural success on the Procedure day and clinical success as per the Standard of Care
|
協力者と研究者
研究記録日
主要日程の研究
研究開始 (実際)
研究開始
一次修了 (推定)
一次修了
研究の完了 (推定)
研究の完了
試験登録日
最初に提出
最初に提出
QC基準を満たした最初の提出物
QC基準を満たした最初の提出物
最初の投稿 (実際)
最初の投稿
学習記録の更新
投稿された最後の更新 (実際)
投稿された最後の更新
QC基準を満たした最後の更新が送信されました
QC基準を満たした最後の更新が送信されました
最終確認日
最終確認日
詳しくは
本研究に関する用語
その他の研究ID番号
その他の研究ID番号
- QM-NI-ABS-034
個々の参加者データ (IPD) の計画
個々の参加者データ (IPD) を共有する予定はありますか?
医薬品およびデバイス情報、研究文書
米国FDA規制医薬品の研究
米国FDA規制機器製品の研究
この情報は、Web サイト clinicaltrials.gov から変更なしで直接取得したものです。研究の詳細を変更、削除、または更新するリクエストがある場合は、register@clinicaltrials.gov。 までご連絡ください。 clinicaltrials.gov に変更が加えられるとすぐに、ウェブサイトでも自動的に更新されます。