EN PROSPEKTIV, MULTISENTER, ENARMET OBSERVASJONSSTUDIE ETTER MARKEDET FOR Å EVALUERE SIKKERHETEN OG KLINISKE YTELSEN TIL ARCHIMEDES BIOLOGISK NEDBRYTBARE GALLEVEKS- OG bukspyttkjertel-STENT (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.
Studieoversikt
Status
Status
Forhold
Forhold
Intervensjon / Behandling
Intervensjon / Behandling
Studietype
Studietype
Registrering (Antatt)
Registrering
Kontakter og plasseringer
Studiekontakt
Studiekontakt
- Navn: NIta Gondaliya
- Telefonnummer: +49 1716578285
- E-post: ngondaliya@q3medical.com
Studer Kontakt Backup
- Navn: Manfred Guelcher
- Telefonnummer: +4941716578200
- E-post: mguelcher@q3medical.com
Studiesteder
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Helsinki, Finland, 00290
- Fullført
- HUS Helsinki University Hospital
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Paris, Frankrike, 75015
- Aktiv, ikke rekrutterende
- Hôpital Européen Georges-Pompidou HEGP Service d'Hépato-gastro-entérologie et endoscopies digestives
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Afula, Israel, 1834111
- Fullført
- Emek Medical Center
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Forlì, Italia, 47121
- Fullført
- AUSL Romagna Ospedale Morgagni - Pierantoni
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Pavia, Italia, 27100
- Aktiv, ikke rekrutterende
- Gastroenterology and Digestive Endoscopy Unit Fondazione I.R.C.C.S. Policlinico San Matteo
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Roma, Italia, 00128
- Aktiv, ikke rekrutterende
- UCBM - Campus Bio-Medico University
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Milano
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Rozzano, Milano, Italia, 20089
- Aktiv, ikke rekrutterende
- Endoscopy Unit, Humanitas Research Hospital
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Singapore, Singapore, 308433
- Fullført
- Tan Tock Seng Hospital Pte Ltd,
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Ljubljana, Slovenia, 1000
- Rekruttering
- University Medical Center Ljubljana
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Ta kontakt med:
- Karin Pulevic, VS
- Telefonnummer: +38615228515
- E-post: karin.pulevic@kclj.si
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Ta kontakt med:
- Dr. Martina Jaklič, MD
- Telefonnummer: +38615222037
- E-post: martina.jaklic@kclj.si
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Hovedetterforsker:
- Dr Samo Plut, MD
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Salamanca, Spania, 37007
- Rekruttering
- Hospital Universitario de Salamanca
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Ta kontakt med:
- Solorzano Garcia Ignacio
- Telefonnummer: 55400 +34 679441022
- E-post: isolorzano.ibsal@saludcastillayleon.es
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Hovedetterforsker:
- Dr. Alberto Álvarez Delgado, MD, PhD
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Düsseldorf, Tyskland, 40217
- Rekruttering
- Evangelisches Krankenhaus Düsseldorf
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Ta kontakt med:
- Biljana Dimitrijevic, PhD
- Telefonnummer: +49 (0)211919483 601
- E-post: Biljana.Dimitrijevic@evk-duesseldorf.de
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Ta kontakt med:
- Carina Friesl
- E-post: carina.friesl@evk-duesseldorf.de
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Hovedetterforsker:
- Dr. Thomas Veiser, PhD
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Deltakelseskriterier
Kvalifikasjonskriterier
Kvalifikasjonskriterier
Alder som er kvalifisert for studier
Tar imot friske frivillige
Kjønn som er kvalifisert for studier
Prøvetakingsmetode
Studiepopulasjon
Patients that will respect the inlcusion criteria will be enrolled in the study.
Beskrivelse
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.
Studieplan
Hvordan er studiet utformet?
Designdetaljer
- Observasjonsmodeller: COHORT
- Tidsperspektiver: PROSPECTIVE
Antall grupper / kohorter
Kohorter og intervensjoner
Gruppe / KohortGruppe / Kohort |
Intervensjon / BehandlingIntervensjon / Behandling |
|---|---|
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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 |
Hva måler studien?
Primære resultatmål
Primære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
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Primary Safety endpoint
Tidsramme: From enrollment to the end of treatment, as per the standard of care.
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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.
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Tiltaksbeskrivelse |
Tidsramme |
|---|---|---|
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Secondary endpoints are defined as:
Tidsramme: Technical and Procedural success on the Procedure day and clinical success as per the Standard of Care
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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:
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Technical and Procedural success on the Procedure day and clinical success as per the Standard of Care
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Samarbeidspartnere og etterforskere
Sponsor
Sponsor
Studierekorddatoer
Studer hoveddatoer
Studiestart (Faktiske)
Studiestart
Primær fullføring (Antatt)
Primær fullføring
Studiet fullført (Antatt)
Studiet fullført
Datoer for studieregistrering
Først innsendt
Først innsendt
Først innsendt som oppfylte QC-kriteriene
Først innsendt som oppfylte QC-kriteriene
Først lagt ut (Faktiske)
Først lagt ut
Oppdateringer av studieposter
Sist oppdatering lagt ut (Faktiske)
Sist oppdatering lagt ut
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Siste oppdatering sendt inn som oppfylte QC-kriteriene
Sist bekreftet
Sist bekreftet
Mer informasjon
Begreper knyttet til denne studien
Andre studie-ID-numre
Andre studie-ID-numre
- QM-NI-ABS-034
Plan for individuelle deltakerdata (IPD)
Planlegger du å dele individuelle deltakerdata (IPD)?
Legemiddel- og utstyrsinformasjon, studiedokumenter
Studerer et amerikansk FDA-regulert medikamentprodukt
Studerer et amerikansk FDA-regulert enhetsprodukt
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