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A Safety and Efficacy Study for Treatment of Painful Vertebral Compression Fractures Caused by Osteoporosis

Primary Purpose

Spinal Fractures

Status
Unknown status
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Percutaneous Vertebral Augmentation of compression fractures
Sponsored by
Orthovita d/b/a Stryker
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Spinal Fractures focused on measuring Osteoporosis, Spine fracture, Back Pain, Vertebroplasty, Vertebral compression fractures related to osteoporosis

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria: Are at least 18 years of age Have sustained a painful osteoporotic vertebral compression fracture (VCF) for at least 4 weeks but no longer than 1 year or have radiographic evidence of at least 5% worsening vertebral collapse as compared to previous radiographic evidence Give written Informed Consent to participate in the study and be willing to comply with protocol requirements Have pain requiring the regular use of analgesics or have a substantially altered life-style due to pain or disability Have central pain over the spinous process upon palpation at the planned level(s) Are appropriately communicative to verbalize and differentiate with regard to location and intensity of their pain Are physically and mentally willing and able to comply with the clinical and radiographic follow-up schedule Have radiographic evidence of one or two, Grade 1 or greater according to Genant's criteria, osteoporotic VCF(s) between (and including) the level of the sixth (6th) thoracic to the fifth (5th) lumbar Have an acute or persistent (not healed) fracture demonstrated by magnetic resonance imaging (MRI) or bone scan Have a patient self-assessment VAS score >= 50 mm at the pre-treatment visit Have a 30% or greater disability score on the baseline ODI (version 2.0). Exclusion Criteria: Have significant vertebral collapse defined as more than 70% of original vertebral height, or a burst or pedicle fracture with posterior cortical wall disruption Have posterior vertebral wall displacement occupying more than 20% of the cross sectional area of the spinal canal Have neurologic symptoms or deficits, or radiculopathy related to the VCF Have pain based on a clinical diagnosis of herniated nucleus pulposus, high energy trauma, severe spinal stenosis as evidenced by progressive weakness or paralysis, or bone tumor at the level(s) of pathology as evidenced by computed tomography (CT) scan Have indications of instability related to the VCF at the level to be treated (e.g., neurologic deficit, kyphosis > 30º, translation > 4 mm, and/or interspinous process widening) Have canal compromise causing clinical manifestations of cord, neural foramen, or nerve root compression at the level(s) to be treated Have a bleeding disorder, including coagulopathy Have severe cardiopulmonary deficiencies Have an active systemic or local infection Are currently being treated for cancer or HIV Have a known allergy to acrylics (e.g., methyl methacrylate) Subject is currently an alcohol, solvent or drug abuser Female patients who are pregnant or nursing, or of childbearing potential not using a reliable contraceptive method Are involved in medical litigation Are prisoners Have participated in another investigational study within 30 days prior to inclusion

Sites / Locations

  • Scottsdale Medical Center
  • Core Orthopaedic Medical Center, P.C.
  • Eisenhower Medical Center
  • St. John's Spine Institute
  • Indian River Radiology
  • Emory Orthopaedics and Spine Center
  • Millenium Pain Center
  • Northwestern University
  • The Spine Institute of Louisiana
  • Washington University Medical Center
  • Montefiore Medical Center
  • Hospital for Special Surgery (HSS)
  • Mission Hospitals
  • Dayton Interventional Radiology
  • Edmond Medical Center
  • Mercy Health Center
  • Pennsylvania Hospital
  • Endovascular Center of Houston

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

CORTOSS

PMMA

Arm Description

Patients prospectively randomized to be treated with Cortoss constitute treatment group.

Patients prospectively randomized to be treated with PMMA constitute active control group.

Outcomes

Primary Outcome Measures

Early and sustained decrease in pain (efficacy prong of primary endpoint) at 24 months compared to pre-treatment baseline using the Visual Analog Scale (VAS)
Maintenance or improvement in function (efficacy prong of primary endpoint) at 24 months compared to pre-treatment baseline using the Oswestry Disability Index (ODI)
Maintenance vertebral height and alignment (efficacy prong of primary endpoint) at 24 Months compared to 1-month post-vertebropalsty baseline radiographs
No device-related subsequent surgical intervention at study treated level

Secondary Outcome Measures

Maintenance or improvement in quality of life (secondary endpoint) at 24 months compared to baseline using the SF-12
Ambulatory status
Patient satisfaction

Full Information

First Posted
February 10, 2006
Last Updated
October 13, 2008
Sponsor
Orthovita d/b/a Stryker
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1. Study Identification

Unique Protocol Identification Number
NCT00290862
Brief Title
A Safety and Efficacy Study for Treatment of Painful Vertebral Compression Fractures Caused by Osteoporosis
Official Title
A Randomized, Controlled Clinical Study to Evaluate the Safety and Effectiveness of CORTOSS® Synthetic Cortical Bone Void Filler in Vertebral Augmentation
Study Type
Interventional

2. Study Status

Record Verification Date
October 2008
Overall Recruitment Status
Unknown status
Study Start Date
September 2004 (undefined)
Primary Completion Date
undefined (undefined)
Study Completion Date
March 2009 (undefined)

3. Sponsor/Collaborators

Name of the Sponsor
Orthovita d/b/a Stryker

4. Oversight

5. Study Description

Brief Summary
Doctors are studying an investigational treatment to be used during the vertebroplasty procedure when treating vertebral compression fractures (spine fractures) that may help to reduce pain and restore mobility. If one has experienced back pain for at least 4 weeks but not longer than 1 year, he/she may be eligible to participate. The purpose of this protocol is to describe the methods for the clinical evaluation of Cortoss for vertebroplasty in patients with painful osteoporotic compression fractures. Eligible patients with painful osteoporotic compression fractures of the spine are divided into two groups. Each enrolled patient will have the vertebroplasty procedure; however one group of patients will have the vertebroplasty procedure using polymethylmethacrylate [PMMA] (a Food and Drug Administration [FDA]-approved bone cement) and the other group of patients will have the vertebroplasty procedure using a relatively new (investigational) biomaterial called Cortoss.
Detailed Description
This is a prospective, multi-center randomized, controlled study designed to evaluate the safety and effectiveness of Cortoss® Synthetic Cortical Bone Void Filler in vertebral augmentation using the percutaneous vertebroplasty technique. Study eligible patients with painful osteoporotic compression fractures will be randomized (2:1) to vertebroplasty with Cortoss (treatment group) or PMMA (control group), respectively. Patients will not be told which treatment they will receive (single blind study design). Safety and effectiveness will be determined by comparing the success rate of the treatment group to the success rate of the control group. Secondary endpoints will include Quality of Life, Patient satisfaction, evaluation of the patient's pain and function post-operatively compared to baseline, and maintenance of vertebral body height and alignment. For the purposes of this study, vertebral augmentation, or vertebroplasty, is defined as a minimally invasive procedure utilizing manual instruments and radiological guidance to deliver an in-situ polymerizable material to stabilize a collapsed or fractured vertebral body. The goal is to alleviate pain caused by the fracture and enhance or prevent further deterioration of function. This multi-center study will evaluate Cortoss for the augmentation of one or two vertebra(e), fractured as a result of osteoporosis, located between (and including) the levels of the sixth thoracic and the fifth lumbar vertebrae. A total of 243 patients will be enrolled at up to 19 sites. All subjects must have radiographic evidence of a vertebral body fracture due to osteoporosis. After complying with all eligibility criteria, subjects will sign an informed consent document and will be randomized into vertebroplasty treatment with Cortoss or PMMA (1:1 ratio). Patients will be followed for at least 24 months and recruitment is expected to take between 9 and 12 months. Visits and assessments are planned according to the time and events schedule.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Spinal Fractures
Keywords
Osteoporosis, Spine fracture, Back Pain, Vertebroplasty, Vertebral compression fractures related to osteoporosis

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
256 (Actual)

8. Arms, Groups, and Interventions

Arm Title
CORTOSS
Arm Type
Experimental
Arm Description
Patients prospectively randomized to be treated with Cortoss constitute treatment group.
Arm Title
PMMA
Arm Type
Active Comparator
Arm Description
Patients prospectively randomized to be treated with PMMA constitute active control group.
Intervention Type
Device
Intervention Name(s)
Percutaneous Vertebral Augmentation of compression fractures
Other Intervention Name(s)
CORTOSS, a Bis-GMA composite material, a vertebral augmentation strengthening agent., PMMA, commercially available poly methyl methacrylate material, on-label for vertebral augmentation.
Intervention Description
Study eligible patients with painful osteoporotic compression fractures will be randomized to percutaneous vertebroplasty with CORTOSS (treatment group) or PMMA (active control group).
Primary Outcome Measure Information:
Title
Early and sustained decrease in pain (efficacy prong of primary endpoint) at 24 months compared to pre-treatment baseline using the Visual Analog Scale (VAS)
Time Frame
24 Months
Title
Maintenance or improvement in function (efficacy prong of primary endpoint) at 24 months compared to pre-treatment baseline using the Oswestry Disability Index (ODI)
Time Frame
24 Months
Title
Maintenance vertebral height and alignment (efficacy prong of primary endpoint) at 24 Months compared to 1-month post-vertebropalsty baseline radiographs
Time Frame
24 Months
Title
No device-related subsequent surgical intervention at study treated level
Time Frame
24 Months
Secondary Outcome Measure Information:
Title
Maintenance or improvement in quality of life (secondary endpoint) at 24 months compared to baseline using the SF-12
Time Frame
24 Months
Title
Ambulatory status
Time Frame
24 Months
Title
Patient satisfaction
Time Frame
24 Months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Are at least 18 years of age Have sustained a painful osteoporotic vertebral compression fracture (VCF) for at least 4 weeks but no longer than 1 year or have radiographic evidence of at least 5% worsening vertebral collapse as compared to previous radiographic evidence Give written Informed Consent to participate in the study and be willing to comply with protocol requirements Have pain requiring the regular use of analgesics or have a substantially altered life-style due to pain or disability Have central pain over the spinous process upon palpation at the planned level(s) Are appropriately communicative to verbalize and differentiate with regard to location and intensity of their pain Are physically and mentally willing and able to comply with the clinical and radiographic follow-up schedule Have radiographic evidence of one or two, Grade 1 or greater according to Genant's criteria, osteoporotic VCF(s) between (and including) the level of the sixth (6th) thoracic to the fifth (5th) lumbar Have an acute or persistent (not healed) fracture demonstrated by magnetic resonance imaging (MRI) or bone scan Have a patient self-assessment VAS score >= 50 mm at the pre-treatment visit Have a 30% or greater disability score on the baseline ODI (version 2.0). Exclusion Criteria: Have significant vertebral collapse defined as more than 70% of original vertebral height, or a burst or pedicle fracture with posterior cortical wall disruption Have posterior vertebral wall displacement occupying more than 20% of the cross sectional area of the spinal canal Have neurologic symptoms or deficits, or radiculopathy related to the VCF Have pain based on a clinical diagnosis of herniated nucleus pulposus, high energy trauma, severe spinal stenosis as evidenced by progressive weakness or paralysis, or bone tumor at the level(s) of pathology as evidenced by computed tomography (CT) scan Have indications of instability related to the VCF at the level to be treated (e.g., neurologic deficit, kyphosis > 30º, translation > 4 mm, and/or interspinous process widening) Have canal compromise causing clinical manifestations of cord, neural foramen, or nerve root compression at the level(s) to be treated Have a bleeding disorder, including coagulopathy Have severe cardiopulmonary deficiencies Have an active systemic or local infection Are currently being treated for cancer or HIV Have a known allergy to acrylics (e.g., methyl methacrylate) Subject is currently an alcohol, solvent or drug abuser Female patients who are pregnant or nursing, or of childbearing potential not using a reliable contraceptive method Are involved in medical litigation Are prisoners Have participated in another investigational study within 30 days prior to inclusion
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Maarten Persenaire, M.D.
Organizational Affiliation
Orthovita, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Scottsdale Medical Center
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85251
Country
United States
Facility Name
Core Orthopaedic Medical Center, P.C.
City
Encinitas
State/Province
California
ZIP/Postal Code
92024
Country
United States
Facility Name
Eisenhower Medical Center
City
Rancho Mirage
State/Province
California
ZIP/Postal Code
92270
Country
United States
Facility Name
St. John's Spine Institute
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Facility Name
Indian River Radiology
City
Vero Beach
State/Province
Florida
ZIP/Postal Code
32960
Country
United States
Facility Name
Emory Orthopaedics and Spine Center
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30329
Country
United States
Facility Name
Millenium Pain Center
City
Bloomington
State/Province
Illinois
ZIP/Postal Code
61701
Country
United States
Facility Name
Northwestern University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60611
Country
United States
Facility Name
The Spine Institute of Louisiana
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71101
Country
United States
Facility Name
Washington University Medical Center
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Montefiore Medical Center
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Facility Name
Hospital for Special Surgery (HSS)
City
New York
State/Province
New York
ZIP/Postal Code
10021
Country
United States
Facility Name
Mission Hospitals
City
Asheville
State/Province
North Carolina
ZIP/Postal Code
28801
Country
United States
Facility Name
Dayton Interventional Radiology
City
Kettering
State/Province
Ohio
ZIP/Postal Code
45409
Country
United States
Facility Name
Edmond Medical Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73034
Country
United States
Facility Name
Mercy Health Center
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73120
Country
United States
Facility Name
Pennsylvania Hospital
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Facility Name
Endovascular Center of Houston
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States

12. IPD Sharing Statement

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A Safety and Efficacy Study for Treatment of Painful Vertebral Compression Fractures Caused by Osteoporosis

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