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Continuous Intrathecal Baclofen Infusion for Chronic Spasticity (CIBI)

Primary Purpose

Spasticity

Status
Withdrawn
Phase
Phase 3
Locations
Study Type
Interventional
Intervention
Prometra Programmable Implantable Pump System
Sponsored by
Flowonix Medical
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Spasticity focused on measuring neurological disorders, multiple sclerosis, stroke, cerebral palsy, spinal cord, brain injuries, neurodegenerative diseases

Eligibility Criteria

22 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

The overall goal of this study is to choose patients most likely to experience therapeutic success while reducing the likelihood of risks, complications and adverse events.

Patients meeting all of the following criteria will be eligible for enrollment in the study:

  1. Patient with a history of severe chronic spastic hypertonia in the lower extremities lasting at least 6 months who:

    • fail to respond to maximum recommended doses of antispasmodic medications including baclofen, or
    • those who experience intolerable CNS side effects at effective oral doses
  2. Patient is >21 years of age
  3. Patient, or legally authorized representative (LAR), has provided written informed consent to participate in the study
  4. Investigator considers the patient willing and able to fulfill all study requirements
  5. Investigator has documented attempts to eliminate factors that can contribute to an increase in spasticity (e.g. infection)
  6. Patient has had a successful trial of Lioresal® for the management of the target spasticity.

Exclusion Criteria:

Patients meeting any of the following criteria are to be excluded from the study:

  1. Patient has MRI of the spine documenting structural abnormality preventing adequate CSF flow. (If the patient has a medical condition that contraindicates screening MRI, the investigator should proceed with the closest appropriate study i.e. CT scan, X-ray, to rule out any spinal abnormalities that would prevent intrathecal drug administration.)
  2. Patient's anatomy is not large enough to accommodate the pump's size and weight.
  3. Patient has a systemic infection.
  4. Patient has renal insufficiency as evidenced by a baseline serum creatinine of >2.0 mg/dl.
  5. Patient has a history of a bleeding disorder.
  6. Patient has a history of blood clots such as deep vein thrombosis (DVT) or pulmonary embolism (PE) within 1 year of enrollment.
  7. Patient is pregnant or breast-feeding, or is of child-bearing potential and not employing effective birth control.
  8. Patient has known allergies or sensitivities to pump system materials (e.g., silicone rubber, titanium, polyphenylsulfone, acetal resin, polyvinylidene fluoride, tungsten).
  9. Patient has known allergies to Lioresal® (baclofen), or would be contraindicated for Lioresal® based on the drug labeling.
  10. Patient has other implantable electronic cardiac devices (i.e. pacemaker, defibrillator, CRT system)
  11. Patient has an occupation where he/she would be exposed to high current industrial equipment, powerful magnets or transmitting towers, such as, electricians, electrical engineers or MRI technicians.
  12. Patient is participating in another clinical trial.

Sites / Locations

    Arms of the Study

    Arm 1

    Arm Type

    Experimental

    Arm Label

    Spasticity. Baclofen

    Arm Description

    This study is a non-randomized, open-label, multi-center study of the Prometra Programmable Implantable Pump System in the administration of Lioresal® intrathecal (baclofen) in patients suffering from severe muscle spasticity of spinal origin.

    Outcomes

    Primary Outcome Measures

    The primary endpoint is: A change in the average lower extremity spasticity score as measured by the Modified Ashworth Scale

    Secondary Outcome Measures

    Secondary Endpoints include: Change in overall spasm frequency as measured by the Penn Spasm Frequency Scale. Change in overall Quality of Life as measured by the SF 36 and PSQI. SAE-free survival. DRAE-free survival. Tabulation of device complications.

    Full Information

    First Posted
    January 15, 2010
    Last Updated
    March 5, 2015
    Sponsor
    Flowonix Medical
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    1. Study Identification

    Unique Protocol Identification Number
    NCT01051128
    Brief Title
    Continuous Intrathecal Baclofen Infusion for Chronic Spasticity
    Acronym
    CIBI
    Official Title
    Continuous Intrathecal Baclofen Infusion for the Management of Chronic Spasticity
    Study Type
    Interventional

    2. Study Status

    Record Verification Date
    March 2015
    Overall Recruitment Status
    Withdrawn
    Why Stopped
    Study was never started. Full IDE-approval not obtained. new IDE will be submitted
    Study Start Date
    January 2010 (undefined)
    Primary Completion Date
    June 2010 (Anticipated)
    Study Completion Date
    December 2010 (Anticipated)

    3. Sponsor/Collaborators

    Name of the Sponsor
    Flowonix Medical

    4. Oversight

    Data Monitoring Committee
    No

    5. Study Description

    Brief Summary
    The purpose of this clinical investigation is to demonstrate product performance of the Prometra Programmable Pump System in the delivery of intrathecal Lioresal® (baclofen) for the management of severe spasticity.
    Detailed Description
    The Prometra Programmable Pump is a battery-operated, implantable, programmable infusion pump that dispenses drug solution into the intrathecal space through an implanted infusion catheter. All functions of the system (e.g., dosing) are controlled externally using a hand-held, battery-operated programmer. Lioresal Intrathecal (baclofen) is indicated for use in the management of severe spasticity. Spasticity is a major problem that has long challenged traditional medical treatment. While the incidence of spasticity is not known with certainty, it likely affects over half a million people in the United States and over 12 million worldwide. Spasticity is associated with some very common neurological disorders such as: multiple sclerosis, stroke, cerebral palsy, spinal cord and brain injuries. Chronic spasticity seriously restricts normal daily activities and reduces the quality of life for many patients.

    6. Conditions and Keywords

    Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
    Spasticity
    Keywords
    neurological disorders, multiple sclerosis, stroke, cerebral palsy, spinal cord, brain injuries, neurodegenerative diseases

    7. Study Design

    Primary Purpose
    Treatment
    Study Phase
    Phase 3
    Interventional Study Model
    Single Group Assignment
    Masking
    None (Open Label)
    Allocation
    N/A
    Enrollment
    0 (Actual)

    8. Arms, Groups, and Interventions

    Arm Title
    Spasticity. Baclofen
    Arm Type
    Experimental
    Arm Description
    This study is a non-randomized, open-label, multi-center study of the Prometra Programmable Implantable Pump System in the administration of Lioresal® intrathecal (baclofen) in patients suffering from severe muscle spasticity of spinal origin.
    Intervention Type
    Device
    Intervention Name(s)
    Prometra Programmable Implantable Pump System
    Intervention Description
    The Prometra Programmable Pump is a battery-operated, implantable, programmable infusion pump that dispenses drug solution into the intrathecal space through an implanted infusion catheter. All functions of the system (e.g., dosing) are controlled externally using a hand-held, battery-operated programmer.
    Primary Outcome Measure Information:
    Title
    The primary endpoint is: A change in the average lower extremity spasticity score as measured by the Modified Ashworth Scale
    Time Frame
    3 months
    Secondary Outcome Measure Information:
    Title
    Secondary Endpoints include: Change in overall spasm frequency as measured by the Penn Spasm Frequency Scale. Change in overall Quality of Life as measured by the SF 36 and PSQI. SAE-free survival. DRAE-free survival. Tabulation of device complications.
    Time Frame
    3 months

    10. Eligibility

    Sex
    All
    Minimum Age & Unit of Time
    22 Years
    Accepts Healthy Volunteers
    No
    Eligibility Criteria
    Inclusion Criteria: The overall goal of this study is to choose patients most likely to experience therapeutic success while reducing the likelihood of risks, complications and adverse events. Patients meeting all of the following criteria will be eligible for enrollment in the study: Patient with a history of severe chronic spastic hypertonia in the lower extremities lasting at least 6 months who: fail to respond to maximum recommended doses of antispasmodic medications including baclofen, or those who experience intolerable CNS side effects at effective oral doses Patient is >21 years of age Patient, or legally authorized representative (LAR), has provided written informed consent to participate in the study Investigator considers the patient willing and able to fulfill all study requirements Investigator has documented attempts to eliminate factors that can contribute to an increase in spasticity (e.g. infection) Patient has had a successful trial of Lioresal® for the management of the target spasticity. Exclusion Criteria: Patients meeting any of the following criteria are to be excluded from the study: Patient has MRI of the spine documenting structural abnormality preventing adequate CSF flow. (If the patient has a medical condition that contraindicates screening MRI, the investigator should proceed with the closest appropriate study i.e. CT scan, X-ray, to rule out any spinal abnormalities that would prevent intrathecal drug administration.) Patient's anatomy is not large enough to accommodate the pump's size and weight. Patient has a systemic infection. Patient has renal insufficiency as evidenced by a baseline serum creatinine of >2.0 mg/dl. Patient has a history of a bleeding disorder. Patient has a history of blood clots such as deep vein thrombosis (DVT) or pulmonary embolism (PE) within 1 year of enrollment. Patient is pregnant or breast-feeding, or is of child-bearing potential and not employing effective birth control. Patient has known allergies or sensitivities to pump system materials (e.g., silicone rubber, titanium, polyphenylsulfone, acetal resin, polyvinylidene fluoride, tungsten). Patient has known allergies to Lioresal® (baclofen), or would be contraindicated for Lioresal® based on the drug labeling. Patient has other implantable electronic cardiac devices (i.e. pacemaker, defibrillator, CRT system) Patient has an occupation where he/she would be exposed to high current industrial equipment, powerful magnets or transmitting towers, such as, electricians, electrical engineers or MRI technicians. Patient is participating in another clinical trial.
    Overall Study Officials:
    First Name & Middle Initial & Last Name & Degree
    Robert Levy, MD, PhD
    Organizational Affiliation
    Northwestern University Hospital
    Official's Role
    Principal Investigator

    12. IPD Sharing Statement

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    Continuous Intrathecal Baclofen Infusion for Chronic Spasticity

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