Study Comparing Lutonix AV Drug Coated Balloon vs Standard Balloon for Treatment of Dysfunctional AV Fistulae
Primary Purpose
Arteriovenous Fistula
Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Lutonix DCB
Standard Balloon Angioplasty Catheter
Percutaneous Transluminal Angiography
Sponsored by
About this trial
This is an interventional treatment trial for Arteriovenous Fistula
Eligibility Criteria
Inclusion Criteria:
- Age ≥21 years;
- The subject is legally competent, has been informed of the nature, the scope and the relevance of the study, voluntarily agrees to participation and the study's provisions, and has duly signed the informed consent form (ICF);
- Arteriovenous fistula located in the arm;
- Native AV fistula was created ≥30 days prior to the index procedure and has undergone one or more hemodialysis sessions;
- Venous stenosis of an AV fistula with the target lesion located from the anastomosis to the axillosubclavian junction and an abnormality attributable to the stenosis as defined by K/DOQI guidelines.;
- Successful pre-dilation of the target lesion with a percutaneous transluminal angioplasty (PTA) balloon;
- Intended target lesion.
Exclusion Criteria:
- Women who are pregnant, lactating, or planning on becoming pregnant during the study;
- Hemodialysis access is located in the leg;
- Subject has more than two lesions in the access circuit;
- Subject has a secondary non-target lesion that cannot be successfully treated;
- Target lesion is located central to the axillosubclavian junction;
- The subject has a secondary lesion located in the central venous system (central to the axillosubclavian junction);
- A thrombosed access;
- Surgical revision of the access site planned;
- Recent prior surgical interventions of the access site;
- Other planned treatment during the index procedure;
- Known contraindication (including allergic reaction) or sensitivity to iodinated contrast media, that cannot be adequately managed with pre-and post-procedure medication;
- Known contraindication (including allergic reaction) or sensitivity to paclitaxel.
Subjects who are taking immunosuppressive therapy or are routinely taking
≥10mg of prednisone per day;
- Subject has another medical condition, which, in the opinion of the Investigator, may cause him/her to be noncompliant with the protocol or confound the data interpretation;
- Subject has a life expectancy <12 months;
- Anticipated for a kidney transplant;
- Anticipated conversion to peritoneal dialysis;
- Subject has a stent located in the target or secondary non target lesion;
- Subject has an infected AV access or systemic infection;
- Currently participating in an investigational drug, biologic, or device study, or previous enrollment in this study.
Sites / Locations
- The Board of Trustees of The University of Alabama for the University of Alabama at Birmingham
- Arizona Kidney Disease and Hypertension Center Medical Research Services, LLC
- Southwest Clinical Research Institute, LLC
- Capital Nephrology Medical Group
- Nephrology Associates, P.A.
- Rush University
- RenalCare Associates, S.C. d/b/a Illinois Kidney Disease & Hypertension Center
- MakrisMD, LLC, d/b/a Chicago Access Care
- Massachusetts General Physicians Organizations, Inc.
- Renal and Transplant Associates of New England, PC
- Michigan Vascular Center
- Minnesota Vascular Surgery Center
- Capital Nephrology Associates, P.A.
- Oklahoma Life Access, PLLC
- Trustees of the University of Pennsylvania
- Providence Interventional Associates, LLC
- Medical University of South Carolina
- Spartanburg Regional Health Services District, Inc.
- University Vascular Access
- Tarrant Vascular Clinic
- San Antonio Kidney Disease Center Physicians Group, PLLC
- University of Virginia
- Board of Regents of the University of Wisconsin System
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
Lutonix DCB
Standard Balloon Angioplasty Catheter
Arm Description
Percutaneous transluminal angiography (PTA) will be performed using the Lutonix AV drug coated balloon.
Percutaneous transluminal angiography (PTA) will be performed using a commercially available uncoated PTA balloon. Balloons with an external wire support, cutting/scoring component or other similar modifications are not permitted. Multiple balloons, inflations and/or prolonged inflation may be used.
Outcomes
Primary Outcome Measures
Percentage of Participants With Target Lesion Primary Patency (TLPP) at 6 Months Post Index Procedure
Primary Patency is defined as the interval following index procedure intervention until clinically driven reintervention of the target lesion or access thrombosis. Target Lesion Primary Patency (TLPP) ends with a clinically driven re-intervention of the target lesion or access thrombosis.
Number of Participants With Freedom From Any Serious Adverse Event(s) Involving the AV Access Circuit at 30 Days Post Index Procedure.
The primary safety endpoint is freedom from localized or systemic serious adverse events through 30 days that reasonably suggests the involvement of the AV access circuit (CEC adjudicated).
Secondary Outcome Measures
Percentage of Participants With Target Lesion Primary Patency at 3, 9, 12, 18, and 24 Months
Primary Patency is defined as the interval following index procedure intervention until clinically driven reintervention of the target lesion or access thrombosis. Target Lesion Primary Patency (TLPP) ends with a clinically driven re-intervention of the target lesion or access thrombosis.
Percentage of Participants With Device, Procedural and Clinical Success
Device Success: Successful delivery to the target lesion, deployment, and retrieval at index procedure.
Procedural Success: At least one indicator of hemodynamic success (e.g., physical examination with restoration of a thrill, direct measurement of flow) in the absence of peri-procedural (index procedure and through hospital stay) Serious Adverse Device Effects (SADEs).
Clinical Success: The resumption of dialysis for at least one session after the index procedure.
Number of Participants With Abandonment of Permanent Access in the Index Extremity at 3, 6, 9, 12, 18, and 24 Months Post Index Procedure
Index access site abandonment refers to an abandonment due to either receiving a kidney transplant, converting to Peritoneal Dialysis, or a new access site being created.
Number of Interventions Required to Maintain Access Circuit Primary Patency (ACPP) at 3, 6, 9, 12, 18, and 24 Months Post Index Procedure
Number of Participants With Device Related Adverse Events at 1, 3, 6, 9, 12, 18, and 24 Months (CEC Adjudicated)
Events adjudicated as 'definitely related' and 'possibly related' by the CEC were combined in all analyses and are displayed as 'related' in this report.
Number of Participants With Target Lesion Primary Patency (TLPP) by Fiber Pre-Dilation Balloon at 6 Months Post Index Procedure
Primary Patency is defined as the interval following index procedure intervention until clinically driven reintervention of the target lesion or access thrombosis. Target Lesion Primary Patency (TLPP) ends with a clinically driven re-intervention of the target lesion or access thrombosis.
Number of Interventions Required to Maintain Target Lesion Primary Patency (TLPP) at 3, 6, 9, 12, 18, and 24 Months Post Index Procedure
Number of Procedure Related Serious Adverse Events (CEC Adjudicated) at 1, 3, 6, 9, 12, 18, and 24 Months Post Index Procedure
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02440022
Brief Title
Study Comparing Lutonix AV Drug Coated Balloon vs Standard Balloon for Treatment of Dysfunctional AV Fistulae
Official Title
A Prospective, Global, Multicenter, Randomized, Controlled Study Comparing Lutonix® 035 AV Drug Coated Balloon PTA Catheter vs. Standard Balloon PTA Catheter for the Treatment of Dysfunctional AV Fistulae
Study Type
Interventional
2. Study Status
Record Verification Date
April 2020
Overall Recruitment Status
Completed
Study Start Date
June 2015 (undefined)
Primary Completion Date
September 2016 (Actual)
Study Completion Date
June 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
C. R. Bard
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
This prospective, global, multicenter, randomized, controlled study is designed to evaluate the safety and effectiveness of the Lutonix 035 AV Drug Coated Balloon PTA Catheter compared to a standard PTA Catheter in treating subjects presenting with clinical and hemodynamic abnormalities in native arteriovenous (AV) fistulae located in the upper extremity.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Arteriovenous Fistula
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
285 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Lutonix DCB
Arm Type
Experimental
Arm Description
Percutaneous transluminal angiography (PTA) will be performed using the Lutonix AV drug coated balloon.
Arm Title
Standard Balloon Angioplasty Catheter
Arm Type
Active Comparator
Arm Description
Percutaneous transluminal angiography (PTA) will be performed using a commercially available uncoated PTA balloon. Balloons with an external wire support, cutting/scoring component or other similar modifications are not permitted. Multiple balloons, inflations and/or prolonged inflation may be used.
Intervention Type
Combination Product
Intervention Name(s)
Lutonix DCB
Intervention Type
Device
Intervention Name(s)
Standard Balloon Angioplasty Catheter
Intervention Type
Procedure
Intervention Name(s)
Percutaneous Transluminal Angiography
Other Intervention Name(s)
PTA
Intervention Description
Percutaneous transluminal angioplasty (PTA) is a procedure that can open up a blocked blood vessel using a small, flexible plastic tube, or catheter, with a "balloon" at the end of it. When the tube is in place, it inflates to open the blood vessel, or artery, so that normal blood flow is restored.
Primary Outcome Measure Information:
Title
Percentage of Participants With Target Lesion Primary Patency (TLPP) at 6 Months Post Index Procedure
Description
Primary Patency is defined as the interval following index procedure intervention until clinically driven reintervention of the target lesion or access thrombosis. Target Lesion Primary Patency (TLPP) ends with a clinically driven re-intervention of the target lesion or access thrombosis.
Time Frame
6 months post index procedure
Title
Number of Participants With Freedom From Any Serious Adverse Event(s) Involving the AV Access Circuit at 30 Days Post Index Procedure.
Description
The primary safety endpoint is freedom from localized or systemic serious adverse events through 30 days that reasonably suggests the involvement of the AV access circuit (CEC adjudicated).
Time Frame
30 Days Post Index Procedure
Secondary Outcome Measure Information:
Title
Percentage of Participants With Target Lesion Primary Patency at 3, 9, 12, 18, and 24 Months
Description
Primary Patency is defined as the interval following index procedure intervention until clinically driven reintervention of the target lesion or access thrombosis. Target Lesion Primary Patency (TLPP) ends with a clinically driven re-intervention of the target lesion or access thrombosis.
Time Frame
3, 9, 12, 18, and 24 Months Post Index Procedure
Title
Percentage of Participants With Device, Procedural and Clinical Success
Description
Device Success: Successful delivery to the target lesion, deployment, and retrieval at index procedure.
Procedural Success: At least one indicator of hemodynamic success (e.g., physical examination with restoration of a thrill, direct measurement of flow) in the absence of peri-procedural (index procedure and through hospital stay) Serious Adverse Device Effects (SADEs).
Clinical Success: The resumption of dialysis for at least one session after the index procedure.
Time Frame
Device and Procedural Success: At time of Index Procedure; Clinical Success: at 1st session of dialysis following index procedure
Title
Number of Participants With Abandonment of Permanent Access in the Index Extremity at 3, 6, 9, 12, 18, and 24 Months Post Index Procedure
Description
Index access site abandonment refers to an abandonment due to either receiving a kidney transplant, converting to Peritoneal Dialysis, or a new access site being created.
Time Frame
3, 6, 9, 12, 18 and 24 Months Post Index Procedure
Title
Number of Interventions Required to Maintain Access Circuit Primary Patency (ACPP) at 3, 6, 9, 12, 18, and 24 Months Post Index Procedure
Time Frame
3, 6, 9, 12, 18 and 24 Months Post Index Procedure
Title
Number of Participants With Device Related Adverse Events at 1, 3, 6, 9, 12, 18, and 24 Months (CEC Adjudicated)
Description
Events adjudicated as 'definitely related' and 'possibly related' by the CEC were combined in all analyses and are displayed as 'related' in this report.
Time Frame
1, 3, 6, 9, 12, 18 and 24 Months Post Index Procedure
Title
Number of Participants With Target Lesion Primary Patency (TLPP) by Fiber Pre-Dilation Balloon at 6 Months Post Index Procedure
Description
Primary Patency is defined as the interval following index procedure intervention until clinically driven reintervention of the target lesion or access thrombosis. Target Lesion Primary Patency (TLPP) ends with a clinically driven re-intervention of the target lesion or access thrombosis.
Time Frame
6 Months Post Index Procedure
Title
Number of Interventions Required to Maintain Target Lesion Primary Patency (TLPP) at 3, 6, 9, 12, 18, and 24 Months Post Index Procedure
Time Frame
3, 6, 9, 12, 18, and 24 Months Post Index Procedure
Title
Number of Procedure Related Serious Adverse Events (CEC Adjudicated) at 1, 3, 6, 9, 12, 18, and 24 Months Post Index Procedure
Time Frame
1, 3, 6, 9, 12, 18, and 24 Months Post Index Procedure
10. Eligibility
Sex
All
Minimum Age & Unit of Time
21 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Age ≥21 years;
The subject is legally competent, has been informed of the nature, the scope and the relevance of the study, voluntarily agrees to participation and the study's provisions, and has duly signed the informed consent form (ICF);
Arteriovenous fistula located in the arm;
Native AV fistula was created ≥30 days prior to the index procedure and has undergone one or more hemodialysis sessions;
Venous stenosis of an AV fistula with the target lesion located from the anastomosis to the axillosubclavian junction and an abnormality attributable to the stenosis as defined by K/DOQI guidelines.;
Successful pre-dilation of the target lesion with a percutaneous transluminal angioplasty (PTA) balloon;
Intended target lesion.
Exclusion Criteria:
Women who are pregnant, lactating, or planning on becoming pregnant during the study;
Hemodialysis access is located in the leg;
Subject has more than two lesions in the access circuit;
Subject has a secondary non-target lesion that cannot be successfully treated;
Target lesion is located central to the axillosubclavian junction;
The subject has a secondary lesion located in the central venous system (central to the axillosubclavian junction);
A thrombosed access;
Surgical revision of the access site planned;
Recent prior surgical interventions of the access site;
Other planned treatment during the index procedure;
Known contraindication (including allergic reaction) or sensitivity to iodinated contrast media, that cannot be adequately managed with pre-and post-procedure medication;
Known contraindication (including allergic reaction) or sensitivity to paclitaxel.
Subjects who are taking immunosuppressive therapy or are routinely taking
≥10mg of prednisone per day;
Subject has another medical condition, which, in the opinion of the Investigator, may cause him/her to be noncompliant with the protocol or confound the data interpretation;
Subject has a life expectancy <12 months;
Anticipated for a kidney transplant;
Anticipated conversion to peritoneal dialysis;
Subject has a stent located in the target or secondary non target lesion;
Subject has an infected AV access or systemic infection;
Currently participating in an investigational drug, biologic, or device study, or previous enrollment in this study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Scott Trerotola, MD
Organizational Affiliation
University of Pennsylvania
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Board of Trustees of The University of Alabama for the University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35233
Country
United States
Facility Name
Arizona Kidney Disease and Hypertension Center Medical Research Services, LLC
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85012
Country
United States
Facility Name
Southwest Clinical Research Institute, LLC
City
Tempe
State/Province
Arizona
ZIP/Postal Code
85284
Country
United States
Facility Name
Capital Nephrology Medical Group
City
Sacramento
State/Province
California
ZIP/Postal Code
95825
Country
United States
Facility Name
Nephrology Associates, P.A.
City
Newark
State/Province
Delaware
ZIP/Postal Code
19713
Country
United States
Facility Name
Rush University
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
RenalCare Associates, S.C. d/b/a Illinois Kidney Disease & Hypertension Center
City
Peoria
State/Province
Illinois
ZIP/Postal Code
61603
Country
United States
Facility Name
MakrisMD, LLC, d/b/a Chicago Access Care
City
Westmont
State/Province
Illinois
ZIP/Postal Code
60559
Country
United States
Facility Name
Massachusetts General Physicians Organizations, Inc.
City
Boston
State/Province
Massachusetts
ZIP/Postal Code
02114
Country
United States
Facility Name
Renal and Transplant Associates of New England, PC
City
Springfield
State/Province
Massachusetts
ZIP/Postal Code
01107
Country
United States
Facility Name
Michigan Vascular Center
City
Flint
State/Province
Michigan
ZIP/Postal Code
48507
Country
United States
Facility Name
Minnesota Vascular Surgery Center
City
New Brighton
State/Province
Minnesota
ZIP/Postal Code
55112
Country
United States
Facility Name
Capital Nephrology Associates, P.A.
City
Raleigh
State/Province
North Carolina
ZIP/Postal Code
27610
Country
United States
Facility Name
Oklahoma Life Access, PLLC
City
Tulsa
State/Province
Oklahoma
ZIP/Postal Code
74104
Country
United States
Facility Name
Trustees of the University of Pennsylvania
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19104
Country
United States
Facility Name
Providence Interventional Associates, LLC
City
Providence
State/Province
Rhode Island
ZIP/Postal Code
02906
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Spartanburg Regional Health Services District, Inc.
City
Spartanburg
State/Province
South Carolina
ZIP/Postal Code
29303
Country
United States
Facility Name
University Vascular Access
City
Memphis
State/Province
Tennessee
ZIP/Postal Code
38115
Country
United States
Facility Name
Tarrant Vascular Clinic
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76104
Country
United States
Facility Name
San Antonio Kidney Disease Center Physicians Group, PLLC
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78215
Country
United States
Facility Name
University of Virginia
City
Charlottesville
State/Province
Virginia
ZIP/Postal Code
22908
Country
United States
Facility Name
Board of Regents of the University of Wisconsin System
City
Madison
State/Province
Wisconsin
ZIP/Postal Code
53715
Country
United States
12. IPD Sharing Statement
Citations:
PubMed Identifier
30042225
Citation
Trerotola SO, Lawson J, Roy-Chaudhury P, Saad TF; Lutonix AV Clinical Trial Investigators. Drug Coated Balloon Angioplasty in Failing AV Fistulas: A Randomized Controlled Trial. Clin J Am Soc Nephrol. 2018 Aug 7;13(8):1215-1224. doi: 10.2215/CJN.14231217. Epub 2018 Jul 24. Erratum In: Clin J Am Soc Nephrol. 2019 Jul 5;14(7):1073.
Results Reference
derived
Learn more about this trial
Study Comparing Lutonix AV Drug Coated Balloon vs Standard Balloon for Treatment of Dysfunctional AV Fistulae
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