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The EVARREST® Pediatric Mild or Moderate Liver and Soft Tissue Bleeding Study

Primary Purpose

Controlling Mild to Moderate Bleeding During Surgery

Status
Recruiting
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
EVARREST® Fibrin Sealant Patch
Sponsored by
Ethicon, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Controlling Mild to Moderate Bleeding During Surgery focused on measuring Bleeding, hemostasis, re-bleeding, hemostatic

Eligibility Criteria

28 Days - 17 Years (Child)All SexesAccepts Healthy Volunteers

Inclusion Criteria:

  1. Pediatric subjects aged ≥28 days (≥1 month) to <18 years, requiring non-emergent open hepatic, abdominal, retroperitoneal, pelvic or thoracic (non-cardiac) surgical procedures; i) The first 31 subjects to be enrolled will be subjects aged ≥1 years to <18 years.

    ii) The next 4 subjects to be enrolled will be subjects aged ≥28 days to <1 year.

  2. The subject's parent/legal guardian must be willing to give permission for the subject to participate in the trial, and provide written Informed Consent for the subject. In addition, assent must be obtained from pediatric subjects who possess the intellectual and emotional ability to comprehend the concepts involved in the trial. If the pediatric subject is not able to provide assent (due to age, maturity and/or inability to intellectually and/or emotionally comprehend the trial), the parent/legal guardian's written Informed Consent for the subject will be acceptable for the subject to be included in the study.
  3. Presence of an appropriate mild or moderate bleeding soft tissue or hepatic parenchyma Target Bleeding Site (TBS) identified intra-operatively by the surgeon;
  4. Ability to firmly press trial treatment at TBS until 4 minutes after TBS identification.

Exclusion Criteria:

  1. Subjects with known intolerance to blood products or to one of the components of the study product or is unwilling to receive blood products;
  2. Female subjects, of childbearing age (i.e. adolescent), who are pregnant or nursing;
  3. Subject is currently participating or plan to participate in any other investigational device or drug study without prior approval from the Sponsor;
  4. Subjects who are known, current alcohol and/or drug abusers
  5. Subjects admitted for trauma surgery
  6. Subjects with any pre or intra-operative findings identified by the surgeon that may preclude conduct of the study procedure
  7. Subjects that have received a COVID-19 vaccine either 4 weeks prior to surgery or scheduled to receive COVID-19 vaccine within the 30-day follow-up period
  8. Subject with TBS in an actively infected field (Class III Contaminated or Class IV Dirty or Infected)
  9. TBS is from large defects in arteries or veins where the injured vascular wall requires repair with maintenance of vessel patency and which would result in persistent exposure of EVARREST to blood flow and pressure during healing and absorption of the product
  10. TBS with major arterial bleeding requiring suture or mechanical ligation;
  11. Bleeding site is in, around, or in proximity to foramina in bone, or areas of bony confine.

Sites / Locations

  • University of Alabama Hospital
  • Nemours Children's Specialty Care
  • University of Kentucky
  • The Johns Hopkins Hospital
  • icahn School of Medicine at Mt SinaiRecruiting
  • Univesity of Utah
  • Birmingham Chrildren's HospitalRecruiting
  • Newcastle upon Tyne Hospitals NHS Foundation TrustRecruiting
  • Southampton University HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

EVARREST® Fibrin Sealant Patch

Arm Description

EVARREST Fibrin Sealant Patch is a sterile, bio-absorbable combination product consisting of two constituent parts- a flexible matrix and a coating of biological components (human plasma-derived fibrinogen and thrombin) embedded in a flexible composite patch component.

Outcomes

Primary Outcome Measures

Absolute time to hemostasis
The absolute time to hemostasis, defined as the absolute time elapsed from TBS identification to the last moment in time at which detectable bleeding at the TBS is observed.

Secondary Outcome Measures

Hemostatic success at 4 minutes
Proportion of subjects achieving hemostatic success at 4 minutes following Target Bleeding Site (TBS) identification and no bleeding requiring treatment at the TBS any time prior to final fascial closure.
Hemostatic success at 10 minutes
Proportion of subjects achieving hemostatic success at 10 minutes following TBS identification and no bleeding requiring treatment at the TBS any time prior to final fascial closure.
No re-bleeding at the TBS
Proportion of subjects with no re-bleeding at the TBS.
Incidence of adverse events that are potentially related to bleeding at the TBS
Incidence of adverse events that are potentially related to bleeding at the TBS.
Incidence of adverse events that are potentially related to thrombotic events
Incidence of adverse events that are potentially related to thrombotic events.
Incidence of re-treatment at the TBS
Incidence of Adverse Events

Full Information

First Posted
July 13, 2017
Last Updated
October 10, 2023
Sponsor
Ethicon, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03255174
Brief Title
The EVARREST® Pediatric Mild or Moderate Liver and Soft Tissue Bleeding Study
Official Title
A Prospective Study Evaluating the Safety and Effectiveness of EVARREST® Fibrin Sealant Patch in Controlling Mild or Moderate Hepatic Parenchyma or Soft Tissue Bleeding During Open Abdominal, Retroperitoneal, Pelvic and Thoracic (Non-cardiac) Surgery in Pediatric Patients
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
March 20, 2018 (Actual)
Primary Completion Date
December 1, 2023 (Anticipated)
Study Completion Date
December 31, 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ethicon, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of this study is to evaluate the safety and hemostatic effectiveness of EVARREST as an adjunct to controlling mild to moderate soft hepatic parenchyma or soft tissue bleeding during open hepatic, abdominal, pelvic, retroperitoneal, and thoracic (non-cardiac) surgery in pediatric population.
Detailed Description
This is an open-label, multicenter, single-arm study evaluating the safety and effectiveness of EVARREST in controlling mild or moderate bleeding in hepatic parenchyma or soft tissue for which standard methods of achieving hemostasis are ineffective or impractical. Eligible subjects will be treated with EVARREST. Subjects will be followed post-operatively through discharge and at 30 days (+/-14 days) post-surgery. Enrollment will be staggered by age. The first group will include 31 subjects ≥1 years to <18 years of age and the subsequent group will include 4 subjects from 1 month (≥ 28 days from birth) to <1 years of age. Ongoing safety assessment will ensure adequate safety monitoring occur during the staged enrollment. At least thirty-five (35) qualified pediatric subjects with an appropriate mild or moderate bleeding TBS will be enrolled in this study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Controlling Mild to Moderate Bleeding During Surgery
Keywords
Bleeding, hemostasis, re-bleeding, hemostatic

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
EVARREST® Fibrin Sealant Patch
Arm Type
Experimental
Arm Description
EVARREST Fibrin Sealant Patch is a sterile, bio-absorbable combination product consisting of two constituent parts- a flexible matrix and a coating of biological components (human plasma-derived fibrinogen and thrombin) embedded in a flexible composite patch component.
Intervention Type
Biological
Intervention Name(s)
EVARREST® Fibrin Sealant Patch
Other Intervention Name(s)
EVARREST
Intervention Description
EVARREST Fibrin Sealant Patch is a sterile, bio-absorbable combination product consisting of two constituent parts- a flexible matrix and a coating of biological components (human plasma-derived fibrinogen and thrombin) embedded in a flexible composite patch component.
Primary Outcome Measure Information:
Title
Absolute time to hemostasis
Description
The absolute time to hemostasis, defined as the absolute time elapsed from TBS identification to the last moment in time at which detectable bleeding at the TBS is observed.
Time Frame
Intraoperative from TBS identification to the last moment in time at which no detectable bleeding at the TBS is observed
Secondary Outcome Measure Information:
Title
Hemostatic success at 4 minutes
Description
Proportion of subjects achieving hemostatic success at 4 minutes following Target Bleeding Site (TBS) identification and no bleeding requiring treatment at the TBS any time prior to final fascial closure.
Time Frame
Intraoperative, 4 minutes after TBS identification
Title
Hemostatic success at 10 minutes
Description
Proportion of subjects achieving hemostatic success at 10 minutes following TBS identification and no bleeding requiring treatment at the TBS any time prior to final fascial closure.
Time Frame
Intraoperative, 10 minutes after TBS identification
Title
No re-bleeding at the TBS
Description
Proportion of subjects with no re-bleeding at the TBS.
Time Frame
Intraoperative, from TBS identification to final fascial closure
Title
Incidence of adverse events that are potentially related to bleeding at the TBS
Description
Incidence of adverse events that are potentially related to bleeding at the TBS.
Time Frame
Intraoperative to 30 (+/- 14) days
Title
Incidence of adverse events that are potentially related to thrombotic events
Description
Incidence of adverse events that are potentially related to thrombotic events.
Time Frame
Intraoperative to 30 (+/- 14) days
Title
Incidence of re-treatment at the TBS
Time Frame
Intraoperative, from TBS identification to final fascial closure
Title
Incidence of Adverse Events
Time Frame
Intraoperative to 30 (+/- 14) days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
28 Days
Maximum Age & Unit of Time
17 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Pediatric subjects aged ≥28 days (≥1 month) to <18 years, requiring non-emergent open hepatic, abdominal, retroperitoneal, pelvic or thoracic (non-cardiac) surgical procedures; i) The first 31 subjects to be enrolled will be subjects aged ≥1 years to <18 years. ii) The next 4 subjects to be enrolled will be subjects aged ≥28 days to <1 year. The subject's parent/legal guardian must be willing to give permission for the subject to participate in the trial, and provide written Informed Consent for the subject. In addition, assent must be obtained from pediatric subjects who possess the intellectual and emotional ability to comprehend the concepts involved in the trial. If the pediatric subject is not able to provide assent (due to age, maturity and/or inability to intellectually and/or emotionally comprehend the trial), the parent/legal guardian's written Informed Consent for the subject will be acceptable for the subject to be included in the study. Presence of an appropriate mild or moderate bleeding soft tissue or hepatic parenchyma Target Bleeding Site (TBS) identified intra-operatively by the surgeon; Ability to firmly press trial treatment at TBS until 4 minutes after TBS identification. Exclusion Criteria: Subjects with known intolerance to blood products or to one of the components of the study product or is unwilling to receive blood products; Female subjects, of childbearing age (i.e. adolescent), who are pregnant or nursing; Subject is currently participating or plan to participate in any other investigational device or drug study without prior approval from the Sponsor; Subjects who are known, current alcohol and/or drug abusers Subjects admitted for trauma surgery Subjects with any pre or intra-operative findings identified by the surgeon that may preclude conduct of the study procedure Subjects that have received a COVID-19 vaccine either 4 weeks prior to surgery or scheduled to receive COVID-19 vaccine within the 30-day follow-up period Subject with TBS in an actively infected field (Class III Contaminated or Class IV Dirty or Infected) TBS is from large defects in arteries or veins where the injured vascular wall requires repair with maintenance of vessel patency and which would result in persistent exposure of EVARREST to blood flow and pressure during healing and absorption of the product TBS with major arterial bleeding requiring suture or mechanical ligation; Bleeding site is in, around, or in proximity to foramina in bone, or areas of bony confine.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Richard Kocharian, M.D., Ph.D.
Phone
1 (908) 642-3787
Email
rkochar1@its.jnj.com
First Name & Middle Initial & Last Name or Official Title & Degree
Ellie Barnett
Email
ebarnett@its.jnj.com
Facility Information:
Facility Name
University of Alabama Hospital
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35222
Country
United States
Individual Site Status
Completed
Facility Name
Nemours Children's Specialty Care
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32207
Country
United States
Individual Site Status
Withdrawn
Facility Name
University of Kentucky
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40536
Country
United States
Individual Site Status
Withdrawn
Facility Name
The Johns Hopkins Hospital
City
Baltimore
State/Province
Maryland
ZIP/Postal Code
21287
Country
United States
Individual Site Status
Withdrawn
Facility Name
icahn School of Medicine at Mt Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Individual Site Status
Recruiting
Facility Name
Univesity of Utah
City
Salt Lake City
State/Province
Utah
ZIP/Postal Code
84113
Country
United States
Individual Site Status
Withdrawn
Facility Name
Birmingham Chrildren's Hospital
City
Birmingham
ZIP/Postal Code
B4 6NH
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Newcastle upon Tyne Hospitals NHS Foundation Trust
City
Newcastle upon Tyne
ZIP/Postal Code
NE1 4LP
Country
United Kingdom
Individual Site Status
Recruiting
Facility Name
Southampton University Hospital
City
Southampton
ZIP/Postal Code
SO16 6YD
Country
United Kingdom
Individual Site Status
Recruiting

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Efficacy and safety results related to the primary and secondary endpoints

Learn more about this trial

The EVARREST® Pediatric Mild or Moderate Liver and Soft Tissue Bleeding Study

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