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Safety Evaluation of Repeat Placement of the S8 Sinus Implant in Chronic Sinusitis Patients With Nasal Polyps (ENCORE)

Primary Purpose

Chronic Sinusitis, Nasal Polyposis

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
S8 Sinus Implant
Sponsored by
Intersect ENT
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Sinusitis focused on measuring corticosteroid, implant

Eligibility Criteria

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

Inclusion Criteria:

  1. Patient has provided written informed consent using a form approved by the reviewing institutional review board (IRB) and sponsor.
  2. Patient is ≥ 18 years of age.
  3. Patient is willing and able to comply with protocol requirements.
  4. Patient has a confirmed diagnosis of CS with nasal polyps, as defined in the 2016 "International Consensus Statement on Allergy and Rhinology".
  5. Patient has undergone prior ESS including bilateral total ethmoidectomy at least 90 days prior to screening.
  6. Patient has evidence of bilateral ethmoid sinus obstruction due to polyposis warranting intervention (polyp grade ≥ 2 on each side).
  7. Patient is able to tolerate daily use of Mometasone Furoate Nasal Spray (MFNS).
  8. Patient is able to tolerate topical/local anesthesia.
  9. In the opinion of the investigator, patient's ethmoid sinus anatomy is amenable to in-office bilateral placement of the S8 Sinus Implant (i.e., able to pass into the middle meatus on both sides the S8 Sinus Implant with 20 mm in nominal length and 7 mm in compressed diameter).
  10. Female patients of reproductive potential must not be pregnant or nursing and must agree to not become pregnant during their participation in the study.
  11. Female patients of childbearing potential must agree to use consistent and acceptable method(s) of birth control during their participation in the study.

Exclusion Criteria:

  1. Patient has extensive ethmoid sinus polyp grade (grade 4 on at least one side).
  2. Patient has extensive adhesions/synechiae (grade 3 or 4).
  3. Patient has used parenteral and injected steroids (e.g., Kenalog injection) during 30 days prior to the baseline procedure.
  4. Patient has used oral steroids, budesonide or other sinus steroid irrigations/rinses, nebulized steroids administered nasally or budesonide drops during 14 days prior to the baseline procedure.
  5. Patient has oral-steroid dependent condition such as chronic obstructive pulmonary disease (COPD) or asthma.
  6. Patient has known history of allergy or intolerance to corticosteroids or mometasone furoate.
  7. Patient has used monoclonal antibodies for asthma, allergies or nasal polyps (e.g., Dupixent, Nucala, Xolair) during 30 days prior to the baseline procedure.
  8. Patient requires monoclonal antibodies for asthma, allergies or nasal polyps during the duration of the study.
  9. Patient has presence of physical obstruction that would preclude access and placement of the S8 Sinus Implant in the middle meatus (e.g., severe septal deviation, septal spur, very small middle meatus, total obstruction of the sinonasal passage with severe adhesion, scarring, polypoid edema or polyps).
  10. Patient has known history of human immunodeficiency virus (HIV) or immunoglobulin G or A subclass deficiency.
  11. Patient has clinical evidence of acute sinusitis (AS), as defined in the 2016 "International Consensus Statement on Allergy and Rhinology".
  12. Patient has clinical evidence or suspicion of invasive fungal sinusitis (e.g., bone erosion on prior computed tomography (CT) scan, necrotic sinus tissue).
  13. Patient has evidence of severe concomitant disease or condition expected to compromise survival or ability to complete assessments during the 365-day study follow-up period (e.g., cancer).
  14. Patient is currently participating in another clinical study.
  15. Patient has previously undergone ESS and experienced a cerebrospinal fluid (CSF) leak or has residual compromised vision as a result of a complication in a prior ESS procedure.
  16. Patient has known dehiscence of the lamina papyracea.
  17. Patient has evidence of active tuberculosis or active viral illness (e.g., ocular herpes simplex, chickenpox, measles).
  18. Patient has known history or diagnosis of glaucoma or ocular hypertension (prior ocular exam with intraocular pressure of >21 mmHg and pressure lowering medication given) or posterior subcapsular cataract.

Sites / Locations

  • Sacramento ENT
  • Yale University School of Medicine
  • DuPage Medical Group
  • Advanced ENT & Allergy
  • Associated Surgical Specialists
  • BreatheAmerica of Albuquerque
  • Madison ENT
  • Charlotte Eye, Ear, Nose and Throat Associates
  • Bridgerland Clinical Research

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

S8 Sinus Implant

Arm Description

corticosteroid-eluting sinus implant containing 1350 mcg of mometasone furoate (MF)

Outcomes

Primary Outcome Measures

Number of Participants With Implant-Related Serious Adverse Events
Evaluated via tabulation of implant-related serious adverse events (SAE) reported by subjects between consent and Day 365.

Secondary Outcome Measures

SNOT-22 Total Score
Sino-Nasal Outcomes Test (SNOT-22) is a validated disease-specific symptom-scoring instrument consisting of 22 questions, each scored on a 6-point scale of 0 (no problem) to 5 (probably as bad as it can be) based on the subject's recollection of symptoms over the past 2 weeks. The total score ranges from 0 to 110, with a higher score reflecting greater symptom burden. Change from baseline to 90 days and to 180 days is calculated as the value at 90/180 days minus the value from baseline. Negative values for change from baseline indicate reduction (improvement) in sino-nasal symptoms.
Nasal Obstruction/Congestion Score
Determined on a scale of 0 (no symptoms) to 3 (severe symptoms) based on the subject's recollection of symptoms over the past week using a reflective paper questionnaire. Change from baseline to 90 days and to 180 days is calculated as the value at 90/180 days minus the value at baseline. Negative values for change from baseline to follow-up indicate reduction (improvement) in nasal obstruction/congestion.

Full Information

First Posted
November 27, 2017
Last Updated
November 26, 2019
Sponsor
Intersect ENT
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1. Study Identification

Unique Protocol Identification Number
NCT03358329
Brief Title
Safety Evaluation of Repeat Placement of the S8 Sinus Implant in Chronic Sinusitis Patients With Nasal Polyps (ENCORE)
Official Title
The ENCORE Study: Safety Evaluation of Repeat Placement of the Corticosteroid-Releasing S8 Sinus Implant in Chronic Sinusitis Patients With Nasal Polyps
Study Type
Interventional

2. Study Status

Record Verification Date
November 2019
Overall Recruitment Status
Completed
Study Start Date
November 13, 2017 (Actual)
Primary Completion Date
January 17, 2019 (Actual)
Study Completion Date
January 17, 2019 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Intersect ENT

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 ENCORE Study is designed to evaluate the repeat administration of the S8 Sinus Implant in chronic sinusitis (CS) patients with recurrent nasal polyps.
Detailed Description
The ENCORE Study is a prospective open-label, non-randomized, multicenter study in CS patients who had undergone prior endoscopic sinus surgery (ESS) including bilateral total ethmoidectomy and present with bilateral ethmoid polyposis.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Sinusitis, Nasal Polyposis
Keywords
corticosteroid, implant

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
S8 Sinus Implant
Arm Type
Experimental
Arm Description
corticosteroid-eluting sinus implant containing 1350 mcg of mometasone furoate (MF)
Intervention Type
Combination Product
Intervention Name(s)
S8 Sinus Implant
Intervention Description
In-office bilateral placement of the S8 Sinus Implant (mometasone furoate, 1350 mcg) in the ethmoid sinuses
Primary Outcome Measure Information:
Title
Number of Participants With Implant-Related Serious Adverse Events
Description
Evaluated via tabulation of implant-related serious adverse events (SAE) reported by subjects between consent and Day 365.
Time Frame
365 days
Secondary Outcome Measure Information:
Title
SNOT-22 Total Score
Description
Sino-Nasal Outcomes Test (SNOT-22) is a validated disease-specific symptom-scoring instrument consisting of 22 questions, each scored on a 6-point scale of 0 (no problem) to 5 (probably as bad as it can be) based on the subject's recollection of symptoms over the past 2 weeks. The total score ranges from 0 to 110, with a higher score reflecting greater symptom burden. Change from baseline to 90 days and to 180 days is calculated as the value at 90/180 days minus the value from baseline. Negative values for change from baseline indicate reduction (improvement) in sino-nasal symptoms.
Time Frame
Baseline, 90 days, 180 days
Title
Nasal Obstruction/Congestion Score
Description
Determined on a scale of 0 (no symptoms) to 3 (severe symptoms) based on the subject's recollection of symptoms over the past week using a reflective paper questionnaire. Change from baseline to 90 days and to 180 days is calculated as the value at 90/180 days minus the value at baseline. Negative values for change from baseline to follow-up indicate reduction (improvement) in nasal obstruction/congestion.
Time Frame
Baseline, 90 days, 180 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patient has provided written informed consent using a form approved by the reviewing institutional review board (IRB) and sponsor. Patient is ≥ 18 years of age. Patient is willing and able to comply with protocol requirements. Patient has a confirmed diagnosis of CS with nasal polyps, as defined in the 2016 "International Consensus Statement on Allergy and Rhinology". Patient has undergone prior ESS including bilateral total ethmoidectomy at least 90 days prior to screening. Patient has evidence of bilateral ethmoid sinus obstruction due to polyposis warranting intervention (polyp grade ≥ 2 on each side). Patient is able to tolerate daily use of Mometasone Furoate Nasal Spray (MFNS). Patient is able to tolerate topical/local anesthesia. In the opinion of the investigator, patient's ethmoid sinus anatomy is amenable to in-office bilateral placement of the S8 Sinus Implant (i.e., able to pass into the middle meatus on both sides the S8 Sinus Implant with 20 mm in nominal length and 7 mm in compressed diameter). Female patients of reproductive potential must not be pregnant or nursing and must agree to not become pregnant during their participation in the study. Female patients of childbearing potential must agree to use consistent and acceptable method(s) of birth control during their participation in the study. Exclusion Criteria: Patient has extensive ethmoid sinus polyp grade (grade 4 on at least one side). Patient has extensive adhesions/synechiae (grade 3 or 4). Patient has used parenteral and injected steroids (e.g., Kenalog injection) during 30 days prior to the baseline procedure. Patient has used oral steroids, budesonide or other sinus steroid irrigations/rinses, nebulized steroids administered nasally or budesonide drops during 14 days prior to the baseline procedure. Patient has oral-steroid dependent condition such as chronic obstructive pulmonary disease (COPD) or asthma. Patient has known history of allergy or intolerance to corticosteroids or mometasone furoate. Patient has used monoclonal antibodies for asthma, allergies or nasal polyps (e.g., Dupixent, Nucala, Xolair) during 30 days prior to the baseline procedure. Patient requires monoclonal antibodies for asthma, allergies or nasal polyps during the duration of the study. Patient has presence of physical obstruction that would preclude access and placement of the S8 Sinus Implant in the middle meatus (e.g., severe septal deviation, septal spur, very small middle meatus, total obstruction of the sinonasal passage with severe adhesion, scarring, polypoid edema or polyps). Patient has known history of human immunodeficiency virus (HIV) or immunoglobulin G or A subclass deficiency. Patient has clinical evidence of acute sinusitis (AS), as defined in the 2016 "International Consensus Statement on Allergy and Rhinology". Patient has clinical evidence or suspicion of invasive fungal sinusitis (e.g., bone erosion on prior computed tomography (CT) scan, necrotic sinus tissue). Patient has evidence of severe concomitant disease or condition expected to compromise survival or ability to complete assessments during the 365-day study follow-up period (e.g., cancer). Patient is currently participating in another clinical study. Patient has previously undergone ESS and experienced a cerebrospinal fluid (CSF) leak or has residual compromised vision as a result of a complication in a prior ESS procedure. Patient has known dehiscence of the lamina papyracea. Patient has evidence of active tuberculosis or active viral illness (e.g., ocular herpes simplex, chickenpox, measles). Patient has known history or diagnosis of glaucoma or ocular hypertension (prior ocular exam with intraocular pressure of >21 mmHg and pressure lowering medication given) or posterior subcapsular cataract.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Peter Manes, MD
Organizational Affiliation
Yale University
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sacramento ENT
City
Sacramento
State/Province
California
ZIP/Postal Code
95815
Country
United States
Facility Name
Yale University School of Medicine
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06519
Country
United States
Facility Name
DuPage Medical Group
City
Naperville
State/Province
Illinois
ZIP/Postal Code
60540
Country
United States
Facility Name
Advanced ENT & Allergy
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40207
Country
United States
Facility Name
Associated Surgical Specialists
City
Covington
State/Province
Louisiana
ZIP/Postal Code
70433
Country
United States
Facility Name
BreatheAmerica of Albuquerque
City
Albuquerque
State/Province
New Mexico
ZIP/Postal Code
87109
Country
United States
Facility Name
Madison ENT
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Charlotte Eye, Ear, Nose and Throat Associates
City
Concord
State/Province
North Carolina
ZIP/Postal Code
29025
Country
United States
Facility Name
Bridgerland Clinical Research
City
North Logan
State/Province
Utah
ZIP/Postal Code
84341
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety Evaluation of Repeat Placement of the S8 Sinus Implant in Chronic Sinusitis Patients With Nasal Polyps (ENCORE)

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