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Latera RCT - Latera vs. Sham Control for Lateral Nasal Valve Collapse

Primary Purpose

Nasal Valve Collapse, Nasal Breathing

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Latera Implant
Sham Procedure
Sponsored by
Spirox, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Nasal Valve Collapse focused on measuring nasal airway obstruction, sham-control, Polylactide absorbable implant

Eligibility Criteria

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

Subjects must meet the following criteria to be included in the study:

  1. Adults aged 18 and above;
  2. Understands and provides written informed consent;
  3. Stated willingness to comply with all study procedures, post-treatment care and availability for the duration of the study follow up of 2 years;
  4. In good general health as evidenced by medical history;
  5. NOSE score ≥55;
  6. Dynamic bi-lateral nasal wall insufficiency as confirmed by Positive Modified Cottle Maneuver;
  7. Nasal and facial anatomy appropriate to receive the Latera Implant;
  8. Documented failure of benefit after at least 4 weeks of conservative medical management, including, for example, antihistamines or nasal steroids, evidenced by lack of efficacy or tolerability.

Subjects meeting any one of the following criteria will be excluded for the study:

  1. Unable to tolerate or not a candidate for procedures performed under local anesthesia;
  2. Pathology other than lateral wall insufficiency (e.g. septal deviation, turbinate or adenoid hypertrophy, polyps, sinusitis, rhinitis) is the primary contributor to airway obstruction;
  3. Requires or is anticipated to require any other concurrent nasal procedures (e.g. Functional Endoscopic Sinus Surgery (FESS), rhinoplasty, sinuplasty, septoplasty, or turbinate reduction) outside of the index procedure within 12 months after the index procedure;
  4. FESS, sinuplasty, septoplasty, inferior turbinate reduction, or rhinoplasty within the past 6 months;
  5. Any other rhinoplasty procedures are planned or planned usage of external dilators within 24 months after the index procedure;
  6. Permanent nasal implant of any type (e.g. autologous, homologous, or synthetic graft) or dilator;
  7. Presence of concomitant inflammatory or infectious conditions or unhealed wounds in the treatment area (e.g., vestibulitis, vasculitis, active acne),
  8. Currently using chronic systemic steroids or recreational intra-nasal drugs;
  9. Currently has cancerous or pre-cancerous nasal lesions, has had radiation in the treatment area, or is currently receiving chemotherapy;
  10. History of a significant healing disorders including hypertrophic scarring, or keloid formation;
  11. Poorly controlled diabetes mellitus;
  12. Known or suspected allergy to PLA or other absorbable implant materials in the Latera Implant;
  13. Severe obstructive sleep apnea (OSA) and cannot or is unwilling to refrain from continuous positive airway pressure (CPAP) for up to 2 weeks post-procedure based on expected healing needs and mask types, in agreement with the treating physician;
  14. Female subjects, of child bearing potential, known or suspected to be pregnant or are lactating;
  15. Any other presenting condition that, in the medical opinion of the investigator, would disqualify the subject from the study.

Sites / Locations

  • Sacramento ENT
  • Breathe Clear Institute
  • ENT of GA
  • Chicago Nasal and Sinus Center
  • Michiana Sleep and ENT Solutions
  • Albany ENT & Allergy
  • Piedmont ENT
  • Texas ENT Specialist
  • ENT Associates of Texas
  • Texas Facial Plastics and ENT
  • Ogden Clinic

Arms of the Study

Arm 1

Arm 2

Arm Type

Sham Comparator

Experimental

Arm Label

Sham Control Arm

Latera Treatment Arm

Arm Description

Subjects in the Sham Control arm will undergo the same preoperative assessments as those in the Latera Treatment arm up to and including anesthesia for the implant, however, no implant will be placed. Crossover - Subjects will be unblinded after the 3-month assessment is complete. Eligible subjects in the Sham Control arm will be treated with the Latera Implant if they still meet all eligibility criteria. Follow up will continue to 24 months post-implant. Subjects who no longer meet the eligibility criteria will exit the study.

Subjects in the active treatment arm will receive the Latera Implant using standard techniques. Follow up continues for 24 months post-implant.

Outcomes

Primary Outcome Measures

NOSE Responder Rate
The primary endpoint of the study is the NOSE Responder Rate, assessed 3 months post-procedure in the per-protocol population of the Latera and Sham arms. The Nasal Obstruction Symptom Evaluation (NOSE) is a validated patient-reported outcome assessment of 5 questions relating to nasal obstruction (congestion, obstruction, trouble breathing through the nose, trouble sleeping, unable to breath through the nose during exercise/exertion. Each question is rated on a Likert scale of 0 (no problem) to 4 (severe problem). The sum of the scores is multiplied by 5 to result in a total score that ranges from 0 to 100. NOSE scores can also be categorized as mild (5-25), moderate (30-50), severe (55-75), and extreme (80-100). A NOSE responder is defined as a participant with at least 1 NOSE class improvement or at least 20% total NOSE score reduction.

Secondary Outcome Measures

Responder Rate
Responder Rate at 7 days, 30 days, and 6, 12, 18 and 24 months will be assessed

Full Information

First Posted
January 3, 2018
Last Updated
January 20, 2021
Sponsor
Spirox, Inc.
Collaborators
New Arch Consulting
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1. Study Identification

Unique Protocol Identification Number
NCT03400787
Brief Title
Latera RCT - Latera vs. Sham Control for Lateral Nasal Valve Collapse
Official Title
Latera Randomized Controlled Trial (RCT) - Latera® Absorbable Nasal Implant vs. Sham Control for Lateral Nasal Valve Collapse
Study Type
Interventional

2. Study Status

Record Verification Date
January 2021
Overall Recruitment Status
Completed
Study Start Date
November 28, 2017 (Actual)
Primary Completion Date
February 1, 2019 (Actual)
Study Completion Date
December 23, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Spirox, Inc.
Collaborators
New Arch Consulting

4. Oversight

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

5. Study Description

Brief Summary
The primary objective of the LATERA RCT is to demonstrate the superiority of the Latera Implant to improve nasal breathing, compared with a Sham Control procedure.
Detailed Description
To evaluate the Latera Absorbable Nasal Implant (Latera Implant) Implant versus Sham Control in subjects with nasal valve collapse due to or primarily due to insufficient cartilaginous support of the lateral nasal wall.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Nasal Valve Collapse, Nasal Breathing
Keywords
nasal airway obstruction, sham-control, Polylactide absorbable implant

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Crossover Assignment
Model Description
Sham procedure participants will be allowed to crossover to receive Latera implants after the 3-month assessment if they continue to meet eligibility criteria. Crossover participants will be followed through 24 months post implant. Sham participants who do not crossover will be exited after the 3-month assessment.
Masking
Participant
Masking Description
Participants will be masked to treatment assignment through the 3-month assessment period.
Allocation
Randomized
Enrollment
137 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Sham Control Arm
Arm Type
Sham Comparator
Arm Description
Subjects in the Sham Control arm will undergo the same preoperative assessments as those in the Latera Treatment arm up to and including anesthesia for the implant, however, no implant will be placed. Crossover - Subjects will be unblinded after the 3-month assessment is complete. Eligible subjects in the Sham Control arm will be treated with the Latera Implant if they still meet all eligibility criteria. Follow up will continue to 24 months post-implant. Subjects who no longer meet the eligibility criteria will exit the study.
Arm Title
Latera Treatment Arm
Arm Type
Experimental
Arm Description
Subjects in the active treatment arm will receive the Latera Implant using standard techniques. Follow up continues for 24 months post-implant.
Intervention Type
Device
Intervention Name(s)
Latera Implant
Intervention Description
Treatment with implant
Intervention Type
Device
Intervention Name(s)
Sham Procedure
Intervention Description
Sham procedure where the Latera delivery device is inserted but no implant delivered.
Primary Outcome Measure Information:
Title
NOSE Responder Rate
Description
The primary endpoint of the study is the NOSE Responder Rate, assessed 3 months post-procedure in the per-protocol population of the Latera and Sham arms. The Nasal Obstruction Symptom Evaluation (NOSE) is a validated patient-reported outcome assessment of 5 questions relating to nasal obstruction (congestion, obstruction, trouble breathing through the nose, trouble sleeping, unable to breath through the nose during exercise/exertion. Each question is rated on a Likert scale of 0 (no problem) to 4 (severe problem). The sum of the scores is multiplied by 5 to result in a total score that ranges from 0 to 100. NOSE scores can also be categorized as mild (5-25), moderate (30-50), severe (55-75), and extreme (80-100). A NOSE responder is defined as a participant with at least 1 NOSE class improvement or at least 20% total NOSE score reduction.
Time Frame
3 months postprocedure.
Secondary Outcome Measure Information:
Title
Responder Rate
Description
Responder Rate at 7 days, 30 days, and 6, 12, 18 and 24 months will be assessed
Time Frame
7 days, 30 days, and 6, 12, 18 and 24 months.

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Subjects must meet the following criteria to be included in the study: Adults aged 18 and above; Understands and provides written informed consent; Stated willingness to comply with all study procedures, post-treatment care and availability for the duration of the study follow up of 2 years; In good general health as evidenced by medical history; NOSE score ≥55; Dynamic bi-lateral nasal wall insufficiency as confirmed by Positive Modified Cottle Maneuver; Nasal and facial anatomy appropriate to receive the Latera Implant; Documented failure of benefit after at least 4 weeks of conservative medical management, including, for example, antihistamines or nasal steroids, evidenced by lack of efficacy or tolerability. Subjects meeting any one of the following criteria will be excluded for the study: Unable to tolerate or not a candidate for procedures performed under local anesthesia; Pathology other than lateral wall insufficiency (e.g. septal deviation, turbinate or adenoid hypertrophy, polyps, sinusitis, rhinitis) is the primary contributor to airway obstruction; Requires or is anticipated to require any other concurrent nasal procedures (e.g. Functional Endoscopic Sinus Surgery (FESS), rhinoplasty, sinuplasty, septoplasty, or turbinate reduction) outside of the index procedure within 12 months after the index procedure; FESS, sinuplasty, septoplasty, inferior turbinate reduction, or rhinoplasty within the past 6 months; Any other rhinoplasty procedures are planned or planned usage of external dilators within 24 months after the index procedure; Permanent nasal implant of any type (e.g. autologous, homologous, or synthetic graft) or dilator; Presence of concomitant inflammatory or infectious conditions or unhealed wounds in the treatment area (e.g., vestibulitis, vasculitis, active acne), Currently using chronic systemic steroids or recreational intra-nasal drugs; Currently has cancerous or pre-cancerous nasal lesions, has had radiation in the treatment area, or is currently receiving chemotherapy; History of a significant healing disorders including hypertrophic scarring, or keloid formation; Poorly controlled diabetes mellitus; Known or suspected allergy to PLA or other absorbable implant materials in the Latera Implant; Severe obstructive sleep apnea (OSA) and cannot or is unwilling to refrain from continuous positive airway pressure (CPAP) for up to 2 weeks post-procedure based on expected healing needs and mask types, in agreement with the treating physician; Female subjects, of child bearing potential, known or suspected to be pregnant or are lactating; Any other presenting condition that, in the medical opinion of the investigator, would disqualify the subject from the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Pablo Stolovitzky, MD
Organizational Affiliation
ENT of Georgia
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Douglas Sidle, MD
Organizational Affiliation
Northwestern Facial Plastic Surgery
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sacramento ENT
City
Roseville
State/Province
California
ZIP/Postal Code
95661
Country
United States
Facility Name
Breathe Clear Institute
City
Torrance
State/Province
California
ZIP/Postal Code
90503
Country
United States
Facility Name
ENT of GA
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
Chicago Nasal and Sinus Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60602
Country
United States
Facility Name
Michiana Sleep and ENT Solutions
City
South Bend
State/Province
Indiana
ZIP/Postal Code
46635
Country
United States
Facility Name
Albany ENT & Allergy
City
Albany
State/Province
New York
ZIP/Postal Code
12206
Country
United States
Facility Name
Piedmont ENT
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
Texas ENT Specialist
City
Houston
State/Province
Texas
ZIP/Postal Code
77094
Country
United States
Facility Name
ENT Associates of Texas
City
McKinney
State/Province
Texas
ZIP/Postal Code
78209
Country
United States
Facility Name
Texas Facial Plastics and ENT
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78239
Country
United States
Facility Name
Ogden Clinic
City
Ogden
State/Province
Utah
ZIP/Postal Code
84403
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
31226238
Citation
Stolovitzky P, Senior B, Ow RA, Mehendale N, Bikhazi N, Sidle DM. Assessment of bioabsorbable implant treatment for nasal valve collapse compared to a sham group: a randomized control trial. Int Forum Allergy Rhinol. 2019 Aug;9(8):850-856. doi: 10.1002/alr.22362. Epub 2019 Jun 21.
Results Reference
result

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Latera RCT - Latera vs. Sham Control for Lateral Nasal Valve Collapse

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