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STAND - Study of the AGN1 LOEP SV Kit Compared to PMMA in Patients With Vertebral Compression Fractures

Primary Purpose

Vertebral Compression Fracture, Compression Fracture, Vertebral Compression

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Treatment Group: AGN1 LOEP SV Kit
Control Group: PMMA bone cement
Sponsored by
AgNovos Healthcare, LLC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Vertebral Compression Fracture focused on measuring LOEP, AGN1

Eligibility Criteria

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

Inclusion Criteria:

  1. Subject is a male or female aged 55 and 85 years, inclusive, of age at time of study treatment.
  2. Subject has only one (1) acute VCF. Note that subjects are eligible if they have an asymptomatic, chronic VCF(s) at any non-target, non-adjacent vertebral level.
  3. The acute VCF meets all of the following criteria:

    1. Due to diagnosed or presumed underlying osteoporosis
    2. T1 to L5 inclusively
    3. Target VCF-related pain < 12 weeks at time of study treatment
  4. Target VCF shows loss of height of the vertebral body ≤ 50% based on X-ray at baseline.
  5. Target VCF is acute or persistent (not healed), as demonstrated on imaging, including T2 weighted STIR MRI, bone scan or bone scan with SPECT/CT, serial radiographs, or other serial imaging demonstrating acuity.
  6. Focal tenderness to palpation of the spinal process of the target VCF on the physical exam correlates with imaging.
  7. Subject has failed conservative medical therapy (bed rest, observation, chiropractic care, orthotics, opioid and non-opioid analgesics, and/or physical therapy), defined as either having a VAS back pain score of ≥ 70 mm after 24 hours to 6 weeks of conservative care or a VAS back pain score of ≥ 50 mm after more than 6 weeks of conservative care.
  8. Subject has an Oswestry Disability Index (ODI) score of ≥ 30% at baseline.
  9. Subject is capable of giving written informed consent to participate in the study.
  10. The subject's willingness, ability, and commitment to participate in screening, treatment, and all follow-up evaluations for the full length of the study has been documented.

Exclusion Criteria:

  1. Target VCF is unstable, including split or burst fracture.
  2. Subject has a bleeding disorder.
  3. Subject has an active infection of the spine or has an infection being actively treated with antibiotics.
  4. Target VCF is due to underlying or suspected tumor.
  5. Target VCF is due to high-energy trauma.
  6. Target VCF is due to osteonecrosis.
  7. Target VCF has a local kyphotic angle of > 30 degrees, measured as the angle between the superior endplate and inferior endplate at the target VCF.
  8. Subject has had any prior surgical treatment at the target vertebral level or adjacent vertebral levels.
  9. The pedicle(s) in the target vertebral body appear unable to safely accommodate transpedicular access instrumentation.
  10. Subject has neurologic symptoms, deficits, or radiculopathy related to the VCF.
  11. Subject has spinal canal compromise causing clinical manifestations of cord, neural foramen, or nerve root compression at the level to be treated.
  12. Subject has pain, progressive weakness, or paralysis due to herniated nucleus pulposus or spinal stenosis.
  13. Subject has spondylolisthesis > Grade 1 at target vertebral body.
  14. Subject requires daily opioid medication for pain not related to the target VCF.
  15. Subject has severe cardiopulmonary deficiencies.
  16. Subject has a Body Mass Index (BMI) > 35.
  17. Subject has a history of metabolic bone disease other than osteoporosis (e.g., Paget's disease, renal osteodystrophy, or osteomalacia).
  18. Subject has a history of tuberculous spondylitis.
  19. Subject has a history of invasive malignancy within the last five (5) years, other than non-melanoma skin cancer. Subject is not excluded if they have a history of malignancy over 5 years ago treated with curative intent and without clinical signs or symptoms since then.
  20. Subject is on oral or parenteral immune-suppressive drugs.
  21. Subject has uncontrolled diabetes mellitus.
  22. Subject has severe renal insufficiency defined as an estimated glomerular filtration rate (eGFR) < 30 mL/min.
  23. Subject has abnormal albumin-corrected serum calcium levels or a calcium metabolism disorder (e.g., hypercalcemia).
  24. Subject has known allergies to calcium-based bone void fillers.
  25. Subject is pregnant or planning to become pregnant during participation in the study.
  26. In the judgment of the Investigator, the subject is not a good study candidate. (e.g. substance abuse or chemical dependency, inability to adhere to follow-up schedule, progression of the fracture between screening and the procedure visit).
  27. Subject is currently enrolled in another interventional clinical study.

Sites / Locations

  • Alabama Clinical TherapeuticsRecruiting
  • Mayo Clinic
  • GW Medical Faculty AssociatesRecruiting
  • Cleveland Clinic FloridaRecruiting
  • Rush University Medical CenterRecruiting
  • NorthShore University HealthSystemRecruiting
  • University of Kansas Medical Center Research Institute, Inc.Recruiting
  • Louisiana Spine InstituteRecruiting
  • Anne Arundel Medical Center (AAMC)
  • Lahey Medical CenterRecruiting
  • Washington University St. LouisRecruiting
  • MontefioreRecruiting
  • Mt. SinaiRecruiting
  • Texas Back InstituteRecruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Treatment with AGN1 LOEP SV Kit

Treatment with PMMA bone cement

Arm Description

The AGN1 LOEP SV Kit is intended for fixation of pathological fractures of the vertebral body using vertebral augmentation. Following saline lavage to create space, the AGN1 implant material is injected and hardens in situ to augment the fractured vertebral body. The AGN1 implant material is then resorbed and replaced with new bone.

High viscosity PMMA bone cement will be used for vertebral augmentation.

Outcomes

Primary Outcome Measures

Change in VCF-related Pain as measured by a 100 mm Visual Analogue Scale (VAS)
Change in VCF-related pain by > 20 mm from baseline as measured by a 100 mm Visual Analogue Scale (VAS) where 0mm is no pain, and 100mm is worst pain possible.
Change in function
change of function from baseline as measured by the Oswestry Disability Index (ODI)
Radiographic evidence of implant resorption (Intervention Group only)
change in resorption from procedure as assessed by independent radiographer
Radiographic evidence of bone formation (Intervention Group only)
change in bone formation from procedure as assessed by independent radiographer
Adverse events
Occurrence of device-related serious adverse events, device-related adverse events or serious adverse events categorized as failure or surgical intervention at the target level occurring post-treatment

Secondary Outcome Measures

Full Information

First Posted
April 5, 2021
Last Updated
October 18, 2023
Sponsor
AgNovos Healthcare, LLC
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1. Study Identification

Unique Protocol Identification Number
NCT04835428
Brief Title
STAND - Study of the AGN1 LOEP SV Kit Compared to PMMA in Patients With Vertebral Compression Fractures
Official Title
A Randomized, Single-Blinded, Non-Inferiority Study Comparing AGN1 Local Osteo-Enhancement Procedure (LOEP) SV Kit Treatment of Vertebral Compression Fragility Fractures to PMMA Bone Cement Treatment
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
May 31, 2022 (Actual)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2026 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
AgNovos Healthcare, LLC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Device Product Not Approved or Cleared by U.S. FDA
Yes
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is a multicenter, single-blinded, randomized controlled clinical trial evaluating the safety and efficacy of the AGN1 LOEP SV Kit for the treatment of painful vertebral compression fragility fractures (VCFs). The objective of this study is to demonstrate non-inferiority of the AGN1 LOEP SV Kit for the treatment of VCFs to standard of care vertebroplasty treatment using bipedicular injection of PMMA bone cement.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Vertebral Compression Fracture, Compression Fracture, Vertebral Compression
Keywords
LOEP, AGN1

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Four hundred eight (408) eligible subjects at up to twenty-five (25) study sites will be randomized 1:1 for treatment using the AGN1 LOEP SV Kit (Intervention Group) or PMMA bone cement (Active Control Group).
Masking
Participant
Masking Description
Study subjects will not be informed of their treatment group assignment at the time of randomization or at any time before the subject's last office visit. The blind will be broken only if it is necessary to protect the safety or welfare of the subject as determined by the Investigator.
Allocation
Randomized
Enrollment
408 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment with AGN1 LOEP SV Kit
Arm Type
Experimental
Arm Description
The AGN1 LOEP SV Kit is intended for fixation of pathological fractures of the vertebral body using vertebral augmentation. Following saline lavage to create space, the AGN1 implant material is injected and hardens in situ to augment the fractured vertebral body. The AGN1 implant material is then resorbed and replaced with new bone.
Arm Title
Treatment with PMMA bone cement
Arm Type
Active Comparator
Arm Description
High viscosity PMMA bone cement will be used for vertebral augmentation.
Intervention Type
Device
Intervention Name(s)
Treatment Group: AGN1 LOEP SV Kit
Intervention Description
The AGN1 LOEP SV Kit is intended for fixation of pathological fractures of the vertebral body using vertebral augmentation. Following saline lavage to create space, the AGN1 implant material is injected and hardens in situ to augment the fractured vertebral body. The AGN1 implant material is then resorbed and replaced with new bone.
Intervention Type
Device
Intervention Name(s)
Control Group: PMMA bone cement
Intervention Description
High viscosity PMMA bone cement will be used for vertebral augmentation.
Primary Outcome Measure Information:
Title
Change in VCF-related Pain as measured by a 100 mm Visual Analogue Scale (VAS)
Description
Change in VCF-related pain by > 20 mm from baseline as measured by a 100 mm Visual Analogue Scale (VAS) where 0mm is no pain, and 100mm is worst pain possible.
Time Frame
24 months
Title
Change in function
Description
change of function from baseline as measured by the Oswestry Disability Index (ODI)
Time Frame
24 months
Title
Radiographic evidence of implant resorption (Intervention Group only)
Description
change in resorption from procedure as assessed by independent radiographer
Time Frame
24 months
Title
Radiographic evidence of bone formation (Intervention Group only)
Description
change in bone formation from procedure as assessed by independent radiographer
Time Frame
24 months
Title
Adverse events
Description
Occurrence of device-related serious adverse events, device-related adverse events or serious adverse events categorized as failure or surgical intervention at the target level occurring post-treatment
Time Frame
24 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is a male or female 50 years of age or older at the time of study treatment. Subject has one (1) or two (2) acute VCF(s). Note that subjects are eligible if they have an asymptomatic, healed VCF(s) at any non-target vertebral level. Each target VCF meets all of the following criteria: Due to diagnosed or presumed underlying osteoporosis T1 to L5 inclusively Target VCF-related pain ≤ 6 months at time of study treatment Each target VCF shows loss of height of the vertebral body ≤ 50% based on X-ray at baseline. Each target VCF is acute or persistent (not healed), as demonstrated on imaging, including T2-weighted, STIR MRI, bone scan or bone scan with SPECT/CT, serial radiographs, or other serial imaging demonstrating acuity. Focal tenderness to palpation of the spinal process of each target VCF on the physical exam correlates with imaging. Subject has failed conservative medical therapy (bed rest, observation, chiropractic care, orthotics, opioid and non-opioid analgesics, and/or physical therapy), defined as either having a VAS back pain score of ≥ 70 mm after 24 hours to 6 weeks of conservative care or a VAS back pain score of ≥ 50 mm after more than 6 weeks of conservative care. Subject has an Oswestry Disability Index (ODI) score of ≥ 30% at baseline. Subject is capable of giving written informed consent to participate in the study. The subject's willingness, ability, and commitment to participate in screening, treatment, and all follow-up evaluations for the full length of the study has been documented Exclusion Criteria: At least one of the target VCF(s) is unstable, including split or burst fracture. Subject has a bleeding disorder. Subject has an active infection of the spine or surgical site. Subject has a bloodborne infection. At least one of the target VCFs is due to underlying or suspected tumor. At least one of the target VCFs is due to high-energy trauma. At least one of the target VCFs is due to osteonecrosis. At least one of the target VCFs has a local kyphotic angle of > 30 degrees, measured as the angle between the superior endplate and inferior endplate at the target VCF. Subject has had any prior surgical treatment at the target vertebral level or adjacent vertebral levels. The pedicle(s) in the target vertebral body appears unable to safely accommodate transpedicular access instrumentation. Subject has neurologic symptoms, deficits, or radiculopathy related to the target VCF(s). Subject has spinal canal compromise causing clinical manifestations of cord, neural foramen, or nerve root compression at the level to be treated. Subject has pain, progressive weakness, or paralysis due to herniated nucleus pulposus or spinal stenosis. Subject has spondylolisthesis > Grade 1 at target vertebral body(ies). Subject requires daily opioid medication for pain not related to the target VCF(s). Subject has severe cardiopulmonary deficiencies. Subject has a Body Mass Index (BMI) > 35. Subject has a history of metabolic bone disease other than osteoporosis (e.g., Paget's disease, renal osteodystrophy, or osteomalacia). Subject has a history of tuberculous spondylitis. Subject has a history of invasive malignancy within the last five (5) years, other than non-melanoma skin cancer. Subject is not excluded if they have a history of malignancy over 5 years ago treated with curative intent and without clinical signs or symptoms since then. Subject is on oral or parenteral immune-suppressive drugs. Subject has uncontrolled diabetes mellitus. Subject has severe renal insufficiency defined as an estimated glomerular filtration rate (eGFR) < 30 mL/min. Subject has a diagnosed calcium metabolism disorder. Subject has known allergies to calcium-based bone void fillers. Subject is pregnant or planning to become pregnant during participation in the study. In the judgment of the Investigator, the subject is not a good study candidate. (e.g. substance abuse or chemical dependency, inability to adhere to follow-up schedule, progression of the fracture between screening and the procedure visit). Subject is currently enrolled in another interventional clinical study.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Allison Gorman
Phone
2407536424
Email
agorman@agnovos.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Kern Singh
Organizational Affiliation
Midwest Orthopedics at Rush
Official's Role
Principal Investigator
Facility Information:
Facility Name
Alabama Clinical Therapeutics
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35235
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Brittany Fry
Phone
205-833-2228
Email
brittany.fry@actstudy.net
First Name & Middle Initial & Last Name & Degree
Jill Andringa
Email
jill.andringa@actstudy.net
First Name & Middle Initial & Last Name & Degree
Bradley Goodman, MD
First Name & Middle Initial & Last Name & Degree
Srinivas Mallempati, MD
Facility Name
Mayo Clinic
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85054
Country
United States
Individual Site Status
Not yet recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Haydee Salgado Broncano, RN
Phone
480-342-2906
First Name & Middle Initial & Last Name & Degree
Chandan Krishna, MD
First Name & Middle Initial & Last Name & Degree
Brian Chong, MD
Facility Name
GW Medical Faculty Associates
City
Washington
State/Province
District of Columbia
ZIP/Postal Code
20037
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Alejandro Jaco
Phone
202-741-3519
Email
aljaco@mfa.gwu.edu
First Name & Middle Initial & Last Name & Degree
Wayne Olan, MD
Facility Name
Cleveland Clinic Florida
City
Stuart
State/Province
Florida
ZIP/Postal Code
34994
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Irene Ball
Phone
772-419-2146
Email
BallI@ccf.org
First Name & Middle Initial & Last Name & Degree
Angelic Gamez
Phone
772-223-5945
Email
gameza3@ccf.org
First Name & Middle Initial & Last Name & Degree
Jeffrey Miller, MD
First Name & Middle Initial & Last Name & Degree
Oszkar Szentirmai, MD
Facility Name
Rush University Medical Center
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Kavita Ahuja
Phone
224-229-2988
Email
kavita.ahuja@rushortho.com
First Name & Middle Initial & Last Name & Degree
Mukesh Ahuja
Phone
312-805-8456
Email
mukesh.ahuja@rushortho.com
First Name & Middle Initial & Last Name & Degree
Kern Singh, MD
Facility Name
NorthShore University HealthSystem
City
Evanston
State/Province
Illinois
ZIP/Postal Code
60201
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Boris Jancan
Phone
847-570-3674
Email
bjancan@northshore.org
First Name & Middle Initial & Last Name & Degree
Robert Frech
Phone
847-570-4046
Email
rfrech@northshore.org
First Name & Middle Initial & Last Name & Degree
Michael Musacchio, MD
First Name & Middle Initial & Last Name & Degree
Shakeel Chowdhry, MD
First Name & Middle Initial & Last Name & Degree
William Ares, MD
Facility Name
University of Kansas Medical Center Research Institute, Inc.
City
Kansas City
State/Province
Kansas
ZIP/Postal Code
66160
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Rachel Henning
Phone
913-945-8072
Email
rhenning2@kumc.edu
First Name & Middle Initial & Last Name & Degree
Daewood Sayed, MD
First Name & Middle Initial & Last Name & Degree
Chris Lam, MD
First Name & Middle Initial & Last Name & Degree
Andrew Sack, MD
First Name & Middle Initial & Last Name & Degree
Timothy Sowder, MD
Facility Name
Louisiana Spine Institute
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71101
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Heather Bowman
Phone
318-629-6337
Email
HBowman@louisianaspine.org
First Name & Middle Initial & Last Name & Degree
Marcus Stone, PhD
Phone
318-629-5585
Email
MStone@louisianaspine.org
First Name & Middle Initial & Last Name & Degree
Pierce Nunley, MD
Facility Name
Anne Arundel Medical Center (AAMC)
City
Annapolis
State/Province
Maryland
ZIP/Postal Code
21401
Country
United States
Individual Site Status
Withdrawn
Facility Name
Lahey Medical Center
City
Burlington
State/Province
Massachusetts
ZIP/Postal Code
01805
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Sandy Alvarez
Email
sandy.l.alvarez@lahey.org
First Name & Middle Initial & Last Name & Degree
Neil Patel, MD
Facility Name
Washington University St. Louis
City
Saint Louis
State/Province
Missouri
ZIP/Postal Code
63130
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Robin Haverman
Phone
314-747-1624
Email
rlhaverman@wustl.edu
First Name & Middle Initial & Last Name & Degree
Theo VanderVelde, MD
First Name & Middle Initial & Last Name & Degree
Jack Jennings, MD
Facility Name
Montefiore
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Aureliana Toma, MD
Phone
973-934-0042
Email
atoma@montefiore.org
First Name & Middle Initial & Last Name & Degree
Seon Kyu Lee, MD
First Name & Middle Initial & Last Name & Degree
Allen Brook, MD
Facility Name
Mt. Sinai
City
New York
State/Province
New York
ZIP/Postal Code
10029
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Serina Deeba
Phone
212-241-1297
Email
srina.deeba@mountsinai.org
First Name & Middle Initial & Last Name & Degree
Sukaina Davdani
Phone
212-241-1297
Email
sukaina.davdani@mountsinai.org
First Name & Middle Initial & Last Name & Degree
Reade De Leacy, MD
First Name & Middle Initial & Last Name & Degree
Amish Doshi, MD
Facility Name
Texas Back Institute
City
Plano
State/Province
Texas
ZIP/Postal Code
75093
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Shannon Rusch
Phone
972-608-5000
Email
srusch@texasback.com
First Name & Middle Initial & Last Name & Degree
David Enenebeaku
Phone
972-608-5000
Email
denebeaku@texasback.com
First Name & Middle Initial & Last Name & Degree
Thomas Kosztowski, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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STAND - Study of the AGN1 LOEP SV Kit Compared to PMMA in Patients With Vertebral Compression Fractures

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