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Safety and Dosing Study of the CHILLS Cryotherapy for the Treatment of OSA (ARCTIC-1)

Primary Purpose

Obstructive Sleep Apnea of Adult

Status
Active
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
CHILLS Procedure
Sponsored by
Cryosa, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Obstructive Sleep Apnea of Adult

Eligibility Criteria

22 Years - 65 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Age 25 - 65 years.
  2. Diagnosed with moderate to severe OSA based on history and physical or have an established diagnosis of OSA (AHI ≥ 15 and ≤ 50) based on a prior sleep study.
  3. BMI is between 28 kg/m2 and 40 kg/m2 at enrollment.
  4. Negative result for COVID-19 polymerase chain reaction (RT-PCR) test and absence of clinical symptoms for COVID-19.

Exclusion Criteria:

  1. Subjects with a high percentage of central apneas suggesting heart failure.
  2. Contraindication to general anesthesia and MRI.
  3. Metal braces, plate or pieces in the head or jaw that may interfere with MRI.
  4. Craniofacial abnormality (e.g. retrognathia, micrognathia, etc.) thought to be the primary cause of OSA.
  5. Obvious fixed upper airway obstructions (tumors, polyps, nasal obstruction) .
  6. Tonsil size ≥ +3.
  7. Previous surgery within 12 weeks of scheduled procedure performed on the soft tissue of the upper airway (e.g., uvula, soft palate or tonsils).
  8. Oral cancer or non-healing oral wounds.
  9. Presence of symptoms of influenza-like symptoms.
  10. Contra-indicated for anesthesia or surgery.
  11. History of surgery affecting the tongue (TORS, semi-glossectomy, RFBOT, MMA, HGNS).
  12. History of radiation therapy to neck or upper respiratory tract
  13. Surgical resection for cancer or congenital malformations in the larynx, tongue, or throat (with exception of tonsillectomy and/or adenoidectomy).
  14. Clinical evidence of severe chronic obstructive or restrictive pulmonary disease (for example chronic bronchitis, emphysema, pulmonary fibrosis).
  15. Active, severe pulmonary vascular disease (for example pulmonary arterial hypertension or pulmonary embolism).
  16. Currently receiving treatment for severe cardiac valvular dysfunction, NYHA Class III or IV heart failure, unstable angina or recent (< 12 month) myocardial infarction or severe cardiac arrhythmias.
  17. Subjects with bleeding event, known bleeding diathesis, impaired immunity for any reason, or heart attack or stroke within the last 12 months.
  18. Clinical evidence of severe renal failure (Stage 4 or 5) undergoing dialysis or expected to institute dialysis within 12 months.
  19. History or current clinical evidence of TIA or stroke or muscular dysfunction.
  20. Taking medications that in the opinion of the consulting physician may alter consciousness, the pattern of respiration, or sleep architecture, such examples being benzodiazepines, opiates, neuroleptics, prescription stimulants, phenothiazine, or any form of chemical substance abuse.
  21. History of dementia or active psychiatric disease that may impact study compliance.
  22. Females who are pregnant or females of childbearing age with intention to become pregnant during the study period (≤ 3 months from treatment date).
  23. Unable and/or unwilling to comply with study requirements or to provide written informed consent.

Sites / Locations

  • Paitilla Medical Center
  • Sanatorio Americano

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single Arm

Arm Description

CHILLS Procedure

Outcomes

Primary Outcome Measures

Incidence of Serious Procedure-Related Complications
No serious procedure-related complications including death, loss of the airway requiring post-anesthesia care unit (PACU) re-intubation, persistent loss (more than 30 days) of tongue movement, or bleeding requiring surgical intervention or transfusion.

Secondary Outcome Measures

Impact of Cryotherapy on Tongue Function: Taste
Evaluated by assessment of change (Definitely, Somewhat, Not at all) to the taste of: salt, sourness, sweetness, bitterness, savory.
Impact of Cryotherapy on Tongue Function: Sensation
Evaluated by assessment of any numbness of the tongue (Yes, No; if Yes: Mild, Mild to Moderate, Moderate, Moderate to Severe, Severe) physical examination, and tests. Evaluated by assessment of any burning of the tongue (Yes, No; if Yes: Mild, Mild to Moderate, Moderate, Moderate to Severe, Severe)
Impact of Cryotherapy on Tongue Function: Movement
Evaluated by assessment of tongue movement via standardized physical examination. Abnormal deviation of the tongue when extended (Yes, No) Difficulty extending the tongue left (Yes, No) Difficulty extending the tongue right(Yes, No) Difficulty extending the tongue up (Yes, No) Difficulty extending the tongue down (Yes, No)
Impact of Cryotherapy on Tongue Function: Swallowing
Evaluated by Physician observation for overt signs of cough or other difficulty during trial swallows (e.g., water) or routine oral intake (Unremarkable or Abnormal, specify)

Full Information

First Posted
March 17, 2021
Last Updated
September 13, 2022
Sponsor
Cryosa, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04864652
Brief Title
Safety and Dosing Study of the CHILLS Cryotherapy for the Treatment of OSA
Acronym
ARCTIC-1
Official Title
Safety and Dosing Study of the CHILLS Cryotherapy for the Treatment of Obstructive Sleep Apnea (OSA): ARCTIC-1
Study Type
Interventional

2. Study Status

Record Verification Date
September 2022
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 30, 2020 (Actual)
Primary Completion Date
September 15, 2023 (Anticipated)
Study Completion Date
December 1, 2024 (Anticipated)

3. Sponsor/Collaborators

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

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
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
ARCTIC-1 is a safety and dosing study to evaluate procedure tolerability in patients with clinically diagnosed moderate or severe OSA.
Detailed Description
The study is a safety and dose titration study to determine the optimum dose of Cryosa CHILLS cryotherapy in patients with clinically diagnosed moderate or severe OSA. Up to 70 subjects are planned to be enrolled and treated with the device at up to 3 clinical sites in Latin America. Subjects will be followed for 90 days with evaluation intervals at discharge, 7 days, 30 days and 90 days post-procedure. Subjects agreeing to long-term follow-up will complete visits every 6 months through 2 years post-procedure.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Obstructive Sleep Apnea of Adult

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
70 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Single Arm
Arm Type
Experimental
Arm Description
CHILLS Procedure
Intervention Type
Device
Intervention Name(s)
CHILLS Procedure
Intervention Description
CHILLS Cryotherapy procedure
Primary Outcome Measure Information:
Title
Incidence of Serious Procedure-Related Complications
Description
No serious procedure-related complications including death, loss of the airway requiring post-anesthesia care unit (PACU) re-intubation, persistent loss (more than 30 days) of tongue movement, or bleeding requiring surgical intervention or transfusion.
Time Frame
30 Days
Secondary Outcome Measure Information:
Title
Impact of Cryotherapy on Tongue Function: Taste
Description
Evaluated by assessment of change (Definitely, Somewhat, Not at all) to the taste of: salt, sourness, sweetness, bitterness, savory.
Time Frame
7 days, 30 days and 90 days
Title
Impact of Cryotherapy on Tongue Function: Sensation
Description
Evaluated by assessment of any numbness of the tongue (Yes, No; if Yes: Mild, Mild to Moderate, Moderate, Moderate to Severe, Severe) physical examination, and tests. Evaluated by assessment of any burning of the tongue (Yes, No; if Yes: Mild, Mild to Moderate, Moderate, Moderate to Severe, Severe)
Time Frame
7 days, 30 days and 90 days
Title
Impact of Cryotherapy on Tongue Function: Movement
Description
Evaluated by assessment of tongue movement via standardized physical examination. Abnormal deviation of the tongue when extended (Yes, No) Difficulty extending the tongue left (Yes, No) Difficulty extending the tongue right(Yes, No) Difficulty extending the tongue up (Yes, No) Difficulty extending the tongue down (Yes, No)
Time Frame
7 days, 30 days and 90 days
Title
Impact of Cryotherapy on Tongue Function: Swallowing
Description
Evaluated by Physician observation for overt signs of cough or other difficulty during trial swallows (e.g., water) or routine oral intake (Unremarkable or Abnormal, specify)
Time Frame
7 days, 30 days and 90 days
Other Pre-specified Outcome Measures:
Title
Exploratory Measures: Home Sleep Apnea Testing (HSAT)
Description
The feasibility of using a Level 3 home sleep study will be evaluated. Two consecutive nights of home sleep testing will be collected. The average Apnea Hypopnea Index (AHI) from the 2 nights of recording will be reported.
Time Frame
90 days
Title
Exploratory Measures: Magnetic Resonance Image (MRI)
Description
An MRI image for fat quantitation without contrast will be collected to evaluate the fat content (% fat) in the treated zone.
Time Frame
45 and 90 days
Title
Exploratory Measures: Patient Reported Outcome Measures
Description
Pain Visual Analog Scale (VAS) with ratings from 0 to 10; 0 being no pain and 10 is the worst possible pain.
Time Frame
2 days, 3 days, 7 days, 30 days, 45 and 90 days
Title
Exploratory Measures: Patient Reported Outcome Measures
Description
Epworth Sleepiness Survey (ESS) that rates a daytime sleepiness on a scale of 0 to 22 with 22 being most sleepy as possible during the day. Patients rate on a 4-point scale (0 to 3, where 0 is no change of dozing and 3 a high chance of dozing) their usual chances of having dozed off or fallen asleep while engaged in eight different activities.
Time Frame
30 and 90 days

10. Eligibility

Sex
All
Minimum Age & Unit of Time
22 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age 25 - 65 years. Diagnosed with moderate to severe OSA based on history and physical or have an established diagnosis of OSA (AHI ≥ 15 and ≤ 50) based on a prior sleep study. BMI is between 28 kg/m2 and 40 kg/m2 at enrollment. Negative result for COVID-19 polymerase chain reaction (RT-PCR) test and absence of clinical symptoms for COVID-19. Exclusion Criteria: Subjects with a high percentage of central apneas suggesting heart failure. Contraindication to general anesthesia and MRI. Metal braces, plate or pieces in the head or jaw that may interfere with MRI. Craniofacial abnormality (e.g. retrognathia, micrognathia, etc.) thought to be the primary cause of OSA. Obvious fixed upper airway obstructions (tumors, polyps, nasal obstruction) . Tonsil size ≥ +3. Previous surgery within 12 weeks of scheduled procedure performed on the soft tissue of the upper airway (e.g., uvula, soft palate or tonsils). Oral cancer or non-healing oral wounds. Presence of symptoms of influenza-like symptoms. Contra-indicated for anesthesia or surgery. History of surgery affecting the tongue (TORS, semi-glossectomy, RFBOT, MMA, HGNS). History of radiation therapy to neck or upper respiratory tract Surgical resection for cancer or congenital malformations in the larynx, tongue, or throat (with exception of tonsillectomy and/or adenoidectomy). Clinical evidence of severe chronic obstructive or restrictive pulmonary disease (for example chronic bronchitis, emphysema, pulmonary fibrosis). Active, severe pulmonary vascular disease (for example pulmonary arterial hypertension or pulmonary embolism). Currently receiving treatment for severe cardiac valvular dysfunction, NYHA Class III or IV heart failure, unstable angina or recent (< 12 month) myocardial infarction or severe cardiac arrhythmias. Subjects with bleeding event, known bleeding diathesis, impaired immunity for any reason, or heart attack or stroke within the last 12 months. Clinical evidence of severe renal failure (Stage 4 or 5) undergoing dialysis or expected to institute dialysis within 12 months. History or current clinical evidence of TIA or stroke or muscular dysfunction. Taking medications that in the opinion of the consulting physician may alter consciousness, the pattern of respiration, or sleep architecture, such examples being benzodiazepines, opiates, neuroleptics, prescription stimulants, phenothiazine, or any form of chemical substance abuse. History of dementia or active psychiatric disease that may impact study compliance. Females who are pregnant or females of childbearing age with intention to become pregnant during the study period (≤ 3 months from treatment date). Unable and/or unwilling to comply with study requirements or to provide written informed consent.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Marquito Caballero, MD
Organizational Affiliation
Sanatorio Americano
Official's Role
Principal Investigator
First Name & Middle Initial & Last Name & Degree
Stella Rowley, MD
Organizational Affiliation
San Fernando Specialized Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Paitilla Medical Center
City
Panama City
Country
Panama
Facility Name
Sanatorio Americano
City
Asunción
Country
Paraguay

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety and Dosing Study of the CHILLS Cryotherapy for the Treatment of OSA

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