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Paclitaxel-Coated Nasal Balloon for the Treatment of Recurrent Chronic Rhinosinusitis With or Without Nasal Polyps (FIH)

Primary Purpose

Chronic Rhinosinusitis

Status
Recruiting
Phase
Early Phase 1
Locations
Paraguay
Study Type
Interventional
Intervention
Airiver Nasal Drug Coated Balloon (DCB) Catheter.
Sponsored by
Airiver Medical, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Rhinosinusitis focused on measuring recurrent, CRS with nasal polyps, CRS without nasal polyps

Eligibility Criteria

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

Inclusion Criteria: Up to 45 CRS subjects with recurrent symptomatic nasal obstruction eligible for Airiver Nasal DCB treatment Males or females, ≥18 years Signed written informed consent Recurrent, symptomatic CRS (with or without nasal polyps, with or without prior sinus surgery), have: Moderate or severe nasal congestion/blockage/obstruction AND decreased or loss of smell (hyposmia or anosmia), Or rhinorrhea (anterior/posterior) For recurrent CRSwNP: candidates for RESS or other treatment due to recurrent symptom, and endoscopically confirmed present with unilateral or bilateral polyps, and/or unilateral or bilateral mucosal disease confirmed by nasal endoscopy and/or CT bilateral sinonasal polyposis that despite prior treatment with systemic corticosteroids (SCS) anytime within the past 2 years; and/or had a medical contraindication / intolerance to SCS with or without Aspirin-Exacerbated Respiratory Disease (AERD) For recurrent CRSsNP: refractory to optimal medical treatment and/or previous surgery with positive CT scan of the sinuses mucosal thickening and obstruction or positive nasal endoscopic finding (purulence or edema) Acute Exacerbation of CRS (AECRS) Subjects with comorbid asthma or COPD must be stable with no exacerbations (e.g., no emergency room visits, hospitalizations) for 6 months before the screening visit Exclusion Criteria: Pediatric CRS (PCRS) Acute bacterial sinusitis (ABRS), acute rhinosinusitis (ARS), or mycetoma and invasive fungal sinusitis Malignancy Experienced a cerebrospinal fluid (CSF) leak in prior skull-based dehiscence Symptomatic without positive CT findings or an asymptomatic Subjects whose symptoms are too severe (eg, temperature >102.58F or extrasinus manifestations, such as orbital cellulitis; dental or facial or brain abscess; cavernous vein thrombosis; or altered mental status Primary ciliary dyskinesia (PCD) Unable to have nasal cavity examination due to septal deviation or spur. Participants who had a sinonasal or sinus surgery changing the lateral wall structure of the nose making impossible the evaluation of NP Have evidence of significant baseline mucosal injury, ulceration, or erosion (eg, exposed cartilage, perforation) on baseline nasal examination Purulent nasal infection, or upper respiratory tract infection within 2 weeks before the screening visit. Potential subjects presenting with any of these infections may be rescreened 4 weeks after symptom resolution Allergy or hypersensitivity to any excipients and paclitaxel. Patient has an inability to tolerate endoscopy Suffering or recovering from COVID-19 (Fully recovered Covid-19 patients is not excluded) Study subject has any disease or condition that interferes with safe completion of the study, such as severe COPD or severe asthma Subjects with abnormal screening laboratory/imaging test results that compromise the ability to assess the benefits/risks (eg, abnormal ECG) Pregnancy or planning on pregnant during the first 12 months of enrollment in the study Life expectancy <1 year Patient is currently enrolled in other current investigational studies. Participation in studies for products approved in the US are not considered investigational. Lack of informed consent Allergic granulomatous angiitis (Churg-Strauss syndrome), granulomatosis with polyangiitis (Wegener's granulomatosis), Young's syndrome, Kartagener's syndrome or other dyskinetic ciliary syndromes -

Sites / Locations

  • Sanatorio Americano HospitalRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Single arm treated by Airiver Nasal DCB

Arm Description

Subjects with recurrent symptomatic nasal obstruction will be treated by Airiver Nasal Drug Coated Balloon (DCB) Catheter at the index procedure. The balloon is coated with a paclitaxel drug (3.5ug/mm2).

Outcomes

Primary Outcome Measures

Primary safety: Freedom from major device related adverse events (MADE) post index procedure assessed by the proportion of subjects free from the primary safety event through 30 days.
Subjects failing any component of the primary safety endpoint will be considered a safety failure, and subjects who remain event free through 30 days will be considered safety successes. MADE is defined as: 1) Cerebrospinal fluid (CSF) leak, 2) Severe epistaxis (nasal bleeding) requiring intervention other than packing, 3) Eye complication requiring surgical treatment, 4) Paclitaxel related nasal mucosal disorder.
Primary efficacy: Freedom from target lesion reintervention due to recurrence of CRS without nasal polyposis or CRS with nasal polyposis (retuning to baseline symptoms or worse) through 6 months.
assessed by Kaplan-Meier survival analysis of the incidence of subjects free from symptom-driven TLR.

Secondary Outcome Measures

Incidence of, and time to symptom-driven reintervention
assessed by Kaplan-Meier survival analysis of the incidence of subjects free from symptom-driven TLR
Change in patient reported 22-item Sino-Nasal Outcome Test (SNOT-22) from the baseline
Total SNOT 22 score is between 0 to 110. Higher scores indicate worse rhinosinusitis.
Change in Lund-Kennedy Endoscopic Scores from the baseline
The scores range is from 0 to 20. Higher scores indicate worse observed disease.
Change in Lund-Mackay computed tomography (LMK-CT) score from the baseline
The score range is from 0 to 24. Higher scores indicate worse disease severity.
Change of Health-related quality -of- life (HRQL) from the baseline (Euro-QOL-5D questionnaire)
The EQ-5D essentially consists of 2 parts: the EQ-5D descriptive system and the EQ VAS. The EQ-5D descriptive system comprises 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. The EQ VAS records the respondent's self-rated health on a vertical VAS. The EQ VAS 'thermometer' has scales of 100 (Best imaginable health state) at the top and 0 (Worst imaginable health state) at the bottom.
Change in sense of smell using the University of Pennsylvania Smell Identification Test (UPSIT) from the baseline
The score range is between 0-40. Higher scores indicate better smell function.
Clinical pharmacokinetics of paclitaxel in 15 subjects
Blood samples will be collected at baseline and post procedure at pre-designated time points and assessed for plasma paclitaxel concentrations.
Change in Asthma Control Questionnaire-6 (ACQ-5) Scores from baseline for subjects with comorbid asthma
A score of 0-6 is assigned to values for each criterion. The total ACQ score is the mean value calculated after adding the individual scores for each criterion. In general, patients with a score below 1.0 are likely to have adequately controlled asthma, above 1.0 their asthma is not likely to be well-controlled.
Nasal DCB performance evaluation in index procedures
Device Performance will be assessed using a rating scale (1-5) to evaluate seven aspects of the test article. Higher scores indicate better performance.

Full Information

First Posted
May 19, 2023
Last Updated
August 21, 2023
Sponsor
Airiver Medical, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT05883462
Brief Title
Paclitaxel-Coated Nasal Balloon for the Treatment of Recurrent Chronic Rhinosinusitis With or Without Nasal Polyps (FIH)
Official Title
Prospective Trial of Paclitaxel-Coated Nasal Balloon for the Treatment of Recurrent Chronic Rhinosinusitis With or Without Nasal Polyps
Study Type
Interventional

2. Study Status

Record Verification Date
August 2023
Overall Recruitment Status
Recruiting
Study Start Date
June 7, 2023 (Actual)
Primary Completion Date
December 2024 (Anticipated)
Study Completion Date
December 2029 (Anticipated)

3. Sponsor/Collaborators

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

4. Oversight

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

5. Study Description

Brief Summary
It is a first in human (FIH) study to evaluate safety, and potential efficacy of Airiver Nasal DCB in the treatment of recurrent CRSwNP or CRSsNP. Participants will receive AIRIVER Nasal drug-coated balloon treatment.
Detailed Description
Paclitaxel coated balloon is designed to offer both mechanical dilation of nasal obstruction and local drug effect for underlying inflammatory disorder and cell hyperplasia. It is hypothesized that Airiver Nasal drug-coated balloon (DCB) will improve patient outcome and as an adjunct to standard of care, will improve nasal patency than the standard of care alone. This is a prospective, single arm, first in human (FIH) study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Rhinosinusitis
Keywords
recurrent, CRS with nasal polyps, CRS without nasal polyps

7. Study Design

Primary Purpose
Treatment
Study Phase
Early Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
45 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Single arm treated by Airiver Nasal DCB
Arm Type
Experimental
Arm Description
Subjects with recurrent symptomatic nasal obstruction will be treated by Airiver Nasal Drug Coated Balloon (DCB) Catheter at the index procedure. The balloon is coated with a paclitaxel drug (3.5ug/mm2).
Intervention Type
Combination Product
Intervention Name(s)
Airiver Nasal Drug Coated Balloon (DCB) Catheter.
Intervention Description
The balloon is coated with a paclitaxel drug (3.5ug/mm2).
Primary Outcome Measure Information:
Title
Primary safety: Freedom from major device related adverse events (MADE) post index procedure assessed by the proportion of subjects free from the primary safety event through 30 days.
Description
Subjects failing any component of the primary safety endpoint will be considered a safety failure, and subjects who remain event free through 30 days will be considered safety successes. MADE is defined as: 1) Cerebrospinal fluid (CSF) leak, 2) Severe epistaxis (nasal bleeding) requiring intervention other than packing, 3) Eye complication requiring surgical treatment, 4) Paclitaxel related nasal mucosal disorder.
Time Frame
30 days
Title
Primary efficacy: Freedom from target lesion reintervention due to recurrence of CRS without nasal polyposis or CRS with nasal polyposis (retuning to baseline symptoms or worse) through 6 months.
Description
assessed by Kaplan-Meier survival analysis of the incidence of subjects free from symptom-driven TLR.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Incidence of, and time to symptom-driven reintervention
Description
assessed by Kaplan-Meier survival analysis of the incidence of subjects free from symptom-driven TLR
Time Frame
12 months
Title
Change in patient reported 22-item Sino-Nasal Outcome Test (SNOT-22) from the baseline
Description
Total SNOT 22 score is between 0 to 110. Higher scores indicate worse rhinosinusitis.
Time Frame
12 months
Title
Change in Lund-Kennedy Endoscopic Scores from the baseline
Description
The scores range is from 0 to 20. Higher scores indicate worse observed disease.
Time Frame
12 months
Title
Change in Lund-Mackay computed tomography (LMK-CT) score from the baseline
Description
The score range is from 0 to 24. Higher scores indicate worse disease severity.
Time Frame
12 months.
Title
Change of Health-related quality -of- life (HRQL) from the baseline (Euro-QOL-5D questionnaire)
Description
The EQ-5D essentially consists of 2 parts: the EQ-5D descriptive system and the EQ VAS. The EQ-5D descriptive system comprises 5 dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. The EQ VAS records the respondent's self-rated health on a vertical VAS. The EQ VAS 'thermometer' has scales of 100 (Best imaginable health state) at the top and 0 (Worst imaginable health state) at the bottom.
Time Frame
12 months
Title
Change in sense of smell using the University of Pennsylvania Smell Identification Test (UPSIT) from the baseline
Description
The score range is between 0-40. Higher scores indicate better smell function.
Time Frame
12 months
Title
Clinical pharmacokinetics of paclitaxel in 15 subjects
Description
Blood samples will be collected at baseline and post procedure at pre-designated time points and assessed for plasma paclitaxel concentrations.
Time Frame
10 days
Title
Change in Asthma Control Questionnaire-6 (ACQ-5) Scores from baseline for subjects with comorbid asthma
Description
A score of 0-6 is assigned to values for each criterion. The total ACQ score is the mean value calculated after adding the individual scores for each criterion. In general, patients with a score below 1.0 are likely to have adequately controlled asthma, above 1.0 their asthma is not likely to be well-controlled.
Time Frame
12 months
Title
Nasal DCB performance evaluation in index procedures
Description
Device Performance will be assessed using a rating scale (1-5) to evaluate seven aspects of the test article. Higher scores indicate better performance.
Time Frame
one day

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Up to 45 CRS subjects with recurrent symptomatic nasal obstruction eligible for Airiver Nasal DCB treatment Males or females, ≥18 years Signed written informed consent Recurrent, symptomatic CRS (with or without nasal polyps, with or without prior sinus surgery), have: Moderate or severe nasal congestion/blockage/obstruction AND decreased or loss of smell (hyposmia or anosmia), Or rhinorrhea (anterior/posterior) For recurrent CRSwNP: candidates for RESS or other treatment due to recurrent symptom, and endoscopically confirmed present with unilateral or bilateral polyps, and/or unilateral or bilateral mucosal disease confirmed by nasal endoscopy and/or CT bilateral sinonasal polyposis that despite prior treatment with systemic corticosteroids (SCS) anytime within the past 2 years; and/or had a medical contraindication / intolerance to SCS with or without Aspirin-Exacerbated Respiratory Disease (AERD) For recurrent CRSsNP: refractory to optimal medical treatment and/or previous surgery with positive CT scan of the sinuses mucosal thickening and obstruction or positive nasal endoscopic finding (purulence or edema) Acute Exacerbation of CRS (AECRS) Subjects with comorbid asthma or COPD must be stable with no exacerbations (e.g., no emergency room visits, hospitalizations) for 6 months before the screening visit Exclusion Criteria: Pediatric CRS (PCRS) Acute bacterial sinusitis (ABRS), acute rhinosinusitis (ARS), or mycetoma and invasive fungal sinusitis Malignancy Experienced a cerebrospinal fluid (CSF) leak in prior skull-based dehiscence Symptomatic without positive CT findings or an asymptomatic Subjects whose symptoms are too severe (eg, temperature >102.58F or extrasinus manifestations, such as orbital cellulitis; dental or facial or brain abscess; cavernous vein thrombosis; or altered mental status Primary ciliary dyskinesia (PCD) Unable to have nasal cavity examination due to septal deviation or spur. Participants who had a sinonasal or sinus surgery changing the lateral wall structure of the nose making impossible the evaluation of NP Have evidence of significant baseline mucosal injury, ulceration, or erosion (eg, exposed cartilage, perforation) on baseline nasal examination Purulent nasal infection, or upper respiratory tract infection within 2 weeks before the screening visit. Potential subjects presenting with any of these infections may be rescreened 4 weeks after symptom resolution Allergy or hypersensitivity to any excipients and paclitaxel. Patient has an inability to tolerate endoscopy Suffering or recovering from COVID-19 (Fully recovered Covid-19 patients is not excluded) Study subject has any disease or condition that interferes with safe completion of the study, such as severe COPD or severe asthma Subjects with abnormal screening laboratory/imaging test results that compromise the ability to assess the benefits/risks (eg, abnormal ECG) Pregnancy or planning on pregnant during the first 12 months of enrollment in the study Life expectancy <1 year Patient is currently enrolled in other current investigational studies. Participation in studies for products approved in the US are not considered investigational. Lack of informed consent Allergic granulomatous angiitis (Churg-Strauss syndrome), granulomatosis with polyangiitis (Wegener's granulomatosis), Young's syndrome, Kartagener's syndrome or other dyskinetic ciliary syndromes -
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Yan Li, MD
Phone
6513530685
Email
liy@airiver.com
First Name & Middle Initial & Last Name or Official Title & Degree
Paul Vajgrt
Phone
7632452566
Email
vaigrtp@airiver.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Coral Leticia Benítez Insaurralde, MD
Organizational Affiliation
Sanatorio Americano Hospital
Official's Role
Principal Investigator
Facility Information:
Facility Name
Sanatorio Americano Hospital
City
Asunción
Country
Paraguay
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Coral Benitez, MD
Phone
0981 469462
Email
dracoralbenitez@gmail.com
First Name & Middle Initial & Last Name & Degree
Nestor Cardozo, MD
Phone
0986 850104
Email
nescard@gmail.com

12. IPD Sharing Statement

Learn more about this trial

Paclitaxel-Coated Nasal Balloon for the Treatment of Recurrent Chronic Rhinosinusitis With or Without Nasal Polyps (FIH)

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