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A Clinical Evaluation of PROPEL® Contour Sinus Implant (EXPAND)

Primary Purpose

Chronic Rhinosinusitis (Diagnosis)

Status
Completed
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
PROPEL Contour Sinus Implant
Balloon Sinus Dilation Alone
Sponsored by
Intersect ENT
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Rhinosinusitis (Diagnosis) focused on measuring Frontal Sinus, Balloon Dilation

Eligibility Criteria

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

Inclusion Criteria:

  1. Patient is 18 years of age or older.
  2. Patient is willing and able to comply with protocol requirements.
  3. Patient has confirmed diagnosis of CRS per International Consensus Statement on Allergy and Rhinology, Rhinosinusitis 2021 (ICAR:RS) guidelines.
  4. Bilateral disease in the frontal sinuses (Lund-Mackay CT score of ≥1 on each side) on CT scan within 90 days prior to the baseline.
  5. A successfully completed in-office bilateral balloon dilation of the FSO with no complication on either side that, in the opinion of the clinical investigator is amenable for PROPEL Contour Sinus Implant placement in both FSO

Exclusion Criteria:

  1. Patient has structural obstruction that precludes endoscopic visualization of one or both FSOs prior to implant placement.
  2. Expanded amount of ethmoid sinonasal polyps extending beyond the middle meatus (grade > 2) unless reduced 30 days prior to the baseline procedure
  3. Oral-steroid dependent condition such as chronic obstructive pulmonary disease (COPD) or other conditions.
  4. Known history of allergy or intolerance to corticosteroids or mometasone furoate.
  5. Patients with a known hypersensitivity to lactide, glycolide or caprolactone copolymers.
  6. Patients with electronic devices in direct connection to the brain or the nervous system such as implantable neurostimulators (e.g. deep brain stimulation), programmable CSF shunts.
  7. Patients with monopolar pacemakers (older designs, with lower resistance to interference) or ICD's (implantable cardioverter defibrillator).
  8. Patients with implantable, body worn devices such as insulin pumps.
  9. Evidence of purulence coming from paranasal sinuses or ostiomeatal complex.
  10. Clinical evidence of acute bacterial sinusitis or invasive fungal sinusitis (e.g. bone erosion on prior CT scan, necrotic sinus tissue).
  11. Active viral illness (e.g., flu, shingles).
  12. Use of parenteral or injected steroids (e.g. Kenalog) 30 days prior to the baseline procedure.
  13. Use of oral steroids, budesonide or other sinus steroid irrigations/rinses or drops, nebulized steroids administered nasally 14 days prior to baseline procedure.

Sites / Locations

  • Sacramento ENT/DaVinci Research, LLC
  • San Francisco Otolaryngology
  • ENT & Allergy Associate of Florida, LLC
  • ENT & Allergy Associate of Florida, LLC
  • ENT of Georgia
  • Ascentist Physicians Group
  • Kentuckiana Ear, Nose & Throat PSC
  • Advanced ENT & Allergy
  • Madison ENT
  • Ohio Sinus Institute
  • Fort Worth ENT & Sinus
  • Collin County ENT
  • ENT Associates of Texas
  • Alamo ENT Associates

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

PROPEL Contour Sinus Implant

Balloon Sinus Dilation Alone

Arm Description

Following successful in-office bilateral balloon dilation, placement of PROPEL Contour Sinus Implant in the randomized side.

Following successful in-office bilateral balloon dilation, placement of no implant on the contralateral side.

Outcomes

Primary Outcome Measures

Difference in FSO Patency by Blinded Reviewer
Side-to-side difference in frontal sinus ostium (FSO) patency at Day 45 based on cross-sectional area of FSO by computed tomography (CT) measurements performed by an independent, blinded reviewer. Cross-sectional area of FSO was measured via computer-assisted segmentation of CT images.

Secondary Outcome Measures

FSO Cross-sectional Area Change From Baseline on CT by an Independent, Blinded Reviewer
FSO cross-sectional area change from baseline to Day 45 and change from baseline to Day 180 per CT assessment performed by an independent, blinded reviewer. FSO cross-sectional area was measured via computer-assisted segmentation of CT images.
CT Frontal Sinus Outflow Tract (FSOT) Volume by Blinded Reviewer
FSOT, referring to the region of the frontal sinus surrounding the FSO, bordered superiorly by the frontal infundibulum and inferiorly by the frontal recess, is assessed by blinded reviewer. FSOT volume was measured via computer-assisted segmentation of CT images.
CT FSO Minimum Diameter by Blinded Reviewer
CT FSO minimum diameter assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses. FSO minimum diameter was measured via computer-assisted segmentation of CT images.
CT Zinreich's Modified Lund-Mackay Score for the Frontal Sinus by Blinded Reviewer
CT Zinreich's modified Lund-Mackay score for the frontal sinus assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses. Zinreich's modified Lund-Mackay scale ranges from 0 to 5. Higher scores indicate a worse outcome.
Number of Sinus Sides Requiring Post-operative Intervention by Clinical Investigators
Need for post-operative intervention as determined by clinical investigators per endoscopy.
CT Cross-sectional Area of FSO by Blinded Reviewer
CT cross-sectional area of FSO assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses. Cross-sectional area of FSO was measured via computer-assisted segmentation of CT images.
CT Lund-Mackay Score for the Frontal Sinus by Blinded Reviewer
CT Lund-Mackay score for the frontal sinus assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses. The Lund-Mackay scale ranges from 0 to 2. Higher scores indicate a worse outcome.
CT Lund-Mackay Score for the Frontal Sinus by Clinical Investigators
CT Lund-Mackay for the frontal sinus assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses. The Lund-Mackay scale ranges from 0 to 2. Higher scores indicate a worse outcome.
Adhesion/Scarring Grade in the Frontal Recess/FSO by Clinical Investigators
Endoscopic grading of adhesion/scarring grade in the frontal recess/FSO by clinical investigators. The adhesion/scarring grade in the frontal recess/FSO scale ranges from 0 to 4. Higher scores indicate a worse outcome.
Inflammation Score in the Frontal Recess/FSO by Clinical Investigators
Endoscopic grading of inflammation score in the frontal recess/FSO by clinical investigators. Inflammation score in the frontal recess/FSO ranges from 0 to 100. Higher scores indicate a worse outcome.
Polypoid Edema in the Frontal Recess/FSO by Clinical Investigators
Endoscopic grading of polypoid edema in the frontal recess/FSO by clinical investigators. Polypoid edema in the frontal recess/FSO scale ranges from 0 to 3. Higher scores indicate a worse outcome.
Adhesion/Scarring Grade in the Ethmoid Sinus by Clinical Investigators
Endoscopic grading of adhesion/scarring grade in the ethmoid sinus by clinical investigators. The adhesion/scarring grade in the ethmoid sinus scale ranges from 0 to 4. Higher scores indicate a worse outcome.
Polyp Grade in the Ethmoid Sinus by Clinical Investigators
Endoscopic grading of polyp grade in the ethmoid sinus by clinical investigators. Polyp grade in the ethmoid sinus scale ranges from 0 to 3. Higher scores indicate a worse outcome.
CRS Side-specific Symptom Score by Subject
Subject-reported outcome of chronic rhinosinusitis (CRS) side-specific symptom score. The chronic rhinosinusitis side-specific symptom score scale ranges from 0 to 30. Higher scores indicate a worse outcome.
SNOT-22 Score by Subject
Subject-reported outcome of SNOT-22 score. The Sino-Nasal Outcome Test, 22 item (SNOT-22) is a validated, disease-specific, symptom-scoring instrument consisting of 22 questions, each scored by the patient on a 6-point scale, ranging from a score of 0 ("no problem") to 5 ("problem as bad as it can be"). The maximum total score for all symptoms is equal to 110. Higher scores indicate a worse outcome.
RSI Score by Subject
Subject-reported outcome of RSI score. The Rhinosinusitis Symptom Inventory (RSI) scale ranges from 0 to 60. Higher scores indicate a worse outcome.
Implant Delivery Success by Clinical Investigators
Number of subjects who underwent successful access and deployment of the PROPEL Contour Sinus Implant into the FSO. Delivery is considered successful if the procedure concludes with correct implant placement on the intended side, even if a second attempt to place the implant is necessary. An attempted deployment occurs when the investigator introduces the delivery system into the subject's nostril with the intent of placing an implant.

Full Information

First Posted
April 21, 2021
Last Updated
March 31, 2023
Sponsor
Intersect ENT
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1. Study Identification

Unique Protocol Identification Number
NCT04858802
Brief Title
A Clinical Evaluation of PROPEL® Contour Sinus Implant
Acronym
EXPAND
Official Title
The EXPAND Study: A Clinical Evaluation of PROPEL® Contour Sinus Implant Placement in the Frontal Sinus Ostium Following In-office Bilateral Balloon Dilation
Study Type
Interventional

2. Study Status

Record Verification Date
March 2023
Overall Recruitment Status
Completed
Study Start Date
May 12, 2021 (Actual)
Primary Completion Date
February 10, 2022 (Actual)
Study Completion Date
June 20, 2022 (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
No
Studies a U.S. FDA-regulated Device Product
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of this study is to evaluate the efficacy of PROPEL Contour placement following an in-office frontal sinus balloon dilation (SBD) in patients with chronic rhinosinusitis (CRS)
Detailed Description
A post-market, randomized, intra-patient controlled, blinded multicenter study with 80 randomized subjects at up to 20 study centers. After successful in-office bilateral balloon dilation of the frontal sinus ostium (FSO) using the VenSure™ Nav Balloon Device and Fiagon Cube Navigation System, patients will be randomized to receive one PROPEL Contour Sinus Implant on one side while the contralateral side serves as the control.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Rhinosinusitis (Diagnosis)
Keywords
Frontal Sinus, Balloon Dilation

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Model Description
Intrapatient control in which eligible subjects will receive the PROPEL Contour Sinus Implant (Treatment) on one side, and no implant (Control) on the contralateral side.
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
80 (Actual)

8. Arms, Groups, and Interventions

Arm Title
PROPEL Contour Sinus Implant
Arm Type
Experimental
Arm Description
Following successful in-office bilateral balloon dilation, placement of PROPEL Contour Sinus Implant in the randomized side.
Arm Title
Balloon Sinus Dilation Alone
Arm Type
Active Comparator
Arm Description
Following successful in-office bilateral balloon dilation, placement of no implant on the contralateral side.
Intervention Type
Device
Intervention Name(s)
PROPEL Contour Sinus Implant
Intervention Description
370 mcg mometasone furoate-coated sinus implant
Intervention Type
Procedure
Intervention Name(s)
Balloon Sinus Dilation Alone
Intervention Description
No PROPEL Contour Sinus Implant
Primary Outcome Measure Information:
Title
Difference in FSO Patency by Blinded Reviewer
Description
Side-to-side difference in frontal sinus ostium (FSO) patency at Day 45 based on cross-sectional area of FSO by computed tomography (CT) measurements performed by an independent, blinded reviewer. Cross-sectional area of FSO was measured via computer-assisted segmentation of CT images.
Time Frame
Day 45
Secondary Outcome Measure Information:
Title
FSO Cross-sectional Area Change From Baseline on CT by an Independent, Blinded Reviewer
Description
FSO cross-sectional area change from baseline to Day 45 and change from baseline to Day 180 per CT assessment performed by an independent, blinded reviewer. FSO cross-sectional area was measured via computer-assisted segmentation of CT images.
Time Frame
Baseline, Day 45, and Day 180
Title
CT Frontal Sinus Outflow Tract (FSOT) Volume by Blinded Reviewer
Description
FSOT, referring to the region of the frontal sinus surrounding the FSO, bordered superiorly by the frontal infundibulum and inferiorly by the frontal recess, is assessed by blinded reviewer. FSOT volume was measured via computer-assisted segmentation of CT images.
Time Frame
Days 45 and 180
Title
CT FSO Minimum Diameter by Blinded Reviewer
Description
CT FSO minimum diameter assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses. FSO minimum diameter was measured via computer-assisted segmentation of CT images.
Time Frame
Days 45 and 180
Title
CT Zinreich's Modified Lund-Mackay Score for the Frontal Sinus by Blinded Reviewer
Description
CT Zinreich's modified Lund-Mackay score for the frontal sinus assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses. Zinreich's modified Lund-Mackay scale ranges from 0 to 5. Higher scores indicate a worse outcome.
Time Frame
Days 45 and 180
Title
Number of Sinus Sides Requiring Post-operative Intervention by Clinical Investigators
Description
Need for post-operative intervention as determined by clinical investigators per endoscopy.
Time Frame
Days 21, 45, 90 and 180
Title
CT Cross-sectional Area of FSO by Blinded Reviewer
Description
CT cross-sectional area of FSO assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses. Cross-sectional area of FSO was measured via computer-assisted segmentation of CT images.
Time Frame
Day 180
Title
CT Lund-Mackay Score for the Frontal Sinus by Blinded Reviewer
Description
CT Lund-Mackay score for the frontal sinus assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses. The Lund-Mackay scale ranges from 0 to 2. Higher scores indicate a worse outcome.
Time Frame
Days 45 and 180
Title
CT Lund-Mackay Score for the Frontal Sinus by Clinical Investigators
Description
CT Lund-Mackay for the frontal sinus assessed by blinded independent reviewer to assess extent of the disease in the frontal sinuses. The Lund-Mackay scale ranges from 0 to 2. Higher scores indicate a worse outcome.
Time Frame
Days 45 and 180
Title
Adhesion/Scarring Grade in the Frontal Recess/FSO by Clinical Investigators
Description
Endoscopic grading of adhesion/scarring grade in the frontal recess/FSO by clinical investigators. The adhesion/scarring grade in the frontal recess/FSO scale ranges from 0 to 4. Higher scores indicate a worse outcome.
Time Frame
Days 21, 45, 90 and 180
Title
Inflammation Score in the Frontal Recess/FSO by Clinical Investigators
Description
Endoscopic grading of inflammation score in the frontal recess/FSO by clinical investigators. Inflammation score in the frontal recess/FSO ranges from 0 to 100. Higher scores indicate a worse outcome.
Time Frame
Days 21, 45, 90 and 180
Title
Polypoid Edema in the Frontal Recess/FSO by Clinical Investigators
Description
Endoscopic grading of polypoid edema in the frontal recess/FSO by clinical investigators. Polypoid edema in the frontal recess/FSO scale ranges from 0 to 3. Higher scores indicate a worse outcome.
Time Frame
Days 21, 45, 90 and 180
Title
Adhesion/Scarring Grade in the Ethmoid Sinus by Clinical Investigators
Description
Endoscopic grading of adhesion/scarring grade in the ethmoid sinus by clinical investigators. The adhesion/scarring grade in the ethmoid sinus scale ranges from 0 to 4. Higher scores indicate a worse outcome.
Time Frame
Day 21, 45, 90, and 180
Title
Polyp Grade in the Ethmoid Sinus by Clinical Investigators
Description
Endoscopic grading of polyp grade in the ethmoid sinus by clinical investigators. Polyp grade in the ethmoid sinus scale ranges from 0 to 3. Higher scores indicate a worse outcome.
Time Frame
Days 21, 45, 90 and 180
Title
CRS Side-specific Symptom Score by Subject
Description
Subject-reported outcome of chronic rhinosinusitis (CRS) side-specific symptom score. The chronic rhinosinusitis side-specific symptom score scale ranges from 0 to 30. Higher scores indicate a worse outcome.
Time Frame
Days 21, 45, 90 and 180
Title
SNOT-22 Score by Subject
Description
Subject-reported outcome of SNOT-22 score. The Sino-Nasal Outcome Test, 22 item (SNOT-22) is a validated, disease-specific, symptom-scoring instrument consisting of 22 questions, each scored by the patient on a 6-point scale, ranging from a score of 0 ("no problem") to 5 ("problem as bad as it can be"). The maximum total score for all symptoms is equal to 110. Higher scores indicate a worse outcome.
Time Frame
Day 180
Title
RSI Score by Subject
Description
Subject-reported outcome of RSI score. The Rhinosinusitis Symptom Inventory (RSI) scale ranges from 0 to 60. Higher scores indicate a worse outcome.
Time Frame
Day 180
Title
Implant Delivery Success by Clinical Investigators
Description
Number of subjects who underwent successful access and deployment of the PROPEL Contour Sinus Implant into the FSO. Delivery is considered successful if the procedure concludes with correct implant placement on the intended side, even if a second attempt to place the implant is necessary. An attempted deployment occurs when the investigator introduces the delivery system into the subject's nostril with the intent of placing an implant.
Time Frame
Baseline

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria: Patient is 18 years of age or older. Patient is willing and able to comply with protocol requirements. Patient has confirmed diagnosis of CRS per International Consensus Statement on Allergy and Rhinology, Rhinosinusitis 2021 (ICAR:RS) guidelines. Bilateral disease in the frontal sinuses (Lund-Mackay CT score of ≥1 on each side) on CT scan within 90 days prior to the baseline. A successfully completed in-office bilateral balloon dilation of the FSO with no complication on either side that, in the opinion of the clinical investigator is amenable for PROPEL Contour Sinus Implant placement in both FSO Exclusion Criteria: Patient has structural obstruction that precludes endoscopic visualization of one or both FSOs prior to implant placement. Expanded amount of ethmoid sinonasal polyps extending beyond the middle meatus (grade > 2) unless reduced 30 days prior to the baseline procedure Oral-steroid dependent condition such as chronic obstructive pulmonary disease (COPD) or other conditions. Known history of allergy or intolerance to corticosteroids or mometasone furoate. Patients with a known hypersensitivity to lactide, glycolide or caprolactone copolymers. Patients with electronic devices in direct connection to the brain or the nervous system such as implantable neurostimulators (e.g. deep brain stimulation), programmable cerebrospinal fluid (CSF) shunts. Patients with monopolar pacemakers (older designs, with lower resistance to interference) or ICD's (implantable cardioverter defibrillator). Patients with implantable, body worn devices such as insulin pumps. Evidence of purulence coming from paranasal sinuses or ostiomeatal complex. Clinical evidence of acute bacterial sinusitis or invasive fungal sinusitis (e.g. bone erosion on prior CT scan, necrotic sinus tissue). Active viral illness (e.g., flu, shingles). Use of parenteral or injected steroids (e.g. Kenalog) 30 days prior to the baseline procedure. Use of oral steroids, budesonide or other sinus steroid irrigations/rinses or drops, nebulized steroids administered nasally 14 days prior to baseline procedure.
Facility Information:
Facility Name
Sacramento ENT/DaVinci Research, LLC
City
Sacramento
State/Province
California
ZIP/Postal Code
95815
Country
United States
Facility Name
San Francisco Otolaryngology
City
San Francisco
State/Province
California
ZIP/Postal Code
94108
Country
United States
Facility Name
ENT & Allergy Associate of Florida, LLC
City
Boca Raton
State/Province
Florida
ZIP/Postal Code
33487
Country
United States
Facility Name
ENT & Allergy Associate of Florida, LLC
City
Boynton Beach
State/Province
Florida
ZIP/Postal Code
33426
Country
United States
Facility Name
ENT of Georgia
City
Atlanta
State/Province
Georgia
ZIP/Postal Code
30342
Country
United States
Facility Name
Ascentist Physicians Group
City
Leawood
State/Province
Kansas
ZIP/Postal Code
66211
Country
United States
Facility Name
Kentuckiana Ear, Nose & Throat PSC
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40205
Country
United States
Facility Name
Advanced ENT & Allergy
City
Louisville
State/Province
Kentucky
ZIP/Postal Code
40220
Country
United States
Facility Name
Madison ENT
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Ohio Sinus Institute
City
Dublin
State/Province
Ohio
ZIP/Postal Code
43016
Country
United States
Facility Name
Fort Worth ENT & Sinus
City
Fort Worth
State/Province
Texas
ZIP/Postal Code
76109
Country
United States
Facility Name
Collin County ENT
City
Frisco
State/Province
Texas
ZIP/Postal Code
75034
Country
United States
Facility Name
ENT Associates of Texas
City
McKinney
State/Province
Texas
ZIP/Postal Code
75070
Country
United States
Facility Name
Alamo ENT Associates
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78258
Country
United States

12. IPD Sharing Statement

Learn more about this trial

A Clinical Evaluation of PROPEL® Contour Sinus Implant

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