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Administration of Two Injections for Multiple Dupuytren's Contractures

Primary Purpose

Dupuytren's Contracture

Status
Completed
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
AA4500 collagenase clostridium histolyticum
Sponsored by
Endo Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Dupuytren's Contracture

Eligibility Criteria

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

Inclusion Criteria:

  1. Provide written informed consent
  2. Be a man or woman ≥ 18 years of age
  3. Have a diagnosis of Dupuytren's disease and have at least 2 fixed-flexion contractures on the same hand that are ≥ 20º in PIP and/or MP joints in fingers, other than the thumbs, which are caused by palpable cords suitable for treatment
  4. Have a positive "table top test" defined as the inability to simultaneously place the affected finger(s) and palm flat against a table top
  5. Either be using an accepted method of birth control (ie, surgical sterilization; intra uterine contraceptive device; oral contraceptive; diaphragm or condom in combination with contraceptive cream, or jelly or foam) and have negative pregnancy testing before administration of AA4500, if a female of childbearing potential, or be a postmenopausal female (no menses for at least 1 year or hysterectomy)
  6. Not have any clinically significant medical history or condition(s) that would, in the opinion of the investigator, substantially increase the risk associated with the subject's participation in the protocol or compromise the scientific objectives of the study
  7. Be able to comply with the study visit schedule as specified in the protocol

Exclusion Criteria:

  1. Received surgery (fasciectomy or surgical fasciotomy) and/or needle aponeurotomy/fasciotomy on the selected joints to be treated within 90 days before the first injection of AA4500
  2. Has a chronic muscular, neurological, or neuromuscular disorder that affects the hands
  3. Has a known systemic allergy to collagenase or any other excipient of AA4500
  4. Has received any collagenase treatments (eg, Santyl® ointment and/or XIAFLEX/XIAPEX) within 30 days before injection of AA4500
  5. Is currently receiving or plans to receive anticoagulant medication or has received anticoagulant medication (except for ≤ 150 mg aspirin daily and over-the-counter nonsteroidal anti-inflammatory drugs [NSAIDs]) within 7 days before injection of AA4500)
  6. Has a known recent history of stroke, bleeding, or other medical condition, which in the investigator's opinion would make the subject unsuitable for enrollment in the study
  7. Is known to be immunocompromised or human immunodeficiency virus (HIV) positive
  8. Has a history of illicit drug abuse or alcoholism within the year before injection of AA4500
  9. Received an investigational drug within 30 days before injection of AA4500
  10. Is a pregnant or lactating female
  11. Has any clinically significant medical history or condition(s), including conditions that affect the hands, that would, in the opinion of the investigator, substantially increase the risk associated with the subject's participation in the protocol or compromise the scientific objectives of the study
  12. Has jewelry on the hand to be treated that cannot be removed

Sites / Locations

  • Tucson Orthopaedic Institute
  • The Indiana Hand Center
  • Department of Orthopaedics SUNY-Stony Brook
  • Health Research Institute
  • AusTrials
  • AusTrials
  • AusTrials
  • Emeritus Research

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

AA4500

Arm Description

AA4500 collagenase clostridium histolyticum

Outcomes

Primary Outcome Measures

Percent Change From Baseline in Total Fixed Flexion
Total fixed flexion is defined as the sum of the fixed flexion contractures of the two joints receiving treatment. Change in fixed-flexion contracture is measured in degrees where a decrease of 100% would correspond to a reduction in contracture to 0 degrees
Change in Total Range of Motion
The total range of motion is the sum of the range of motion measurements of the two treated joints. Range of motion is defined as difference between full flexion angle and full extension angle expressed in degrees.

Secondary Outcome Measures

Subject Satisfaction With Treatment
At the Day 60 follow-up visit, each subject will be asked to rate his/her satisfaction with treatment as follows: Very Satisfied Quite Satisfied Neither Satisfied nor Dissatisfied Quite Dissatisfied Very Dissatisfied
Investigator Assessment of Improvement With Treatment
At the Day 60 follow-up visit, the investigator will determine the degree of improvement in the severity of the subject's treated finger(s) compared with screening as follows: Very Much Improved Much improved Minimally Improved No Change Minimally Worse Much Worse Very Much Worse
Clinical Success by Joint Type
Clinical success is defined as a reduction in fixed flexion contracture to 5° or less 30 days after injection of AA4500.

Full Information

First Posted
July 29, 2011
Last Updated
September 7, 2017
Sponsor
Endo Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT01407068
Brief Title
Administration of Two Injections for Multiple Dupuytren's Contractures
Official Title
An Open-label Study to Assess the Safety and Efficacy of Concurrent Administration of Two Injections of AA4500 0.58 mg Into the Same Hand of Subjects With Multiple Dupuytren's Contractures
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
September 2011 (undefined)
Primary Completion Date
February 2012 (Actual)
Study Completion Date
February 2012 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Endo Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objectives of this study are to assess the safety and efficacy of concurrent administration of two injections of AA4500 into the same hand of subjects with multiple Dupuytren's contractures caused by palpable cords.
Detailed Description
Methodology/Study Design: This is an open-label, study in men and women with multiple Dupuytren's contractures. Approximately 60 subjects who have at least two Dupuytren's contractures caused by palpable cords in the same hand will be enrolled. After all pre-injection procedures are completed on Day 1, eligible men and women will receive two concurrent injections of AA4500 0.58 mg into the same hand. On Day 2, a finger extension procedure to facilitate cord disruption will be performed in those subjects who do not have spontaneous disruption of their cord(s). Follow-up visits for the evaluation of safety and efficacy will be on Day 8, Day 30, and Day 60. Upon completion of the Day 60 follow-up visit, subjects who require further treatment will have the option to receive three additional open-label treatments according to the XIAFLEX package insert (Appendix C). Subjects may receive up to a total of five injections and individual cords may receive up to a total of three injections.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Dupuytren's Contracture

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
60 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AA4500
Arm Type
Experimental
Arm Description
AA4500 collagenase clostridium histolyticum
Intervention Type
Biological
Intervention Name(s)
AA4500 collagenase clostridium histolyticum
Other Intervention Name(s)
Xiaflex, Xiapex
Intervention Description
2 concurrent injections (0.58 mg) into 2 cords on the same hand
Primary Outcome Measure Information:
Title
Percent Change From Baseline in Total Fixed Flexion
Description
Total fixed flexion is defined as the sum of the fixed flexion contractures of the two joints receiving treatment. Change in fixed-flexion contracture is measured in degrees where a decrease of 100% would correspond to a reduction in contracture to 0 degrees
Time Frame
30 days after last injection
Title
Change in Total Range of Motion
Description
The total range of motion is the sum of the range of motion measurements of the two treated joints. Range of motion is defined as difference between full flexion angle and full extension angle expressed in degrees.
Time Frame
30 days after last injection
Secondary Outcome Measure Information:
Title
Subject Satisfaction With Treatment
Description
At the Day 60 follow-up visit, each subject will be asked to rate his/her satisfaction with treatment as follows: Very Satisfied Quite Satisfied Neither Satisfied nor Dissatisfied Quite Dissatisfied Very Dissatisfied
Time Frame
60 days after last injection
Title
Investigator Assessment of Improvement With Treatment
Description
At the Day 60 follow-up visit, the investigator will determine the degree of improvement in the severity of the subject's treated finger(s) compared with screening as follows: Very Much Improved Much improved Minimally Improved No Change Minimally Worse Much Worse Very Much Worse
Time Frame
60 days after last injection
Title
Clinical Success by Joint Type
Description
Clinical success is defined as a reduction in fixed flexion contracture to 5° or less 30 days after injection of AA4500.
Time Frame
30 days after injection

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Provide written informed consent Be a man or woman ≥ 18 years of age Have a diagnosis of Dupuytren's disease and have at least 2 fixed-flexion contractures on the same hand that are ≥ 20º in PIP and/or MP joints in fingers, other than the thumbs, which are caused by palpable cords suitable for treatment Have a positive "table top test" defined as the inability to simultaneously place the affected finger(s) and palm flat against a table top Either be using an accepted method of birth control (ie, surgical sterilization; intra uterine contraceptive device; oral contraceptive; diaphragm or condom in combination with contraceptive cream, or jelly or foam) and have negative pregnancy testing before administration of AA4500, if a female of childbearing potential, or be a postmenopausal female (no menses for at least 1 year or hysterectomy) Not have any clinically significant medical history or condition(s) that would, in the opinion of the investigator, substantially increase the risk associated with the subject's participation in the protocol or compromise the scientific objectives of the study Be able to comply with the study visit schedule as specified in the protocol Exclusion Criteria: Received surgery (fasciectomy or surgical fasciotomy) and/or needle aponeurotomy/fasciotomy on the selected joints to be treated within 90 days before the first injection of AA4500 Has a chronic muscular, neurological, or neuromuscular disorder that affects the hands Has a known systemic allergy to collagenase or any other excipient of AA4500 Has received any collagenase treatments (eg, Santyl® ointment and/or XIAFLEX/XIAPEX) within 30 days before injection of AA4500 Is currently receiving or plans to receive anticoagulant medication or has received anticoagulant medication (except for ≤ 150 mg aspirin daily and over-the-counter nonsteroidal anti-inflammatory drugs [NSAIDs]) within 7 days before injection of AA4500) Has a known recent history of stroke, bleeding, or other medical condition, which in the investigator's opinion would make the subject unsuitable for enrollment in the study Is known to be immunocompromised or human immunodeficiency virus (HIV) positive Has a history of illicit drug abuse or alcoholism within the year before injection of AA4500 Received an investigational drug within 30 days before injection of AA4500 Is a pregnant or lactating female Has any clinically significant medical history or condition(s), including conditions that affect the hands, that would, in the opinion of the investigator, substantially increase the risk associated with the subject's participation in the protocol or compromise the scientific objectives of the study Has jewelry on the hand to be treated that cannot be removed
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Veronica Urdaneta, MD, MPPH
Organizational Affiliation
Endo Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Tucson Orthopaedic Institute
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85712
Country
United States
Facility Name
The Indiana Hand Center
City
Indianapolis
State/Province
Indiana
ZIP/Postal Code
46260
Country
United States
Facility Name
Department of Orthopaedics SUNY-Stony Brook
City
Stony Brook
State/Province
New York
ZIP/Postal Code
11794
Country
United States
Facility Name
Health Research Institute
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73109
Country
United States
Facility Name
AusTrials
City
Auchenflower
ZIP/Postal Code
QLD 4067
Country
Australia
Facility Name
AusTrials
City
Auchenflower
ZIP/Postal Code
QLD4066
Country
Australia
Facility Name
AusTrials
City
Kippa Ring
ZIP/Postal Code
QLD 4020
Country
Australia
Facility Name
Emeritus Research
City
Malvern
ZIP/Postal Code
VIC 3144
Country
Australia

12. IPD Sharing Statement

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Administration of Two Injections for Multiple Dupuytren's Contractures

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