NASHA/Dx as a Perianal Implant for the Treatment of Persistent Fecal Incontience After Anorectal Malformation
Primary Purpose
Fecal Incontinence, Anorectal Malformation
Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
NASHA/Dx (Solesta®)
Sponsored by
About this trial
This is an interventional treatment trial for Fecal Incontinence focused on measuring Fecal incontinence, Anorectal malformation
Eligibility Criteria
Inclusion Criteria:
- Persistent FI (Miller incontinence score >5)
- Anorectal malformation.
Exclusion Criteria:
- Pregnancy
- Rectal prolapse
- Significant mucosal prolapse
- Inflammatory bowel disease
- Anorectal surgery within the last year Before inclusion
- Anticoagulant medication/bleeding diathesis
- Anorectal sepsis in the past
- Immunodeficiency
- Immunosuppressing therapy
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Treatment arm
Arm Description
Patients are given NASHA/Dx as a perianal injection
Outcomes
Primary Outcome Measures
Change in number of incontinence episodes
The number of incontinences episodes as measured over a two week interval The number of incontience episodes is measured with a bowel-movement-diary over a two week period.
Secondary Outcome Measures
Miller´s incontinence score
Change of Miller´s incontinence score
Quality of life, general
Change in quality of Life as observed with SF-36
Adverse events
Control of any adverse events during the course of the study
Quality of life, disease specific
Change in quality of Life as observed with FIQL
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03746834
Brief Title
NASHA/Dx as a Perianal Implant for the Treatment of Persistent Fecal Incontience After Anorectal Malformation
Official Title
NASHA/Dx as a Perianal Implant for the Treatment of Persistent Fecal Incontience After Anorectal Malformation
Study Type
Interventional
2. Study Status
Record Verification Date
November 2018
Overall Recruitment Status
Completed
Study Start Date
September 20, 2013 (Actual)
Primary Completion Date
December 12, 2015 (Actual)
Study Completion Date
December 12, 2015 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Uppsala University
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
Persistent fecal incontinence (FI) after anorectal malformations (ARM) is a common occurence. During the last two decades perianal injection therapy has emerged as an option for treating patients with FI due to other causes than ARMs. The studies done on different implants have always expempted patients with ARM which has led to ARM being a formal contraindication for treatment with perianal injection therapy.
The study aims to treat patients with persistent FI after ARM with perianal injection of NASHA/Dx (Solesta®) and follow them with Clinical examination and questionnaires up to 18 months post treatment.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Fecal Incontinence, Anorectal Malformation
Keywords
Fecal incontinence, Anorectal malformation
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Model Description
Patients are treated with injection of NASHA/Dx and act as their own Controls over time.
Masking
None (Open Label)
Allocation
N/A
Enrollment
7 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Treatment arm
Arm Type
Experimental
Arm Description
Patients are given NASHA/Dx as a perianal injection
Intervention Type
Device
Intervention Name(s)
NASHA/Dx (Solesta®)
Intervention Description
Perianal submucosal injection of 3-4 ml of NASHA/Dx
Primary Outcome Measure Information:
Title
Change in number of incontinence episodes
Description
The number of incontinences episodes as measured over a two week interval The number of incontience episodes is measured with a bowel-movement-diary over a two week period.
Time Frame
The change in number of incontinence episodes before treatment is compared with data at 18 months after injection.
Secondary Outcome Measure Information:
Title
Miller´s incontinence score
Description
Change of Miller´s incontinence score
Time Frame
Before treatment compared with data at 18 months after treatment. Miller´s incontinence score is measured on a scale from 0 (meaning total fecal continence) to 18 (meaning total fecal incontinence).
Title
Quality of life, general
Description
Change in quality of Life as observed with SF-36
Time Frame
Before treatment compared with data at 18 months after treatment. SF-36 measures quality of life in 8 subscales. Each scaled from 0 to 100. Higher score is considered better. Two total scores of mental and physical QoL can be calculated.
Title
Adverse events
Description
Control of any adverse events during the course of the study
Time Frame
Before treatment compared with data at 18 months after treatment
Title
Quality of life, disease specific
Description
Change in quality of Life as observed with FIQL
Time Frame
Before treatment compared with data at 18 months after treatment. Measures 4 subscales, each measuring 1-4. Higher score implies better quality of life.
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Persistent FI (Miller incontinence score >5)
Anorectal malformation.
Exclusion Criteria:
Pregnancy
Rectal prolapse
Significant mucosal prolapse
Inflammatory bowel disease
Anorectal surgery within the last year Before inclusion
Anticoagulant medication/bleeding diathesis
Anorectal sepsis in the past
Immunodeficiency
Immunosuppressing therapy
12. IPD Sharing Statement
Plan to Share IPD
No
IPD Sharing Plan Description
The data collected is of very personal type and since the number of subjects is so small there would be a risk of identification if all the data was released.
Citations:
PubMed Identifier
23224913
Citation
Danielson J, Karlbom U, Wester T, Graf W. Efficacy and quality of life 2 years after treatment for faecal incontinence with injectable bulking agents. Tech Coloproctol. 2013 Aug;17(4):389-95. doi: 10.1007/s10151-012-0949-8. Epub 2012 Dec 7.
Results Reference
result
PubMed Identifier
19581853
Citation
Danielson J, Karlbom U, Sonesson AC, Wester T, Graf W. Submucosal injection of stabilized nonanimal hyaluronic acid with dextranomer: a new treatment option for fecal incontinence. Dis Colon Rectum. 2009 Jun;52(6):1101-6. doi: 10.1007/DCR.0b013e31819f5cbf.
Results Reference
result
PubMed Identifier
27894765
Citation
Danielson J, Karlbom U, Graf W, Wester T. Outcome in adults with anorectal malformations in relation to modern classification - Which patients do we need to follow beyond childhood? J Pediatr Surg. 2017 Mar;52(3):463-468. doi: 10.1016/j.jpedsurg.2016.10.051. Epub 2016 Nov 15.
Results Reference
result
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NASHA/Dx as a Perianal Implant for the Treatment of Persistent Fecal Incontience After Anorectal Malformation
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