PREvention of Intrauterine Adhesion After Adhesiolysis With Novel Tri-block deGradable Polymer Film. (PREG2)
Primary Purpose
Asherman Syndrome, Intrauterine Adhesion
Status
Recruiting
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Womed Leaf
Sponsored by
About this trial
This is an interventional prevention trial for Asherman Syndrome focused on measuring Asherman Syndrome, Intrauterine adhesion, Hysteroscopy, Adhesiolysis, Adhesion prevention, Infertility
Eligibility Criteria
Inclusion Criteria:
- Women with moderate or severe intrauterine adhesions according to the AFS classification, i.e AFS score >=5, confirmed by hysteroscopy right before adhesiolysis
- Scheduled for hysteroscopic adhesiolysis
- Age above or equal to 18
- Subjects who are willing to provide a written informed consent.
- Subjects who can comply with the study follow-up (second look hysteroscopy) and other study requirements
Exclusion Criteria:
Pre-operative criteria
- Post menopause
- Abnormal uterine cavity according to ESHRE classification I to V such as unicornis, bicornis, septate, duplex
- Known or suspected endometrial hyperplasia
- History of cervical or endometrial cancer
- Active pelvic infection or history of pelvic peritonitis
- History of endometrial ablation
- Known contraindication or hypersensitivity to Womed Leaf component
- Current participation in another clinical investigation that has not yet received the primary endpoint.
- Any other condition that makes participation in the study contrary to the patient's best interests.
Intra-operative criteria, post adhesiolysis:
- Perforation during adhesiolysis
- Uterine depth < 5cm or > 10cm
Sites / Locations
- Gent UZRecruiting
- CHU BicêtreRecruiting
- Hopital La ConceptionRecruiting
- CHU LariboisièreRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
No Intervention
Arm Label
Womed Leaf
Control
Arm Description
IUA prevention: The novel intrauterine barrier film (Womed Leaf) is inserted immediately after completion of the hysteroscopic adhesiolysis
No IUA prevention - no placebo after adhesiolysis
Outcomes
Primary Outcome Measures
Efficacy - IUA severity
Change of AFS score between pre-adhesiolysis and second-look hysteroscopy (AFS) score
Safety - Adverse events
The number, severity and type of adverse events at second look hysteroscopy.
Secondary Outcome Measures
Freedom from IUA
Rate of IUA
IUA severity at second look
Average of AFS scores at second look hysteroscopy
IUA severity after adhesiolysis
Average of AFS scores post adhesiolysis
AFS score components
Average of each component of AFS score: extent of IUA, type of IUA and menstrual pattern
Change in AFS score components
Average of the change in each component of AFS score between post-adhesiolysis and second look hysteroscopy
Change in AFS score
Change of AFS score between post-adhesiolysis and second-look hysteroscopy
IUA severity according to ESGE classification
Median of ESGE stage at second look hysteroscopy
Reintervention rate
Reintervention rate, during second look hysteroscopy or scheduled later up to one year
Number of re-intervention procedures
Number of adhesiolysis procedures after second look up to one year
Pregnancy rate
Pregnancy rate defined as presence of foetal sac or heartbeat by ultrasound, whether spontaneous or IVF
Pregnancy rate
Pregnancy rate defined as presence of foetal sac or heartbeat by ultrasound, whether spontaneous or IVF
Live birth
Live birth rate
Live birth
Live birth rate
Pregnancy complication
Pregnancy complication rate
Time to pregnancy
Time to pregnancy (i.e. time between the second look hysteroscopy and pregnancy start)
Improvement of IUA severity
Percentage of patients who have improvement on the IUA severity according to Clinical Category:
Percentage of patients who have Mild adhesions or no adhesion at second look Percentage of patients who improved from Severe to Moderate or from Moderate to Mild Percentage of patients who improved from Severe to Mild
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04963179
Brief Title
PREvention of Intrauterine Adhesion After Adhesiolysis With Novel Tri-block deGradable Polymer Film.
Acronym
PREG2
Official Title
PREvention of Intrauterine Adhesion After Adhesiolysis With Novel Tri-block deGradable Polymer Film.
Study Type
Interventional
2. Study Status
Record Verification Date
May 2022
Overall Recruitment Status
Recruiting
Study Start Date
November 29, 2021 (Actual)
Primary Completion Date
March 2023 (Anticipated)
Study Completion Date
September 2024 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Womed
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
PREG2 is a randomized controlled trial that aims to evaluate efficacy in preventing intrauterine adhesion recurrence after hysteroscopic adhesiolysis of a novel intrauterine barrier film named Womed Leaf
Detailed Description
PREG2 is a prospective, multi-center, randomized, controlled, two arm clinical study. The objective is to evaluate the efficacy of Womed Leaf in preventing intrauterine adhesion recurrence after adhesiolysis compared to adhesiolysis alone.
The study will be performed on women with moderate or severe adhesions (AFS score >=5) scheduled for adhesiolysis. Indeed, the risk of intrauterine adhesion is very high (up to 60%) in this population of patients.
A follow-up diagnostic hysteroscopy will be performed 6-8 weeks after the adhesiolysis procedure to determine the presence and severity of IUAs according to the American Fertility Society and European Society of Gynecologic Endoscopy classification systems of adhesions. Fertility-related outcome will include live pregnancy at 1 year and 2 years and will be reported as secondary endpoints. 154 women are planned to be included in the PREG2 study.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Asherman Syndrome, Intrauterine Adhesion
Keywords
Asherman Syndrome, Intrauterine adhesion, Hysteroscopy, Adhesiolysis, Adhesion prevention, Infertility
7. Study Design
Primary Purpose
Prevention
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantOutcomes Assessor
Allocation
Randomized
Enrollment
154 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Womed Leaf
Arm Type
Experimental
Arm Description
IUA prevention: The novel intrauterine barrier film (Womed Leaf) is inserted immediately after completion of the hysteroscopic adhesiolysis
Arm Title
Control
Arm Type
No Intervention
Arm Description
No IUA prevention - no placebo after adhesiolysis
Intervention Type
Device
Intervention Name(s)
Womed Leaf
Intervention Description
Womed Leaf™ device is composed of a uterine anti-adhesion film pre-loaded inside a flexible inserter.
Womed Leaf™ is inserted in the uterine cavity by the gynecologist surgeon as a film folded into a 5 mm diameter flexible inserter. Once released, the film will unfold and swell into the uterine cavity to keep uterus walls separated during approximately 5 days. It is degraded and discharged naturally through the cervix and vagina in less than 30 days.
Primary Outcome Measure Information:
Title
Efficacy - IUA severity
Description
Change of AFS score between pre-adhesiolysis and second-look hysteroscopy (AFS) score
Time Frame
At second look hysteroscopy between 4 and 8 weeks
Title
Safety - Adverse events
Description
The number, severity and type of adverse events at second look hysteroscopy.
Time Frame
At second look hysteroscopy between 4 and 8 weeks
Secondary Outcome Measure Information:
Title
Freedom from IUA
Description
Rate of IUA
Time Frame
At second look hysteroscopy between 4 and 8 weeks
Title
IUA severity at second look
Description
Average of AFS scores at second look hysteroscopy
Time Frame
At second look hysteroscopy between 4 and 8 weeks
Title
IUA severity after adhesiolysis
Description
Average of AFS scores post adhesiolysis
Time Frame
Just after adhesiolysis
Title
AFS score components
Description
Average of each component of AFS score: extent of IUA, type of IUA and menstrual pattern
Time Frame
At second look hysteroscopy between 4 and 8 weeks
Title
Change in AFS score components
Description
Average of the change in each component of AFS score between post-adhesiolysis and second look hysteroscopy
Time Frame
At second look hysteroscopy between 4 and 8 weeks
Title
Change in AFS score
Description
Change of AFS score between post-adhesiolysis and second-look hysteroscopy
Time Frame
At second look hysteroscopy between 4 and 8 weeks
Title
IUA severity according to ESGE classification
Description
Median of ESGE stage at second look hysteroscopy
Time Frame
At second look hysteroscopy between 4 and 8 weeks
Title
Reintervention rate
Description
Reintervention rate, during second look hysteroscopy or scheduled later up to one year
Time Frame
1 year
Title
Number of re-intervention procedures
Description
Number of adhesiolysis procedures after second look up to one year
Time Frame
1 year
Title
Pregnancy rate
Description
Pregnancy rate defined as presence of foetal sac or heartbeat by ultrasound, whether spontaneous or IVF
Time Frame
1 year
Title
Pregnancy rate
Description
Pregnancy rate defined as presence of foetal sac or heartbeat by ultrasound, whether spontaneous or IVF
Time Frame
2 years
Title
Live birth
Description
Live birth rate
Time Frame
1 year
Title
Live birth
Description
Live birth rate
Time Frame
2 years
Title
Pregnancy complication
Description
Pregnancy complication rate
Time Frame
2 years
Title
Time to pregnancy
Description
Time to pregnancy (i.e. time between the second look hysteroscopy and pregnancy start)
Time Frame
2 years
Title
Improvement of IUA severity
Description
Percentage of patients who have improvement on the IUA severity according to Clinical Category:
Percentage of patients who have Mild adhesions or no adhesion at second look Percentage of patients who improved from Severe to Moderate or from Moderate to Mild Percentage of patients who improved from Severe to Mild
Time Frame
At second look hysteroscopy between 4 and 8 weeks
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Women with moderate or severe intrauterine adhesions according to the AFS classification, i.e AFS score >=5, confirmed by hysteroscopy right before adhesiolysis
Scheduled for hysteroscopic adhesiolysis
Age above or equal to 18
Subjects who are willing to provide a written informed consent.
Subjects who can comply with the study follow-up (second look hysteroscopy) and other study requirements
Exclusion Criteria:
Pre-operative criteria
Post menopause
Abnormal uterine cavity according to ESHRE classification I to V such as unicornis, bicornis, septate, duplex
Known or suspected endometrial hyperplasia
History of cervical or endometrial cancer
Active pelvic infection or history of pelvic peritonitis
History of endometrial ablation
Known contraindication or hypersensitivity to Womed Leaf component
Current participation in another clinical investigation that has not yet received the primary endpoint.
Any other condition that makes participation in the study contrary to the patient's best interests.
Intra-operative criteria, post adhesiolysis:
Perforation during adhesiolysis
Uterine depth < 5cm or > 10cm
Facility Information:
Facility Name
Gent UZ
City
Gent
ZIP/Postal Code
9000
Country
Belgium
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Steven Weyers
Phone
+32 9 332 37 57
Email
steven.weyers@uzgent.be
Facility Name
CHU Bicêtre
City
Le Kremlin-Bicêtre
ZIP/Postal Code
94270
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Hervé Fernandez
Phone
0145217763
Email
bureau.fernandez.bct@aphp.fr
Facility Name
Hopital La Conception
City
Marseille
ZIP/Postal Code
13005
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Aubert Agostini
Phone
0491383785
Email
aubert.AGOSTINI@ap-hm.fr
Facility Name
CHU Lariboisière
City
Paris
ZIP/Postal Code
75010
Country
France
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jean Louis Benifla
Phone
0149956236
Email
jlbenifla@gmail.com
12. IPD Sharing Statement
Plan to Share IPD
Yes
IPD Sharing Plan Description
Individual participant data that underlie the result that will be reported in an article and study protocol may be made available to researchers who provide a methodologically sound proposal, immediately after article publication and during 5 years
IPD Sharing Time Frame
immediately after article publication and during 5 years
IPD Sharing Access Criteria
researchers who provide a methodologically sound proposal
Learn more about this trial
PREvention of Intrauterine Adhesion After Adhesiolysis With Novel Tri-block deGradable Polymer Film.
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