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Safety and Preliminary Efficacy Study of NeoFuse in Subjects Requiring Lumbar Interbody Fusion

Primary Purpose

Degenerative Disc Disease, Degenerative Spondylolisthesis, Spinal Stenosis

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Lumbar Interbody Fusion with Autograft
Lumbar Interbody Fusion with NeoFuse
Lumbar Interbody Fusion with NeoFuse
Sponsored by
Mesoblast, Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Degenerative Disc Disease focused on measuring Degenerative disc disease, Spondylolisthesis, Spinal stenosis, Stem cells, Adult Stem Cells, Spinal Fusion, Lumbar Spinal Fusion, TLIF, PLIF, Mesoblast

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or females at least 18 years of age, but not older than 70.
  2. Have the ability to understand the requirements of the study, to provide written informed consent, and to comply with the study protocol.
  3. Have the ability to understand and provide written authorization for the use and disclosure of personal health information (PHI) [per Health Insurance Portability and Accountability Act (HIPAA) privacy ruling in the US].
  4. Have a documented symptomatic diagnosis of DDD at L1-S1 with or without stenosis and with or without up to and including Grade II degenerative spondylolisthesis.
  5. Have clinical symptoms of neurogenic claudication.
  6. Have failed 6 months of non-operative low back pain management.
  7. Are candidates for posterior lumbar interbody fusion in combination with posterior pedicle screw stabilization and require surgery at a 1 or 2 adjacent vertebral levels between L1 and S1.
  8. Have a stable screening electrocardiogram (ECG), as determined by the investigator that would not preclude surgery.

Exclusion Criteria:

  1. Female subjects who are pregnant or nursing, or women planning to become pregnant during the first year (12 months) following surgery.

    • Male subjects with partners of childbearing potential must agree to use adequate contraception (barrier method or abstinence) from the time of surgery and for a period of at least 1 year after surgery.
  2. Have a current or prior history within the last 3 years of neoplasm (excluding basal cell carcinoma) and/or any active neoplasm within the last 24 months, prior to screening.
  3. Have osteoporosis as defined by a DEXA T score of ≤ -3.0 or a history of fragility fractures or other significant bone disease contraindicating the use of spinal instrumentation.
  4. Have a documented medical history or radiographic evidence of a metabolic bone disease or other condition which would negatively impact the bone healing process.
  5. Have a positive screen for human immunodeficiency virus (HIV) antibodies.
  6. Have had treatment with any investigational therapy or device within 6 months of study surgery and/or plans to participate in any other allogeneic stem cell/progenitor cell therapy trial during the 3-year follow-up period.
  7. Have been a recipient of prior stem cell/progenitor cell therapy for spinal fusion surgery.
  8. Have a body mass index (BMI) > 35.
  9. Have 20% or greater anti-human leukocyte antigen (HLA) antibody titer and/or has antibody specificities to donor HLA antigens.
  10. Are transient or has been treated in the last 6 months before enrollment for alcohol and/or drug abuse in an inpatient substance abuse program.

Sites / Locations

  • The Spine Institute
  • Denver Spine
  • Rocky Mountain Associates in Orthopedic Medicine, P.C.
  • Fort Wayne Orthopaedics
  • Central Texas Spine Institute

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Active Comparator

Experimental

Experimental

Arm Label

Autograft

Low Dose

High Dose

Arm Description

Lumbar Interbody Fusion with Autograft

Lumbar Interbody Fusion with NeoFuse-Low Dose

Lumbar Interbody Fusion with NeoFuse-High Dose

Outcomes

Primary Outcome Measures

To determine the overall safety of NeoFuse plus carrier using physical examinations, vital signs, treatment emergent adverse events (TEAEs), and the results of clinical lab tests (hematology, serum chemistry, inflammation, and immunology).

Secondary Outcome Measures

To evaluate the overall fusion success with NeoFuse plus carrier compared to autograft using CT scans and x-ray of the involved lumbar spine levels and assess the change in outcomes (ODI, SF-36, and WPAI) and pain (VAS)at the 12-month follow-up visit.

Full Information

First Posted
October 9, 2009
Last Updated
June 25, 2020
Sponsor
Mesoblast, Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT00996073
Brief Title
Safety and Preliminary Efficacy Study of NeoFuse in Subjects Requiring Lumbar Interbody Fusion
Official Title
A Prospective, Multicenter, Randomized, Open-Label, Controlled Study Evaluating Safety and Preliminary Efficacy of NeoFuse When Combined With MasterGraft Matrix in Subjects Undergoing Lumbar Interbody Fusion With Instrumentation
Study Type
Interventional

2. Study Status

Record Verification Date
June 2020
Overall Recruitment Status
Completed
Study Start Date
September 2009 (undefined)
Primary Completion Date
July 2012 (Actual)
Study Completion Date
July 2014 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Mesoblast, Ltd.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to evaluate the safety and preliminary efficacy of NeoFuse in subjects with a diagnosis of degenerative disc disease (DDD) in 1 or 2 adjacent vertebral levels between L1 and S1. All subjects in this study will undergo interbody fusion via Transforaminal Lumbar Interbody Fusion (TLIF) or Posterior Lumbar Interbody Fusion (PLIF) procedures with Food and Drug Administration (FDA) approved/cleared supplemental posterior instrumentation.
Detailed Description
This is a prospective, multicenter, randomized, open-label controlled Phase 2 study designed to evaluate the safety and preliminary efficacy of adult, allogeneic mesenchymal precursor cells (MPCs) combined with MasterGraft Matrix when compared to use of autologous iliac crest bone graft in the lumbar interbody fusion site in subjects requiring 1 or 2 level interbody fusion procedure with instrumentation. All subjects in this study will undergo a 1 or 2-level (2 or 3 vertebrae) interbody fusion with supplemental posterior instrumentation. After the screening and surgical visits, each subject will be evaluated clinically and radiographically within 3 days and 30 days after surgery, and at 3, 6, 9, 12, 24, and 36 months after surgery. Subjects will be evaluated at the same time points for safety.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Degenerative Disc Disease, Degenerative Spondylolisthesis, Spinal Stenosis
Keywords
Degenerative disc disease, Spondylolisthesis, Spinal stenosis, Stem cells, Adult Stem Cells, Spinal Fusion, Lumbar Spinal Fusion, TLIF, PLIF, Mesoblast

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
Outcomes Assessor
Allocation
Randomized
Enrollment
24 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Autograft
Arm Type
Active Comparator
Arm Description
Lumbar Interbody Fusion with Autograft
Arm Title
Low Dose
Arm Type
Experimental
Arm Description
Lumbar Interbody Fusion with NeoFuse-Low Dose
Arm Title
High Dose
Arm Type
Experimental
Arm Description
Lumbar Interbody Fusion with NeoFuse-High Dose
Intervention Type
Biological
Intervention Name(s)
Lumbar Interbody Fusion with Autograft
Other Intervention Name(s)
Spinal Fusion, Control
Intervention Description
Single Dose Autograft Surgical Implantation
Intervention Type
Biological
Intervention Name(s)
Lumbar Interbody Fusion with NeoFuse
Other Intervention Name(s)
Spinal Fusion, Stem Cells
Intervention Description
Single Dose NeoFuse Surgical Implantation
Intervention Type
Biological
Intervention Name(s)
Lumbar Interbody Fusion with NeoFuse
Other Intervention Name(s)
Spinal Fusion, Stem Cells
Intervention Description
Single Dose NeoFuse Surgical Implantation
Primary Outcome Measure Information:
Title
To determine the overall safety of NeoFuse plus carrier using physical examinations, vital signs, treatment emergent adverse events (TEAEs), and the results of clinical lab tests (hematology, serum chemistry, inflammation, and immunology).
Time Frame
3 years
Secondary Outcome Measure Information:
Title
To evaluate the overall fusion success with NeoFuse plus carrier compared to autograft using CT scans and x-ray of the involved lumbar spine levels and assess the change in outcomes (ODI, SF-36, and WPAI) and pain (VAS)at the 12-month follow-up visit.
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or females at least 18 years of age, but not older than 70. Have the ability to understand the requirements of the study, to provide written informed consent, and to comply with the study protocol. Have the ability to understand and provide written authorization for the use and disclosure of personal health information (PHI) [per Health Insurance Portability and Accountability Act (HIPAA) privacy ruling in the US]. Have a documented symptomatic diagnosis of DDD at L1-S1 with or without stenosis and with or without up to and including Grade II degenerative spondylolisthesis. Have clinical symptoms of neurogenic claudication. Have failed 6 months of non-operative low back pain management. Are candidates for posterior lumbar interbody fusion in combination with posterior pedicle screw stabilization and require surgery at a 1 or 2 adjacent vertebral levels between L1 and S1. Have a stable screening electrocardiogram (ECG), as determined by the investigator that would not preclude surgery. Exclusion Criteria: Female subjects who are pregnant or nursing, or women planning to become pregnant during the first year (12 months) following surgery. Male subjects with partners of childbearing potential must agree to use adequate contraception (barrier method or abstinence) from the time of surgery and for a period of at least 1 year after surgery. Have a current or prior history within the last 3 years of neoplasm (excluding basal cell carcinoma) and/or any active neoplasm within the last 24 months, prior to screening. Have osteoporosis as defined by a DEXA T score of ≤ -3.0 or a history of fragility fractures or other significant bone disease contraindicating the use of spinal instrumentation. Have a documented medical history or radiographic evidence of a metabolic bone disease or other condition which would negatively impact the bone healing process. Have a positive screen for human immunodeficiency virus (HIV) antibodies. Have had treatment with any investigational therapy or device within 6 months of study surgery and/or plans to participate in any other allogeneic stem cell/progenitor cell therapy trial during the 3-year follow-up period. Have been a recipient of prior stem cell/progenitor cell therapy for spinal fusion surgery. Have a body mass index (BMI) > 35. Have 20% or greater anti-human leukocyte antigen (HLA) antibody titer and/or has antibody specificities to donor HLA antigens. Are transient or has been treated in the last 6 months before enrollment for alcohol and/or drug abuse in an inpatient substance abuse program.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Roger Brown
Organizational Affiliation
Senior Vice President of Musculoskeletal Repair
Official's Role
Study Director
Facility Information:
Facility Name
The Spine Institute
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Facility Name
Denver Spine
City
Greenwood Village
State/Province
Colorado
ZIP/Postal Code
80111
Country
United States
Facility Name
Rocky Mountain Associates in Orthopedic Medicine, P.C.
City
Loveland
State/Province
Colorado
ZIP/Postal Code
80538
Country
United States
Facility Name
Fort Wayne Orthopaedics
City
Fort Wayne
State/Province
Indiana
ZIP/Postal Code
46804
Country
United States
Facility Name
Central Texas Spine Institute
City
Austin
State/Province
Texas
ZIP/Postal Code
78731
Country
United States

12. IPD Sharing Statement

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Safety and Preliminary Efficacy Study of NeoFuse in Subjects Requiring Lumbar Interbody Fusion

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