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Safety Evaluation of ART352-L in Subjects Undergoing Posterolateral Spinal Fusion

Primary Purpose

Degenerative Spondylolisthesis

Status
Unknown status
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
ART352-L
Sponsored by
Ankasa Regenerative Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Degenerative Spondylolisthesis focused on measuring spine, spondylolisthesis, degenerative disc disease, back pain

Eligibility Criteria

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

Inclusion Criteria:

  1. Male or female subjects ≥50 years of age scheduled to undergo single level posterolateral lumbar spinal fusion surgery in conjunction with local autograft bone for degenerative spondylolisthesis
  2. Psychosocially, mentally, and physically able to fully comply with this protocol including the required follow-up visits, the filling out of required forms, and have the ability to understand and give written informed consent
  3. Willing and able to undergo diagnostic imaging, inclusive of X-rays and CT scans with contrast
  4. Persistent, disabling pain after at least 6 months of non-surgical intervention (e.g., anti-inflammatory medication, physical therapy, chiropractic care) prior to providing informed consent
  5. Pre-operative Oswestry Disability Index (ODI) Score ≥30
  6. Grade 1 or less spondylolisthesis or retrolisthesis
  7. Absence of neurological motor deficit
  8. Agree to use a highly reliable method of birth control (male and female subjects) for at least 90 days after administration of Investigational Product (IP) - Women of childbearing potential must have a negative pregnancy test at screening and again ≤7 days prior to surgery. Perimenopausal women must be amenorrheic for at least 12 months prior to the time of providing informed consent to be considered of non-childbearing potential.
  9. Agree to remain nicotine-free for the duration of their participation in the study

Exclusion Criteria:

  1. Multiple level spondylolistheses or a primary diagnosis of low back pain syndrome secondary to diseases other than degenerative spondylolisthesis
  2. Concurrent medications that affect bone homeostasis including, but not limited to, bisphosphonates
  3. Ongoing / existing infections in or around the surgical site or spine
  4. Prior lumbar spine arthrodesis
  5. Concurrent clinically significant autoimmune disorder or systemic inflammatory disease
  6. Known hypersensitivity to recombinant Wnt proteins
  7. Use of tobacco; subjects must be nicotine-free at screening and agree to remain nicotine free for the duration of the study
  8. Use of medications that may impair cell proliferation and bone healing including: chemotherapy, radiation, chronic steroids and immunosuppressive drugs. Note: Medications that may impair cell proliferation are to be discussed with the protocol medical monitor prior to enrollment
  9. Severe established osteoporosis requiring active treatment e.g., with bone density more than 2.5 standard deviations below the young adult mean with one or more osteoporotic fractures
  10. A Body Mass index (BMI) ≥ 40 unless documentation clearly demonstrates why BMI is not a primary factor in the subject's decreased mobility
  11. Chronic opioid use
  12. History of deep vein thrombosis (DVT) or blood clotting abnormalities
  13. Uncontrolled diabetes mellitus
  14. Pre-operative/anesthesia evaluations deeming the subject ineligible for surgery
  15. Female subjects who are pregnant or intend to become pregnant during the course of the study
  16. Male subjects, if not infertile or surgically sterilized, who will not agree to use highly-effective contraception or to not donate sperm from screening until at least 90 days after receiving IP
  17. Active malignancy ≤5 years prior to providing informed consent. EXCEPTIONS: Non-melanotic skin cancer, carcinoma-in-situ of the cervix. NOTE: If there is a history of prior malignancy, the subject must not be receiving other specific treatment for their cancer.
  18. Concurrent participation in another investigational drug, biologic or device study that could confound study data
  19. Involvement in or plans to engage in litigation or receiving Worker's Compensation related to neck, back, or leg pain

Sites / Locations

  • Keck School of Medicine, University of Southern CaliforniaRecruiting
  • Mayo ClinicRecruiting
  • Wexner Medical Center, The Ohio State UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

ART252-L

Arm Description

local autologous bone graft will be treated ex vivo once with ART352-L prior to re-implantation into the site of spinal fusion

Outcomes

Primary Outcome Measures

Safety and Tolerability
Incidence of adverse events and adverse events of special interest
Safety and Tolerability
Incidence of adverse events and adverse events of special interest
Safety and Tolerability
Incidence of adverse events and adverse events of special interest
Safety and Tolerability
Incidence of adverse events and adverse events of special interest
Safety and Tolerability
Incidence of adverse events and adverse events of special interest

Secondary Outcome Measures

Rate of early fusion
Rate of early fusion using Lenke scoring of computed tomography (CT) scans
Rate of fusion
Rate of fusion using Lenke scoring of CT scans
Rate of fusion
Rate of fusion using Lenke scoring of CT scans
Oswestry Disability Index
Change from baseline in Oswestry Disability Index
Oswestry Disability Index
Change from baseline in Oswestry Disability Index
Oswestry Disability Index
Change from baseline in Oswestry Disability Index
Oswestry Disability Index
Change from baseline in Oswestry Disability Index
Short Form-36 (SF-36)
Change from baseline in Short Form-36 (SF-36) score
Short Form-36 (SF-36)
Change from baseline in Short Form-36 (SF-36) score
Short Form-36 (SF-36)
Change from baseline in Short Form-36 (SF-36) score
Short Form-36 (SF-36)
Change from baseline in Short Form-36 (SF-36) score
Visual Analog Scale (VAS) Pain
Change from baseline in Visual Analog Scale (VAS) Pain assessment
Visual Analog Scale (VAS) Pain
Change from baseline in Visual Analog Scale (VAS) Pain assessment
Visual Analog Scale (VAS) Pain
Change from baseline in Visual Analog Scale (VAS) Pain assessment
Visual Analog Scale (VAS) Pain
Change from baseline in Visual Analog Scale (VAS) Pain assessment
Patient Reported Outcomes Measurement Information System (PROMIS) - Global 10
Change from baseline in Patient Reported Outcomes Measurement Information System (PROMIS) Global-10 Score
Patient Reported Outcomes Measurement Information System (PROMIS) - Global 10
Change from baseline in Patient Reported Outcomes Measurement Information System (PROMIS) Global-10 Score
Patient Reported Outcomes Measurement Information System (PROMIS) - Global 10
Change from baseline in Patient Reported Outcomes Measurement Information System (PROMIS) Global-10 Score
Patient Reported Outcomes Measurement Information System (PROMIS) - Global 10
Change from baseline in Patient Reported Outcomes Measurement Information System (PROMIS) Global-10 Score

Full Information

First Posted
April 30, 2020
Last Updated
October 9, 2020
Sponsor
Ankasa Regenerative Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04378543
Brief Title
Safety Evaluation of ART352-L in Subjects Undergoing Posterolateral Spinal Fusion
Official Title
A Phase 1b/2a Safety Evaluation of ART352-L in Subjects Undergoing Posterolateral Spinal Fusion
Study Type
Interventional

2. Study Status

Record Verification Date
October 2020
Overall Recruitment Status
Unknown status
Study Start Date
September 30, 2020 (Actual)
Primary Completion Date
April 2022 (Anticipated)
Study Completion Date
October 2023 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ankasa Regenerative Therapeutics, Inc.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
Ankasa Regenerative Therapeutics, Inc. (Ankasa) is developing ART352-L, a liposomal formulation of recombinant human Wnt3A protein, that is applied ex vivo, to harvested autologous bone grafts (autograft) to enhance the osteogenic properties of the autograft prior to reimplantation in orthopedic surgeries. This is a phase 1/2 open label safety evaluation of ART352-L treated autologous bone grafts in patients undergoing posterolateral lumbar spinal fusion to treat single level degenerative spondylolisthesis. The primary objective of the study is to evaluate the safety and tolerability of ART352-L treated local bone autografts in patients being treated for this condition, with the secondary objective to evaluate the rates of early and overall spinal fusion. Additionally, changes in patient mobility and quality of life measures from baseline following treatment with ART352-L will be evaluated.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Degenerative Spondylolisthesis
Keywords
spine, spondylolisthesis, degenerative disc disease, back pain

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1, Phase 2
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
12 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
ART252-L
Arm Type
Experimental
Arm Description
local autologous bone graft will be treated ex vivo once with ART352-L prior to re-implantation into the site of spinal fusion
Intervention Type
Biological
Intervention Name(s)
ART352-L
Intervention Description
recombinant human Wnt3a protein delivered on liposomes to local autologous bone graft during posterolateral fusion procedures
Primary Outcome Measure Information:
Title
Safety and Tolerability
Description
Incidence of adverse events and adverse events of special interest
Time Frame
2 weeks
Title
Safety and Tolerability
Description
Incidence of adverse events and adverse events of special interest
Time Frame
8 weeks
Title
Safety and Tolerability
Description
Incidence of adverse events and adverse events of special interest
Time Frame
26 weeks
Title
Safety and Tolerability
Description
Incidence of adverse events and adverse events of special interest
Time Frame
52 weeks
Title
Safety and Tolerability
Description
Incidence of adverse events and adverse events of special interest
Time Frame
104 weeks
Secondary Outcome Measure Information:
Title
Rate of early fusion
Description
Rate of early fusion using Lenke scoring of computed tomography (CT) scans
Time Frame
26 weeks
Title
Rate of fusion
Description
Rate of fusion using Lenke scoring of CT scans
Time Frame
52 weeks
Title
Rate of fusion
Description
Rate of fusion using Lenke scoring of CT scans
Time Frame
104 weeks
Title
Oswestry Disability Index
Description
Change from baseline in Oswestry Disability Index
Time Frame
8 weeks
Title
Oswestry Disability Index
Description
Change from baseline in Oswestry Disability Index
Time Frame
26 weeks
Title
Oswestry Disability Index
Description
Change from baseline in Oswestry Disability Index
Time Frame
52 weeks
Title
Oswestry Disability Index
Description
Change from baseline in Oswestry Disability Index
Time Frame
104 weeks
Title
Short Form-36 (SF-36)
Description
Change from baseline in Short Form-36 (SF-36) score
Time Frame
8 weeks
Title
Short Form-36 (SF-36)
Description
Change from baseline in Short Form-36 (SF-36) score
Time Frame
26 weeks
Title
Short Form-36 (SF-36)
Description
Change from baseline in Short Form-36 (SF-36) score
Time Frame
52 weeks
Title
Short Form-36 (SF-36)
Description
Change from baseline in Short Form-36 (SF-36) score
Time Frame
104 weeks
Title
Visual Analog Scale (VAS) Pain
Description
Change from baseline in Visual Analog Scale (VAS) Pain assessment
Time Frame
8 weeks
Title
Visual Analog Scale (VAS) Pain
Description
Change from baseline in Visual Analog Scale (VAS) Pain assessment
Time Frame
26 weeks
Title
Visual Analog Scale (VAS) Pain
Description
Change from baseline in Visual Analog Scale (VAS) Pain assessment
Time Frame
52 weeks
Title
Visual Analog Scale (VAS) Pain
Description
Change from baseline in Visual Analog Scale (VAS) Pain assessment
Time Frame
104 weeks
Title
Patient Reported Outcomes Measurement Information System (PROMIS) - Global 10
Description
Change from baseline in Patient Reported Outcomes Measurement Information System (PROMIS) Global-10 Score
Time Frame
8 weeks
Title
Patient Reported Outcomes Measurement Information System (PROMIS) - Global 10
Description
Change from baseline in Patient Reported Outcomes Measurement Information System (PROMIS) Global-10 Score
Time Frame
26 weeks
Title
Patient Reported Outcomes Measurement Information System (PROMIS) - Global 10
Description
Change from baseline in Patient Reported Outcomes Measurement Information System (PROMIS) Global-10 Score
Time Frame
52 weeks
Title
Patient Reported Outcomes Measurement Information System (PROMIS) - Global 10
Description
Change from baseline in Patient Reported Outcomes Measurement Information System (PROMIS) Global-10 Score
Time Frame
104 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female subjects ≥50 years of age scheduled to undergo single level posterolateral lumbar spinal fusion surgery in conjunction with local autograft bone for degenerative spondylolisthesis Psychosocially, mentally, and physically able to fully comply with this protocol including the required follow-up visits, the filling out of required forms, and have the ability to understand and give written informed consent Willing and able to undergo diagnostic imaging, inclusive of X-rays and CT scans with contrast Persistent, disabling pain after at least 6 months of non-surgical intervention (e.g., anti-inflammatory medication, physical therapy, chiropractic care) prior to providing informed consent Pre-operative Oswestry Disability Index (ODI) Score ≥30 Grade 1 or less spondylolisthesis or retrolisthesis Absence of neurological motor deficit Agree to use a highly reliable method of birth control (male and female subjects) for at least 90 days after administration of Investigational Product (IP) - Women of childbearing potential must have a negative pregnancy test at screening and again ≤7 days prior to surgery. Perimenopausal women must be amenorrheic for at least 12 months prior to the time of providing informed consent to be considered of non-childbearing potential. Agree to remain nicotine-free for the duration of their participation in the study Exclusion Criteria: Multiple level spondylolistheses or a primary diagnosis of low back pain syndrome secondary to diseases other than degenerative spondylolisthesis Concurrent medications that affect bone homeostasis including, but not limited to, bisphosphonates Ongoing / existing infections in or around the surgical site or spine Prior lumbar spine arthrodesis Concurrent clinically significant autoimmune disorder or systemic inflammatory disease Known hypersensitivity to recombinant Wnt proteins Use of tobacco; subjects must be nicotine-free at screening and agree to remain nicotine free for the duration of the study Use of medications that may impair cell proliferation and bone healing including: chemotherapy, radiation, chronic steroids and immunosuppressive drugs. Note: Medications that may impair cell proliferation are to be discussed with the protocol medical monitor prior to enrollment Severe established osteoporosis requiring active treatment e.g., with bone density more than 2.5 standard deviations below the young adult mean with one or more osteoporotic fractures A Body Mass index (BMI) ≥ 40 unless documentation clearly demonstrates why BMI is not a primary factor in the subject's decreased mobility Chronic opioid use History of deep vein thrombosis (DVT) or blood clotting abnormalities Uncontrolled diabetes mellitus Pre-operative/anesthesia evaluations deeming the subject ineligible for surgery Female subjects who are pregnant or intend to become pregnant during the course of the study Male subjects, if not infertile or surgically sterilized, who will not agree to use highly-effective contraception or to not donate sperm from screening until at least 90 days after receiving IP Active malignancy ≤5 years prior to providing informed consent. EXCEPTIONS: Non-melanotic skin cancer, carcinoma-in-situ of the cervix. NOTE: If there is a history of prior malignancy, the subject must not be receiving other specific treatment for their cancer. Concurrent participation in another investigational drug, biologic or device study that could confound study data Involvement in or plans to engage in litigation or receiving Worker's Compensation related to neck, back, or leg pain
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Gloria Matthews, DVM, PhD
Phone
404-947-6472
Email
gmatthews@wnt3.com
First Name & Middle Initial & Last Name or Official Title & Degree
Sanford Madigan, PhD
Email
smadigan@wnt3.com
Facility Information:
Facility Name
Keck School of Medicine, University of Southern California
City
Los Angeles
State/Province
California
ZIP/Postal Code
90033
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Jeffrey Wang, MD
Facility Name
Mayo Clinic
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Brett Freedman, MD
Facility Name
Wexner Medical Center, The Ohio State University
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43210
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Safdar Khan, MD

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety Evaluation of ART352-L in Subjects Undergoing Posterolateral Spinal Fusion

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