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The PRIORi-T Trial--Prospective Randomized Investigation of Radiofrequency Targeted Vertebral Augmentation (PRIORi-T)

Primary Purpose

Painful Osteoporotic Vertebral Compression Fractures (VCF)

Status
Withdrawn
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Vertebral Augmentation (STABILIT)
Non-operative Management
Sponsored by
DFINE Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Painful Osteoporotic Vertebral Compression Fractures (VCF) focused on measuring VCF, Osteoporosis, Minimally Invasive, Non-operative management, Medical Management

Eligibility Criteria

21 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Subject is ≥ 21 and ≤ 90 years of age.
  2. Subject has one (1) to three (3) painful vertebral compression fracture(s) at T5-L5 due to primary or secondary osteoporosis (i.e. non-malignant) and recent history of sudden onset of pain in area of index vertebra (e).
  3. Subject's index vertebra (e) is confirmed as the active source of back pain as evidenced by concordant pain and bone marrow edema via magnetic resonance imaging (MRI) or Computerized Tomography (CT) plus bone scan.
  4. Subject has a history of vertebral fracture-related back pain ≤ 8 weeks old at time of enrollment (confirmed by medical history).
  5. Subject has a pain related VAS score ≥ 5 on a scale of 0 to 10 at time of enrollment. Pain represents the worst level of back pain while standing, walking or elevating from chair, bed, or car during the preceding 24 hours associated with the index vertebra (e).
  6. Subject has a Roland Morris Disability Questionnaire (RDQ) score ≥ 10 on scale of 0 to 24 at time of enrollment.
  7. Subject is a suitable candidate for minimally invasive VCF procedure.
  8. Subject has sufficient mental and physical capacity to comply with the Investigational Plan requirements and is willing and able to provide informed consent; agrees to release medical information for the purposes of this study; and agrees to comply with the Investigational Plan requirements and return for specified follow-up evaluations.
  9. Subject is a male; a documented infertile female (either postmenopausal or surgical contraception); or is a non-pregnant, non-lactating female of childbearing potential who agrees to use a medically accepted method of birth control throughout the duration of the trial.

Exclusion Criteria:

  1. Subject's VCF morphology is deemed unsuitable for RF-TVA in the judgment of the Investigator.
  2. Subject requires additional non-kyphoplasty or vertebroplasty surgical treatment for the index fracture.
  3. Subject has surgery to the spine planned for at least one (1) month following enrollment.
  4. Subject has high-energy trauma-related and/or, non-osteoporotic vertebral fractures.
  5. Subject has a spinal cord compression or significant canal compromise requiring decompression, in the judgment of the investigator.
  6. Subject has a neurologic deficit associated with the vertebral level(s) to be treated that is more severe than radiculopathy (e.g. myelopathy, cauda equina syndrome).
  7. Subject has irreversible coagulopathy or bleeding disorder.
  8. Subject requires, at time of enrollment, the use of high-dose steroids (e.g. ≥ 100 mg prednisone or 20 mg dexamethasone per day), intravenous (IV) pain medication, or nerve block to control chronic back pain unrelated to index VCF(s).
  9. Subject has significant clinical co-morbidities that may potentially interfere with the collection of data concerning pain and function.
  10. Subject has a known allergy to device materials (e.g. polymethylmethacrylate (PMMA) or barium).
  11. Subject has a contraindication to local or general anesthesia.
  12. Subject has a medical and/or surgical condition contrary to the kyphoplasty or vertebroplasty procedure (e.g. presence of local or systemic infection).
  13. Subject is receiving Worker's Compensation.
  14. Subject is a prisoner.

Sites / Locations

  • Washington University - Mallinckrodt Institute of Radiology
  • Dartmouth-Hitchcock Medical Center, Department of Radiology
  • Montefiore Hospital/Einstein Medical School, Department of Radiology
  • Winthrop University Hospital, Department of Radiology
  • Penn State Hershey Medical Center, Department of Radiology
  • Swedish Neuroscience Institute, Cherry Hill Campus, Department of Neurosurgery

Arms of the Study

Arm 1

Arm 2

Arm Type

Active Comparator

Active Comparator

Arm Label

RF-TVA with STABILIT Vertebral Augmentation System

Non Operative Management

Arm Description

All RadioFrequency-Targeted Vertebral Augmentation (RF-TVA) arm participants will be treated with the StabiliT Vertebral Augmentation System. This system is a commercially available device in the United States designed to perform percutaneous vertebral augmentation (also known as kyphoplasty).

All non-operative management (NOM) arm participants will receive non-operative standard of care management, which can include: analgesics, bed rest, back braces, physiotherapy, rehabilitation programs, and walking aids according to standard practices of participating institutions.

Outcomes

Primary Outcome Measures

Improvement in back pain from baseline at the 1 month follow-up visit as measured by the Visual Analog Scale.

Secondary Outcome Measures

Change in VAS from baseline at the 3, 6, and 12 month follow-up visits.
Change in Roland-Morris Questionnaire (RDQ) from baseline at the 1, 3, 6, and 12 month follow-up visits.
Change in SF-36 physical component score from baseline at the 1, 3, 6, and 12 month follow-up visits.
Change in IOF Quality of Life Questionnaire from baseline at the 1, 3, 6, and 12 month follow-up visits.

Full Information

First Posted
November 23, 2011
Last Updated
January 18, 2017
Sponsor
DFINE Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01480167
Brief Title
The PRIORi-T Trial--Prospective Randomized Investigation of Radiofrequency Targeted Vertebral Augmentation
Acronym
PRIORi-T
Official Title
Prospective Randomized Investigation of Radiofrequency Targeted Vertebral Augmentation (The PRIORi-T Trial)
Study Type
Interventional

2. Study Status

Record Verification Date
January 2017
Overall Recruitment Status
Withdrawn
Why Stopped
Lack of enrollment
Study Start Date
November 2011 (Actual)
Primary Completion Date
December 2012 (Actual)
Study Completion Date
undefined (undefined)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
DFINE Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The objective of this post market clinical investigation is to evaluate the clinical effectiveness of a minimally invasive vertebral augmentation procedure, Radiofrequency-Targeted Vertebral Augmentation (RF-TVA) as compared to non-operative management (NOM) for the treatment of appropriately diagnosed acute (≤ 8 weeks) painful osteoporotic vertebral compression fractures (VCF).
Detailed Description
This is a multi-center, prospective, randomized, post marketing clinical trial designed to evaluate the clinical effectiveness of a minimally invasive procedure, Radiofrequency-Targeted Vertebral Augmentation (RF-TVA), compared to Non Operative Management (NOM) for the treatment of appropriately diagnosed, acute (≤ 8 weeks), painful, osteoporotic vertebral compression fractures. Eligible subjects will be randomly allocated to receive either RF-TVA or NOM in a 1:1 randomization ratio. Subjects will be followed for 12 months post procedure. Primary effectiveness will be determined by comparing the Visual Analogue Scale for each treatment group for back pain from the baseline to the 1-month post procedure visit and between treatment groups at 1-month. Up to 15 sites will participate in this trial.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Painful Osteoporotic Vertebral Compression Fractures (VCF)
Keywords
VCF, Osteoporosis, Minimally Invasive, Non-operative management, Medical Management

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
0 (Actual)

8. Arms, Groups, and Interventions

Arm Title
RF-TVA with STABILIT Vertebral Augmentation System
Arm Type
Active Comparator
Arm Description
All RadioFrequency-Targeted Vertebral Augmentation (RF-TVA) arm participants will be treated with the StabiliT Vertebral Augmentation System. This system is a commercially available device in the United States designed to perform percutaneous vertebral augmentation (also known as kyphoplasty).
Arm Title
Non Operative Management
Arm Type
Active Comparator
Arm Description
All non-operative management (NOM) arm participants will receive non-operative standard of care management, which can include: analgesics, bed rest, back braces, physiotherapy, rehabilitation programs, and walking aids according to standard practices of participating institutions.
Intervention Type
Device
Intervention Name(s)
Vertebral Augmentation (STABILIT)
Other Intervention Name(s)
Kyphoplasty, Radiofrequency Targeted Vertebral Augmentation (RF-TVA), Radiofrequency Kyphoplasty (RFK)
Intervention Description
Vertebral Augmentation with the STABILIT Vertebral Augmentation System
Intervention Type
Other
Intervention Name(s)
Non-operative Management
Other Intervention Name(s)
Medical Management
Intervention Description
Conservative Care
Primary Outcome Measure Information:
Title
Improvement in back pain from baseline at the 1 month follow-up visit as measured by the Visual Analog Scale.
Time Frame
1 month
Secondary Outcome Measure Information:
Title
Change in VAS from baseline at the 3, 6, and 12 month follow-up visits.
Time Frame
3, 6, and 12 months
Title
Change in Roland-Morris Questionnaire (RDQ) from baseline at the 1, 3, 6, and 12 month follow-up visits.
Time Frame
1,3,6,12 months
Title
Change in SF-36 physical component score from baseline at the 1, 3, 6, and 12 month follow-up visits.
Time Frame
1,3,6,12 months
Title
Change in IOF Quality of Life Questionnaire from baseline at the 1, 3, 6, and 12 month follow-up visits.
Time Frame
1,3,6,12 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
21 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subject is ≥ 21 and ≤ 90 years of age. Subject has one (1) to three (3) painful vertebral compression fracture(s) at T5-L5 due to primary or secondary osteoporosis (i.e. non-malignant) and recent history of sudden onset of pain in area of index vertebra (e). Subject's index vertebra (e) is confirmed as the active source of back pain as evidenced by concordant pain and bone marrow edema via magnetic resonance imaging (MRI) or Computerized Tomography (CT) plus bone scan. Subject has a history of vertebral fracture-related back pain ≤ 8 weeks old at time of enrollment (confirmed by medical history). Subject has a pain related VAS score ≥ 5 on a scale of 0 to 10 at time of enrollment. Pain represents the worst level of back pain while standing, walking or elevating from chair, bed, or car during the preceding 24 hours associated with the index vertebra (e). Subject has a Roland Morris Disability Questionnaire (RDQ) score ≥ 10 on scale of 0 to 24 at time of enrollment. Subject is a suitable candidate for minimally invasive VCF procedure. Subject has sufficient mental and physical capacity to comply with the Investigational Plan requirements and is willing and able to provide informed consent; agrees to release medical information for the purposes of this study; and agrees to comply with the Investigational Plan requirements and return for specified follow-up evaluations. Subject is a male; a documented infertile female (either postmenopausal or surgical contraception); or is a non-pregnant, non-lactating female of childbearing potential who agrees to use a medically accepted method of birth control throughout the duration of the trial. Exclusion Criteria: Subject's VCF morphology is deemed unsuitable for RF-TVA in the judgment of the Investigator. Subject requires additional non-kyphoplasty or vertebroplasty surgical treatment for the index fracture. Subject has surgery to the spine planned for at least one (1) month following enrollment. Subject has high-energy trauma-related and/or, non-osteoporotic vertebral fractures. Subject has a spinal cord compression or significant canal compromise requiring decompression, in the judgment of the investigator. Subject has a neurologic deficit associated with the vertebral level(s) to be treated that is more severe than radiculopathy (e.g. myelopathy, cauda equina syndrome). Subject has irreversible coagulopathy or bleeding disorder. Subject requires, at time of enrollment, the use of high-dose steroids (e.g. ≥ 100 mg prednisone or 20 mg dexamethasone per day), intravenous (IV) pain medication, or nerve block to control chronic back pain unrelated to index VCF(s). Subject has significant clinical co-morbidities that may potentially interfere with the collection of data concerning pain and function. Subject has a known allergy to device materials (e.g. polymethylmethacrylate (PMMA) or barium). Subject has a contraindication to local or general anesthesia. Subject has a medical and/or surgical condition contrary to the kyphoplasty or vertebroplasty procedure (e.g. presence of local or systemic infection). Subject is receiving Worker's Compensation. Subject is a prisoner.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Allan Brook, M.D.
Organizational Affiliation
Montefiore Hospital/Einstein Medical School
Official's Role
Principal Investigator
Facility Information:
Facility Name
Washington University - Mallinckrodt Institute of Radiology
City
St. Louis
State/Province
Missouri
ZIP/Postal Code
63110
Country
United States
Facility Name
Dartmouth-Hitchcock Medical Center, Department of Radiology
City
Lebanon
State/Province
New Hampshire
ZIP/Postal Code
03756
Country
United States
Facility Name
Montefiore Hospital/Einstein Medical School, Department of Radiology
City
Bronx
State/Province
New York
ZIP/Postal Code
10467
Country
United States
Facility Name
Winthrop University Hospital, Department of Radiology
City
Mineola
State/Province
New York
ZIP/Postal Code
11501
Country
United States
Facility Name
Penn State Hershey Medical Center, Department of Radiology
City
Hershey
State/Province
Pennsylvania
ZIP/Postal Code
17033
Country
United States
Facility Name
Swedish Neuroscience Institute, Cherry Hill Campus, Department of Neurosurgery
City
Seattle
State/Province
Washington
ZIP/Postal Code
98122
Country
United States

12. IPD Sharing Statement

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The PRIORi-T Trial--Prospective Randomized Investigation of Radiofrequency Targeted Vertebral Augmentation

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