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| Name | Class |
|---|---|
| Cromsource | INDUSTRY |
| Antaros Medical | INDUSTRY |
| VIEDOC | UNKNOWN |
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The goal of this clinical trial is to establish safety and tolerability of STA363 injected into a herniated intervertebral disc in patients with sciatica due to disc herniation. The main questions the trial aims to answer are:
Researchers will compare safety, tolerability, effects on disc and herniation volume and on symptoms between the group of patients injected with placebo and the group injected with STA363.
The study will include 24 patients, recruited at 4 different sites, suffering from radiculopathy due to lumbar disc herniation (LDH). Patients will be screened for symptoms, disease history and magnetic resonance imaging (MRI) evidence of LDH. Baseline data (e.g. pain recording and MRI data) will be collected, and 1/3 of the patients will then be randomized to intradiscal injection with placebo (Omnipaque with water for injection, 1.5 mL) and 2/3 of the patients will be randomized to STA363 (lactic acid, 120 mg/mL with Omnipaque, 1.5 mL). The injections will be done using fluoroscopic guidance, and the patients will be treated with intravenous antibiotics and sedatives. The first follow-up will be done by phone 1 week after the treatment, while the other follow-ups will be physical visits at month 1, 3 and 6 at the site. In conjunction with the visits, the patient will record daily pain intensity (Numerical Rating Scale) for 7 days using an eDiary, and MRI will be performed. The primary completion time is 6 months with the primary objectives safety and tolerability. Important secondary objectives will be changes of disc volume and pain.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Placebo | Placebo Comparator | 1.5 mL of Omnipaque mixed with water for injection |
|
| STA363 | Experimental | 1.5 mL of STA363 (lactic acid, 120 mg/mL) mixed with Omnipaque |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Lactic Acid | Drug | 180 mg of STA363 will be slowly injected into a symptom-generating herniated lumbar disc |
|
| Measure | Description | Time Frame |
|---|---|---|
| Safety and tolerability | Safety and tolerability will be measured using the following outcomes:
| Baseline and 1 week and 1,3 and 6 months after intervention for all outcomes except changes in IVD morphology (time frame 1, 3 and 6 months after intervention) |
| Measure | Description | Time Frame |
|---|---|---|
| Disc volume | Volume will be measured by MRI | Baseline and 1,3 and 6 months after intervention |
| Disc height | Height will be measured by MRI |
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Inclusion Criteria:
Signed informed consent prior to any study-related procedures
Patient has a single subligamentous posteriolateral lumbar disc herniation (protrusion or extrusion) of any lumbar disc below L1/L2 diagnosed by clinical symptoms and/or physical findings and confirmed by MRI
Patient has symptoms and/or physical findings consistent with a unilateral radiculopathy affecting one nerve root (L2-L5)
Patient has leg pain of the dermatome consistent with the nerve root affected by the herniation
The herniated disc is 3 or lower on the Pfirrmann scale (grade 1-5)
Patient has experienced symptoms of a herniated disc for at least 6 weeks prior to randomisation without sufficient relief with pain medications and other conservative therapies
Ability to understand the written and verbal information about the study
Male and female patients 18 years or older but 50 years or younger
Women of childbearing potential eligible if using effective contraceptives
Patient has a body mass index (BMI) of ≥18 to ≤35 kg/m2
Patients who meet all the following NRS selection criteria for radicular leg pain:
Exclusion criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jarkko Kalliomäki, MD, PhD | Stayble Therapeutics AB | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Samodzielny Publiczny Szpital Kliniczny nr 4, Klinika Ortopedii i Rehabilitacji | Lublin | Lublin Voivodeship | 20-002 | Poland |
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| ID | Term |
|---|---|
| D007405 | Intervertebral Disc Displacement |
| D011843 | Radiculopathy |
| ID | Term |
|---|---|
| D013122 | Spinal Diseases |
| D001847 | Bone Diseases |
| D009140 | Musculoskeletal Diseases |
| D006547 | Hernia |
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| ID | Term |
|---|---|
| D019344 | Lactic Acid |
| ID | Term |
|---|---|
| D007773 | Lactates |
| D006880 | Hydroxy Acids |
| D002264 | Carboxylic Acids |
| D009930 | Organic Chemicals |
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| Placebo | Drug | 1.5 mL of Omnipaque in water for injection will be slowly injected into a symptom-generating herniated lumbar disc |
|
| Baseline and 1,3 and 6 months after intervention |
| Radicular leg pain | Leg pain will be reported by the patients using an NRS. (minimum value: 0; maximum value: 10) for 7 consecutive days. Lower scores means a better outcome. | Baseline and 1 week and 1,3 and 6 months after intervention |
| Patient Global Impression of Change (PGIC) | PGIC will be reported by the patients using an electronic device | Baseline and 1 week and 1,3 and 6 months after intervention |
| Disc intensity | The intensity of the disc will be measured using T2-weighted MRI | Baseline and 1,3 and 6 months after intervention |
| D020763 |
| Pathological Conditions, Anatomical |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010523 | Peripheral Nervous System Diseases |
| D009468 | Neuromuscular Diseases |
| D009422 | Nervous System Diseases |