The primary objective of the clinical investigation is to demonstrate successful clinical use of the ThecaFlex DRx™ System in delivering nusinersen in subjects with spinal muscular atrophy (SMA). All enrolled subjects will undergo implantation of the investigational device (ThecaFlex DRx™ System) and will be followed for 12 months after receiving the implant. The 12-month data will be used to assess the primary endpoint support a Pre-Market Approval (PMA) application.
This is a multicenter, multi-national, prospective, non-randomized, single arm, group sequential design, pivotal clinical investigation (device exemption study) to assess the safety and performance of the ThecaFlex DRx™ System in subjects with SMA. The subject population will include subjects aged ≥ 3 years with SMA who are considered candidates for intrathecal port and catheter implantation because they require chronic, bolus intrathecal administration of necessary therapy, and who meet all the inclusion/exclusion criteria for the clinical investigation. After a screening period of up to 200 days, all enrolled subjects will undergo implantation of the investigational device (ThecaFlex DRx™ System) and will be followed for 12 months after receiving the implant. In agreement with the nusinersen dosing information, the treatment frequency will be adapted for non-naïve and naïve subjects: Subjects who are not naïve to nusinersen should have nusinersen maintenance doses administered via the implant every 4 months (i.e., 4, 8, and 12 months after their last nusinersen dose, before enrollment in the clinical investigation). Subjects who are naïve to nusinersen will have their first three loading doses administered via the implant at 14-day intervals. The fourth loading dose should be administered 30 days after the third dose. A maintenance dose should be administered once every 4 months thereafter within the 12 months post-implantation. A DMC and Clinical Events Committee (CEC), independent of each other and the Sponsor, will be used to perform ongoing consistent adjudication of events related to the safety throughout the entire duration of the clinical investigation and to periodically review data that relate to the safety of the study. The clinical investigation will enroll 90 subjects. The clinical investigation incorporates a lead-in phase which consists of 10 subjects enrolled, implanted, and followed for 30-days. Enrollment for the lead-in phase is expected to take approximately 6 to 9 months, at which point the Data Monitoring Committee (DMC) will review the data for safety and approve continuation of enrollment. The second phase of enrollment is expected to take approximately 12 to 15 months. Individual subjects are anticipated to be enrolled in the clinical investigation for approximately 37 months. The total duration of this clinical investigation is estimated to be approximately 60 months.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
90
The ThecaFlex DRx™ System consists of an implantable intrathecal catheter, and an implantable subcutaneous port, designed specifically to meet the implantation, Cerebrospinal Fluid (CSF) aspiration, and intrathecal delivery and dosing needs of patients (aged ≥ 3 years) requiring repeated/on-going intermittent chronic bolus intrathecal treatment for life threatening, debilitating Central Nervous System (CNS) disorders who are precluded from Lumbar Puncture (LP) due to complex spine conditions, or who are resistant to LP for therapy administration or CSF aspiration.
Barrow Neurological Institute
Phoenix, Arizona, United States
RECRUITINGChildren's Hospital Orange County
Orange, California, United States
RECRUITINGStanford Medical Center
Palo Alto, California, United States
RECRUITINGRady Children's Hospital
San Diego, California, United States
RECRUITINGLurie Childrens Hospital
Chicago, Illinois, United States
RECRUITINGBoston Children's Hospital
Boston, Massachusetts, United States
RECRUITINGHelen DeVos Children's Hospital
Grand Rapids, Michigan, United States
RECRUITINGColumbia University Irving Medical Center/NewYork Presbyterian Hospital
New York, New York, United States
RECRUITINGUH Rainbow Babies and Children's Hospital
Cleveland, Ohio, United States
RECRUITINGPenn State Milton S. Hershey Medical Center
Hershey, Pennsylvania, United States
RECRUITING...and 10 more locations
The proportion of subjects with successful Implantation of the ThecaFlex DRx™ Port and Catheter
The primary outcome measures the proportion of subjects with successful implantation of the ThecaFlex DRx™ Port and Catheter System who are able to receive successful intrathecal therapy infusion(s).
Time frame: 12 Months
The proportion of subjects with successful Intrathecal Therapy Infusion(s) through 12 months
Time frame: 12 Months
Proportion of subjects with reduced anesthesia and radiation exposure compared to repeat LP for nusinersen infusion in SMA subjects.
Time frame: 12 months
Incidence of device-related adverse events (AEs)/complications through 12 months
Time frame: 12 months
Incidence of procedural complications through 12 months
Time frame: 12 months
Incidence of nusinersen-related AEs
Time frame: 12 months
Mean duration of radiation exposure from implant through 12-month follow-up
Time frame: 12 months
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