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: 1. Is the treatment safe and tolerable? 2. Does the volume of the disc and the herniation decrease? 3. Is sciatica reduced? Participants will be given an injection into the herniated disc of either placebo or STA363 (one dose). 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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
25
180 mg of STA363 will be slowly injected into a symptom-generating herniated lumbar disc
1.5 mL of Omnipaque in water for injection will be slowly injected into a symptom-generating herniated lumbar disc
Samodzielny Publiczny Szpital Kliniczny nr 4, Klinika Ortopedii i Rehabilitacji
Lublin, Lublin Voivodeship, Poland
Safety and tolerability
Safety and tolerability will be measured using the following outcomes: * Incidence and nature of adverse events (AEs) * Changes in * physical examination findings * blood pressure and heart rate * 12-lead electrocardiogram * Hematology and clinical chemistry * Pain intensity at the injection site during and 15 minutes after injection (numerical rating scale; NRS). NRS is reported on a 0-10 scale where 0 represents "No pain" and 10 "Worst imaginable pain" * Other aspects of intervertebral disc morphology (IVD) morphology from baseline (e.g., Modic changes)
Time frame: 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)
Disc volume
Volume will be measured by MRI
Time frame: Baseline and 1,3 and 6 months after intervention
Disc height
Height will be measured by MRI
Time frame: 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.
Time frame: 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
Time frame: 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
Time frame: Baseline and 1,3 and 6 months after intervention
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