The goal of this clinical trial is to evaluate the safety and preliminary efficacy of the autologous 3D osteogenic implant NVD-003 for bone reconstruction for the treatment of recalcitrant lower limb nonunion.
This is a first in man study conducted as a prospective, single-arm, non-randomized clinical study. A sample of 5 to 10 patients will be enrolled in the study in order to assess the safety of the use of NVD-003 bone graft implantation in patients with recalcitrant lower limb nonunion. The sample size of 5 to 10 patients was considered sufficient to give a preliminary indication on the safety of the ATMP.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
11
Autologous osteogenic implant NVD-003 for bone reconstruction
Centre Hospitalier Interregional Edith Cavel (CHIREC) - Clinique Ste Anne-St Remi
Anderlecht, Belgium
Algemeen Ziekenhuis (AZ) Sint-Jan Brugge - Oostende AV - Campus Sint-Jan
Bruges, Belgium
Centre Hospitalier Universitaire CHU/UVC Brugmann (Site Horta)
Brussels, Belgium
Safety - Adverse Events
All Adverse Events (AEs) including Serious Adverse Events (SAEs), Adverse Events of Special Interest (AESI) and Procedure Related AE's (PRAE).
Time frame: From graft implantation until completion of visit 24 months
Safety - Abnormalities of vital signs
Vital signs abnormalities: blood pressure
Time frame: At hospital discharge (1-2 weeks after grafting surgery), at visit 1,5 months, at visit 3 months, at visit 6 months, at visit 12 months and visit 24 months
Safety - Abnormalities of vital signs
Vital signs abnormalities: heart rate
Time frame: At hospital discharge (1-2 weeks after grafting surgery), at visit 1,5 months, at visit 3 months, at visit 6 months, at visit 12 months and visit 24 months
Safety - Abnormalities of physical examination
Physical examinations abnormalities: cardiovascular system
Time frame: At hospital discharge (1-2 weeks after grafting surgery), at visit 1,5 months, at visit 3 months, at visit 6 months, at visit 12 months and visit 24 months
Safety - Abnormalities of physical examination
Physical examinations abnormalities: respiratory system
Time frame: At hospital discharge (1-2 weeks after grafting surgery), at visit 1,5 months, at visit 3 months, at visit 6 months, at visit 12 months and visit 24 months
Safety - Abnormalities of physical examination
Physical examinations abnormalities: legs examination (inspection of both legs and extensive examination of the affected leg)
Time frame: At hospital discharge (1-2 weeks after grafting surgery), at visit 1,5 months, at visit 3 months, at visit 6 months, at visit 12 months and visit 24 months
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Grand Hôpital De Charleroi
Charleroi, Belgium
Ziekenhuis Oost-Limburg (ZOL)
Genk, Belgium
Universitair Ziekenhuis Leuven, Campus Gasthuisberg
Leuven, Belgium
CHU Ambroise Paré
Mons, Belgium
Centre Hospitalier Regional De Namur
Namur, Belgium
Centre Hospitalier de Luxembourg
Luxembourg, Luxembourg
University Hospital Basel
Basel, Switzerland
Safety - Abnormalities of laboratories
Safety laboratories abnormalities: blood sampling: haematology (tests that yield information on the qualitative and quantitative composition of the cellular components of the blood)
Time frame: At hospital discharge (1-2 weeks after grafting surgery), at visit 1,5 months, at visit 3 months, at visit 6 months, at visit 12 months and visit 24 months
Safety - Abnormalities of laboratories
Safety laboratories abnormalities: blood sampling: coagulation (measure your blood's ability to clot, and how long it takes to clot)
Time frame: At hospital discharge (1-2 weeks after grafting surgery), at visit 1,5 months, at visit 3 months, at visit 6 months, at visit 12 months and visit 24 months
Safety - Abnormalities of laboratories
Safety laboratories abnormalities: blood sampling: biochemistry (tests to evaluate organ function, electrolyte status, hormone levels and more (calcium, vitamin D))
Time frame: At hospital discharge (1-2 weeks after grafting surgery), at visit 1,5 months, at visit 3 months, at visit 6 months, at visit 12 months and visit 24 months
Healing efficacy: plain X-ray
Plain X-ray healing defined as 3 united cortices (the strong type of bone on the outer layer) out of 4, on antero-posterior and lateral X-ray views
Time frame: At 6 weeks, 3 months, 6 months, 12 months, at additional visits (if no healing at 12 months after graft implant surgery) up to 24 months.
Healing efficacy: CT-scan
Computerized Tomography (CT)-scan healing defined as 3 united cortices out of 4
Time frame: At 6, 12 and 24 months
Healing efficacy: average time from Investigational Medicinal Product grafting surgery till first observation of plain X-ray and CT-scan confirmed fracture healing
The average time from IMP grafting surgery till first observation of plain X-ray and CT-scan confirmed fracture healing
Time frame: Average time from IMP grafting surgery till first observation of plain X-ray and CT-scan up to 24 months
Healing efficacy: investigator assessed clinical healing
Investigator assessed clinical healing based on the overall clinical evaluation of the patient: ability to bear weight (non-weight bearing, toe-touch weight bearing, partial weight bearing, full weight bearing and full weight bearing with walking), the pain score at palpation at the fracture site (patient to rate the pain from 0 to 10 with the understanding that 0 is equal to no pain and 10 is equal to worst possible pain) and the pain medication intake by the patient.
Time frame: From 6 weeks post-grafting onwards up to 24 months
Healing efficacy: average time from IMP grafting surgery to Investigator assessed clinical healing
The average time from IMP grafting surgery to Investigator assessed clinical healing
Time frame: Time from grafting surgery till first observation of investigator assessed clinical healing up to 24 months
Grafting Surgery parameters
Parameter 1: duration of grafting surgery
Time frame: Duration of grafting surgery (visit 1) and duration of hospitalization after grafting surgery (visit 2)
Grafting Surgery parameters
Parameter 2: duration of hospitalization
Time frame: Duration of grafting surgery (visit 1) and duration of hospitalization after grafting surgery (visit 2)
Complications: rate of subsequent surgical interventions
Rate of subsequent surgical interventions (e.g. revision, removal, reoperation and/or supplemental fixation)
Time frame: At 12 and 24 months post-implant surgery
Quality of Life: pain evaluation
Pain evaluation with the Brief Pain Inventory (Short Form) (BPI-SF) (pain severity and pain interference with function)
Time frame: At screening and at 6 weeks, 3, 6, 12 and 24 months post-graft
Quality of Life: questionnaire EuroQol-5 Dimensions
QoL questionnaire EuroQol-5 Dimensions (EQ-5D-5L)
Time frame: At screening and at 6 weeks, 3, 6, 12 and 24 months post-graft
Quality of Life: overall treatment effect
Overall Treatment Effect rating scale
Time frame: At 3, 6, 12 and 24 months post-graft
General Pre-graft implantation safety: all SAEs, AESI and PRAE
All AEs including Serious Adverse Events (SAEs), Adverse Events of Special Interest (AESI) and Procedure Related AE's (PRAE).
Time frame: Pre-graft implantation
All SAEs during the extended safety follow-up period
All Serious Adverse Events (SAEs).
Time frame: During the extended safety follow-up period (between 24 months FU visit and 5 years post-grafting surgery)