The purpose of this study is to assess the efficacy and safety of NVD003 in pediatric participants with unilateral Congenital Pseudarthrosis of the Tibia (CPT) compared with iliac crest bone graft (ICBG) at 12 months post graft surgery.
CPT is a rare disorder affecting the tibia and/or the ipsilateral fibula in children. The disease is usually diagnosed during the first year of life and is characterized by nonunion of a tibial diaphyseal fracture that either develops spontaneously or after a history of trivial trauma in a previously dysplastic segment of the bone. The treatment of CPT remains a challenge, often due to failure of ICBG to achieve and maintain bone union, resulting in multiple revision surgeries and occasionally amputation of the lower leg. NVD003 is a novel 3-dimensional osteogenic graft that is derived from autologous adipose stem cells combined with hydroxyapatite/beta-tricalcium phosphate particles. As an alternative to ICBG, NVD003 is intended to promote bone formation and support the bone healing process, even in severely disturbed pathophysiological conditions like CPT. This is a prospective, randomized, controlled, multicenter, phase 3 clinical study in pediatric participants with CPT who have a non-healing Paley type 3 or 4 diaphyseal fracture and are candidates to undergo surgical treatment with internal fixation (intramedullary rod).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
12
Bone correction and grafting surgery
Either a single-stage Grafting Surgery with internal fixation and cross-union or the 2-stage "induced membrane" Grafting Surgery approach, depending on the surgeon's own standard of care.
Phoenix Children's Hospital, Inc.
Phoenix, Arizona, United States
RECRUITINGLoma Linda University Health
Loma Linda, California, United States
RECRUITINGLifeBridge Health - International Center for Limb Lengthening
Baltimore, Maryland, United States
To assess the efficacy of NVD003 for the surgical treatment of CPT in pediatric participants
Overall healing at 12 months, defined as a binary (yes/no) outcome derived from the following 3 outcomes: * Radiographic healing, defined as a score ≥13 on the modified Radiological Union Scale for Tibia (mRUST) scale (range 1 to 16) assessed by independent central readers (ICRs) * Clinical healing measured by the absence of pain with weight-bearing, based on clinician's assessment * No use of secondary interventions to promote or accelerate bone healing All 3 criteria must be met for a "yes" on overall healing for this endpoint to be achieved.
Time frame: At 12 months post GS
Efficacy: To assess the efficacy of NVD003 with respect to individual components of overall healing - radiographic healing
Radiographic healing, defined as a score ≥13 on the modified Radiological Union Scale for Tibia (mRUST) scale (range 1 to 16) assessed by independent central readers (ICRs)
Time frame: 12 months after grafting surgery
Efficacy: To assess the efficacy of NVD003 with respect to individual components of overall healing - clinical healing
Clinical healing measured by the absence of pain with weight-bearing, based on clinician's assessment
Time frame: 12 months after grafting surgery
Efficacy: To assess the efficacy of NVD003 with respect to individual components of overall healing - No use of secondary intervention
No use of secondary interventions to promote or accelerate bone healing
Time frame: 12 months after grafting surgery
Safety: To assess the safety of NVD003 for the surgical treatment of CPT in pediatric participants - Adverse events
Number and severity of adverse events (AEs) related to NVD003
Time frame: 12 months after grafting surgery
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Mayo Clinic
Rochester, Minnesota, United States
RECRUITINGCliniques Universitaires Saint-Luc ASBL (CUSCL)
Brussels, Brussels Capital, Belgium
RECRUITINGCHU Amiens-Picardie
Amiens, Picardie, France
RECRUITINGSafety: To assess the safety of NVD003 for the surgical treatment of CPT in pediatric participants - Serious adverse events
Number of serious adverse events (SAEs) related to NVD003
Time frame: 12 months after grafting surgery
Safety: To assess the safety of NVD003 for the surgical treatment of CPT in pediatric participants - Units of blood transfused perioperatively
Units of blood transfused perioperatively (in Liters or milliliters)
Time frame: from start of surgical procedure (Day 1) until hospital discharge
Safety: To assess the safety of NVD003 for the surgical treatment of CPT in pediatric participants - Duration of Grafting Surgery
Duration of Grafting Surgery (in hours)
Time frame: Grafting Surgery (Day 1)
Safety: To assess the safety of NVD003 for the surgical treatment of CPT in pediatric participants - duration of hospitalization
Duration of hospitalization after GS (in days)
Time frame: from grafting surgery (Day 1) until hospital discharge
Safety: To assess the safety of NVD003 for the surgical treatment of CPT in pediatric participants - Recurrent fracture
Recurrent fracture within 12 months after GS
Time frame: 12 months after grafting surgery
To further evaluate the efficacy of NVD003 for the surgical treatment of CPT in pediatric participants based on other measures of bone healing - Radiological
• Radiological bone union status at 3, 6, and 12 months after Grafting Surgery, assessed centrally by independent central readers (ICRs) using the total extended Lane and Sandhu scoring (eLSS) method (maximum of 12 points)
Time frame: Post grafting surgery (Day 1), and at months 3, 6 and 12
To further evaluate the efficacy of NVD003 for the surgical treatment of CPT in pediatric participants based on other measures of bone healing - functional walking
Functional walking outcome, assessed using the timed 10-meter walking test (when appropriate) post Grafting Surgery at 3, 6, and 12 months (in second)
Time frame: Post grafting surgery (Day 1), and at months 3, 6 and 12
To evaluate the effects of NVD003 on quality of life (QoL)
Mean change from Baseline to 6 and 12 months after GS in QoL: * Pediatric Outcomes Data Collection Instrument (PODCI) parent report for children 2 years of age and above. ("0" represents a poor outcome/worse health while "100" is the best possible outcome/best health.)
Time frame: Baseline and months 6 and 12 post grafting surgery