Trial Outcomes & Findings for Treatment of Symptomatic Lumbar Internal Disc Disruption (IDD) With the Biostat® System (NCT NCT01011816)

NCT ID: NCT01011816

Last Updated: 2014-05-16

Results Overview

Subject success based on a composite of minimum 30% decrease in low back pain, 30% improvement in function, maintenance of neurological status, no secondary interventions, and no serious adverse events.

Recruitment status

TERMINATED

Study phase

PHASE3

Target enrollment

220 participants

Primary outcome timeframe

26 weeks

Results posted on

2014-05-16

Participant Flow

Participant milestones

Participant milestones
Measure
BIOSTAT BIOLOGX
One injection of up to 4 mL of BIOSTAT BIOLOGX Fibrin Sealant into a single lumbar intervertebral disc using the Biostat Delivery Device
Saline
One injection of up to 4 mL of saline solution into a single lumbar intervertebral disc using the Biostat Delivery Device
26-Week Primary Endpoint
STARTED
164
56
26-Week Primary Endpoint
COMPLETED
157
54
26-Week Primary Endpoint
NOT COMPLETED
7
2
78-Week Extended Follow-up
STARTED
157
54
78-Week Extended Follow-up
COMPLETED
85
26
78-Week Extended Follow-up
NOT COMPLETED
72
28

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Treatment of Symptomatic Lumbar Internal Disc Disruption (IDD) With the Biostat® System

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
BIOSTAT BIOLOGX
n=164 Participants
One injection of up to 4 mL of BIOSTAT BIOLOGX Fibrin Sealant into a single lumbar intervertebral disc using the Biostat Delivery Device
Saline
n=56 Participants
One injection of up to 4 mL of saline solution into a single lumbar intervertebral disc using the Biostat Delivery Device
Total
n=220 Participants
Total of all reporting groups
Age, Continuous
39.7 years
STANDARD_DEVIATION 10.7 • n=99 Participants
41.9 years
STANDARD_DEVIATION 11.4 • n=107 Participants
40.2 years
STANDARD_DEVIATION 10.9 • n=206 Participants
Age, Customized
≥18-≤29 years
30 participants
n=99 Participants
11 participants
n=107 Participants
41 participants
n=206 Participants
Age, Customized
≥30-≤39 years
50 participants
n=99 Participants
12 participants
n=107 Participants
62 participants
n=206 Participants
Age, Customized
≥40-≤49 years
51 participants
n=99 Participants
20 participants
n=107 Participants
71 participants
n=206 Participants
Age, Customized
≥50-≤59 years
28 participants
n=99 Participants
9 participants
n=107 Participants
37 participants
n=206 Participants
Age, Customized
≥60 years
5 participants
n=99 Participants
4 participants
n=107 Participants
9 participants
n=206 Participants
Sex: Female, Male
Female
83 Participants
n=99 Participants
32 Participants
n=107 Participants
115 Participants
n=206 Participants
Sex: Female, Male
Male
81 Participants
n=99 Participants
24 Participants
n=107 Participants
105 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
8 Participants
n=99 Participants
5 Participants
n=107 Participants
13 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
156 Participants
n=99 Participants
51 Participants
n=107 Participants
207 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
15 Participants
n=99 Participants
2 Participants
n=107 Participants
17 Participants
n=206 Participants
Race (NIH/OMB)
White
147 Participants
n=99 Participants
52 Participants
n=107 Participants
199 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
2 Participants
n=99 Participants
1 Participants
n=107 Participants
3 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
BMI
28.0 kg/m^2
STANDARD_DEVIATION 6.1 • n=99 Participants
27.5 kg/m^2
STANDARD_DEVIATION 5.6 • n=107 Participants
27.9 kg/m^2
STANDARD_DEVIATION 5.9 • n=206 Participants
Currently Employed
Yes
96 participants
n=99 Participants
34 participants
n=107 Participants
130 participants
n=206 Participants
Currently Employed
No
65 participants
n=99 Participants
22 participants
n=107 Participants
87 participants
n=206 Participants
Currently Employed
No Response
3 participants
n=99 Participants
0 participants
n=107 Participants
3 participants
n=206 Participants
Smoking Status
Never
90 participants
n=99 Participants
21 participants
n=107 Participants
111 participants
n=206 Participants
Smoking Status
Previous
46 participants
n=99 Participants
19 participants
n=107 Participants
65 participants
n=206 Participants
Smoking Status
Current
28 participants
n=99 Participants
16 participants
n=107 Participants
44 participants
n=206 Participants
Previous Back Surgery
None
161 participants
n=99 Participants
55 participants
n=107 Participants
216 participants
n=206 Participants
Previous Back Surgery
Cervical
3 participants
n=99 Participants
1 participants
n=107 Participants
4 participants
n=206 Participants
History Low Back Pain
0.5 - 1 year
7 participants
n=99 Participants
3 participants
n=107 Participants
10 participants
n=206 Participants
History Low Back Pain
1 - <5 years
76 participants
n=99 Participants
24 participants
n=107 Participants
100 participants
n=206 Participants
History Low Back Pain
5 - <10 years
41 participants
n=99 Participants
9 participants
n=107 Participants
50 participants
n=206 Participants
History Low Back Pain
10 - <20 years
32 participants
n=99 Participants
12 participants
n=107 Participants
44 participants
n=206 Participants
History Low Back Pain
>=20 years
8 participants
n=99 Participants
8 participants
n=107 Participants
16 participants
n=206 Participants
History Right Leg Pain
None
118 participants
n=99 Participants
40 participants
n=107 Participants
158 participants
n=206 Participants
History Right Leg Pain
<1 year
8 participants
n=99 Participants
3 participants
n=107 Participants
11 participants
n=206 Participants
History Right Leg Pain
1 - <2 years
11 participants
n=99 Participants
2 participants
n=107 Participants
13 participants
n=206 Participants
History Right Leg Pain
2 - <3 years
11 participants
n=99 Participants
5 participants
n=107 Participants
16 participants
n=206 Participants
History Right Leg Pain
3 - <4 years
2 participants
n=99 Participants
0 participants
n=107 Participants
2 participants
n=206 Participants
History Right Leg Pain
>=4 years
14 participants
n=99 Participants
6 participants
n=107 Participants
20 participants
n=206 Participants
History Left Leg Pain
None
110 participants
n=99 Participants
33 participants
n=107 Participants
143 participants
n=206 Participants
History Left Leg Pain
<1 year
11 participants
n=99 Participants
6 participants
n=107 Participants
17 participants
n=206 Participants
History Left Leg Pain
1 - <2 years
7 participants
n=99 Participants
2 participants
n=107 Participants
9 participants
n=206 Participants
History Left Leg Pain
2 - <3 years
14 participants
n=99 Participants
7 participants
n=107 Participants
21 participants
n=206 Participants
History Left Leg Pain
3 - <4 years
3 participants
n=99 Participants
1 participants
n=107 Participants
4 participants
n=206 Participants
History Left Leg Pain
>=4years
19 participants
n=99 Participants
7 participants
n=107 Participants
26 participants
n=206 Participants
Baseline Opioid Medication for Back Pain
Yes
109 participants
n=99 Participants
37 participants
n=107 Participants
146 participants
n=206 Participants
Baseline Opioid Medication for Back Pain
No
55 participants
n=99 Participants
19 participants
n=107 Participants
74 participants
n=206 Participants
Lumbar Level Treated
L3/L4
12 participants
n=99 Participants
8 participants
n=107 Participants
20 participants
n=206 Participants
Lumbar Level Treated
L4/L5
48 participants
n=99 Participants
11 participants
n=107 Participants
59 participants
n=206 Participants
Lumbar Level Treated
L5/S1
104 participants
n=99 Participants
37 participants
n=107 Participants
141 participants
n=206 Participants
Reason for Stopping Injection
Subject Discomfort
4 participants
n=99 Participants
2 participants
n=107 Participants
6 participants
n=206 Participants
Reason for Stopping Injection
Maximum Pressure Reached
91 participants
n=99 Participants
6 participants
n=107 Participants
97 participants
n=206 Participants
Reason for Stopping Injection
Total Available Volume Delivered
68 participants
n=99 Participants
45 participants
n=107 Participants
113 participants
n=206 Participants
Reason for Stopping Injection
Other [investigator discretion; saline backflow]
1 participants
n=99 Participants
3 participants
n=107 Participants
4 participants
n=206 Participants
Maximum Injection Pressure
83.0 psi
STANDARD_DEVIATION 29.3 • n=99 Participants
49.7 psi
STANDARD_DEVIATION 25.7 • n=107 Participants
74.6 psi
STANDARD_DEVIATION 31.9 • n=206 Participants
Injection Volume
2.8 ml
STANDARD_DEVIATION 0.9 • n=99 Participants
3.3 ml
STANDARD_DEVIATION 0.8 • n=107 Participants
2.9 ml
STANDARD_DEVIATION 0.9 • n=206 Participants

PRIMARY outcome

Timeframe: 26 weeks

Population: All subjects adjudicated as a success or failure. Missed 26-week visit counted as failure (7 BIOSTAT BIOLOGX; 2 Saline). Unblinded subjects counted as failures (2 BIOSTAT BIOLOGX).

Subject success based on a composite of minimum 30% decrease in low back pain, 30% improvement in function, maintenance of neurological status, no secondary interventions, and no serious adverse events.

Outcome measures

Outcome measures
Measure
BIOSTAT BIOLOGX
n=164 Participants
One injection of up to 4 mL of BIOSTAT BIOLOGX Fibrin Sealant into a single lumbar intervertebral disc BIOSTAT BIOLOGX: One injection of up to 4 mL of BIOSTAT BIOLOGX Fibrin Sealant into a single lumbar intervertebral disc using the Biostat Delivery Device
Saline
n=56 Participants
One injection of up to 4 mL of saline solution into a single lumbar intervertebral disc Saline: One injection of up to 4 mL of saline using the Biostat Delivery Device
Subject Composite Success
33.5 percentage of subjects
39.3 percentage of subjects

SECONDARY outcome

Timeframe: 26-weeks

Population: All subjects assigned success or failure. Missed 26-week visit counted as failure (7 BIOSTAT BIOLOGX; 2 Saline). Unblinded subjects counted as failures (2 BIOSTAT BIOLOGX).

Percent of subjects achieving a minimum 30% decrease in pain from baseline. The visual analog scale is a horizontal 100 mm line anchored on the left with the words "No Pain" and on the right with the words "Worst Possible Pain". Scores were obtained by measuring the distance in millimeters from the left origin of the line (0) to the point indicated with a slash placed by the subject to indicate the subject's level of low back pain experienced over the last week.

Outcome measures

Outcome measures
Measure
BIOSTAT BIOLOGX
n=164 Participants
One injection of up to 4 mL of BIOSTAT BIOLOGX Fibrin Sealant into a single lumbar intervertebral disc BIOSTAT BIOLOGX: One injection of up to 4 mL of BIOSTAT BIOLOGX Fibrin Sealant into a single lumbar intervertebral disc using the Biostat Delivery Device
Saline
n=56 Participants
One injection of up to 4 mL of saline solution into a single lumbar intervertebral disc Saline: One injection of up to 4 mL of saline using the Biostat Delivery Device
Visual Analog Scale for Low Back Pain
42.1 percentage of subjects
50.0 percentage of subjects

SECONDARY outcome

Timeframe: 26-weeks

Population: All subjects assigned as success or failure. Missed 26-week visit counted as failure (7 BIOSTAT BIOLOGX; 2 Saline). Unblinded subjects counted as failures (2 BIOSTAT BIOLOGX).

Percent of subjects achieving a minimum 30% decrease in Roland-Morris Disability Questionnaire score The Roland-Morris Disability Questionnaire is a widely studied and frequently used instrument for the assessment of function and disability related to low back pain. The questionnaire consists of 24 statements related to how a subject's back condition affects various activities of daily living. Subjects marked whether the statement either applied to them or did not apply at the time they responded to the statements. The score is the total number of questions with which the subject agreed. A higher score indicates less function and greater disability.

Outcome measures

Outcome measures
Measure
BIOSTAT BIOLOGX
n=164 Participants
One injection of up to 4 mL of BIOSTAT BIOLOGX Fibrin Sealant into a single lumbar intervertebral disc BIOSTAT BIOLOGX: One injection of up to 4 mL of BIOSTAT BIOLOGX Fibrin Sealant into a single lumbar intervertebral disc using the Biostat Delivery Device
Saline
n=56 Participants
One injection of up to 4 mL of saline solution into a single lumbar intervertebral disc Saline: One injection of up to 4 mL of saline using the Biostat Delivery Device
Roland-Morris Disability Questionnaire Score
52.4 percentage of subjects
50.0 percentage of subjects

Adverse Events

BIOSTAT BIOLOGX

Serious events: 22 serious events
Other events: 49 other events
Deaths: 0 deaths

Saline

Serious events: 7 serious events
Other events: 11 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
BIOSTAT BIOLOGX
n=164 participants at risk
One injection of up to 4 mL of BIOSTAT BIOLOGX Fibrin Sealant into a single lumbar intervertebral disc using the Biostat Delivery Device
Saline
n=56 participants at risk
One injection of up to 4 mL of saline solution into a single lumbar intervertebral disc using the Biostat Delivery Device
Cardiac disorders
Myocardial Infarction
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
1.8%
1/56 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Endocrine disorders
Adrenal Mass
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Gastrointestinal disorders
Crohn's Disease
0.00%
0/164 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
1.8%
1/56 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Gastrointestinal disorders
Diverticular Perforation
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Hepatobiliary disorders
Cholecystitis
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Infections and infestations
Pneumonia
1.2%
2/164 • Number of events 2 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Injury, poisoning and procedural complications
Fall
0.00%
0/164 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
1.8%
1/56 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Injury, poisoning and procedural complications
Wrist Fracture
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Musculoskeletal and connective tissue disorders
Back Pain
3.7%
6/164 • Number of events 7 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
1.8%
1/56 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Musculoskeletal and connective tissue disorders
Intervertebral Disc Protrusion
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Musculoskeletal and connective tissue disorders
Osteoarthritis
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Uterine Leiomyoma
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Nervous system disorders
Cerebral Haemorrhage
0.00%
0/164 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
1.8%
1/56 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Nervous system disorders
Migraine
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Nervous system disorders
Radiculopathy
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Psychiatric disorders
Completed Suicide
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Psychiatric disorders
Conversion Disorder
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Psychiatric disorders
Delirium
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Psychiatric disorders
Eating Disorder
0.00%
0/164 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
1.8%
1/56 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Psychiatric disorders
Substance Abuse
0.00%
0/164 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
1.8%
1/56 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Renal and urinary disorders
Nephrolithiasis
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
3.6%
2/56 • Number of events 2 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Reproductive system and breast disorders
Uterine Haemorrhage
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Surgical and medical procedures
Hysterectomy
0.61%
1/164 • Number of events 1 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
0.00%
0/56 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination

Other adverse events

Other adverse events
Measure
BIOSTAT BIOLOGX
n=164 participants at risk
One injection of up to 4 mL of BIOSTAT BIOLOGX Fibrin Sealant into a single lumbar intervertebral disc using the Biostat Delivery Device
Saline
n=56 participants at risk
One injection of up to 4 mL of saline solution into a single lumbar intervertebral disc using the Biostat Delivery Device
Musculoskeletal and connective tissue disorders
Back Pain
12.2%
20/164 • Number of events 21 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
5.4%
3/56 • Number of events 3 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Injury, poisoning and procedural complications
Fall
7.9%
13/164 • Number of events 14 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
5.4%
3/56 • Number of events 3 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Musculoskeletal and connective tissue disorders
Pain in Extremity
9.8%
16/164 • Number of events 16 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
5.4%
3/56 • Number of events 4 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
Musculoskeletal and connective tissue disorders
Arthralgia
3.7%
6/164 • Number of events 7 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination
3.6%
2/56 • Number of events 3 • 78-weeks postprocedure or until study termination for those subjects not reaching the 78-week follow-up examination

Additional Information

Jeff Doerzbacher

formerly Spinal Restoration, Inc

Results disclosure agreements

  • Principal investigator is a sponsor employee Disclosure restrictions: * Sponsor can review results communication prior to public release and can embargo communications regarding trial results for up to 30 days from the time submitted for review. * If the communication contains patentable invention information, disclosure may be delayed up to 6 months for patent application filing. * If the communication contains confidential information, Sponsor will notify the PI to remove the confidential information prior to release.
  • Publication restrictions are in place

Restriction type: OTHER