Trial Outcomes & Findings for A Clinical Trial to Evaluate the Safety, Tolerability and Preliminary Effectiveness of Single Administration Intradiscal rhGDF-5 for the Treatment of Early Stage Lumbar Disc Degeneration (NCT NCT01182337)

NCT ID: NCT01182337

Last Updated: 2016-02-26

Results Overview

Neurological Assessment for Motor Function and Reflexes/Sensory- Number of patients with Clinically Significant Abnormal results at 12 months. For Motor Function, Clinically Significant Abnormal results are determined by the surgeon investigator and are further classified by grade: 0= No Movement, 1= Flicker/trace of contraction, 2=Active movement when gravity removed, 3= Active movement against gravity, 4= Active Movement against gravity and resistance. For Reflexes/Sensory, Clinically Significant Abnormal results are determined by the surgeon investigator and are based on exams of the Knee, Ankle, L3-L5 Dermatone, and S1 Dermatome. Tension signs are evaluated with a straight leg raise to determine at which point, if any, sciatic pain occurs.

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

31 participants

Primary outcome timeframe

12 months

Results posted on

2016-02-26

Participant Flow

Participant milestones

Participant milestones
Measure
Intradiscal rhGDF-5 1.0mg
The API is recombinant human growth and differentiation factor-5 (rhGDF-5), a recombinant version of human GDF-5. GDF-5 is a member of the transforming growth factor-b (TGF-b) superfamily and the bone morphogenetic protein (BMP) subfamily, and is known to influence the growth and differentiation of various tissues, including the intervertebral disc.
Vehicle Control
Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection Vehicle control: Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection
Overall Study
STARTED
22
9
Overall Study
COMPLETED
19
7
Overall Study
NOT COMPLETED
3
2

Reasons for withdrawal

Reasons for withdrawal
Measure
Intradiscal rhGDF-5 1.0mg
The API is recombinant human growth and differentiation factor-5 (rhGDF-5), a recombinant version of human GDF-5. GDF-5 is a member of the transforming growth factor-b (TGF-b) superfamily and the bone morphogenetic protein (BMP) subfamily, and is known to influence the growth and differentiation of various tissues, including the intervertebral disc.
Vehicle Control
Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection Vehicle control: Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection
Overall Study
Withdrawal by Subject
3
1
Overall Study
Lost to Follow-up
0
1

Baseline Characteristics

A Clinical Trial to Evaluate the Safety, Tolerability and Preliminary Effectiveness of Single Administration Intradiscal rhGDF-5 for the Treatment of Early Stage Lumbar Disc Degeneration

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Intradiscal rhGDF-5
n=22 Participants
The API is recombinant human growth and differentiation factor-5 (rhGDF-5), a recombinant version of human GDF-5. GDF-5 is a member of the transforming growth factor-b (TGF-b) superfamily and the bone morphogenetic protein (BMP) subfamily, and is known to influence the growth and differentiation of various tissues, including the intervertebral disc.
Vehicle Control
n=9 Participants
Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection Vehicle control: Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection
Total
n=31 Participants
Total of all reporting groups
Age, Continuous
41.4 years
STANDARD_DEVIATION 11.78 • n=5 Participants
40.6 years
STANDARD_DEVIATION 15.63 • n=7 Participants
41.2 years
STANDARD_DEVIATION 12.74 • n=5 Participants
Sex: Female, Male
Female
10 Participants
n=5 Participants
3 Participants
n=7 Participants
13 Participants
n=5 Participants
Sex: Female, Male
Male
12 Participants
n=5 Participants
6 Participants
n=7 Participants
18 Participants
n=5 Participants
Region of Enrollment
Korea, Republic of
22 participants
n=5 Participants
9 participants
n=7 Participants
31 participants
n=5 Participants

PRIMARY outcome

Timeframe: 12 months

Population: Safety Population For the Neurological Assessment at 12 months, only 21 subjects from the rhGDF-5 group completed the assessment (out of 22 total subjects) and 5 subjects from the Control group completed the assessment (out of 9 subjects total).

Neurological Assessment for Motor Function and Reflexes/Sensory- Number of patients with Clinically Significant Abnormal results at 12 months. For Motor Function, Clinically Significant Abnormal results are determined by the surgeon investigator and are further classified by grade: 0= No Movement, 1= Flicker/trace of contraction, 2=Active movement when gravity removed, 3= Active movement against gravity, 4= Active Movement against gravity and resistance. For Reflexes/Sensory, Clinically Significant Abnormal results are determined by the surgeon investigator and are based on exams of the Knee, Ankle, L3-L5 Dermatone, and S1 Dermatome. Tension signs are evaluated with a straight leg raise to determine at which point, if any, sciatic pain occurs.

Outcome measures

Outcome measures
Measure
Intradiscal rhGDF-5 1.0mg
n=21 Participants
The API is recombinant human growth and differentiation factor-5 (rhGDF-5), a recombinant version of human GDF-5. GDF-5 is a member of the transforming growth factor-b (TGF-b) superfamily and the bone morphogenetic protein (BMP) subfamily, and is known to influence the growth and differentiation of various tissues, including the intervertebral disc.
Vehicle Control
n=5 Participants
Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection Vehicle control: Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection
Neurological Assessment for Motor Function and Reflexes/Sensory
0 participants
0 participants

PRIMARY outcome

Timeframe: Through a 12 month period and annual telephone contact at 24 and 36 months for subject health status follow-up

Population: Safety Population

Number of patients with Treatment Emergent Adverse Events that were designated as Definitely Related to Study Drug.

Outcome measures

Outcome measures
Measure
Intradiscal rhGDF-5 1.0mg
n=22 Participants
The API is recombinant human growth and differentiation factor-5 (rhGDF-5), a recombinant version of human GDF-5. GDF-5 is a member of the transforming growth factor-b (TGF-b) superfamily and the bone morphogenetic protein (BMP) subfamily, and is known to influence the growth and differentiation of various tissues, including the intervertebral disc.
Vehicle Control
n=9 Participants
Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection Vehicle control: Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection
Treatment Emergent Adverse Events- Relationship to Study Drug
0 participants
0 participants

PRIMARY outcome

Timeframe: 12 month period and annual telephone contact at 24 and 36 months for subject health status follow-up

Population: Safety Population

Number of patients with Treatment Emergent Adverse Events that were designated as Possibly or Probably Related to Study Drug.

Outcome measures

Outcome measures
Measure
Intradiscal rhGDF-5 1.0mg
n=22 Participants
The API is recombinant human growth and differentiation factor-5 (rhGDF-5), a recombinant version of human GDF-5. GDF-5 is a member of the transforming growth factor-b (TGF-b) superfamily and the bone morphogenetic protein (BMP) subfamily, and is known to influence the growth and differentiation of various tissues, including the intervertebral disc.
Vehicle Control
n=9 Participants
Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection Vehicle control: Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection
Treatment Emergent Adverse Events- Relationship to Study Drug
0 participants
1 participants

SECONDARY outcome

Timeframe: 12 month

Population: FAS Population

The Oswestry Disability Index (ODI) is a 10-category (Pain Intensity, Personal Care, Lifting, Walking, Sitting, Standing, Sleeping, Sex Life, Social Life, Traveling) disability measurement scale with a graded response from 0 to 5, with 0 being the best score (no impairment) to 5 being the worst score (significant impairment). ODI score for a subject is calculated by adding the scores and converting the score to a 100 point scale.

Outcome measures

Outcome measures
Measure
Intradiscal rhGDF-5 1.0mg
n=22 Participants
The API is recombinant human growth and differentiation factor-5 (rhGDF-5), a recombinant version of human GDF-5. GDF-5 is a member of the transforming growth factor-b (TGF-b) superfamily and the bone morphogenetic protein (BMP) subfamily, and is known to influence the growth and differentiation of various tissues, including the intervertebral disc.
Vehicle Control
n=9 Participants
Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection Vehicle control: Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection
Change in Function Assessed by Oswestry Disability Index Change at 12 Months From Baseline.
-13.5 units on a scale
Standard Deviation 13.86
-10.4 units on a scale
Standard Deviation 8.98

SECONDARY outcome

Timeframe: 12 months

Population: FAS Population

The Visual Analog Scale (VAS) pain score asks the subject to place a vertical mark on a horizontal line (that is approximately 10 cm long) with 'No Pain' (score of 0 = 0 cm) listed on the left and 'Very severe pain' (score of 10=10cm) labeled on the right. The subject is instructed to indicate the amount of pain they feel in their back.

Outcome measures

Outcome measures
Measure
Intradiscal rhGDF-5 1.0mg
n=22 Participants
The API is recombinant human growth and differentiation factor-5 (rhGDF-5), a recombinant version of human GDF-5. GDF-5 is a member of the transforming growth factor-b (TGF-b) superfamily and the bone morphogenetic protein (BMP) subfamily, and is known to influence the growth and differentiation of various tissues, including the intervertebral disc.
Vehicle Control
n=9 Participants
Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection Vehicle control: Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection
Change in Pain Visual Analog Scale (VAS) at 12 Months From Baseline.
-2.49 units on a scale
Standard Deviation 2.211
-1.42 units on a scale
Standard Deviation 3.177

SECONDARY outcome

Timeframe: 12 months

Population: FAS Population Only 21 subjects from the rhGDF-5 group (out of 22 total subjects) completed the baseline PCS, SF-36.

The 36-item Short Form Health Survey (SF-36) is a patient reported outcome survey that evaluates functional health and well-being. The survey is converted into two summary measures (the Physical Component - PCS and Mental Component- MCS) that are scored from 0 to 100 (where 100 indicates the highest level of health).

Outcome measures

Outcome measures
Measure
Intradiscal rhGDF-5 1.0mg
n=21 Participants
The API is recombinant human growth and differentiation factor-5 (rhGDF-5), a recombinant version of human GDF-5. GDF-5 is a member of the transforming growth factor-b (TGF-b) superfamily and the bone morphogenetic protein (BMP) subfamily, and is known to influence the growth and differentiation of various tissues, including the intervertebral disc.
Vehicle Control
n=9 Participants
Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection Vehicle control: Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection
Change in Physical Component Summary of Quality of Life Measure Assessed by Short Form 36 at 12 Months From Baseline
2.52 units on a scale
Standard Deviation 7.354
3.24 units on a scale
Standard Deviation 9.879

SECONDARY outcome

Timeframe: 12 Months

Population: FAS Population Only 21 subjects from the rhGDF-5 group (out of 22 subjects total) completed the MCS, SF-36.

The 36-item Short Form Health Survey (SF-36) is a patient reported outcome survey that evaluates functional health and well-being. The survey is converted into two summary measures (the Physical Component - PCS and Mental Component- MCS) that are scored from 0 to 100 (where 100 indicates the highest level of health).

Outcome measures

Outcome measures
Measure
Intradiscal rhGDF-5 1.0mg
n=21 Participants
The API is recombinant human growth and differentiation factor-5 (rhGDF-5), a recombinant version of human GDF-5. GDF-5 is a member of the transforming growth factor-b (TGF-b) superfamily and the bone morphogenetic protein (BMP) subfamily, and is known to influence the growth and differentiation of various tissues, including the intervertebral disc.
Vehicle Control
n=9 Participants
Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection Vehicle control: Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection
Change in Mental Component Summary Quality of Life Measure Assessed by Short Form SF-36 at 12 Months From Baseline.
4.03 units on a scale
Standard Deviation 14.050
4.34 units on a scale
Standard Deviation 10.727

Adverse Events

Intradiscal rhGDF-5

Serious events: 5 serious events
Other events: 16 other events
Deaths: 0 deaths

Vehicle Control

Serious events: 2 serious events
Other events: 5 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Intradiscal rhGDF-5
n=22 participants at risk
The API is recombinant human growth and differentiation factor-5 (rhGDF-5), a recombinant version of human GDF-5. GDF-5 is a member of the transforming growth factor-b (TGF-b) superfamily and the bone morphogenetic protein (BMP) subfamily, and is known to influence the growth and differentiation of various tissues, including the intervertebral disc.
Vehicle Control
n=9 participants at risk
Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection Vehicle control: Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection
Musculoskeletal and connective tissue disorders
Intervertebral Disc Protrusion
9.1%
2/22 • Number of events 2 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
0.00%
0/9 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Musculoskeletal and connective tissue disorders
Neck Pain
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Injury, poisoning and procedural complications
Road Traffic Accident
4.5%
1/22 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Injury, poisoning and procedural complications
Meniscus Lesion
4.5%
1/22 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
0.00%
0/9 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Injury, poisoning and procedural complications
Muscle Injury
4.5%
1/22 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
0.00%
0/9 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Injury, poisoning and procedural complications
Muscle Strain
4.5%
1/22 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
0.00%
0/9 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Ear and labyrinth disorders
Vertigo Positional
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Infections and infestations
Appendicitis
4.5%
1/22 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
0.00%
0/9 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Pregnancy, puerperium and perinatal conditions
Abortion Spontaneous
4.5%
1/22 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
0.00%
0/9 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months

Other adverse events

Other adverse events
Measure
Intradiscal rhGDF-5
n=22 participants at risk
The API is recombinant human growth and differentiation factor-5 (rhGDF-5), a recombinant version of human GDF-5. GDF-5 is a member of the transforming growth factor-b (TGF-b) superfamily and the bone morphogenetic protein (BMP) subfamily, and is known to influence the growth and differentiation of various tissues, including the intervertebral disc.
Vehicle Control
n=9 participants at risk
Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection Vehicle control: Excipients in Intradiscal rhGDF-5, to include Trehalose, Glycine, HCl, and Water for Injection
Musculoskeletal and connective tissue disorders
Back Pain
36.4%
8/22 • Number of events 9 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
33.3%
3/9 • Number of events 4 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Musculoskeletal and connective tissue disorders
Musculoskeletal Pain
18.2%
4/22 • Number of events 5 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
0.00%
0/9 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Musculoskeletal and connective tissue disorders
Pain in Extremity
13.6%
3/22 • Number of events 3 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Musculoskeletal and connective tissue disorders
Intervertebral Disc Protrusion
9.1%
2/22 • Number of events 2 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
0.00%
0/9 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Gastrointestinal disorders
Abdominal Pain Upper
4.5%
1/22 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Gastrointestinal disorders
Gastritis
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Infections and infestations
Nasopharyngitis
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Nervous system disorders
Headache
4.5%
1/22 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Nervous system disorders
Dizziness
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Injury, poisoning and procedural complications
Road Traffic Accident
4.5%
1/22 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Respiratory, thoracic and mediastinal disorders
Dysphonia
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Skin and subcutaneous tissue disorders
Dermatitis Contact
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Skin and subcutaneous tissue disorders
Rash
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Metabolism and nutrition disorders
Diabetes Mellitus
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Vascular disorders
Varicose Vein
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Ear and labyrinth disorders
Vertigo Positional
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Hepatobiliary disorders
Hepatic Steatosis
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Musculoskeletal and connective tissue disorders
Neck Pain
4.5%
1/22 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Musculoskeletal and connective tissue disorders
Trigger Finger
0.00%
0/22 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
11.1%
1/9 • Number of events 1 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Infections and infestations
Upper Respiratory Tract Infection
9.1%
2/22 • Number of events 3 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
0.00%
0/9 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Injury, poisoning and procedural complications
Muscle Strain
9.1%
2/22 • Number of events 2 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
0.00%
0/9 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
Respiratory, thoracic and mediastinal disorders
Oropharyngeal Pain
9.1%
2/22 • Number of events 2 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months
0.00%
0/9 • Adverse events were collected through a 12 month period and annual telephone contact at 24 months and 36 months

Additional Information

Mark Lotito

DePuy Synthes Spine

Phone: 508-880-8045

Results disclosure agreements

  • Principal investigator is a sponsor employee Clinical Investigators may freely present or publish results of the Clinical Investigation in a manner which fairly sets forth the conclusions reached by the Clinical Investigators, but only after the Sponsor has been given the opportunity of reviewing the proposed presentation or publication at least 60 days prior to the intended submission, presentation, or publication date.
  • Publication restrictions are in place

Restriction type: OTHER