Trial Outcomes & Findings for The EVICEL® Neurosurgery Phase III Study (NCT NCT02457546)

NCT ID: NCT02457546

Last Updated: 2019-01-10

Results Overview

The primary endpoint was the proportion of subjects that had no inter-operative CSF leak following Valsalva maneuver and no CSF leak or pseudomeningocele in the surgical area during the 30-day follow-up period

Recruitment status

COMPLETED

Study phase

PHASE3

Target enrollment

234 participants

Primary outcome timeframe

Intraoperatively through 30-day follow-up

Results posted on

2019-01-10

Participant Flow

Subjects were recruited from medical centers in North America, Europe, and Asia-Pacific. The first subject was randomized on July 7 2015 and the last subject completed the study October 12 2017

Participant milestones

Participant milestones
Measure
Evicel
EVICEL® is a human plasma-derived fibrin sealant. EVICEL® consists of two components: a concentrate of Human Fibrinogen (referred to as Biological Component 2; BAC2) and a solution of Human Thrombin, which incorporates calcium.
DuraSeal
DuraSeal™ Dural Sealant System is a commercially available synthetic sealant intended for use as an adjunct to sutured dural repair during cranial surgery to provide watertight closure. The product is a synthetic absorbable sealant composed of a polyethylene glycol (PEG) ester solution and a rilysine amine solution.
Overall Study
STARTED
114
120
Overall Study
COMPLETED
105
116
Overall Study
NOT COMPLETED
9
4

Reasons for withdrawal

Reasons for withdrawal
Measure
Evicel
EVICEL® is a human plasma-derived fibrin sealant. EVICEL® consists of two components: a concentrate of Human Fibrinogen (referred to as Biological Component 2; BAC2) and a solution of Human Thrombin, which incorporates calcium.
DuraSeal
DuraSeal™ Dural Sealant System is a commercially available synthetic sealant intended for use as an adjunct to sutured dural repair during cranial surgery to provide watertight closure. The product is a synthetic absorbable sealant composed of a polyethylene glycol (PEG) ester solution and a rilysine amine solution.
Overall Study
Other reasons
4
1
Overall Study
Refused to complete study/procedures
1
1
Overall Study
Lost to Follow-up
4
1
Overall Study
Adverse Event
0
1

Baseline Characteristics

The EVICEL® Neurosurgery Phase III Study

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Evicel
n=114 Participants
EVICEL® is a human plasma-derived fibrin sealant. EVICEL® consists of two components: a concentrate of Human Fibrinogen (referred to as Biological Component 2; BAC2) and a solution of Human Thrombin, which incorporates calcium.
DuraSeal
n=120 Participants
DuraSeal™ Dural Sealant System is a commercially available synthetic sealant intended for use as an adjunct to sutured dural repair during cranial surgery to provide watertight closure. The product is a synthetic absorbable sealant composed of a polyethylene glycol (PEG) ester solution and a rilysine amine solution.
Total
n=234 Participants
Total of all reporting groups
Age, Continuous
53.4 years
STANDARD_DEVIATION 14.9 • n=5 Participants
56.0 years
STANDARD_DEVIATION 15.0 • n=7 Participants
54.7 years
STANDARD_DEVIATION 15.0 • n=5 Participants
Sex: Female, Male
Female
59 Participants
n=5 Participants
59 Participants
n=7 Participants
118 Participants
n=5 Participants
Sex: Female, Male
Male
55 Participants
n=5 Participants
61 Participants
n=7 Participants
116 Participants
n=5 Participants
Race/Ethnicity, Customized
White/Caucasian
102 Participants
n=5 Participants
101 Participants
n=7 Participants
203 Participants
n=5 Participants
Race/Ethnicity, Customized
Black or African American
9 Participants
n=5 Participants
9 Participants
n=7 Participants
18 Participants
n=5 Participants
Race/Ethnicity, Customized
American Indian or Alaska Native
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
1 Participants
n=5 Participants
3 Participants
n=7 Participants
4 Participants
n=5 Participants
Race/Ethnicity, Customized
Asian
1 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
Race/Ethnicity, Customized
Other
1 Participants
n=5 Participants
4 Participants
n=7 Participants
5 Participants
n=5 Participants
BMI
27.5 kg/m^2
STANDARD_DEVIATION 6.0 • n=5 Participants
26.9 kg/m^2
STANDARD_DEVIATION 5.0 • n=7 Participants
27.2 kg/m^2
STANDARD_DEVIATION 5.5 • n=5 Participants
BMI (Grouped)
Underweight
1 Participants
n=5 Participants
1 Participants
n=7 Participants
2 Participants
n=5 Participants
BMI (Grouped)
Normal
37 Participants
n=5 Participants
46 Participants
n=7 Participants
83 Participants
n=5 Participants
BMI (Grouped)
Overweight
45 Participants
n=5 Participants
39 Participants
n=7 Participants
84 Participants
n=5 Participants
BMI (Grouped)
Obese
27 Participants
n=5 Participants
34 Participants
n=7 Participants
61 Participants
n=5 Participants
BMI (Grouped)
Morbidly Obese
4 Participants
n=5 Participants
0 Participants
n=7 Participants
4 Participants
n=5 Participants
Ethnicity
Hispanic
2 Participants
n=5 Participants
3 Participants
n=7 Participants
5 Participants
n=5 Participants
Ethnicity
Non-Hispanic
112 Participants
n=5 Participants
117 Participants
n=7 Participants
229 Participants
n=5 Participants

PRIMARY outcome

Timeframe: Intraoperatively through 30-day follow-up

Population: Per Protocol Set

The primary endpoint was the proportion of subjects that had no inter-operative CSF leak following Valsalva maneuver and no CSF leak or pseudomeningocele in the surgical area during the 30-day follow-up period

Outcome measures

Outcome measures
Measure
Evicel
n=102 Participants
EVICEL® is a human plasma-derived fibrin sealant. EVICEL® consists of two components: a concentrate of Human Fibrinogen (referred to as Biological Component 2; BAC2) and a solution of Human Thrombin, which incorporates calcium.
DuraSeal
n=106 Participants
DuraSeal™ Dural Sealant System is a commercially available synthetic sealant intended for use as an adjunct to sutured dural repair during cranial surgery to provide watertight closure. The product is a synthetic absorbable sealant composed of a polyethylene glycol (PEG) ester solution and a rilysine amine solution.
Primary Effectiveness Endpoint Success Number of Successes (Subjects That Had no Inter-operative CSF Leak Following Valsalva Maneuver and no CSF Leak or Pseudomeningocele in the Surgical Area During the 30-day Follow-up Period)
Posterior Fossa
22 Participants
23 Participants
Primary Effectiveness Endpoint Success Number of Successes (Subjects That Had no Inter-operative CSF Leak Following Valsalva Maneuver and no CSF Leak or Pseudomeningocele in the Surgical Area During the 30-day Follow-up Period)
Supratentorial
73 Participants
69 Participants
Primary Effectiveness Endpoint Success Number of Successes (Subjects That Had no Inter-operative CSF Leak Following Valsalva Maneuver and no CSF Leak or Pseudomeningocele in the Surgical Area During the 30-day Follow-up Period)
Total
95 Participants
92 Participants

OTHER_PRE_SPECIFIED outcome

Timeframe: Intraoperatively, after final Valsalva maneuver

Population: No Valsalva maneuver performed in 2 participants in the Evicel Arm and 1 participant in the DuraSeal Arm

Intra-operative CSF leakage follow final Valsalva

Outcome measures

Outcome measures
Measure
Evicel
n=112 Participants
EVICEL® is a human plasma-derived fibrin sealant. EVICEL® consists of two components: a concentrate of Human Fibrinogen (referred to as Biological Component 2; BAC2) and a solution of Human Thrombin, which incorporates calcium.
DuraSeal
n=119 Participants
DuraSeal™ Dural Sealant System is a commercially available synthetic sealant intended for use as an adjunct to sutured dural repair during cranial surgery to provide watertight closure. The product is a synthetic absorbable sealant composed of a polyethylene glycol (PEG) ester solution and a rilysine amine solution.
Safety Endpoint: Intra-operative CSF Leakage Follow Final Valsalva
10 Participants
13 Participants

Adverse Events

Evicel

Serious events: 32 serious events
Other events: 103 other events
Deaths: 3 deaths

DuraSeal

Serious events: 37 serious events
Other events: 109 other events
Deaths: 2 deaths

Serious adverse events

Serious adverse events
Measure
Evicel
n=114 participants at risk
EVICEL® is a human plasma-derived fibrin sealant. EVICEL® consists of two components: a concentrate of Human Fibrinogen (referred to as Biological Component 2; BAC2) and a solution of Human Thrombin, which incorporates calcium.
DuraSeal
n=120 participants at risk
DuraSeal™ Dural Sealant System is a commercially available synthetic sealant intended for use as an adjunct to sutured dural repair during cranial surgery to provide watertight closure. The product is a synthetic absorbable sealant composed of a polyethylene glycol (PEG) ester solution and a rilysine amine solution.
Blood and lymphatic system disorders
Neutropenia
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Cardiac disorders
Atrial flutter
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Eye disorders
Blindness unilateral
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Gastrointestinal disorders
Gastric perforation
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Gastrointestinal disorders
Intestinal obstruction
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Gastrointestinal disorders
Large intestine perforation
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Gastrointestinal disorders
Oesophageal haemorrhage
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Gastrointestinal disorders
Vomiting
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Infections and infestations
Brain empyema
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Infections and infestations
Empyema
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Infections and infestations
Meningitis
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Infections and infestations
Pneumonia
3.5%
4/114 • From surgical procedure through the 60 day follow-up visit
2.5%
3/120 • From surgical procedure through the 60 day follow-up visit
Infections and infestations
Postoperative wound infection
1.8%
2/114 • From surgical procedure through the 60 day follow-up visit
4.2%
5/120 • From surgical procedure through the 60 day follow-up visit
Infections and infestations
Propionibacterium infection
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Infections and infestations
Sepsis
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Injury, poisoning and procedural complications
Post procedural haemorrhage
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Injury, poisoning and procedural complications
Pseudomeningocele
1.8%
2/114 • From surgical procedure through the 60 day follow-up visit
7.5%
9/120 • From surgical procedure through the 60 day follow-up visit
Injury, poisoning and procedural complications
Seroma
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Injury, poisoning and procedural complications
Subdural haematoma
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Injury, poisoning and procedural complications
Subdural haemorrhage
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Investigations
White blood cell count increased
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Metabolism and nutrition disorders
Hyponatraemia
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Metabolism and nutrition disorders
Lactic acidosis
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Musculoskeletal and connective tissue disorders
Neck pain
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Brain neoplasm
1.8%
2/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Glioblastoma
1.8%
2/114 • From surgical procedure through the 60 day follow-up visit
3.3%
4/120 • From surgical procedure through the 60 day follow-up visit
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Malignant melanoma
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Metastases to central nervous system
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Metastases to meninges
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Non-small cell lung cancer
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Aphasia
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Brain oedema
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Cerebellar haemorrhage
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Cerebral infarction
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Cerebrospinal fluid leakage
2.6%
3/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Cerebrovascular accident
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Convulsion
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
4.2%
5/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Grand mal convulsion
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Haemorrhagic stroke
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Headache
1.8%
2/114 • From surgical procedure through the 60 day follow-up visit
1.7%
2/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Hydrocephalus
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Nerve root compression
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Subdural hygroma
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Syncope
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Psychiatric disorders
Mental status changes
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
1.7%
2/120 • From surgical procedure through the 60 day follow-up visit
Renal and urinary disorders
Nephrolithiasis
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Respiratory, thoracic and mediastinal disorders
Acute respiratory distress syndrome
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Respiratory, thoracic and mediastinal disorders
Dyspnoea
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Respiratory, thoracic and mediastinal disorders
Pulmonary embolism
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Respiratory, thoracic and mediastinal disorders
Respiratory tract oedema
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Vascular disorders
Deep vein thrombosis
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
1.7%
2/120 • From surgical procedure through the 60 day follow-up visit
Vascular disorders
Hypertension
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit
Vascular disorders
Subgaleal haematoma
0.88%
1/114 • From surgical procedure through the 60 day follow-up visit
0.00%
0/120 • From surgical procedure through the 60 day follow-up visit

Other adverse events

Other adverse events
Measure
Evicel
n=114 participants at risk
EVICEL® is a human plasma-derived fibrin sealant. EVICEL® consists of two components: a concentrate of Human Fibrinogen (referred to as Biological Component 2; BAC2) and a solution of Human Thrombin, which incorporates calcium.
DuraSeal
n=120 participants at risk
DuraSeal™ Dural Sealant System is a commercially available synthetic sealant intended for use as an adjunct to sutured dural repair during cranial surgery to provide watertight closure. The product is a synthetic absorbable sealant composed of a polyethylene glycol (PEG) ester solution and a rilysine amine solution.
Cardiac disorders
Tachycardia
4.4%
5/114 • From surgical procedure through the 60 day follow-up visit
5.0%
6/120 • From surgical procedure through the 60 day follow-up visit
Gastrointestinal disorders
Constipation
28.1%
32/114 • From surgical procedure through the 60 day follow-up visit
24.2%
29/120 • From surgical procedure through the 60 day follow-up visit
Gastrointestinal disorders
Nausea
28.1%
32/114 • From surgical procedure through the 60 day follow-up visit
24.2%
29/120 • From surgical procedure through the 60 day follow-up visit
Gastrointestinal disorders
Vomiting
17.5%
20/114 • From surgical procedure through the 60 day follow-up visit
11.7%
14/120 • From surgical procedure through the 60 day follow-up visit
General disorders
Chest pain
4.4%
5/114 • From surgical procedure through the 60 day follow-up visit
5.0%
6/120 • From surgical procedure through the 60 day follow-up visit
General disorders
Fatigue
3.5%
4/114 • From surgical procedure through the 60 day follow-up visit
5.0%
6/120 • From surgical procedure through the 60 day follow-up visit
General disorders
Pyrexia
2.6%
3/114 • From surgical procedure through the 60 day follow-up visit
8.3%
10/120 • From surgical procedure through the 60 day follow-up visit
Infections and infestations
Pneumonia
4.4%
5/114 • From surgical procedure through the 60 day follow-up visit
5.0%
6/120 • From surgical procedure through the 60 day follow-up visit
Infections and infestations
Postoperative wound infection
3.5%
4/114 • From surgical procedure through the 60 day follow-up visit
5.0%
6/120 • From surgical procedure through the 60 day follow-up visit
Injury, poisoning and procedural complications
Incision site pain
9.6%
11/114 • From surgical procedure through the 60 day follow-up visit
10.0%
12/120 • From surgical procedure through the 60 day follow-up visit
Injury, poisoning and procedural complications
Procedural pain
16.7%
19/114 • From surgical procedure through the 60 day follow-up visit
15.8%
19/120 • From surgical procedure through the 60 day follow-up visit
Injury, poisoning and procedural complications
Pseudomeningocele
1.8%
2/114 • From surgical procedure through the 60 day follow-up visit
7.5%
9/120 • From surgical procedure through the 60 day follow-up visit
Injury, poisoning and procedural complications
Wound secretion
5.3%
6/114 • From surgical procedure through the 60 day follow-up visit
6.7%
8/120 • From surgical procedure through the 60 day follow-up visit
Metabolism and nutrition disorders
Hyponatraemia
6.1%
7/114 • From surgical procedure through the 60 day follow-up visit
0.83%
1/120 • From surgical procedure through the 60 day follow-up visit
Musculoskeletal and connective tissue disorders
Neck pain
3.5%
4/114 • From surgical procedure through the 60 day follow-up visit
5.8%
7/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Convulsion
2.6%
3/114 • From surgical procedure through the 60 day follow-up visit
7.5%
9/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Dizziness
4.4%
5/114 • From surgical procedure through the 60 day follow-up visit
8.3%
10/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Headache
32.5%
37/114 • From surgical procedure through the 60 day follow-up visit
45.0%
54/120 • From surgical procedure through the 60 day follow-up visit
Nervous system disorders
Hemiparesis
6.1%
7/114 • From surgical procedure through the 60 day follow-up visit
2.5%
3/120 • From surgical procedure through the 60 day follow-up visit
Psychiatric disorders
Confusional state
0.00%
0/114 • From surgical procedure through the 60 day follow-up visit
5.8%
7/120 • From surgical procedure through the 60 day follow-up visit
Vascular disorders
Hypertension
10.5%
12/114 • From surgical procedure through the 60 day follow-up visit
10.0%
12/120 • From surgical procedure through the 60 day follow-up visit
Vascular disorders
Hypotension
5.3%
6/114 • From surgical procedure through the 60 day follow-up visit
6.7%
8/120 • From surgical procedure through the 60 day follow-up visit

Additional Information

Richard Kocharian, MD, PhD

Ethicon, Inc.

Phone: 1-908-218-2013

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place

Restriction type: GT60