TIPS Microspheres for Perianal Fistula

Perianal Fistula Clinical Trial

Official title:

First-in-human Open Label Feasibility Study to Assess the Safety of TIPS Microspheres in Perianal Fistulas

Clinical Trial Details — Status: Recruiting

Administrative data

• NCT number: NCT03707769
• Other study ID #: 14/0845
• Status: Recruiting
• Phase: N/A
• Start date: March 15, 2017
• Est. completion date: August 31, 2025

Study information

• Verified date: May 2024
• Source: University College, London
• Contact: Richard Day, PhD
• Phone: +442031082183
• Email: r.m.day[@]ucl.ac.uk
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

Phase of Investigation: First-in-human feasibility study

Objectives: Primary objective: Demonstration that TIPS microspheres do not compromise the clinical condition or safety of the patient.

Secondary objective: To demonstrate that TIPS microspheres facilitate natural healing in the context of perianal fistula.

Type of Investigation: First-in-human single site, open label, feasibility study to assess the safety of TIPS microspheres in perianal fistulas and indicative functionality.

Investigation design and methods: First-in-human single delivery of a bioabsorbable device to treat perianal fistula. A standard of care internal flap procedure performed to close the internal fistula opening and up to 300 mg of TIPS microspheres will be inserted into each perianal fistula. Participants will be assessed for healing, inflammation, abscess, sepsis, pain and continence by clinical assessments, blood tests, MRI and questionnaires.

Description:

TIPS microspheres are manufactured from GMP grade poly(lactide-co-glycolide) (PLGA) under Good Laboratory Practice (GLP) conditions.

Microspheres will be delivered into the fistula tract using the following procedure:

i) Tract identification with special emphasis on locating the internal and external openings using a fistula probe.

ii) Curettage to remove epithelium lining the tract and cleaning by irrigation with hydrogen peroxide and saline.

iii) Closure of the internal opening by means of a rectoanal advancement flap. iv) Following device kit instructions, prepare a paste of TIPS microspheres with GranuGel.

v) Introduction of TIPS microsphere paste by back-filling. vi) Retention of the microsphere paste using Comfeel adhesive hydrocolloid dressing designed to remain in place for 1 - 14 days.

Each subject will receive a single administration of up to 300 mg of TIPS microspheres implanted into the fistula tract.

Recruitment information / eligibility

• Status: Recruiting
• Enrollment: 15
• Est. completion date: August 31, 2025
• Est. primary completion date: January 31, 2025
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Age 18 years and above

• Cryptoglandular perianal fistula

• High and low simple trans-sphincteric fistula

Exclusion Criteria:

• Secondary fistula, including Crohn's disease, carcinoma, radiotherapy, tuberculosis

• Evidence of branching fistula anatomy or cavity on MRI

• Inter-sphincteric fistula

• Low trans-phincterictrans-sphincteric fistula amenable to simple fistulotomy

• Immunosuppressed patients

• Participants less than 18 years of age

• Unable to consent

Related Conditions & MeSH terms

• Fistula
• Perianal Fistula
• Rectal Fistula

Intervention

Device:
• TIPS microspheres
TIPS microspheres manufactured from GMP grade poly(lactide-co-glycolide) (PLGA) prepared as a paste with GranuGel.

Locations

Country	Name	City	State
United Kingdom	University College London Hospitals	London

Sponsors (2)

Lead Sponsor	Collaborator
University College, London	University College London Hospitals

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Incidence of Treatment-Emergent Adverse Events [Safety and Tolerability]	Safety as defined by morbidity, measured by occurrence of adverse events / reactions, in particular: perianal sepsis, perianal abscess, or reoperation due to sepsis	Within 9 months of device implantation
Secondary	Clinical evidence of fistula healing	Efficacy through facilitation of natural healing as determined by: clinical evidence of fistula healing; MRI evidence of fistula healing; improvement of quality of life assessment Improvement of pain score assessment	9 months after device implantation