Assessing the Safety and Efficacy of a Novel Subcutaneous Implant Insertion Device on Healthy Adults

Sponsor
University of Michigan (Other)
Overall Status
Terminated
CT.gov ID
NCT03621787
Collaborator
Michigan Translation and Commercialization for Life Sciences Hub (Other), Grand Challenges Canada (Other), VentureWell (Other), Unite for Sight (Other)
9
1
1
12.7
0.7

Study Details

Study Description

Brief Summary

The investigators have created a device designed to make it easier to insert pharmaceutical implants under the skin. The device uses a blood pressure cuff to hold the skin on a person's arm in place while a mechanical guide places implants underneath the skin. This device may prevent implants from being embedded too deeply.

The investigators are performing this study to determine the safety and efficacy of the device for use in adult women. The study will determine if the implants are placed accurately under the skin (in the sub-dermal layer). It will also assess if the device causes any discomfort or last pain from use.

Condition or Disease Intervention/Treatment Phase
  • Device: Implant insertion device
N/A

Detailed Description

Subcutaneous contraceptive implants are one of the preferred methods of long-term contraception by the World health Organization and ministries of health in low- and middle-income countries. These implants offer between three and five years of protection (allowing women to safely space pregnancies and thereby reduce maternal and infant mortality), are 99.95% efficacious, allow women to return to fertility quickly when removed, requires no daily/monthly effort on the part of the woman, and cause minimal side effects in comparison to other methods. However, availability of contraceptive implants in rural areas is limited due to the skill necessary to administer them safely and accurately.

The investigators have created a device designed to make it easier to insert pharmaceutical implants under the skin. The device uses a blood pressure cuff to hold the skin on a person's arm in place while a mechanical guide places implants underneath the skin. This device is designed to prevent implants from being embedded too deeply.

In this trial, the investigators will use the implant insertion device with a placebo sub-cutaneous implant. Implants will be inserted with the device and the accuracy of the placement will be assessed through palpation and ultrasound depth measurements. This data will allow the investigators to assess whether the device ensures accurate insertions of sub-cutaneous implants.

Study Design

Study Type:
Interventional
Actual Enrollment :
9 participants
Allocation:
N/A
Intervention Model:
Single Group Assignment
Intervention Model Description:
Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising, bleeding, and pain to participant. A follow-up questionnaire will assess pain, bruising, and infection risk. A final visit will assess pain, bruising, and infection risk by a physician.Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising, bleeding, and pain to participant. A follow-up questionnaire will assess pain, bruising, and infection risk. A final visit will assess pain, bruising, and infection risk by a physician.
Masking:
None (Open Label)
Primary Purpose:
Basic Science
Official Title:
Assessing the Safety and Efficacy of the SubQ Assist Implant Insertion Device
Actual Study Start Date :
Nov 8, 2018
Actual Primary Completion Date :
Nov 1, 2019
Actual Study Completion Date :
Dec 1, 2019

Arms and Interventions

Arm Intervention/Treatment
Experimental: Single arm study: implant insertion

Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising and bleeding. A follow-up questionnaire will assess bruising and infection risk. A final visit will assess bruising and infection risk by a physician.

Device: Implant insertion device
Device designed to assist healthcare providers in administering subcutaneous implants safely and accurately.
Other Names:
  • SubQ Assist
  • Outcome Measures

    Primary Outcome Measures

    1. Implant Depth: Distal End [Up to 60 minutes after insertion]

      Depth of distal end of implant beneath the skin after insertion. Measured via high frequency ultrasound with linear probe. Measured in centimeters below skin surface. Measurements will be aggregated via mean and standard deviation.

    2. Implant Depth: Proximal End [Up to 60 minutes after insertion]

      Depth of distal end of implant beneath the skin after insertion. Measured via high frequency ultrasound with linear probe. Measured in centimeters below skin surface. Measurements will be aggregated via mean and standard deviation.

    3. Implant Palpability [Up to 15 minutes after insertion]

      A binary (yes/no) assessment of whether the implant is palpable by a physician under the skin after insertion. Measurements will be aggregated based on percent of implants that are palpable.

    Secondary Outcome Measures

    1. Number of Participants With Bruising [Up to 15 minutes after insertion.]

      Bruising may occur from inflation of the blood pressure cuff over the device being studied. A binary assessment of bruising (yes/no) will be assessed by the physician after insertion.

    2. Presence of Bruising [7 to 14 days after insertion]

      Bruising may occur from inflation of the blood pressure cuff over the device being studied. Bruising will be assessed by the participant in a survey (binary yes/no indication of bruising around insertion site).

    3. Number of Participants With More Bleeding Than Typical [Up to 10 minutes after insertion]

      Bleeding from insertion will be assessed by the physician who has extensive training with implant insertions. The number of participants with more bleeding than is typically associated with insertion will be measured.

    4. Number of Participants With Signs of Infection [7 to 10 days after insertion]

      Infection will be assessed during the follow-up questionnaire. A binary assessment (yes/no) of the following will be assessed by the participant. 1) Is there currently any fluid draining from the incision? 2) Is there currently any redness or swelling of the insertion site? 3) Is there currently any bleeding from the insertion site? Participants who answer "Yes" to all three questions are deemed to have shown signs of infection.

    5. Number of Participants With Signs of Infection [21 to 28 days after insertion]

      A follow-up appointment with all participants was conducted by the physician who administered the implant. A binary assessment (yes/no) of the following will be assessed for each participant by the physician. 1) Is there currently any fluid draining from the incision? 2) Is there currently any redness or swelling of the insertion site? 3) Is there currently any bleeding from the insertion site? If the physician answers "Yes" to all three questions, the participant is deemed to have shown signs of infection.

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    18 Years to 49 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    Yes
    Inclusion Criteria:
    • Healthy adult subjects aged 18 to 49

    • Ability to understand study procedure and informed consent document

    Exclusion Criteria:
    • Patients with a history of keloid scarring

    • Pregnancy

    • Any rashes or skin conditions around the insertion site

    • Known silicone allergies

    • Known allergy to lidocaine

    • History of bleeding disorders or abnormal bleeding

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 University of Michigan Ann Arbor Michigan United States 48109

    Sponsors and Collaborators

    • University of Michigan
    • Michigan Translation and Commercialization for Life Sciences Hub
    • Grand Challenges Canada
    • VentureWell
    • Unite for Sight

    Investigators

    • Principal Investigator: Kathleen H Sienko, PhD, Associate Professor
    • Principal Investigator: Carrie L Bell, MD, Assistant Professor

    Study Documents (Full-Text)

    More Information

    Publications

    None provided.
    Responsible Party:
    Ibrahim Mohedas, Postdoctoral Fellow, University of Michigan
    ClinicalTrials.gov Identifier:
    NCT03621787
    Other Study ID Numbers:
    • SubQAssist0001
    First Posted:
    Aug 8, 2018
    Last Update Posted:
    Nov 19, 2020
    Last Verified:
    Oct 1, 2020
    Individual Participant Data (IPD) Sharing Statement:
    Undecided
    Plan to Share IPD:
    Undecided
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    Yes
    Product Manufactured in and Exported from the U.S.:
    No

    Study Results

    Participant Flow

    Recruitment Details
    Pre-assignment Detail
    Arm/Group Title Single Arm Study: Implant Insertion
    Arm/Group Description Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising and bleeding. A follow-up questionnaire will assess bruising and infection risk. A final visit will assess bruising and infection risk by a physician. Implant insertion device: Device designed to assist healthcare providers in administering subcutaneous implants safely and accurately.
    Period Title: Overall Study
    STARTED 9
    COMPLETED 9
    NOT COMPLETED 0

    Baseline Characteristics

    Arm/Group Title Single Arm Study: Implant Insertion
    Arm/Group Description Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising and bleeding. A follow-up questionnaire will assess bruising and infection risk. A final visit will assess bruising and infection risk by a physician. Implant insertion device: Device designed to assist healthcare providers in administering subcutaneous implants safely and accurately.
    Overall Participants 9
    Age (Count of Participants)
    <=18 years
    0
    0%
    Between 18 and 65 years
    9
    100%
    >=65 years
    0
    0%
    Sex: Female, Male (Count of Participants)
    Female
    7
    77.8%
    Male
    2
    22.2%
    Race and Ethnicity Not Collected (Count of Participants)
    Region of Enrollment (participants) [Number]
    United States
    9
    100%
    Arm circumference (centimeters) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [centimeters]
    23.67
    (1.95)
    Weight (kilograms) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [kilograms]
    62.57
    (11.86)
    Height (centimeters) [Mean (Standard Deviation) ]
    Mean (Standard Deviation) [centimeters]
    167.5
    (10.9)

    Outcome Measures

    1. Primary Outcome
    Title Implant Depth: Distal End
    Description Depth of distal end of implant beneath the skin after insertion. Measured via high frequency ultrasound with linear probe. Measured in centimeters below skin surface. Measurements will be aggregated via mean and standard deviation.
    Time Frame Up to 60 minutes after insertion

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Single Arm Study: Implant Insertion
    Arm/Group Description Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising and bleeding. A follow-up questionnaire will assess bruising and infection risk. A final visit will assess bruising and infection risk by a physician. Implant insertion device: Device designed to assist healthcare providers in administering subcutaneous implants safely and accurately.
    Measure Participants 9
    Measure Implants 18
    Mean (Standard Deviation) [centimeters]
    0.26
    (0.05)
    2. Primary Outcome
    Title Implant Depth: Proximal End
    Description Depth of distal end of implant beneath the skin after insertion. Measured via high frequency ultrasound with linear probe. Measured in centimeters below skin surface. Measurements will be aggregated via mean and standard deviation.
    Time Frame Up to 60 minutes after insertion

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Single Arm Study: Implant Insertion
    Arm/Group Description Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising and bleeding. A follow-up questionnaire will assess bruising and infection risk. A final visit will assess bruising and infection risk by a physician. Implant insertion device: Device designed to assist healthcare providers in administering subcutaneous implants safely and accurately.
    Measure Participants 9
    Measure implants 18
    Mean (Standard Deviation) [centimeters]
    .35
    (.07)
    3. Primary Outcome
    Title Implant Palpability
    Description A binary (yes/no) assessment of whether the implant is palpable by a physician under the skin after insertion. Measurements will be aggregated based on percent of implants that are palpable.
    Time Frame Up to 15 minutes after insertion

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Single Arm Study: Implant Insertion
    Arm/Group Description Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising and bleeding. A follow-up questionnaire will assess bruising and infection risk. A final visit will assess bruising and infection risk by a physician. Implant insertion device: Device designed to assist healthcare providers in administering subcutaneous implants safely and accurately.
    Measure Participants 9
    Measure implants 18
    Number [palpable implants]
    18
    4. Secondary Outcome
    Title Number of Participants With Bruising
    Description Bruising may occur from inflation of the blood pressure cuff over the device being studied. A binary assessment of bruising (yes/no) will be assessed by the physician after insertion.
    Time Frame Up to 15 minutes after insertion.

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Single Arm Study: Implant Insertion
    Arm/Group Description Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising and bleeding. A follow-up questionnaire will assess bruising and infection risk. A final visit will assess bruising and infection risk by a physician. Implant insertion device: Device designed to assist healthcare providers in administering subcutaneous implants safely and accurately.
    Measure Participants 9
    Count of Participants [Participants]
    1
    11.1%
    5. Secondary Outcome
    Title Presence of Bruising
    Description Bruising may occur from inflation of the blood pressure cuff over the device being studied. Bruising will be assessed by the participant in a survey (binary yes/no indication of bruising around insertion site).
    Time Frame 7 to 14 days after insertion

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Single Arm Study: Implant Insertion
    Arm/Group Description Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising and bleeding. A follow-up questionnaire will assess bruising and infection risk. A final visit will assess bruising and infection risk by a physician. Implant insertion device: Device designed to assist healthcare providers in administering subcutaneous implants safely and accurately.
    Measure Participants 9
    Count of Participants [Participants]
    1
    11.1%
    6. Secondary Outcome
    Title Number of Participants With More Bleeding Than Typical
    Description Bleeding from insertion will be assessed by the physician who has extensive training with implant insertions. The number of participants with more bleeding than is typically associated with insertion will be measured.
    Time Frame Up to 10 minutes after insertion

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Single Arm Study: Implant Insertion
    Arm/Group Description Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising and bleeding. A follow-up questionnaire will assess bruising and infection risk. A final visit will assess bruising and infection risk by a physician. Implant insertion device: Device designed to assist healthcare providers in administering subcutaneous implants safely and accurately.
    Measure Participants 9
    Count of Participants [Participants]
    1
    11.1%
    7. Secondary Outcome
    Title Number of Participants With Signs of Infection
    Description Infection will be assessed during the follow-up questionnaire. A binary assessment (yes/no) of the following will be assessed by the participant. 1) Is there currently any fluid draining from the incision? 2) Is there currently any redness or swelling of the insertion site? 3) Is there currently any bleeding from the insertion site? Participants who answer "Yes" to all three questions are deemed to have shown signs of infection.
    Time Frame 7 to 10 days after insertion

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Single Arm Study: Implant Insertion
    Arm/Group Description Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising and bleeding. A follow-up questionnaire will assess bruising and infection risk. A final visit will assess bruising and infection risk by a physician. Implant insertion device: Device designed to assist healthcare providers in administering subcutaneous implants safely and accurately.
    Measure Participants 9
    Count of Participants [Participants]
    0
    0%
    8. Secondary Outcome
    Title Number of Participants With Signs of Infection
    Description A follow-up appointment with all participants was conducted by the physician who administered the implant. A binary assessment (yes/no) of the following will be assessed for each participant by the physician. 1) Is there currently any fluid draining from the incision? 2) Is there currently any redness or swelling of the insertion site? 3) Is there currently any bleeding from the insertion site? If the physician answers "Yes" to all three questions, the participant is deemed to have shown signs of infection.
    Time Frame 21 to 28 days after insertion

    Outcome Measure Data

    Analysis Population Description
    [Not Specified]
    Arm/Group Title Single Arm Study: Implant Insertion
    Arm/Group Description Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising and bleeding. A follow-up questionnaire will assess bruising and infection risk. A final visit will assess bruising and infection risk by a physician. Implant insertion device: Device designed to assist healthcare providers in administering subcutaneous implants safely and accurately.
    Measure Participants 9
    Count of Participants [Participants]
    0
    0%

    Adverse Events

    Time Frame Adverse events were tracked for each participant from the beginning of the study through their follow-up appointment. Up to 28 days.
    Adverse Event Reporting Description
    Arm/Group Title Single Arm Study: Implant Insertion
    Arm/Group Description Participants in trial will be within a single study arm. All participants will have a placebo subcutaneous implant inserted with the device being studied. The implant accuracy will be assess through palpation and ultrasound depth measurements. The implant will then be removed. Safety will be assessed by measuring bruising and bleeding. A follow-up questionnaire will assess bruising and infection risk. A final visit will assess bruising and infection risk by a physician. Implant insertion device: Device designed to assist healthcare providers in administering subcutaneous implants safely and accurately.
    All Cause Mortality
    Single Arm Study: Implant Insertion
    Affected / at Risk (%) # Events
    Total 0/9 (0%)
    Serious Adverse Events
    Single Arm Study: Implant Insertion
    Affected / at Risk (%) # Events
    Total 1/9 (11.1%)
    Surgical and medical procedures
    Difficulty removing implant 1/9 (11.1%) 1
    Other (Not Including Serious) Adverse Events
    Single Arm Study: Implant Insertion
    Affected / at Risk (%) # Events
    Total 0/9 (0%)

    Limitations/Caveats

    [Not Specified]

    More Information

    Certain Agreements

    Principal Investigators are NOT employed by the organization sponsoring the study.

    There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.

    Results Point of Contact

    Name/Title Kathleen Sienko
    Organization co-PI
    Phone 734647249
    Email sienko@umich.edu
    Responsible Party:
    Ibrahim Mohedas, Postdoctoral Fellow, University of Michigan
    ClinicalTrials.gov Identifier:
    NCT03621787
    Other Study ID Numbers:
    • SubQAssist0001
    First Posted:
    Aug 8, 2018
    Last Update Posted:
    Nov 19, 2020
    Last Verified:
    Oct 1, 2020