RecruitingPhase 2NCT04789044

Evaluating the Safety and Efficacy of Polyethylene Glycol (PEG) Mediated Fusion (PEG Fusion)

A Phase 2a Multicenter Randomized Controlled Trial Evaluating the Safety and Efficacy of Polyethylene Glycol (PEG) Mediated Fusion (PEG Fusion) Compared to Standard of Care in the Repair of Mixed Motor-sensory Acute Peripheral Nerve Injuries (PNI) for Rapid and Immediate Improvement in Outcome

Sponsor

Major Extremity Trauma Research Consortium

Enrollment

40 participants

Start Date

Jun 1, 2023

Study Type

INTERVENTIONAL

Conditions

Peripheral Nerve Injuries

Summary

The overall objective of this study is to determine the safety of PEG fusion when used with primary repair or reconstruction in patients with an acute upper extremity peripheral nerve injury. PEG is safe and effective for extending the half-life of circulating pharmaceutical products, when used in conjunction with a topical hemostatic agent in surgical wounds, and when used as a colon cleanser for endoscopic surgical procedures. However, PEG fusion has not been rigorously tested as a safe reagent to promote nerve regeneration in humans. Therefore, the goal of this Phase 2a clinical trial is to establish safety data and to examine the effect of PEG fusion on clinical outcomes including recovery of sensory and motor function. Results will be externally validated using data collected in the DoD funded prospective NERVE study and will provide preliminary evidence to power a larger phase II efficacy trial.

Eligibility

Min Age: 18 YearsMax Age: 80 Years

Inclusion Criteria4

Ages 18-80
Sustained a complete peripheral nerve injury resulting from upper extremity trauma presenting within 48 hours of injury
Involves injury or dysfunction to motor and/or sensory function of the axillary, radial, median, ulnar, or musculocutaneous nerve with injury localized between the proximal humerus and the distal flexion crease of the wrist
Involves a "mixed" nerve segment (i.e., involves a location of any of the above specified nerves that can be expected to have both sensory and motor axons present).

Exclusion Criteria13

Patients beginning surgery within hours after injury.
Injury to the brachial plexus nerves
Injury to the nerves distal to the distal flexion crease of the wrist
Injury that involves a distal extension of the parent nerve that is considered sensory only (superficial radial nerve, lateral antebrachial cutaneous nerve, etc.) or the posterior interosseus or anterior interosseus nerve distal to the midpoint of the forearm (i.e., distal to what can be considered the main motor branches of the PIN and AIN).
Previous peripheral nerve injury resulting from trauma, stroke, muscular, neurologic, or neuromuscular disorder
Documented psychiatric disorder that is expected to result in high probability of self-harm or interfere with study follow-up.
Severe problems with maintaining follow up (e.g., patients who are prisoners or homeless at time of injury or who are intellectually challenged without adequate family support).
Not expected to survive the next 30 days due to their injuries/health condition.
The subject has a known allergy to polyethylene glycol (PEG).
If any of the assessments cannot be done on the contralateral side (CL) or the MRCC sensory 2PD value is \> 10 mm on the CL side during baseline period, the subject is a screen failure.
The subject is pregnant and/or is breastfeeding.
The subject has a significant medical comorbidity precluding immediate repair.
The subject is not able to strictly adhere to the rules of the current clinical protocol.

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Interventions

DRUGNTX-001

• PEG fusion is the application of a polyethylene glycol (PEG) using a combination of sequenced reagents to a freshly performed nerve coaptation, or neurorrhaphy, to allow the axonal membranes of the proximal and distal axonal stumps to fuse back together and re-establish full axonal continuity.