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Auto-Adjustable MOBIDERM® Autofit NIGHT-time Compression Armsleeve in the Upper Limb LYMphedema in Maintenance Phase

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Studies

Study First Submitted Date 2019-12-16
Study First Posted Date 2019-12-18
Last Update Posted Date 2022-11-10
Start Month Year July 1, 2020
Primary Completion Month Year September 2023
Verification Month Year November 2022
Verification Date 2022-11-30
Last Update Posted Date 2022-11-10

Detailed Descriptions

Sequence: 20796874
Description The gold standard treatment to achieve volume reduction of lymphedema is based on a Decongestive Lymphedema Therapy (DLT).that consists in 2 consecutive phases: the initial intensive phase which aim is to obtain maximal reduction of lymphedema volume and a second, the maintenance phase which aim is to maintain the initial volumetric reduction achieved during phase 1 as long as possible. The second maintenance phase mostly based on patient self-management of his treatment, is not strictly codified, but includes compression therapy, nutritional recommendations, skin cares, physical exercises and manual lymphatic drainage.

24 hours compression using garments or bandages seems to be crucial for long term management of lymphedema.

Garment and bandages prescriptions for daily treatment are a common practice in the maintenance phase but are often unsuitable for night treatment, as bandages are effective when well applied but are highly dependent on the patients’ skills, and garments, due to their nature, can be poorly tolerated leading to low adherence from patients to self-management care. In the end, there is an unmet medical need for night treatment during maintenance phase. .

In this context THUASNE developed a specific night-time garment, for lymphedema maintenance phase. It is a standard Auto-Adjustable Armsleeve using the MOBIDERM® technology.

MOBIDERM® AUTOFIT is a standard self-adjusting compressive MOBIDERM® sleeve, with mitten.The sleeves are made of polyamide and elastane on the outside and adhesive non-woven fabric and polyethylene foam on the inside.

Several small rigid straps are placed throughout the product to facilitate the passage of the arm, to adapt the garment to the morphology of each patient and to tighten it. MOBIDERM® foam squares are smaller on the thumb than on the arm to facilitate limb mobility. The product is a ready-to-use garment made in 6 different sizes, 2 lengths, left/right arm according to the size grid.

The level of pressure is around 10-15mmHg. The patient will then be able to adjust the product more or less tightly in his everyday life.

The product is currently marketed in many countries and is reimbursed in the following countries: the Netherlands, UK, Scandinavia, Slovakia, Korea, Japan, Cz Republic in the indication of the treatment of lymphedema.

A first pilot randomized controlled study demonstrated some benefit to use MOBIDERM Autofit during night-time as an adjuvant treatment to daily compressive garment.

The objective of this new study is to confirm, using a more robust methodology, the effect of Auto-Adjustable MOBIDERM® Autofit Armsleeve on maintenance phase treatment, worn during the night, within the period at risk for the so called rebound effect as reported in several observational studies.

Facilities

Sequence: 200767801 Sequence: 200767802 Sequence: 200767803 Sequence: 200767804
Status Recruiting Status Not yet recruiting Status Recruiting Status Not yet recruiting
Name Chu Montpellier Name Ghr Mulhouse Name Chu Toulouse Name CHRU Tours
City Montpellier City Mulhouse City Toulouse City Tours
Zip 37044
Country France Country France Country France Country France

Facility Investigators

Sequence: 18399644 Sequence: 18399645 Sequence: 18399646 Sequence: 18399647 Sequence: 18399648
Facility Id 200767801 Facility Id 200767802 Facility Id 200767803 Facility Id 200767804 Facility Id 200767804
Role Principal Investigator Role Principal Investigator Role Principal Investigator Role Sub-Investigator Role Principal Investigator
Name Isabelle QUERE, PUPH, MD Name Amer HAMADE, MD Name Julie MALLOIZEL, MD Name Loic VAILLANT, PUPH,MD Name Valerie TAUVERON, MD

Conditions

Sequence: 52364127
Name Lymphedema of Upper Arm
Downcase Name lymphedema of upper arm

Id Information

Sequence: 40296625 Sequence: 40296626
Id Source org_study_id Id Source secondary_id
Id Value EC29 Id Value ANSM
Id Type Other Identifier
Id Type Description 2019-A02216-51

Countries

Sequence: 42719752
Name France
Removed False

Design Groups

Sequence: 55807660 Sequence: 55807661
Group Type Placebo Comparator Group Type Experimental
Title Control group : Day-time compression sleeve Title Day-time compression sleeve and Night-time MOBIDERM Autofit
Description Control group : Patients will wear the Day-time compression sleeve : THUASNE lymphatrex (± mitten) during 90 days. Description Intervention group : Patients will wear the Day-time compression sleeve : THUASNE lymphatrex (± mitten) + night-time Auto-Adjustable MOBIDERM® Autofit Armsleeve device with the possibility to wear an additional MOBIDERM® glove if a patient has a finger edema during 90 days.

Interventions

Sequence: 52674765 Sequence: 52674766
Intervention Type Device Intervention Type Device
Name Control group : Day-time compression sleeve Name Intervention group : Day-time compression sleeve and Night-time MOBIDERM® Autofit
Description In the control group, patients wear only day-time compression garment : lymphatrex during 3 months.

The protocol will require 3 visits during the maintenance phase.

Visit 1 at day 0 (until 5 days after the end of hospital): includes the inclusion visit with the reception of devices and some evaluations (clinical examination, lymphedema volume, questionnaires, ultrasound on a patients sub-group).

Visit 2 at 30 days after the inclusion : includes some evaluations (clinical examination, lymphedema volume, questionnaires, ultrasound on a patients sub-group)

Visite 3 at 90 days after the inclusion : includes some evaluations (clinical examination, lymphedema volume, questionnaires, ultrasound on a patients sub-group).

Description In the intervention group, patients wear a day-time compression garment : lymphatrex and the night-time compression garment : MOBIDERM AUTOFIT during 3 months.

The protocol will require 3 visits during the maintenance phase.

Visit 1 at day 0 (until 5 days after the end of hospital): includes the inclusion visit with the reception of devices and some evaluations (clinical examination, lymphedema volume, questionnaires, ultrasound on a patients sub-group).

Visit 2 at 30 days after the inclusion : includes some evaluations (clinical examination, lymphedema volume, questionnaires, ultrasound on a patients sub-group)

Visite 3 at 90 days after the inclusion : includes some evaluations (clinical examination, lymphedema volume, questionnaires, ultrasound on a patients sub-group).

Keywords

Sequence: 80133295 Sequence: 80133296 Sequence: 80133297 Sequence: 80133298
Name Lymphedema of upper arm Name Auto-Adjustable MOBIDERM® Autofit Armsleeve Name Compression garments Name Maintenance phase
Downcase Name lymphedema of upper arm Downcase Name auto-adjustable mobiderm® autofit armsleeve Downcase Name compression garments Downcase Name maintenance phase

Design Outcomes

Sequence: 178092040 Sequence: 178092041 Sequence: 178092042 Sequence: 178092043 Sequence: 178092044 Sequence: 178092045 Sequence: 178092046 Sequence: 178092047 Sequence: 178092048 Sequence: 178092049 Sequence: 178092050 Sequence: 178092051 Sequence: 178092052
Outcome Type primary Outcome Type secondary Outcome Type secondary Outcome Type secondary Outcome Type secondary Outcome Type secondary Outcome Type secondary Outcome Type secondary Outcome Type secondary Outcome Type secondary Outcome Type secondary Outcome Type secondary Outcome Type secondary
Measure The volume excess variation Measure The quality of life (QoL): LYMQOL ARM self-questionnaire Measure The range of motion Measure The volume excess variation Measure Patient’s opinion on Global Impression of Change (PGI-C) Measure Doctors’ opinion on improving the patient’s health condition (Clinical Global Improvement Impression) Measure Doctors’ opinion on severity about the lymphedema (CGI-S) Measure number of days/nights : The compliance to treatment Measure The evolution of quality of sleep: Jenkins self-questionnaire Measure The satisfaction about the device: questionnaire Measure Number and type of serious and non-serious Adverse Device Effects Measure The elastometry Measure The percentage of patients presenting with a failure of maintenance
Time Frame 90 days Time Frame 30 and 90 days Time Frame 30 and 90 days Time Frame 30 days Time Frame 30 and 90 days Time Frame 30 and 90 days Time Frame 30 and 90 days Time Frame 30 and 90 days Time Frame 30 and 90 days Time Frame 90 days Time Frame 90 days Time Frame 30 and 90 days Time Frame 30 and 90 days
Description The primary endpoint of this study is to compare the volume excess variation of the upper limb between both groups from D0 to D90. Volume excess is defined as the volumetric difference between the affected upper limb compared to the contralateral upper limb, calculated with truncated cone formula. Description The evolution of QoL is measured by LYMQOL ARM self-questionnaire and specific questions. This tool was designed as patient-completed questionnaire. The questions cover four domains : symptoms, body image/appearance, function, mood. Each item in each domain was scored : not at all (1), a little (2), Quite a bit (3), A lot (4). Specific questions are about patient’s perception of benefit. Description The evolution of range of motion of the arm is measured by joint movements : Antepulsion (flexion), retropulsion (extension), total abduction, adduction, lateral rotation (external rotation), medial rotation (internal rotation) Description Volume excess is defined as the volumetric difference between the affected upper limb compared to the contralateral upper limb, calculated with truncated cone formula. Description Patient’s opinion on Global Impression of Change about her general condition is measured by the modified PGI-C questionnaire (Patient’s opinion on Global Impression of Change). The scale has 7 levels from “no change or condition has got worsed”(worse outcome) to “a great deal better, and a considerable improvement that has made all the difference ( better outcome)”. Intermediate levels are: “almost the same, hardly any change at all”; “a little better, but no noticeable change”, “somewhat better, but the change has not made any real difference”; “moderately better, and a slight but noticeable change”; “better, and a definite improvement that has made a real and worthwhile difference. Description Doctors’ opinion on improving the patient’s health condition caused by lymphedema is measured by the CGI-I modified questionnaire (Clinical Global Improvement Impression). This questionnaire allows doctors to evaluate the improvement of patients. The scale has 7 levels from “very strongly improved”(better outcome) to “very strongly aggravated”(worse outcome).Intermediate levels are: ” Significantly improved ” ; ” Slightly improved ” ; ” No improvement ” ; ” Slightly aggravated ” ; ” Seriously aggravated “. Description Doctors’ opinion on severity about the lymphedema is measured by CGI-S. This questionnaire assesses the severity of lymphedema. This scale has 7 levels from “normal, not sick at all” (better outcome) to ” among the most severely ill patients “(worse outcome). Intermediate levels are: ” borderline ill ” ; ” slightly ill ” ; ” moderately ill ” ; ” clearly ill ” ; ” severely ill “. Description The compliance to treatment (day-time and night-time only for Intervention Group) is reported by the physician in the e-CRF according to the patient diary. The compliance is measured in number of days and or nights (groupe I) when the device was worn and the average wearing time was : Full day/night, >50% of the day/night,<50% of the day/night Description The evolution of quality of sleep is measured by Jenkins self-questionnaire. This scale is composed of four questions about the quality of sleep. Description Patient’s satisfaction with regards to MOBIDERM® Autofit for patients from intervention group only by a satisfaction questionnaire. This questionnaire is focused on the product positioning and the comfort. Description Number and type of serious and non-serious Adverse Device Effects (ADE) with a focus on cutaneous ADE will be reported during the study. Description To compare the evolution of skin thickness, elasticity, suppleness on a subgroup of patients by ultrasound. Description Percentage of patients presenting with a failure of maintenance phase, defined by a volume increase ≥ 30% of the volume reduction observed during intensive phase of decongestive lymphedema therapy (DLT)

Browse Conditions

Sequence: 194220575 Sequence: 194220576
Mesh Term Lymphedema Mesh Term Lymphatic Diseases
Downcase Mesh Term lymphedema Downcase Mesh Term lymphatic diseases
Mesh Type mesh-list Mesh Type mesh-ancestor

Sponsors

Sequence: 48498939 Sequence: 48498940
Agency Class INDUSTRY Agency Class OTHER
Lead Or Collaborator lead Lead Or Collaborator collaborator
Name Thuasne Name International Clinical Trials Association

Overall Officials

Sequence: 29387123
Role Principal Investigator
Name ISABELLE QUERE, PUPH,MD
Affiliation University Hospital, Montpellier

Central Contacts

Sequence: 12057694 Sequence: 12057695
Contact Type primary Contact Type backup
Name ISABELLE QUERE, PUPH, MD Name ASTRID PICOLET
Phone +33467337028 Phone +33640392490
Email [email protected] Email [email protected]
Role Contact Role Contact

Design Group Interventions

Sequence: 68412145 Sequence: 68412146
Design Group Id 55807660 Design Group Id 55807661
Intervention Id 52674765 Intervention Id 52674766

Eligibilities

Sequence: 30876649
Gender Female
Minimum Age 18 Years
Maximum Age N/A
Healthy Volunteers No
Criteria Inclusion Criteria:

Women responding positively to the lymphedema reduction phase defined by a ≥ 30% decrease in lymphedema volume at the end of DLT
Unilateral secondary upper limb lymphedema of stage II or III according to the criteria defined by the International Society of Lymphology, following breast cancer
Affected arm that fits with one of the 6 standard sizes of the Auto-Adjustable MOBIDERM® Autofit armsleeve provided
Signed informed consent prior to any study-mandated procedure
Affiliated to the General regime of the Social Security or covered by a similar health insurance system

Non-inclusion criteria :

Stage I lymphedema or located in several places
Active cellulitis / Infectious dermo-hypodermatitis
Lymphedema associated with active cancer needing acute chemotherapy
Motor and sensitive neurological deficiency / psychiatric or addictive disorders
Post-operative edema (i.e acute edema occurring during the days following breast cancer-related surgery)
Patients for whom compression is contraindicated, such as untreated infections, skin irritation, thrombosis, presence of skin lesions on the armsleeve placement
Pregnant or breastfeeding patient
Previous history of hypersensitivity to MOBIDERM® technology or lymphatrex garment General conditions
Participation to any other clinical study which has an impact on the different endpoints
Unlikely to be followed up to 3 months with clinical assessment as per investigator’s judgment
Vulnerable patient according to the article L.1121-6 of the French Public Health Code, the adults being the object of a legal protective measure or enable to express their consent according to the article L.1121-8 of French Public Health Code

Adult True
Child False
Older Adult True

Calculated Values

Sequence: 254073686
Number Of Facilities 4
Registered In Calendar Year 2019
Were Results Reported False
Has Us Facility False
Has Single Facility False
Minimum Age Num 18
Minimum Age Unit Years
Number Of Primary Outcomes To Measure 1
Number Of Secondary Outcomes To Measure 12

Designs

Sequence: 30622439
Allocation Randomized
Intervention Model Parallel Assignment
Observational Model
Primary Purpose Treatment
Time Perspective
Masking Single
Masking Description For the same patient, all measurements will be performed as far as possible by the same health professional who doesn’t have the knowledge of the patient’s group.
Intervention Model Description Prospective open-label RIPH 2 study multicenter, controlled, randomized, with two parallel groups.
Outcomes Assessor Masked True

Responsible Parties

Sequence: 28988979
Responsible Party Type Sponsor

Study References

Sequence: 52268958 Sequence: 52268959 Sequence: 52268960
Pmid 24931830 Pmid 28281052 Pmid 24013569
Reference Type background Reference Type background Reference Type background
Citation Quere I, Presles E, Coupe M, Vignes S, Vaillant L, Eveno D, Laporte S, Leizorovicz A; POLIT Study investigators. Prospective multicentre observational study of lymphedema therapy: POLIT study. J Mal Vasc. 2014 Jul;39(4):256-63. doi: 10.1016/j.jmv.2014.05.004. Epub 2014 Jun 12. Citation Mestre S, Calais C, Gaillard G, Nou M, Pasqualini M, Ben Amor C, Quere I. Interest of an auto-adjustable nighttime compression sleeve (MOBIDERM(R) Autofit) in maintenance phase of upper limb lymphedema: the MARILYN pilot RCT. Support Care Cancer. 2017 Aug;25(8):2455-2462. doi: 10.1007/s00520-017-3652-5. Epub 2017 Mar 9. Citation Brown JC, Cheville AL, Tchou JC, Harris SR, Schmitz KH. Prescription and adherence to lymphedema self-care modalities among women with breast cancer-related lymphedema. Support Care Cancer. 2014 Jan;22(1):135-43. doi: 10.1007/s00520-013-1962-9. Epub 2013 Sep 7.