124I-Evuzamitide PET/CT Imaging In Patients With Lumbar Spinal Stenosis and Carpal Tunnel Syndrome

University of Tennessee Graduate School of Medicine

Status and phase: Invitation-only; Phase 2

Conditions: Cardiac Amyloidosis; Lumbar Spinal Stenosis; Carpal Tunnel Syndrome (CTS)

Treatments: Drug: 124I-evuzamitide

Study type: Interventional

Funder types: Other; Industry

Identifiers

NCT06907849

UTGSM-172768-101

Details and patient eligibility

About

This clinical trial will use the amyloid-binding radiotracer, 124I-evuzamitide, to potentially detect amyloid, in the heart and elsewhere, in patients who have a history of lumbar spinal stenosis and/or carpal tunnel syndrome.

Full description

This is a single center, open label, pilot study using an amyloid-reactive peptide labeled with iodine-124 (124I-evuzamitide) and PET/CT imaging to detect the presence of cardiac and extracardiac amyloid in patients who have undergone surgical intervention for lumbar spinal stenosis (LSS) or carpal tunnel syndrome (CTS) and who have amyloid-positive connective tissue [ligamentum flavum (LF) in LSS patients or tenosynovium in CTS patients] assessed at the time of the corrective surgery.

Enrollment: 40 estimated patients

Sex: All

Ages: 60+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Must be ≥ 60 years of age.
• Must have given written informed consent (signed and dated) and any authorizations required by local law and be able to comply with all study requirements.
• Must have a Congo red positive ligamentum flavum or tenosynovial specimen analysis after laminectomy or carpal tunnel release surgery that is visually categorized as either "extensive" amyloid load or "mild/moderate" amyloid load by an experienced reviewer.
• Those with mild/moderate amyloid load in the connective tissue who also have a history of at least one other orthopedic clinical manifestation, including, but not limited to, carpal tunnel syndrome, lumbar spinal stenosis, trigger finger, biceps tendon rupture, and shoulder/hip/knee arthroplasty.
• Females must be non-pregnant and non-lactating.

Exclusion criteria

• Subjects on dialysis.
• Subjects with a confirmed diagnosis of systemic amyloidosis, other than musculoskeletal tissue.
• Inability or unwillingness to comply with the study requirements.
• Subjects taking heparin, or heparin derivatives (e.g. low molecular weight heparins) for anticoagulation.
• Inability to lie still for ~40 minutes on the PET/CT scanner.
• History of iodine (potassium iodide) allergy.
• Other reason that would make the subject inappropriate for entry into this study.

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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40 participants in 1 patient group

Biodistribution

Experimental group

Description:

Participants will be administered \~1 mCi of 124I-evuzamitide (up to 1 mg of peptide) by IV push at a proposed rate of \~1 mL per 5 seconds. Three hours after injection, a PET/CT image acquisition from shoulder to thigh as well as a 10 min static PET image of the heart will be performed.

Treatment:

Drug: 124I-evuzamitide