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U.S. Department of Health and Human Services

Post-Approval Studies (PAS)

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The FDA has the authority to require sponsors to perform a post-approval study (or studies) at the time of approval of a premarket approval (PMA), humanitarian device exemption (HDE), or product development protocol (PDP) application. Post-approval studies can provide patients, health care professionals, the device industry, the FDA and other stakeholders information on the continued safety and effectiveness (or continued probable benefit, in the case of an HDE) of approved medical devices. This database allows you to search Post-Approval Study information by applicant or device information.

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Elevess CTA Study

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Study Status Completed
Application Number P050033 / PAS001
Date Current Protocol Accepted 04/29/2008
Study Name Elevess CTA Study
General Study Protocol Parameters
Study Design Prospective Cohort Study
Data Source New Data Collection
Comparison Group No Control
Analysis Type Descriptive
Study Population Transit. Adolescent B (as adults) : 18-21 yrs, Adult: >21
Detailed Study Protocol Parameters
Study Design Description This study is a 24-week, multi-center, single arm prospective cohort study. All subjects in the study receive the device.
Study Population Description The device is indicated for injection into the mid to deep dermis for the correction of moderate to severe facial wrinkles and folds, such as nasolabial folds. The study population includes Fitzpatrick skin types V, V, and VI.
Sample Size 100 subjects, 9 sites
Data Collection Endpoints include observed and reported adverse events at each visit and in a subject diary. Specific safety endpoints include keloid formation and pigmentation change at the site of injection.
Follow-up Visits and Length of Follow-up Treatment visits will be conducted every 14 days until optimal cosmetic correction is obtained. Follow-up visits will take place at 2, 6, 12, and 24 weeks after the last injection.
Interim or Final Data Summary
Actual Number of Patients Enrolled 122
Actual Number of Sites Enrolled 9
Patient Follow-up Rate 96%
Final Safety Findings Of the 122 patients enrolled, a total of 100 were included in the analysis.

(1) No keloids were observed at the injection site during the 24-week follow-up.

(2) Ten (10%) subjects experienced 13 occurrences of mild hyperpigmentation, none requiring treatment or medical intervention. The incidence of injection site discoloration is 23 per 100 person years, which is greater than that observed in the pivotal clinical study.

(3) A total of 47 (47%) experienced a total of 95 adverse events. All local adverse events were attributed to the device. From patient diaries, 80% of patients reported some type of injection site reaction, all reactions were mild and the most common reactions were swelling bruising and redness. The most serious adverse events were abcesses or cysts at the site of injection requiring further surgical or medical intervention. Rare adverse events were also reported: disfigurement (6 reports), facial nerve palsy (1 report), impaired vision (1 report), swollen lymph nodes (1 report).

Specific device related events that were higher in the post-approval study than the pivotal study include injection site discoloration (10% vs. 1.4%), induration (5% vs. 0.5%), nodule (4% vs. 1%) and pain (4% vs. 1%).

Final Effect Findings Not applicable
Study Strengths & Weaknesses Strengths:

The high follow-up rate of 96% for 100 subjects minimizes the potential bias that might arise due to losses to follow-up. None of the patients who were lost to follow-up discontinued participation due to adverse events. The most often reason for discontinuation cited was person/family reasons.

Because the methods of injection, dose and intended use for Hydrelle in this study are similar to the approved use, it was possible to compare the incidence of patient and physician-reported adverse outcomes in the current study with those observed in the pre-market pivotal study.

Data collected on volume of injection and number of touch-ups allowed evaluation of trends in association between these variables and the study endpoints.


Given the small sample size within each site, no conclusions can be drawn about the impact of device dose on the adverse events. The small sample size at each study site also limited the ability to interpret the results of analyses of the association between all adverse events and Fitzpatrick skin type.

There were a significant number of protocol deviations mostly involving observations outside of the study window (61of 107 protocol violations).

Recommendations for Labeling Changes Yes, to update the AEs for Fitzpatrick skin types IV-VI

Elevess CTA Study Schedule

Report Schedule
Date Due
FDA Receipt
Applicant's Reporting Status
1 year report 12/20/2007 12/26/2007 Overdue/Received
18 month report 10/29/2008 11/14/2008 Overdue/Received
2 year report 12/19/2008 12/19/2008 On Time
3 year report 12/21/2009 12/18/2009 On Time
study status report 07/13/2010 07/13/2010 On Time
Final report 09/30/2010 09/30/2010 On Time

Contact Us

Julie Unger
Project Manager, Post-Approval Studies Program
Food and Drug Administration
10903 New Hampshire Ave
WO66-4206v Silver Spring, MD

Phone: (301) 796-6134
Fax: (301) 847-8140

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