K Number
K192817
Device Name
Curian HpSA, Curian Analyzer
Date Cleared
2020-03-13

(164 days)

Product Code
Regulation Number
866.3110
AI/MLSaMDIVD (In Vitro Diagnostic)TherapeuticDiagnosticis PCCP Authorized
Intended Use
Curian HpSA, for use with the Curian Analyzer, is a rapid, qualitative, fluorescent immunoassay for the detection of Helicobacter pylori antigen in human stool. Test results are intended to aid in the diagnosis of H, pylori infection and to demonstrate loss of H. pyloriantigen following treatment. Accepted medical practice recommends that testing by any current method, to confirm eradication, be done at least following completion of therapy. Test results should be taken into consideration by the physician in conjunction with the patient history and symptoms.
Device Description
The Curian™ HpSA® assay is a qualitative in vitro diagnostic test for the detection of Helicobacter pylori in human stool. The Curian™ HpSA® assay utilizes fluorescence technology with the newly developed Curian™ Analyzer to detect H. pylori antigen. The Curian™ Analyzer has been designed to disposition sample results from lateral flow immunoassays.
More Information

Not Found

No
The document describes a qualitative fluorescent immunoassay and an analyzer designed to read lateral flow immunoassays. There is no mention of AI, ML, or image processing, and the performance study focuses on agreement with a comparator EIA, not on the performance of an AI/ML algorithm.

No.
The device is described as an in vitro diagnostic test for the detection of Helicobacter pylori antigen in human stool, intended to aid in diagnosis and confirm eradication, which classifies it as a diagnostic tool rather than a therapeutic device.

Yes

The "Intended Use / Indications for Use" section states that "Test results are intended to aid in the diagnosis of H, pylori infection." This clearly indicates its role in diagnosis.

No

The device description explicitly states that the Curian™ HpSA® assay utilizes fluorescence technology with the "newly developed Curian™ Analyzer" to detect H. pylori antigen. This indicates the presence of a hardware component (the analyzer) that is integral to the device's function, making it more than just software.

Yes, this device is an IVD (In Vitro Diagnostic).

Here's why:

  • Intended Use/Indications for Use: The description explicitly states it is "for use with the Curian Analyzer, is a rapid, qualitative, fluorescent immunoassay for the detection of Helicobacter pylori antigen in human stool." It also mentions that test results are "intended to aid in the diagnosis of H. pylori infection." These phrases clearly indicate that the device is used to test samples taken from the human body to provide information for diagnostic purposes.
  • Device Description: The description states, "The Curian™ HpSA® assay is a qualitative in vitro diagnostic test for the detection of Helicobacter pylori in human stool." This is a direct declaration that the device is an in vitro diagnostic test.
  • Anatomical Site: The test is performed on "human stool," which is a sample taken from the human body.

These points align with the definition of an In Vitro Diagnostic device, which is a medical device intended for use in vitro for the examination of specimens derived from the human body solely or principally for the purpose of providing information concerning a physiological or pathological state, or concerning a congenital abnormality, or to determine the safety and compatibility of any tissue or organ for transplantation.

N/A

Intended Use / Indications for Use

Curian HpSA, for use with the Curian Analyzer, is a rapid, qualitative, fluorescent immunoassay for the detection of Helicobacter pylori antigen in human stool. Test results are intended to aid in the diagnosis of H, pylori infection and to demonstrate loss of H. pyloriantigen following treatment. Accepted medical practice recommends that testing by any current method, to confirm eradication, be done at least following completion of therapy. Test results should be taken into consideration by the physician in conjunction with the patient history and symptoms.

Product codes (comma separated list FDA assigned to the subject device)

LYR

Device Description

The Curian™ HpSA® assay is a qualitative in vitro diagnostic test for the detection of Helicobacter pylori in human stool. The Curian™ HpSA® assay utilizes fluorescence technology with the newly developed Curian™ Analyzer to detect H. pylori antigen. The Curian™ Analyzer has been designed to disposition sample results from lateral flow immunoassays.

Mentions image processing

Not Found

Mentions AI, DNN, or ML

Not Found

Input Imaging Modality

Not Found

Anatomical Site

human stool

Indicated Patient Age Range

Not Found

Intended User / Care Setting

Not Found

Description of the training set, sample size, data source, and annotation protocol

Not Found

Description of the test set, sample size, data source, and annotation protocol

Not Found

Summary of Performance Studies (study type, sample size, AUC, MRMC, standalone performance, key results)

NON-CLINICAL PERFORMANCE DATA

Precision/Reproducibility
Reproducibility of the Curian™ HpSA® assay was evaluated by testing contrived sample panels at three investigational sites over a period of five days. Contrived panel members were prepared by spiking H. pylori purified flagellar antigen into negative diluted natural stool/ 30% physiological saline) at antigen concentrations above, near and below the assay limit of detection. The sample panel consisted of a low positive (1.5x LoD), moderate positive (3x LoD), high negative (0.5x LoD), and true negative samples. Diluted natural stool was used because of difficulties preparing dilutions with neat stool for analytical testing. The moderate positive and low positive panel members were positive 99.3% (149/150) and 98.0% (147/150) of the time. The high negative and true neqative panel members were negative 88.7% (133/150) of the time. These results are acceptable.

Analytical Sensitivity
Analytical sensitivity studies were performed to determine the analytical limit of detection (LoD) of purified Helicobacter pylori stool antigens (HpSA) in human stool matrix for the Curian HpSA assay. For this study, HpSA antigen was diluted at varying concentrations into diluted natural stool matrix. Three lots of the Curian HpSA assay were evaluated. The LoD is defined as the lowest concentration of the target analyte that produces positive results >= 95% of the time.
The LoD for the Curian HpSA assay was determined to be 2.0 ng/mL.

Prozone / Hook Effect
A study was performed to determine the potential for a high-dose prozone/hook effect with the Curian HpSA assay. A prozone/ hook effect can occur when very high levels of farget antigen are present in the test sample, leading to a false negative result.
Dilutions of H. pylori stool antigens (HpSA) were prepared in diluted natural negative sample matrix to create contrived HpSA positive samples containing known concentrations of antigen. Individual reactions were prepared such that the concentration in each replicate was that of a high positive specimen approximately 25X to 6250X LoD; ranging from 51 to 12,500 ng/mL. Each sample was tested to determine whether a prozone/ hook effect is observed with the Curian HpSA assay.
Results confirmed that prozone/ hook effect was not observed with the Curian HpSA assay when testing samples containing high concentrations of Helicobacter pylori stool antigens.

Analytical Specificity Cross-Reactivity:
The specificity of Curian HpSA was tested utilizing the following bacterial, fungal and viral strains. Each potentially cross-reactive microorganism was added at minimum concentrations of 1.0 x 10^7 CFU/mL (bacteria/fungi) or 1.0 x 10^5 TCIDso/mL (for viruses) to a diluted natural negative matrix and a contrived positive matrix sample. No crossreactivity or microbial interference with the Curian HpSA assay was observed.

Interfering Substances:
Interference testing was performed in the presence of chemical and biological substances introduced directly into contrived HpSA low positive and negative samples generated using diluted natural stool matrix. No interference was observed with the Curian HpSA assay for any of the substances tested.

Assay Reactivity/ Inclusivity
A total of five strains of H. pylori were evaluated for reactivity with the Curian HpSA assay. The final reactive concentrations observed for each strain are listed below.

H. pylori strain testedGeographic origin & other informationReactive Concentration
ATCC 43504Australia1.0 x 10^5 CFU/mL
CCUG 38771Unknown3.0 x 10^5 CFU/mL
CCUG 19087South Africa3.0 x 10^5 CFU/mL
ATCC 700392UK; clade hpEurope6.0 x 10^5 CFU/mL
ATCC 700824US; clade hpAfrica13.0 x 10^5 CFU/mL

CLINICAL PERFORMANCE DATA
Comparison of Curian™ HpSA® assay to an FDA-cleared H. pylori Stool Antigen ElA
A multi-center Method Comparison Study was conducted at three sites in the USA to evaluate of the Curian HpSA for detecting H. pylori stool antigen in human stool from patients suspected of H. pylori infection. Test results were compared to results from an FDA-cleared H. pylori stool antigen EIA that was previously evaluated relative to the endoscopy biopsy composite reference method (i.e., culture, histology, and RUT) for initial H. pylori diagnosis with a demonstrated sensitivity and specificity greater than or equal to 95% and a lower bound of the twosided 95% confidence interval (CI) greater than 89%.
Five hundred forty-two (542) evaluable specimens from the intended use population were enrolled in the study.

Key Metrics (Sensitivity, Specificity, PPV, NPV, etc.)

Positive percent agreement of 96.05% (95% Cl: 89.03%, 98.65%)
negative percent agreement of 97.00% (95% Cl: 95.02%, with the comparator EIA)
PPA (73/76): 96.1% (95% CI: 89.0%, 98.6%)
NPA (452/466): 97.0% (95% CI: 95.0%, 98.2%)

Predicate Device(s): If the device was cleared using the 510(k) pathway, identify the Predicate Device(s) K/DEN number used to claim substantial equivalence and list them here in a comma separated list exactly as they appear in the text. List the primary predicate first in the list.

K182559

Reference Device(s): Identify the Reference Device(s) K/DEN number and list them here in a comma separated list exactly as they appear in the text.

Not Found

Predetermined Change Control Plan (PCCP) - All Relevant Information for the subject device only (e.g. presence / absence, what scope was granted / cleared under the PCCP, any restrictions, etc).

Not Found

§ 866.3110

Campylobacter fetus serological reagents.(a)
Identification. Campylobacter fetus serological reagents are devices that consist of antisera conjugated with a fluorescent dye used to identifyCampylobacter fetus from clinical specimens or cultured isolates derived from clinical specimens. The identification aids in the diagnosis of diseases caused by this bacterium and provides epidemiological information on these diseases.Campylobacter fetus is a frequent cause of abortion in sheep and cattle and is sometimes responsible for endocarditis (inflammation of certain membranes of the heart) and enteritis (inflammation of the intestines) in humans.(b)
Classification. Class I (general controls).

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Image /page/0/Picture/0 description: The image contains the logo of the U.S. Food and Drug Administration (FDA). On the left is the Department of Health & Human Services logo. To the right of that is the FDA logo, which is a blue square with the letters "FDA" in white. To the right of the blue square is the text "U.S. FOOD & DRUG ADMINISTRATION" in blue.

March 13, 2020

Meridian Bioscience, Inc. Cathlena Martinez Senior Specialist, Regulatory Affairs 3471 River Hills Drive Cincinnati, Ohio 45244

Re: K192817

Trade/Device Name: Curian HpSA, Curian Analyzer Regulation Number: 21 CFR 866.3110 Regulation Name: Campylobacter fetus Serological Reagents Regulatory Class: Class I. reserved Product Code: LYR Dated: September 30, 2019 Received: October 1, 2019

Dear Cathlena Martinez:

We have reviewed your Section 510(k) premarket notification of intent to market the device referenced above and have determined the device is substantially equivalent (for the indications for use stated in the enclosure) to legally marketed predicate devices marketed in interstate commerce prior to May 28, 1976, the enactment date of the Medical Device Amendments, or to devices that have been reclassified in accordance with the provisions of the Federal Food, Drug, and Cosmetic Act (Act) that do not require approval of a premarket approval application (PMA). You may, therefore, market the device, subject to the general controls provisions of the Act. Although this letter refers to your product as a device, please be aware that some cleared products may instead be combination products. The 510(k) Premarket Notification Database located at https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm identifies combination product submissions. The general controls provisions of the Act include requirements for annual registration, listing of devices, good manufacturing practice, labeling, and prohibitions against misbranding and adulteration. Please note: CDRH does not evaluate information related to contract liability warranties. We remind you, however, that device labeling must be truthful and not misleading.

If your device is classified (see above) into either class II (Special Controls) or class III (PMA), it may be subject to additional controls. Existing major regulations affecting your device can be found in the Code of Federal Regulations, Title 21, Parts 800 to 898. In addition, FDA may publish further announcements concerning your device in the Federal Register.

Please be advised that FDA's issuance of a substantial equivalence determination does not mean that FDA has made a determination that your device complies with other requirements of the Act or any Federal statutes and regulations administered by other Federal agencies. You must comply with all the Act's requirements, including, but not limited to: registration and listing (21 CFR Part 807); labeling (21 CFR Part

1

801 and Part 809); medical device reporting of medical device-related adverse events) (21 CFR 803) for devices or postmarketing safety reporting (21 CFR 4, Subpart B) for combination products (see https://www.fda.gov/combination-products/guidance-regulatory-information/postmarketing-safety-reportingcombination-products); good manufacturing practice requirements as set forth in the quality systems (QS) regulation (21 CFR Part 820) for devices or current good manufacturing practices (21 CFR 4. Subpart A) for combination products; and, if applicable, the electronic product radiation control provisions (Sections 531-542 of the Act); 21 CFR 1000-1050.

Also, please note the regulation entitled, "Misbranding by reference to premarket notification" (21 CFR Part 807.97). For questions regarding the reporting of adverse events under the MDR regulation (21 CFR Part 803), please go to https://www.fda.gov/medical-device-safety/medical-device-reportingmdr-how-report-medical-device-problems.

For comprehensive regulatory information about medical devices and radiation-emitting products, including information about labeling regulations, please see Device Advice (https://www.fda.gov/medicaldevices/device-advice-comprehensive-regulatory-assistance) and CDRH Learn (https://www.fda.gov/training-and-continuing-education/cdrh-learn). Additionally, you may contact the Division of Industry and Consumer Education (DICE) to ask a question about a specific regulatory topic. See the DICE website (https://www.fda.gov/medical-device-advice-comprehensive-regulatoryassistance/contact-us-division-industry-and-consumer-education-dice) for more information or contact DICE by email (DICE@fda.hhs.gov) or phone (1-800-638-2041 or 301-796-7100).

Sincerely,

Ribhi Shawar, Ph.D. (ABMM) Chief. General Bacteriology and Antimicrobial Susceptibility Branch Division of Microbiology Devices OHT7: Office of In Vitro Diagnostics and Radiological Health Office of Product Evaluation and Quality Center for Devices and Radiological Health

Enclosure

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510(k) Summary

510(k) number: K192817

Date of Preparation: September 30, 2019

| Owner: | Meridian Bioscience, Inc.
3471 River Hills Drive
Cincinnati, Ohio 45244 USA
Phone: (513) 271-3700
Fax: (513) 272-5213 |
|----------------------|-----------------------------------------------------------------------------------------------------------------------------------|
| Contact: | Primary Contact:
Cathlena Martinez
Senior Regulatory Affairs Specialist |
| | Secondary Contact:
Jack Rogers
Director, Regulatory Affairs and Design Assurance |
| Trade Name: | Curian™ HpSA® |
| Common Name: | Helicobacter pylori |
| Classification Name: | Campylobacter fetus serological reagents
(21 CFR 866.3110, Product Code LYR) |
| Predicate Device: | PREMIER Platinum HpSA® PLUS
K182559 |

Device Description

The Curian™ HpSA® assay is a qualitative in vitro diagnostic test for the detection of Helicobacter pylori in human stool. The Curian™ HpSA® assay utilizes fluorescence technology with the newly developed Curian™ Analyzer to detect H. pylori antigen. The Curian™ Analyzer has been designed to disposition sample results from lateral flow immunoassays.

Intended Use / Indications for Use

Curian HpSA, for use with the Curian Analyzer, is a rapid, qualitative, fluorescent immunoassay for the detection of Helicobacter pylori antigen in human stool. Test results are intended to aid in the diagnosis of H, pylori infection and to demonstrate loss of H. pyloriantigen following treatment. Accepted medical practice recommends that testing by any current method, to confirm eradication, be done at least following completion of therapy. Test results should be taken into consideration by the physician in conjunction with the patient history and symptoms.

3

Similarities Between the New Device and the Predicate Device
NEW DEVICE
Curian™ HpSA®
K192817PREDICATE DEVICE
PREMIER Platinum HpSA® PLUS
K182559
Product CodeSame as predicateLYR
Intended Use /
Indications for UseCurian HpSA, for use with the Curian
Analyzer, is a rapid, qualitative, fluorescent
immunoassay for the detection of
Helicobacter pylori antigen in human stool.
Test results are intended to aid in the
diagnosis of H. pylori infection and to
demonstrate loss of H. pylori antigen
following treatment. Accepted medical
practice recommends that testing by any
current method, to confirm eradication, be
done at least four weeks following
completion of therapy. Test results should
be taken into consideration by the
physician in conjunction with the patient
history and symptoms.The Premier Platinum HpSA PLUS enzyme
immunoassay (EIA) is an in vitro qualitative
procedure for the detection of Helicobacter
pylori antigens in human stool. Test results
are intended to aid in the diagnosis of H.
pylori infection and to monitor response
during and post-therapy in patients.
Accepted medical practice recommends that
testing by any current method, to confirm
eradication, be done at least four weeks
following completion of therapy.
MeasurandSame as predicateH. pylori stool antigen
Target PopulationSame as predicatePersons suspected of having H. pylori
infection
Specimen TypeSame as predicateUnpreserved human Stool
Type of TestSame as predicateQualitative
Quality ControlSame as predicatePositive and Negative Controls are provided
in kit
Kit StorageSame as predicateRefrigerated (2 to 8 °C)
Differences Between the New Device and the Predicate Device
NEW DEVICE
Curian™ HpSA®
K192817PREDICATE DEVICE
PREMIER Platinum HpSA® PLUS
K182559
TechnologyFluorescent immunoassayEnzyme immunoassay (EIA)
FormatSingle use lateral flow cassetteMicrowell plate
Result InterpretationInstrument reportVisual or Spectrophotometric
Time to Result20 minutes15 minutes

NON-CLINICAL PERFORMANCE DATA

Analytical Performance

Precision/Reproducibility

Reproducibility of the Curian™ HpSA® assay was evaluated by testing contrived sample panels at three investigational sites over a period of five days. Contrived panel members were prepared by spiking H. pylori purified flagellar antigen into negative diluted natural stool/ 30% physiological saline) at antigen concentrations above, near and below the assay limit of detection. The sample panel consisted of a low positive

4

(1.5x LoD), moderate positive (3x LoD), high negative (0.5x LoD), and true negative samples. Diluted natural stool was used because of difficulties preparing dilutions with neat stool for analytical testing. The moderate positive and low positive panel members were positive 99.3% (149/150) and 98.0% (147/150) of the time. The high negative and true neqative panel members were negative 88.7% (133/150) of the time. These results are acceptable.

Analytical Sensitivity

Analytical sensitivity studies were performed to determine the analytical limit of detection (LoD) of purified Helicobacter pylori stool antigens (HpSA) in human stool matrix for the Curian HpSA assay. For this study, HpSA antigen was diluted at varying concentrations into diluted natural stool matrix. Three lots of the Curian HpSA assay were evaluated. The LoD is defined as the lowest concentration of the target analyte that produces positive results ≥ 95% of the time.

The LoD for the Curian HpSA assay was determined to be 2.0 ng/mL.

Prozone / Hook Effect

A study was performed to determine the potential for a high-dose prozone/hook effect with the Curian HpSA assay. A prozone/ hook effect can occur when very high levels of farget antigen are present in the test sample, leading to a false negative result.

Dilutions of H. pylori stool antigens (HpSA) were prepared in diluted natural negative sample matrix to create contrived HpSA positive samples containing known concentrations of antigen. Individual reactions were prepared such that the concentration in each replicate was that of a high positive specimen approximately 25X to 6250X LoD; ranging from 51 to 12,500 ng/mL. Each sample was tested to determine whether a prozone/ hook effect is observed with the Curian HpSA assay.

Results confirmed that prozone/ hook effect was not observed with the Curian HpSA assay when testing samples containing high concentrations of Helicobacter pylori stool antigens.

5

Analytical Specificity

Cross-Reactivity:

The specificity of Curian HpSA was tested utilizing the following bacterial, fungal and viral strains. Each potentially cross-reactive microorganism was added at minimum concentrations of 1.0 x 107 CFU/mL (bacteria/fungi) or 1.0 x 105 TCIDso/mL (for viruses) to a diluted natural negative matrix and a contrived positive matrix sample. No crossreactivity or microbial interference with the Curian HpSA assay was observed.

Organism NameStrain IDOrganism NameStrain ID
Adenovirus 40DuganKlebsiella pneumoniaeATCC 13883
Aeromonas hydrophilaATCC 35654Proteus vulgarisCCUG 6380
Bacillus cereusCCUG
52704Pseudomonas aeruginosaATCC 39324
Borrelia burgdorferiB31.5A19RotavirusWA
Campylobacter coliATCC 10956Salmonella spp. DublinATCC 15480
Campylobacter jejuniATCC 29411Salmonella spp. HilversumATCC 15784
Candida albicansATCC 18804Salmonella spp. MinnesotaATCC 9700
Citrobacter freundiiATCC 8090Salmonella typhimurium Group BATCC 14028
Clostridium difficileATCC 43255Shigella boydiiATCC 9207
Clostridium perfringensATCC 12915Shigella dysenteriaeATCC 9361
Enterobacter cloacaeATCC 15337Shigella flexneriATCC 12022
Enterococcus faecalisATCC 49532Shigella sonneiATCC 25931
E. coli O157:H7ATCC 43895Staphylococcus aureusATCC 6538
E. coliATCC 9637Staphylococcus aureus Cowan IATCC 12598
Escherichia fergusoniiATCC 35469Staphylococcus epidermidisATCC 51625
Haemophilus influenzaeATCC 9006Yersinia enterocoliticaATCC 23715

Organisms evaluated for cross-reactivity are listed below.

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Interfering Substances:

Interference testing was performed in the presence of chemical and biological substances introduced directly into contrived HpSA low positive and negative samples generated using diluted natural stool matrix. No interference was observed with the Curian HpSA assay for any of the substances tested. Substances tested and concentrations evaluated are listed below.

Substance (active ingredient(s))Test Concentration
Barium Sulfate5% w/v (50 mg/mL)
Benzalkonium chloride1% v/v
Ciprofloxacin0.25% w/v (2.5 mg/mL)
Ethanol1% v/v
Hog gastric mucin3.5% w/v (35 mg/mL)
Human blood (whole)40% v/v
Human hemoglobin12.5% w/v (125 mg/mL)
Human urine5% v/v
Hydrocortisone1% w/v (10 mg/mL)
Imodium® (Loperamide HCl, 1 mg/7.5 mL)5% v/v
Kaopectate® (Bismuth subsalicylate 262 mg/15 mL)5% v/v
Leukocytes0.05% v/v
Mesalazine (5-Aminosalicylic acid)10% w/v (100 mg/mL)
Metronidazole0.25% w/v (2.5 mg/mL)
MiraLAX® (Polyethylene Glycol 3350, 17 g/dose)7% w/v (70 mg/mL)
Mineral Oil10% v/v
Mylanta® (per 10 mL: (Aluminum hydroxide 800 mg, Magnesium hydroxide 800 mg, Simethicone 80 mg)4.2 mg/mL (2.5% v/v)
Naproxen Sodium5% w/v (50 mg/mL)
Nonoxynol-91% v/v
Nystatin1% w/v (10 mg/mL)
Palmitic acid (fecal fat)20% w/v (200 mg/mL)
Pepto-Bismol® (Bismuth subsalicylate 525 mg/30 mL)5% v/v
Phenylephrine1% w/v (10 mg/mL)
Prilosec OTC® (Omeprazole 20 mg/tablet)5 mg/mL
Sennosides1% w/v (10 mg/mL)
Simethicone10% v/v
Stearic acid (fecal fat)20% w/v (200 mg/mL)
Tagamet HB 200® (Cimetidine 200 mg/tablet)5 mg/mL
TUMS®5 mg/mL
Vancomycin0.25% w/v (2.5 mg/mL)

Assay Reactivity/ Inclusivity

A total of five strains of H. pylori were evaluated for reactivity with the Curian HpSA assay. The final reactive concentrations observed for each strain are listed below.

| H. pylori strain
tested | Geographic origin &
other information | Reactive
Concentration |
|-----------------------------------|------------------------------------------|---------------------------|
| ATCC 43504 | Australia | $1.0 x 10^5$ CFU/mL |
| CCUG 38771 | Unknown | $3.0 x 10^5$ CFU/mL |
| CCUG 19087 | South Africa | $3.0 x 10^5$ CFU/mL |
| ATCC 700392 | UK; clade hpEurope | $6.0 x 10^5$ CFU/mL |
| ATCC 700824 | US; clade hpAfrica1 | $3.0 x 10^5$ CFU/mL |

CLINICAL PERFORMANCE DATA

Comparison of Curian™ HpSA® assay to an FDA-cleared H. pylori Stool Antigen ElA

A multi-center Method Comparison Study was conducted at three sites in the USA to evaluate of the Curian HpSA for detecting H. pylori stool antigen in human stool from patients suspected of H. pylori infection. Test results were compared to results from an FDA-cleared H. pylori stool antigen EIA that was previously evaluated

7

relative to the endoscopy biopsy composite reference method (i.e., culture, histology, and RUT) for initial H. pylori diagnosis with a demonstrated sensitivity and specificity greater than or equal to 95% and a lower bound of the twosided 95% confidence interval (CI) greater than 89%.

Five hundred forty-two (542) evaluable specimens from the intended use population were enrolled in the study.

Positive and negative percent agreement were determined between the Curian HpSA and comparator ElA in detecting HpSA antigens in human stool. The Curian HpSA demonstrated a positive percent agreement of 96.05% (95% Cl: 89.03%, 98.65%) and a negative percent agreement of 97.00% (95% Cl: 95.02%, with the comparator EIA

Performance:

| Positive and Negative Curian HpSA Results vs. FDA-cleared H. pylori stool

antigen EIA
FDA-cleared H. pylori stool antigen EIA
PositiveNegativeTotal
Curian HpSA AssayPositive7314b87
Negative3a452455
Total76466542
Agreement95% CI (%)
PPA96.1%(73/76)89.0%, 98.6%
NPA97.0%(452/466)95.0%, 98.2%

ª 2/3 Curian HpSA false negatives were dispositioned as negative by PCR

b 8/14 Curian HpSA false positives were dispositioned as positive by PCR

CONCLUSION

The Curian™ HpSA® assay, as supported by the information submitted in this premarket submission, is substantially equivalent to the predicate device.