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The Safety and Effectiveness of AA4500 in Subjects With Peyronie's Disease

Primary Purpose

Peyronie's Disease

Status
Completed
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
AA4500
Placebo
Sponsored by
Endo Pharmaceuticals
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Peyronie's Disease focused on measuring Peyronie's disease, penile plaque, penile curvature

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Heterosexual male ≥ 18 years of age
  • In a stable relationship with a partner/spouse for at least 3 months before screening
  • Have a diagnosis of Peyronie's disease for at least 6 months before first dose of study drug
  • Have a penile curvature of at least 30° in the dorsal, lateral, or dorsal/lateral plane
  • Have functional difficulty related to Peyronie's disease (eg, difficulty with intromission or erectile dysfunction)
  • Be judged to be in good health based upon the results of medical history, physical examination and laboratory profile
  • Voluntarily sign an informed consent agreement approved by the Institutional Review Board/Independent Ethics Committee (IRB/IEC). The subject must have also signed an authorization form to allow disclosure of his protected health information. The protected health information authorization form and informed consent form may have been an integrated form or may have been separate forms, depending on the institution
  • Be able to complete and understand the various rating instruments

Exclusion Criteria:

  • Have had an average of three successive blood pressure readings ≥ 160/100 mmHg during screening or the Day 1 assessments
  • Severe pain during penile palpation
  • Any of the following conditions:

    • Chordee in the presence or absence of hypospadias
    • Thrombosis of the dorsal penile artery
    • Infiltration by a benign or malignant mass resulting in penile curvature
    • Infiltration by an infectious agent, such as lymphogranuloma venereum
    • Ventral curvature from any cause
    • Presence of sexually transmitted disease
    • Known Hepatitis B or C
    • Known immune deficiency disease or be positive for human immunodeficiency virus (HIV)
  • Previously undergone surgery for Peyronie's disease
  • Penile curvature of less than 30° or greater than 90°
  • Failed to have a rigid erection after pharmacological stimulation with a vasoactive injection of Prostaglandin E1 10 to 20 µg, which, in the opinion of the investigator, was sufficient to accurately measure the subject's penile deformity
  • Had a calcified plaque as evident by appropriate radiographic evaluation, penile x-ray, or penile ultrasound. Non-contiguous stippling of calcium was acceptable for inclusion
  • Had an isolated hourglass deformity of the penis without curvature
  • Had the plaque causing curvature of the penis located proximal to the base of the penis, so that the injection of the local anesthetic would have interfered with the injection of AA4500 into the plaque
  • Received alternative medical therapies for Peyronie's disease administered by the intralesional route (including, but not limited to, steroids, verapamil, and the naturally occurring low molecular weight protein, interferon-α2b) within 3 months before the first dose of study drug or plans to use any of these medical therapies at any time during the study
  • Received alternative medical therapies for Peyronie's disease administered by the oral (including, but not limited to, vitamin E (>500IU), potassium aminobenzoate [Potaba], tamoxifen, colchicine, pentoxifylline, over-the-counter erectile dysfunction medications, or steroidal anti inflammatory drugs) or topical routes (including, but not limited to, verapamil applied as a cream) within 4 weeks before the first dose of study drug or plans to use any of these medical therapies at any time during the study
  • Used any mechanical type device for correction of Peyronie's disease within the 2-week period before screening or plans to use any these devices at any time during the study
  • Used a mechanical device to induce a passive erection within the 2-week period before screening or plans to use any of these devices at any time during the study
  • Significant erectile dysfunction that has failed to respond to oral treatment with phosphodiesterase type 5 (PDE5) inhibitors
  • Recent history of stroke, bleeding, or other medical condition, which in the investigator's opinion would make the subject unsuitable for enrollment in the study
  • Unwilling or unable to cooperate with the requirements of the study including completion of all scheduled study visits
  • Received an investigational drug or treatment within 30 days before the first dose of study drug
  • Allergy to collagenase or any other excipient of AA4500
  • Allergy to any concomitant medication required as per the protocol
  • Received anticoagulant medication (except for ≤ 165 mg aspirin daily or ≤ 800 mg of over-the-counter NSAIDS daily) during the 7 days before each dose of study drug
  • Received doxycycline or a tetracycline derivative during the 7 days before each dose of study drug or plans to use these drugs within 2 days after the injection of study drug
  • Received any collagenase treatments within 30 days of the first dose of study drug

Sites / Locations

  • Urology Associates Medical Group
  • Urology Specialists Connecticut Clinical Research Center, LLC
  • The Urology Center, PC
  • South Florida Medical Research
  • Urology Specialists, SC
  • Northeast Indiana Research, LLC
  • Metropolitan Urology, PSC
  • Maimonides Medical Center Divison of Urology
  • University Urology Associates
  • Tristate Urologic Services
  • Baylor College of Medicine, Scott Department of Urology
  • Urology of Virginia (a division of Sentara Medical Group)

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Placebo Comparator

Arm Label

AA4500

Placebo

Arm Description

Clostridial collagenase for injection

Outcomes

Primary Outcome Measures

Change From Baseline in Penile Curvature
Negative change reflects improvement in penile curvature
Change From Baseline in Peyronie's Disease Questionnaire (PDQ) Peyronie's Disease Symptom Bother
Peyronie's disease Symptom Bother Scale: 0-20 lower numbers reflect 'less symptom bother'; higher numbers reflect 'more symptom bother' Change from baseline equals Week 36 minus baseline. Negative change reflects improvement in the symptom bother scale.
Change From Baseline in PDQ Intercourse Contraint
Peyronie's disease intercourse contraint Scale: 0-12 lower numbers reflect 'less intercourse contraint'; higher numbers reflect 'more intercourse constraint' Change from baseline equals Week 36 minus baseline. Negative change reflects improvement in the intercourse constraint scale.
Change From Baseline in PDQ Intercourse Discomfort
Peyronie's disease intercourse discomfort Scale: 0-15 lower numbers reflect 'less intercourse discomfort'; higher numbers reflect 'more intercourse discomfort' Change from baseline equals Week 36 minus baseline. Negative change reflects improvement in the intercourse discomfort scale.
Change From Baseline in PDQ Penile Pain
Peyronie's disease penile pain Scale: 0-40 lower numbers reflect 'less penile pain'; higher numbers reflect 'more penile pain' Change from baseline=Week 36 minus baseline. Negative change reflects improvement in the penile pain scale.

Secondary Outcome Measures

Full Information

First Posted
September 16, 2008
Last Updated
September 7, 2017
Sponsor
Endo Pharmaceuticals
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1. Study Identification

Unique Protocol Identification Number
NCT00755222
Brief Title
The Safety and Effectiveness of AA4500 in Subjects With Peyronie's Disease
Official Title
A Phase 2b, Double-Blind, Randomized, Placebo-Controlled Study of the Safety and Effectiveness of AA4500 Administered Two Times a Week for Up to Three Treatment Cycles (2 x 3) in Subjects With Peyronie's Disease
Study Type
Interventional

2. Study Status

Record Verification Date
September 2017
Overall Recruitment Status
Completed
Study Start Date
August 2008 (undefined)
Primary Completion Date
December 2009 (Actual)
Study Completion Date
December 2009 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Endo Pharmaceuticals

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
This study evaluated the safety and effectiveness of AA4500 in improving the impact of Peyronie's disease on quality of life and improving penile curvature in men with Peyronie's disease
Detailed Description
A Phase 2b randomized, double-blind, placebo-controlled study of AA4500 in the treatment of subjects with Peyronie's disease. During the screening period, subjects had a physical examination including body weight and height, vital sign measurements, a 12-lead electrocardiogram (ECG), and clinical laboratory testing. Medical history, prior and concomitant medications, and demographic data were recorded.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Peyronie's Disease
Keywords
Peyronie's disease, penile plaque, penile curvature

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
147 (Actual)

8. Arms, Groups, and Interventions

Arm Title
AA4500
Arm Type
Experimental
Arm Description
Clostridial collagenase for injection
Arm Title
Placebo
Arm Type
Placebo Comparator
Intervention Type
Biological
Intervention Name(s)
AA4500
Other Intervention Name(s)
Clostridial collagenase for injection (AA4500)
Intervention Description
2 single injections of study drug per each treatment series up to three treatment series total in study. Each treatment series was separated by 6 weeks.
Intervention Type
Biological
Intervention Name(s)
Placebo
Intervention Description
2 single injections of study drug per each treatment series up to three treatment series total in study. Each treatment series is separated by 6 weeks.
Primary Outcome Measure Information:
Title
Change From Baseline in Penile Curvature
Description
Negative change reflects improvement in penile curvature
Time Frame
Baseline and Week 36 or last observation carried forward (LOCF)
Title
Change From Baseline in Peyronie's Disease Questionnaire (PDQ) Peyronie's Disease Symptom Bother
Description
Peyronie's disease Symptom Bother Scale: 0-20 lower numbers reflect 'less symptom bother'; higher numbers reflect 'more symptom bother' Change from baseline equals Week 36 minus baseline. Negative change reflects improvement in the symptom bother scale.
Time Frame
Baseline to Week 36 or LOCF
Title
Change From Baseline in PDQ Intercourse Contraint
Description
Peyronie's disease intercourse contraint Scale: 0-12 lower numbers reflect 'less intercourse contraint'; higher numbers reflect 'more intercourse constraint' Change from baseline equals Week 36 minus baseline. Negative change reflects improvement in the intercourse constraint scale.
Time Frame
Baseline to Week 36 or LOCF
Title
Change From Baseline in PDQ Intercourse Discomfort
Description
Peyronie's disease intercourse discomfort Scale: 0-15 lower numbers reflect 'less intercourse discomfort'; higher numbers reflect 'more intercourse discomfort' Change from baseline equals Week 36 minus baseline. Negative change reflects improvement in the intercourse discomfort scale.
Time Frame
Baseline to Week 36 or LOCF
Title
Change From Baseline in PDQ Penile Pain
Description
Peyronie's disease penile pain Scale: 0-40 lower numbers reflect 'less penile pain'; higher numbers reflect 'more penile pain' Change from baseline=Week 36 minus baseline. Negative change reflects improvement in the penile pain scale.
Time Frame
Baseline to Week 36 or LOCF

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Heterosexual male ≥ 18 years of age In a stable relationship with a partner/spouse for at least 3 months before screening Have a diagnosis of Peyronie's disease for at least 6 months before first dose of study drug Have a penile curvature of at least 30° in the dorsal, lateral, or dorsal/lateral plane Have functional difficulty related to Peyronie's disease (eg, difficulty with intromission or erectile dysfunction) Be judged to be in good health based upon the results of medical history, physical examination and laboratory profile Voluntarily sign an informed consent agreement approved by the Institutional Review Board/Independent Ethics Committee (IRB/IEC). The subject must have also signed an authorization form to allow disclosure of his protected health information. The protected health information authorization form and informed consent form may have been an integrated form or may have been separate forms, depending on the institution Be able to complete and understand the various rating instruments Exclusion Criteria: Have had an average of three successive blood pressure readings ≥ 160/100 mmHg during screening or the Day 1 assessments Severe pain during penile palpation Any of the following conditions: Chordee in the presence or absence of hypospadias Thrombosis of the dorsal penile artery Infiltration by a benign or malignant mass resulting in penile curvature Infiltration by an infectious agent, such as lymphogranuloma venereum Ventral curvature from any cause Presence of sexually transmitted disease Known Hepatitis B or C Known immune deficiency disease or be positive for human immunodeficiency virus (HIV) Previously undergone surgery for Peyronie's disease Penile curvature of less than 30° or greater than 90° Failed to have a rigid erection after pharmacological stimulation with a vasoactive injection of Prostaglandin E1 10 to 20 µg, which, in the opinion of the investigator, was sufficient to accurately measure the subject's penile deformity Had a calcified plaque as evident by appropriate radiographic evaluation, penile x-ray, or penile ultrasound. Non-contiguous stippling of calcium was acceptable for inclusion Had an isolated hourglass deformity of the penis without curvature Had the plaque causing curvature of the penis located proximal to the base of the penis, so that the injection of the local anesthetic would have interfered with the injection of AA4500 into the plaque Received alternative medical therapies for Peyronie's disease administered by the intralesional route (including, but not limited to, steroids, verapamil, and the naturally occurring low molecular weight protein, interferon-α2b) within 3 months before the first dose of study drug or plans to use any of these medical therapies at any time during the study Received alternative medical therapies for Peyronie's disease administered by the oral (including, but not limited to, vitamin E (>500IU), potassium aminobenzoate [Potaba], tamoxifen, colchicine, pentoxifylline, over-the-counter erectile dysfunction medications, or steroidal anti inflammatory drugs) or topical routes (including, but not limited to, verapamil applied as a cream) within 4 weeks before the first dose of study drug or plans to use any of these medical therapies at any time during the study Used any mechanical type device for correction of Peyronie's disease within the 2-week period before screening or plans to use any these devices at any time during the study Used a mechanical device to induce a passive erection within the 2-week period before screening or plans to use any of these devices at any time during the study Significant erectile dysfunction that has failed to respond to oral treatment with phosphodiesterase type 5 (PDE5) inhibitors Recent history of stroke, bleeding, or other medical condition, which in the investigator's opinion would make the subject unsuitable for enrollment in the study Unwilling or unable to cooperate with the requirements of the study including completion of all scheduled study visits Received an investigational drug or treatment within 30 days before the first dose of study drug Allergy to collagenase or any other excipient of AA4500 Allergy to any concomitant medication required as per the protocol Received anticoagulant medication (except for ≤ 165 mg aspirin daily or ≤ 800 mg of over-the-counter NSAIDS daily) during the 7 days before each dose of study drug Received doxycycline or a tetracycline derivative during the 7 days before each dose of study drug or plans to use these drugs within 2 days after the injection of study drug Received any collagenase treatments within 30 days of the first dose of study drug
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Veronica Urdaneta, MD
Organizational Affiliation
Endo Pharmaceuticals
Official's Role
Study Director
Facility Information:
Facility Name
Urology Associates Medical Group
City
Burbank
State/Province
California
ZIP/Postal Code
91505
Country
United States
Facility Name
Urology Specialists Connecticut Clinical Research Center, LLC
City
Middlebury
State/Province
Connecticut
ZIP/Postal Code
06762
Country
United States
Facility Name
The Urology Center, PC
City
New Haven
State/Province
Connecticut
ZIP/Postal Code
06511
Country
United States
Facility Name
South Florida Medical Research
City
Aventura
State/Province
Florida
ZIP/Postal Code
33180
Country
United States
Facility Name
Urology Specialists, SC
City
Chicago
State/Province
Illinois
ZIP/Postal Code
60612
Country
United States
Facility Name
Northeast Indiana Research, LLC
City
Fort Wayne
State/Province
Indiana
ZIP/Postal Code
46825
Country
United States
Facility Name
Metropolitan Urology, PSC
City
Jeffersonville
State/Province
Indiana
ZIP/Postal Code
47130
Country
United States
Facility Name
Maimonides Medical Center Divison of Urology
City
Brooklyn
State/Province
New York
ZIP/Postal Code
11219
Country
United States
Facility Name
University Urology Associates
City
New York
State/Province
New York
ZIP/Postal Code
10016
Country
United States
Facility Name
Tristate Urologic Services
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45212
Country
United States
Facility Name
Baylor College of Medicine, Scott Department of Urology
City
Houston
State/Province
Texas
ZIP/Postal Code
77030
Country
United States
Facility Name
Urology of Virginia (a division of Sentara Medical Group)
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23502
Country
United States

12. IPD Sharing Statement

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The Safety and Effectiveness of AA4500 in Subjects With Peyronie's Disease

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