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Safety and Efficacy of Intranasal TBS-1 Treatment of Male Hypogonadism

Primary Purpose

Male Hypogonadism

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Testosterone
Testosterone
Sponsored by
Acerus Pharmaceuticals Corporation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Male Hypogonadism

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)MaleDoes not accept healthy volunteers

Inclusion Criteria

  • Male between 18 and 80 years of age
  • Able to understand and provide signed informed consent
  • Have 2 fasting morning (0900 h ± 30 min) serum total testosterone levels <300 ng/dL
  • Body mass index between 18.5 kg/m2 and 35 kg/m2
  • Hemoglobin level > or = 13.0 g/dL
  • Screening laboratory assessments within ±15% of the normal range, with the exception of liver function tests (which need to be within the normal range) and HbA1c (which must be <7.0% [9.5 mmol/L]); lipid profile and endocrine profile assessments are also exempt from this range unless the assessments indicate a significant intercurrent illness other than testosterone deficiency
  • Ear, nose and throat examination including nasal endoscopy without clinically significant abnormal findings
  • Normal prostate for age based on digital rectal exam and a serum PSA <4.0 ng/mL.

Exclusion Criteria

  • Significant intercurrent disease of any type, in particular liver, kidney, heart disease, or psychiatric illness
  • Hyperparathyroidism, uncontrolled diabetes mellitus, hypothyroidism, or hyperthyroidism (thyroid stimulating hormone should be <1.5 times the upper limit of normal)
  • Hematocrit >54% at screening
  • History of pituitary or hypothalamic tumors or history of malignancy within the past 5 years, excluding basal cell or squamous cell carcinoma of the skin curatively treated by surgery
  • History of nasal surgery, specifically turbinoplasty, septoplasty, rhinoplasty, "nose job," or sinus surgery
  • History of nasal fractures within the past 6 months and/or prior nasal fractures that caused a severely deviated anterior nasal septum
  • Active allergies, such as rhinitis, rhinorrhea, and nasal congestion
  • Mucosal inflammatory disorders, specifically pemphigus or Sjogren's syndrome
  • Sinus disease, specifically acute sinusitis, chronic sinusitis, or allergic fungal sinusitis
  • History of nasal disorders (eg, polyposis, recurrent epistaxis [>1 nose bleed per month], abuse of nasal decongestants) or sleep apnea
  • Use of any form of intranasal medication delivery, specifically nasal corticosteroids and oxymetazoline-containing nasal sprays (eg, Dristan® 12-Hour Nasal Spray)
  • History of severe adverse drug reaction or leukopenia
  • A known hypersensitivity to lidocaine or any materials that may be used during the study
  • History of abnormal bleeding tendencies or thrombophlebitis unrelated to venipuncture or intravenous cannulation
  • History of hepatitis B, a positive test for hepatitis B surface antigen, a history of hepatitis C, or a positive test for hepatitis C antibody
  • Presence of human immunodeficiency virus infection or antibodies
  • History of asthma and ongoing asthma treatment
  • History of sleeping problems or a shift worker
  • Smoker of >10 cigarettes (or equivalent) per day
  • Regular consumption of more than 4 units of alcohol daily (1 unit is defined as 300 mL of beer, 1 glass of wine, or 1 measure of spirit) or difficulty abstaining from alcohol during the 48 hours prior to the 24 hour blood sampling visits
  • History or current evidence of abuse of alcohol or any drug substance, licit or illicit, or positive urine drug and alcohol screen
  • Treatment with androgen therapy within at least 2 weeks prior to baseline evaluations (subjects on androgen therapy will require a washout period of 4 weeks for depot products administered intramuscularly [eg, testosterone enanthate 200 mg/mL] and 2 weeks for products administered orally or topically [oral, patch, gel, or buccal])
  • Current treatment with other androgens (eg, dehydroepiandrosterone [DHEA]), anabolic steroids, or other sex hormones
  • Treatment with estrogens, gonadotropin-releasing hormone (GnRH) agonists, or growth hormone within previous 12 months
  • Treatment with drugs that interfere with the metabolism of testosterone, such as anastrozole, clomiphene, dutasteride, finasteride, flutamide, ketoconazole, spironolactone, or testolactone
  • Treatment with any antihypertensive, antidepressant, tranquilizer, or histamine 2 (H2) receptor blocker that is not part of a stable regimen (stable dose for at least 3 months prior to baseline);
  • Poor compliance history or low likelihood of maintaining attendance
  • Participation in any other research study during the conduct of this study or 30 days prior to the initiation of this study or blood donation at any time during this study and within the 12 week period prior to screening

Sites / Locations

  • Alabama Clinical Therapeutics LLC
  • Medical Affiliated Research Center, Inc.
  • Coastal Clinical Research
  • Quality of Life Medical Research Center
  • SC Clinical Research Inc
  • Diablo Clinical Reseach Inc.
  • Innovative Research of West Florida
  • Clinical Research of South Florida
  • Pharmax Research Clinic
  • Compass Research East LLC
  • Central Kentucky Research Associates
  • Commonwealth Biomedical Research LLC
  • Regional Urology LLC
  • Center for Pharmaceutical Research
  • Clinical Research Center of Nevada
  • Rochester Clinical Research
  • Lynn Health Science Institute
  • The Clinical Trial Center
  • Omega Medical Research
  • Coastal Carolina Research Center Inc
  • Austin Center for Clinical Research
  • Reseach Across America
  • Centex Research
  • Clinical Trial Network
  • Cetero Research
  • Granger Medical Clinic
  • National Clinical Research - Norfolk
  • National Clinical Research
  • Capital Clinical Reseach Center
  • Rainier Clinical Research Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Experimental

Arm Label

TBS-1 - b.i.d.

TBS-1 - t.i.d.

Arm Description

5.5 mg per nostril of 4.5% TBS-1 BID

5.5 mg per nostril of 4.5% TBS-1 TID

Outcomes

Primary Outcome Measures

Serum Testosterone Cavg
The percentage of patients with an average serum total testosterone concentration (Cavg) within the normal range (300 to 1050 ng/dL)

Secondary Outcome Measures

Patients With a Certain Serum Total Testosterone Maximum Concentration on Day 90
To determine the efficacy of 4.5% TBS-1 gel, administered 2 or 3 times daily at a dose of 5.5 mg per nostril, in achieving the following serum total testosterone maximum concentration (Cmax) on Day 90: A Cmax (maximum testosterone concentration) value of 1500 ng/dL or more in at least 85% of the participants analyzed A Cmax (maximum testosterone concentration) value of 1800 to 2500 ng/dL in fewer than 5% of participants analyzed No analyzed participants with a Cmax (maximum testosterone concentration) >2500 ng/dL

Full Information

First Posted
September 30, 2011
Last Updated
May 15, 2018
Sponsor
Acerus Pharmaceuticals Corporation
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1. Study Identification

Unique Protocol Identification Number
NCT01446042
Brief Title
Safety and Efficacy of Intranasal TBS-1 Treatment of Male Hypogonadism
Official Title
A 90-Day, Randomized, Dose-Ranging Study, Including Potential Dose Titration, Evaluating the Efficacy and Safety of Intranasal TBS-1 in the Treatment of Male Hypogonadism With Sequential Safety Extension Periods of 90 and 180 Days
Study Type
Interventional

2. Study Status

Record Verification Date
March 2018
Overall Recruitment Status
Completed
Study Start Date
September 2011 (undefined)
Primary Completion Date
December 2012 (Actual)
Study Completion Date
March 2013 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Acerus Pharmaceuticals Corporation

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine the efficacy (based on the pharmacokinetic profile of testosterone) and safety of TBS-1 in the treatment of hypogonadal men
Detailed Description
This study is a 4 Period study consists of 16 visits with overnight clinic stays that span over year to help determine the efficacy of TBS-1 gel administered twice daily (b.i.d) and three times daily (t.i.d) In addition, this study will investigate the safety and tolerability of TBS-1 after 90, 180 and 360 days of treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Male Hypogonadism

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
306 (Actual)

8. Arms, Groups, and Interventions

Arm Title
TBS-1 - b.i.d.
Arm Type
Experimental
Arm Description
5.5 mg per nostril of 4.5% TBS-1 BID
Arm Title
TBS-1 - t.i.d.
Arm Type
Experimental
Arm Description
5.5 mg per nostril of 4.5% TBS-1 TID
Intervention Type
Drug
Intervention Name(s)
Testosterone
Intervention Description
Intranasal testosterone
Intervention Type
Drug
Intervention Name(s)
Testosterone
Intervention Description
Intranasal testosterone
Primary Outcome Measure Information:
Title
Serum Testosterone Cavg
Description
The percentage of patients with an average serum total testosterone concentration (Cavg) within the normal range (300 to 1050 ng/dL)
Time Frame
90 days
Secondary Outcome Measure Information:
Title
Patients With a Certain Serum Total Testosterone Maximum Concentration on Day 90
Description
To determine the efficacy of 4.5% TBS-1 gel, administered 2 or 3 times daily at a dose of 5.5 mg per nostril, in achieving the following serum total testosterone maximum concentration (Cmax) on Day 90: A Cmax (maximum testosterone concentration) value of 1500 ng/dL or more in at least 85% of the participants analyzed A Cmax (maximum testosterone concentration) value of 1800 to 2500 ng/dL in fewer than 5% of participants analyzed No analyzed participants with a Cmax (maximum testosterone concentration) >2500 ng/dL
Time Frame
90 days

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria Male between 18 and 80 years of age Able to understand and provide signed informed consent Have 2 fasting morning (0900 h ± 30 min) serum total testosterone levels <300 ng/dL Body mass index between 18.5 kg/m2 and 35 kg/m2 Hemoglobin level > or = 13.0 g/dL Screening laboratory assessments within ±15% of the normal range, with the exception of liver function tests (which need to be within the normal range) and HbA1c (which must be <7.0% [9.5 mmol/L]); lipid profile and endocrine profile assessments are also exempt from this range unless the assessments indicate a significant intercurrent illness other than testosterone deficiency Ear, nose and throat examination including nasal endoscopy without clinically significant abnormal findings Normal prostate for age based on digital rectal exam and a serum PSA <4.0 ng/mL. Exclusion Criteria Significant intercurrent disease of any type, in particular liver, kidney, heart disease, or psychiatric illness Hyperparathyroidism, uncontrolled diabetes mellitus, hypothyroidism, or hyperthyroidism (thyroid stimulating hormone should be <1.5 times the upper limit of normal) Hematocrit >54% at screening History of pituitary or hypothalamic tumors or history of malignancy within the past 5 years, excluding basal cell or squamous cell carcinoma of the skin curatively treated by surgery History of nasal surgery, specifically turbinoplasty, septoplasty, rhinoplasty, "nose job," or sinus surgery History of nasal fractures within the past 6 months and/or prior nasal fractures that caused a severely deviated anterior nasal septum Active allergies, such as rhinitis, rhinorrhea, and nasal congestion Mucosal inflammatory disorders, specifically pemphigus or Sjogren's syndrome Sinus disease, specifically acute sinusitis, chronic sinusitis, or allergic fungal sinusitis History of nasal disorders (eg, polyposis, recurrent epistaxis [>1 nose bleed per month], abuse of nasal decongestants) or sleep apnea Use of any form of intranasal medication delivery, specifically nasal corticosteroids and oxymetazoline-containing nasal sprays (eg, Dristan® 12-Hour Nasal Spray) History of severe adverse drug reaction or leukopenia A known hypersensitivity to lidocaine or any materials that may be used during the study History of abnormal bleeding tendencies or thrombophlebitis unrelated to venipuncture or intravenous cannulation History of hepatitis B, a positive test for hepatitis B surface antigen, a history of hepatitis C, or a positive test for hepatitis C antibody Presence of human immunodeficiency virus infection or antibodies History of asthma and ongoing asthma treatment History of sleeping problems or a shift worker Smoker of >10 cigarettes (or equivalent) per day Regular consumption of more than 4 units of alcohol daily (1 unit is defined as 300 mL of beer, 1 glass of wine, or 1 measure of spirit) or difficulty abstaining from alcohol during the 48 hours prior to the 24 hour blood sampling visits History or current evidence of abuse of alcohol or any drug substance, licit or illicit, or positive urine drug and alcohol screen Treatment with androgen therapy within at least 2 weeks prior to baseline evaluations (subjects on androgen therapy will require a washout period of 4 weeks for depot products administered intramuscularly [eg, testosterone enanthate 200 mg/mL] and 2 weeks for products administered orally or topically [oral, patch, gel, or buccal]) Current treatment with other androgens (eg, dehydroepiandrosterone [DHEA]), anabolic steroids, or other sex hormones Treatment with estrogens, gonadotropin-releasing hormone (GnRH) agonists, or growth hormone within previous 12 months Treatment with drugs that interfere with the metabolism of testosterone, such as anastrozole, clomiphene, dutasteride, finasteride, flutamide, ketoconazole, spironolactone, or testolactone Treatment with any antihypertensive, antidepressant, tranquilizer, or histamine 2 (H2) receptor blocker that is not part of a stable regimen (stable dose for at least 3 months prior to baseline); Poor compliance history or low likelihood of maintaining attendance Participation in any other research study during the conduct of this study or 30 days prior to the initiation of this study or blood donation at any time during this study and within the 12 week period prior to screening
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Natalia Tkachenko, MD
Organizational Affiliation
Trimel Pharmaceuticals Corporation
Official's Role
Study Director
Facility Information:
Facility Name
Alabama Clinical Therapeutics LLC
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35235
Country
United States
Facility Name
Medical Affiliated Research Center, Inc.
City
Huntsville
State/Province
Alabama
ZIP/Postal Code
35801
Country
United States
Facility Name
Coastal Clinical Research
City
Mobile
State/Province
Alabama
ZIP/Postal Code
36608
Country
United States
Facility Name
Quality of Life Medical Research Center
City
Tucson
State/Province
Arizona
ZIP/Postal Code
85712
Country
United States
Facility Name
SC Clinical Research Inc
City
Garden Grove
State/Province
California
ZIP/Postal Code
92844
Country
United States
Facility Name
Diablo Clinical Reseach Inc.
City
Walnut Creek
State/Province
California
ZIP/Postal Code
94598
Country
United States
Facility Name
Innovative Research of West Florida
City
Clearwater
State/Province
Florida
ZIP/Postal Code
33756
Country
United States
Facility Name
Clinical Research of South Florida
City
Coral Gables
State/Province
Florida
ZIP/Postal Code
33134
Country
United States
Facility Name
Pharmax Research Clinic
City
Miami
State/Province
Florida
ZIP/Postal Code
33126
Country
United States
Facility Name
Compass Research East LLC
City
Oviedo
State/Province
Florida
ZIP/Postal Code
32765
Country
United States
Facility Name
Central Kentucky Research Associates
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40509
Country
United States
Facility Name
Commonwealth Biomedical Research LLC
City
Madisonville
State/Province
Kentucky
ZIP/Postal Code
42431
Country
United States
Facility Name
Regional Urology LLC
City
Shreveport
State/Province
Louisiana
ZIP/Postal Code
71106
Country
United States
Facility Name
Center for Pharmaceutical Research
City
Kansas City
State/Province
Missouri
ZIP/Postal Code
61114
Country
United States
Facility Name
Clinical Research Center of Nevada
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89104
Country
United States
Facility Name
Rochester Clinical Research
City
Rochester
State/Province
New York
ZIP/Postal Code
14609
Country
United States
Facility Name
Lynn Health Science Institute
City
Oklahoma City
State/Province
Oklahoma
ZIP/Postal Code
73112
Country
United States
Facility Name
The Clinical Trial Center
City
Jenkintown
State/Province
Pennsylvania
ZIP/Postal Code
19046
Country
United States
Facility Name
Omega Medical Research
City
Warwick
State/Province
Rhode Island
ZIP/Postal Code
02886
Country
United States
Facility Name
Coastal Carolina Research Center Inc
City
Mount Pleasant
State/Province
South Carolina
ZIP/Postal Code
29464
Country
United States
Facility Name
Austin Center for Clinical Research
City
Austin
State/Province
Texas
ZIP/Postal Code
78756
Country
United States
Facility Name
Reseach Across America
City
Dallas
State/Province
Texas
ZIP/Postal Code
75234
Country
United States
Facility Name
Centex Research
City
Houston
State/Province
Texas
ZIP/Postal Code
77062
Country
United States
Facility Name
Clinical Trial Network
City
Houston
State/Province
Texas
ZIP/Postal Code
77074
Country
United States
Facility Name
Cetero Research
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78229
Country
United States
Facility Name
Granger Medical Clinic
City
West Valley City
State/Province
Utah
ZIP/Postal Code
84120
Country
United States
Facility Name
National Clinical Research - Norfolk
City
Norfolk
State/Province
Virginia
ZIP/Postal Code
23502
Country
United States
Facility Name
National Clinical Research
City
Richmond
State/Province
Virginia
ZIP/Postal Code
23294
Country
United States
Facility Name
Capital Clinical Reseach Center
City
Olympia
State/Province
Washington
ZIP/Postal Code
98502
Country
United States
Facility Name
Rainier Clinical Research Center
City
Renton
State/Province
Washington
ZIP/Postal Code
98057
Country
United States

12. IPD Sharing Statement

Citations:
PubMed Identifier
26695758
Citation
Rogol AD, Tkachenko N, Bryson N. Natesto , a novel testosterone nasal gel, normalizes androgen levels in hypogonadal men. Andrology. 2016 Jan;4(1):46-54. doi: 10.1111/andr.12137. Epub 2015 Dec 22. Erratum In: Andrology. 2017 Jul;5(4):844.
Results Reference
derived

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Safety and Efficacy of Intranasal TBS-1 Treatment of Male Hypogonadism

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