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Efficacy and Safety of a Single TRUS-guided Intraprostatic Injection of NX-1207 in Patients With LUTS Due to BPH

Primary Purpose

Lower Urinary Tract Symptoms

Status
Terminated
Phase
Phase 3
Locations
International
Study Type
Interventional
Intervention
NX-1207
Tamsulosin
Sponsored by
RECORDATI GROUP
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Lower Urinary Tract Symptoms focused on measuring LUTS, BPH

Eligibility Criteria

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

Inclusion Criteria:

  • Signed informed consent;
  • Age 45 or older;
  • Medical history of LUTS/BPH
  • Use of a marketed α-blocker for LUTS/BPH in the last 8 weeks;
  • LUTS/BPH not adequately controlled by medical therapy with α-blockers;
  • Presence of moderate-severe LUTS (IPSS ≥ 15) at screening and at baseline (after a 4 week run-in period with tamsulosin 0.4 mg QD);
  • Prostate Volume ≥ 30 mL and ≤ 70 mL (as assessed by TRUS);
  • Qmax < 15 mL/sec based on a minimum void of 125 mL;
  • Agree not to use any other approved or experimental BPH or overactive bladder (OAB) medication anytime during the core study;
  • Agree to perform follow-up visits even in case of oral treatment discontinuation before study end;
  • Satisfactory compliance to run-in medication at Visit 2 (baseline).

Exclusion Criteria:

  • Previous surgical or invasive prostate treatments such as TURP, TUMT, TUNA, laser or any other minimally invasive treatment;
  • Acute or chronic prostatitis or suspected prostatitis including chronic pain, intermittent pain or abnormal sensation in the penis, testis, anal or pelvic area in the past 12 months;
  • PSA ≥ 10 ng/mL. In case of a PSA between 4.0 and 10.0 ng/mL, prostate cancer must have been ruled out to the satisfaction of the clinical Investigator by an historical biopsy;
  • Prostate or bladder cancer, history of pelvic irradiation;
  • Active or recurrent urinary tract infections (more than 1 episode in the last 12 months);
  • History of neurogenic bladder or LUTS secondary to neurologic disease;
  • Use of self-catheterization for urinary retention;
  • Post-void residual urine volume > 200 mL;
  • Haematuria which has not been appropriately evaluated to determine safe subject participation;
  • Renal insufficiency (serum creatinine >2.0 mg/dL);
  • Liver insufficiency (any liver function tests [LFTs]>2x upper limit of normal [ULN]);
  • Poorly controlled diabetes (type 1 or type 2), as determined by HbA1c >6% and/or glycosuria;
  • Any bleeding disorder such as haemophilia, clotting factor(s) deficiency or bleeding diathesis;
  • Immunosuppressive disorders, such as Human Immunodeficiency (HIV) Virus, Acquired Immune Deficiency Syndrome (AIDS), lymphoproliferative disorders;
  • Acute or chronic intestinal disease, such as ulcerative colitis, Crohn's disease, acute gastroenteritis in the run-in period; acute painful perianal disorder;
  • Unstable cardiovascular or cerebrovascular disease (including acute myocardial infarction, unstable angina pectoris, by-pass, Percutaneous Transluminal Coronary Angioplasty (PTCA), congestive heart failure NYHA Class III-IV, stroke, transient ischemic attack and episodes of cardiac arrhythmia requiring treatment in the last 6 months);
  • Any condition that would interfere with the subject's ability to provide informed consent, to comply with study instructions, or that might confound the interpretation of the study results, such as dementia, psychosis, manic depressive disorder, post-traumatic stress disorder, stroke, Alzheimer's, depression, psychiatric illness, history or current evidence of drug or alcohol abuse within the last 12 months etc.;
  • Participation in a study of any investigational drug or device within the previous 6 months;
  • Hypersensitivity or contraindication to tamsulosin use;
  • Use of prohibited medications that could endanger subjects performing the intraprostatic injection or that could interfere with the evaluation of study parameters;
  • Men planning to have children in the future;
  • Any other condition that may interfere with the study or endanger the subject.

Sites / Locations

  • Klinikum der Ludwig-Maximilians-universität München
  • Vita e Salute University, Department of Urology, Istituto Scientifico Ospedale San Raffaele
  • Niepubliczny Zaklad Opieki Zdrowotnej Specjalista
  • Hospital General Universitario Gregorio Marañón
  • Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

NX-1207

Comparator

Arm Description

Subjects randomised to the NX-1207 group will receive a single NX-1207 (2.5 mg) TRUS-guided intraprostatic injection (under antibiotic prophylaxis), followed by a placebo QD oral treatment for 12 months.

Subjects randomised to the comparative arm will undergo TRUS only (under placebo prophylaxis) and will continue the tamsulosin 0.4 mg QD oral treatment for 12 months

Outcomes

Primary Outcome Measures

Change from baseline in the total IPSS score.
The primary efficacy parameter is the change from baseline in the total score (Questions 1 to 7) of the IPSS at 12 months. The IPSS questionnaire will be filled by the subjects in blind conditions and will be reviewed by the investigators for its completeness. Validated local translations of the IPSS questionnaire will be used in each country.

Secondary Outcome Measures

Effects on Lower Urinary Tract Symptoms
Change from baseline in IPSS total score at 1, 3, 6 and 9 months; Change from baseline in IPSS subscores for storage symptoms; Change from baseline in IPSS subscores for voiding symptoms; Response rate by IPSS
Effects on Quality of Life (QoL) due to urinary symptoms
Change from baseline in IPSS subscore Quality of Life due to urinary symptoms; Change from baseline in BPH Impact Index
Effects on general health related Quality of Life
The change from baseline in the EQ-5D-5L questionnaire at 12 months or in case of early termination will be considered. The EQ-5D-5L questionnaire is a standardised validated instrument for use as a measure of health outcome.
Patient's global assessment of treatment
A patient-rated global assessment of treatment benefit, satisfaction and willingness to continue will be performed at 12 months (or in case of early termination) by using the BSW questionnaire. The BSW is a validated questionnaire that consists of three, single-item measures designed to capture the patient's perception of the effect of treatment in terms of the relative benefit, their satisfaction, and their intention or willingness to continue on therapy.
Effects on maximum urinary flow rate (Qmax)
To evaluate the effect on urinary flow, the change from baseline in maximum urinary flow (Qmax) at 3, 6, 9, 12 months will be considered. The same validated device and procedure will be used in all centres and a blinded centralized reading is foreseen.
Effects on prostate volume
The change from baseline in TRUS assessed prostate volume at 3 and 12 months (or in case of early termination) will be considered.

Full Information

First Posted
December 2, 2013
Last Updated
May 19, 2022
Sponsor
RECORDATI GROUP
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1. Study Identification

Unique Protocol Identification Number
NCT02003742
Brief Title
Efficacy and Safety of a Single TRUS-guided Intraprostatic Injection of NX-1207 in Patients With LUTS Due to BPH
Official Title
Efficacy and Safety of a Single Transrectal Ultrasound(TRUS)-Guided Intraprostatic Injection of NX-1207 in Patients With Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: A Phase III European Study
Study Type
Interventional

2. Study Status

Record Verification Date
December 2013
Overall Recruitment Status
Terminated
Why Stopped
The study was stopped because in two other clinical studies the drug was not superior in comparison with placebo
Study Start Date
September 2013 (undefined)
Primary Completion Date
January 29, 2015 (Actual)
Study Completion Date
January 29, 2015 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
RECORDATI GROUP

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of the this international, multicenter, randomised, single-blind, parallel group, Phase III study is to demonstrate that a single transrectal ultrasound (TRUS)-guided intraprostatic injection of NX-1207 provides a long lasting therapeutic improvement of Lower Urinary Tract Symptoms (LUTS) associated with Benign Prostatic Hyperplasia (BPH) in patients not adequately controlled by medical therapy with α-blockers, as assessed by a change from baseline in the International Prostate Symptom Score (IPSS) total score.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Lower Urinary Tract Symptoms
Keywords
LUTS, BPH

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
Participant
Allocation
Randomized
Enrollment
104 (Actual)

8. Arms, Groups, and Interventions

Arm Title
NX-1207
Arm Type
Experimental
Arm Description
Subjects randomised to the NX-1207 group will receive a single NX-1207 (2.5 mg) TRUS-guided intraprostatic injection (under antibiotic prophylaxis), followed by a placebo QD oral treatment for 12 months.
Arm Title
Comparator
Arm Type
Active Comparator
Arm Description
Subjects randomised to the comparative arm will undergo TRUS only (under placebo prophylaxis) and will continue the tamsulosin 0.4 mg QD oral treatment for 12 months
Intervention Type
Drug
Intervention Name(s)
NX-1207
Intervention Description
Single TRUS-guided intraprostatic injection of 2.5 mg of NX-1207
Intervention Type
Drug
Intervention Name(s)
Tamsulosin
Intervention Description
1 film coated, prolonged release tablet of tamsulosin 0.4 mg, to be taken orally (p.o.) QD
Primary Outcome Measure Information:
Title
Change from baseline in the total IPSS score.
Description
The primary efficacy parameter is the change from baseline in the total score (Questions 1 to 7) of the IPSS at 12 months. The IPSS questionnaire will be filled by the subjects in blind conditions and will be reviewed by the investigators for its completeness. Validated local translations of the IPSS questionnaire will be used in each country.
Time Frame
12 months
Secondary Outcome Measure Information:
Title
Effects on Lower Urinary Tract Symptoms
Description
Change from baseline in IPSS total score at 1, 3, 6 and 9 months; Change from baseline in IPSS subscores for storage symptoms; Change from baseline in IPSS subscores for voiding symptoms; Response rate by IPSS
Time Frame
1,3,6,9 and 12 months
Title
Effects on Quality of Life (QoL) due to urinary symptoms
Description
Change from baseline in IPSS subscore Quality of Life due to urinary symptoms; Change from baseline in BPH Impact Index
Time Frame
1,3,6,9 and 12 months
Title
Effects on general health related Quality of Life
Description
The change from baseline in the EQ-5D-5L questionnaire at 12 months or in case of early termination will be considered. The EQ-5D-5L questionnaire is a standardised validated instrument for use as a measure of health outcome.
Time Frame
12 months
Title
Patient's global assessment of treatment
Description
A patient-rated global assessment of treatment benefit, satisfaction and willingness to continue will be performed at 12 months (or in case of early termination) by using the BSW questionnaire. The BSW is a validated questionnaire that consists of three, single-item measures designed to capture the patient's perception of the effect of treatment in terms of the relative benefit, their satisfaction, and their intention or willingness to continue on therapy.
Time Frame
12 months
Title
Effects on maximum urinary flow rate (Qmax)
Description
To evaluate the effect on urinary flow, the change from baseline in maximum urinary flow (Qmax) at 3, 6, 9, 12 months will be considered. The same validated device and procedure will be used in all centres and a blinded centralized reading is foreseen.
Time Frame
3,6,9 and 12 months
Title
Effects on prostate volume
Description
The change from baseline in TRUS assessed prostate volume at 3 and 12 months (or in case of early termination) will be considered.
Time Frame
3 and 12 months
Other Pre-specified Outcome Measures:
Title
Long term follow-up evaluation
Description
The following data will be evaluated: Percentage of subjects requiring medical therapy, MIST, TURP or surgery for LUTS/BPH and time to treatment failure; Change from baseline in the total score of the IPSS; Change from baseline in QoL due to urinary symptoms Change from baseline in general health-related QoL (EQ-5D-5L); SAEs and episodes of acute urinary retention.
Time Frame
24 months

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Signed informed consent; Age 45 or older; Medical history of LUTS/BPH Use of a marketed α-blocker for LUTS/BPH in the last 8 weeks; LUTS/BPH not adequately controlled by medical therapy with α-blockers; Presence of moderate-severe LUTS (IPSS ≥ 15) at screening and at baseline (after a 4 week run-in period with tamsulosin 0.4 mg QD); Prostate Volume ≥ 30 mL and ≤ 70 mL (as assessed by TRUS); Qmax < 15 mL/sec based on a minimum void of 125 mL; Agree not to use any other approved or experimental BPH or overactive bladder (OAB) medication anytime during the core study; Agree to perform follow-up visits even in case of oral treatment discontinuation before study end; Satisfactory compliance to run-in medication at Visit 2 (baseline). Exclusion Criteria: Previous surgical or invasive prostate treatments such as TURP, TUMT, TUNA, laser or any other minimally invasive treatment; Acute or chronic prostatitis or suspected prostatitis including chronic pain, intermittent pain or abnormal sensation in the penis, testis, anal or pelvic area in the past 12 months; PSA ≥ 10 ng/mL. In case of a PSA between 4.0 and 10.0 ng/mL, prostate cancer must have been ruled out to the satisfaction of the clinical Investigator by an historical biopsy; Prostate or bladder cancer, history of pelvic irradiation; Active or recurrent urinary tract infections (more than 1 episode in the last 12 months); History of neurogenic bladder or LUTS secondary to neurologic disease; Use of self-catheterization for urinary retention; Post-void residual urine volume > 200 mL; Haematuria which has not been appropriately evaluated to determine safe subject participation; Renal insufficiency (serum creatinine >2.0 mg/dL); Liver insufficiency (any liver function tests [LFTs]>2x upper limit of normal [ULN]); Poorly controlled diabetes (type 1 or type 2), as determined by HbA1c >6% and/or glycosuria; Any bleeding disorder such as haemophilia, clotting factor(s) deficiency or bleeding diathesis; Immunosuppressive disorders, such as Human Immunodeficiency (HIV) Virus, Acquired Immune Deficiency Syndrome (AIDS), lymphoproliferative disorders; Acute or chronic intestinal disease, such as ulcerative colitis, Crohn's disease, acute gastroenteritis in the run-in period; acute painful perianal disorder; Unstable cardiovascular or cerebrovascular disease (including acute myocardial infarction, unstable angina pectoris, by-pass, Percutaneous Transluminal Coronary Angioplasty (PTCA), congestive heart failure NYHA Class III-IV, stroke, transient ischemic attack and episodes of cardiac arrhythmia requiring treatment in the last 6 months); Any condition that would interfere with the subject's ability to provide informed consent, to comply with study instructions, or that might confound the interpretation of the study results, such as dementia, psychosis, manic depressive disorder, post-traumatic stress disorder, stroke, Alzheimer's, depression, psychiatric illness, history or current evidence of drug or alcohol abuse within the last 12 months etc.; Participation in a study of any investigational drug or device within the previous 6 months; Hypersensitivity or contraindication to tamsulosin use; Use of prohibited medications that could endanger subjects performing the intraprostatic injection or that could interfere with the evaluation of study parameters; Men planning to have children in the future; Any other condition that may interfere with the study or endanger the subject.
Facility Information:
Facility Name
Klinikum der Ludwig-Maximilians-universität München
City
Munich
ZIP/Postal Code
81377
Country
Germany
Facility Name
Vita e Salute University, Department of Urology, Istituto Scientifico Ospedale San Raffaele
City
Milan
ZIP/Postal Code
20132
Country
Italy
Facility Name
Niepubliczny Zaklad Opieki Zdrowotnej Specjalista
City
Kutno
ZIP/Postal Code
99-300
Country
Poland
Facility Name
Hospital General Universitario Gregorio Marañón
City
Madrid
ZIP/Postal Code
28007
Country
Spain
Facility Name
Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital
City
Sheffield
ZIP/Postal Code
S10 2JF
Country
United Kingdom

12. IPD Sharing Statement

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Efficacy and Safety of a Single TRUS-guided Intraprostatic Injection of NX-1207 in Patients With LUTS Due to BPH

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