An Open-label Study to Assess the Safety and Effectiveness of AA4500 in Combination With the ErecAid® Esteem® Manual Vacuum Therapy System in Treating Men With Peyronie's Disease
Primary Purpose
Peyronie's Disease
Status
Completed
Phase
Phase 3
Locations
United Kingdom
Study Type
Interventional
Intervention
AA4500
ErecAid® Esteem® Manual Vacuum Therapy System
Investigator Modeling
Sponsored by
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
Inclusion Criteria:
- Be a male ≥ 18 years of age
- Have symptom(s) of Peyronie's disease and have evidence of stable disease as determined by the investigator
- Have penile curvature of at least 30° in the dorsal, lateral, or dorsal/lateral plane at screening. It must be possible to delineate the single plane of maximal curvature for evaluation during the study
- Be judged to be in good health, based upon the results of a medical history, physical examination, and laboratory profile
- Voluntarily sign and date an informed consent agreement approved by the Independent Ethics Committee (IEC).
- Be able to read, complete and understand the various rating instruments in English.
Exclusion Criteria:
- Has a penile curvature of less than 30° or greater than 90° at the screening visit
Has any of the following conditions:
- Chordee in the presence or absence of hypospadias
- Thrombosis of the dorsal penile artery and/or vein
- 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 an active sexually transmitted disease
- Known active hepatitis B or C
- Known immune deficiency disease or be positive for human immunodeficiency virus (HIV)
- Has a history of spontaneous priapism (ie, erection that lasts more than four hours)
- Has previously undergone surgery for Peyronie's disease
- Fails to have an erection which, in the opinion of the investigator, is sufficient to accurately measure the subject's penile deformity after administration of prostaglandin E1
- Has a calcified plaque as evident by appropriate radiographic evaluation, penile ultrasound that would prevent proper injection of study medication. Non-contiguous stippling of calcium is acceptable for inclusion provided the calcium deposit does not interfere with the injection of AA4500 into the plaque
- Has an isolated hourglass deformity of the penis
- Has the plaque causing curvature of the penis located proximal to the base of the penis, so that the injection of the local anesthetic would interfere with the injection of AA4500 into the plaque
- Has previously 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
- Has received alternative medical therapies for Peyronie's disease administered by the oral (including, but not limited to, vitamin E [>500 U], 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 3 months before the first dose of study drug or plans to use any of these medical therapies at any time during the study
- Has had extracorporeal shock wave therapy (ESWT) for the correction of Peyronie's disease within the 6-month period before screening or plans to have ESWT at any time during the study
- Has 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 (except for that prescribed by protocol) at any time during the study
- Has used a mechanical device to induce a passive erection within the 2-week period before screening or plans to use any of these devices (except for that prescribed by protocol) at any time during the study
- Has significant erectile dysfunction that has failed to respond to oral treatment with phosphodiesterase type 5 (PDE5) inhibitors
- Has a penile Duplex Doppler ultrasound evaluation at screening that shows compromised penile hemodynamics that in the opinion of the investigator is clinically significant
- Has uncontrolled hypertension, as determined by the investigator
- Has a known recent history of stroke, bleeding, or other significant medical condition, which in the investigator's opinion would make the subject unsuitable for enrollment in the study
- Has sickle cell trait or disease, multiple myeloma, Hodgkin's lymphoma, and/or a blood dyscrasia that carries the risk for clotting or priapism
- Has an impairment of the hand(s) that would prevent safe use of the vacuum pump, as determined by the investigator
- Is unwilling or unable to cooperate with the requirements of the study including completion of all scheduled study visits
- Has received an investigational drug or treatment within 30 days before the first dose of study drug
- Has a known allergy to collagenase or any other excipient of AA4500
- Has a known allergy to any concomitant medication required as per the protocol
- Has a coagulation disorder
- Is taking a medication for chronic anticoagulation (except for ≤ 150 mg aspirin daily)
- Has received any collagenase treatments within 30 days of the first dose of study drug
- Has, at any time, received AA4500 for the treatment of Peyronie's disease
Sites / Locations
- Hospital of St John and St Elizabeth
Arms of the Study
Arm 1
Arm 2
Arm Type
Active Comparator
Active Comparator
Arm Label
AA4500 with investigator modeling and vacuum therapy
AA4500 without investigator modeling/with vacuum therapy
Arm Description
AA4500 with investigator modeling and home use of the ErecAid® Esteem® Manual Vacuum Therapy System.
AA4500 without investigator modeling but with home use of the ErecAid® Esteem® Manual Vacuum Therapy System.
Outcomes
Primary Outcome Measures
Percent in improvement from baseline in penile curvature
measurement of erect penis at day 42 (cycle 2), day 84 (cycle 3), day 126 (cycle 4), day 168 (follow up visit 1) and day 252 (follow up visit 2)
Secondary Outcome Measures
Change in Peyronies disease bother
Questionnaire at Day 168 (follow up 1) and day 252 (follow up 2)
Change in Peyronies disease physical symptoms
measurement of erect penis at day 42 (cycle 2), day 84 (cycle 3), day 126 (cycle 4), day 168 (follow up visit 1) and day 252 (follow up visit 2)
Change in Peyronies disease psychological symptoms
Questionnaire at Day 168 (follow up 1) and day 252 (follow up 2)
Change in penile plaque consistency
Flaccid penile exam at day 42 (cycle 2), day 84 (cycle 3), day 126 (cycle 4), day 168 (follow up visit 1) and day 252 (follow up visit 2)
Change in penile length
Flaccid penile exam at day 42 (cycle 2), day 84 (cycle 3), day 126 (cycle 4), day 168 (follow up visit 1) and day 252 (follow up visit 2)3), day 126 (cycle 4), day 168 (follow up visit 1) and day 252 (follow up visit 2)
Change in Peyronies disease penile pain
examination for pain done on day 42 (cycle 2), day 84 (cycle 3), day 126 (cycle 4), day 168 (follow up visit 1) and day 252 (follow up visit 2)
A responder analysis based on subject global assessment
Questionnaire at Day 168 (follow up 1) and day 252 (follow up 2)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT02267460
Brief Title
An Open-label Study to Assess the Safety and Effectiveness of AA4500 in Combination With the ErecAid® Esteem® Manual Vacuum Therapy System in Treating Men With Peyronie's Disease
Official Title
A Phase 3b, Open-label Pilot Study to Evaluate the Safety and Effectiveness of up to Four Treatment Cycles of AA4500 in Combination With the ErecAid® Esteem® Manual Vacuum Therapy System in Men With Peyronie's Disease
Study Type
Interventional
2. Study Status
Record Verification Date
November 2017
Overall Recruitment Status
Completed
Study Start Date
October 2014 (undefined)
Primary Completion Date
October 2015 (Actual)
Study Completion Date
March 2016 (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
Enrollment will include approximately 30 AA4500 naïve subjects. Subjects will be divided by degree of penile curvature and then randomized in a 1:1 ratio to one of the following treatment groups:
AA4500 with investigator modeling
AA4500 without investigator modeling
Each subject will receive 2 injections of AA4500, separated by approximately 24 hours to 72 hours, repeated after 42 days (± 5 days) for up to 4 treatment cycles.
Approximately 14 days after the second injection of AA4500, each subject will visit the study site and the investigator will assess the subject and instruct the subject on appropriate use of the ErecAid® Esteem® Manual Vacuum Therapy System.
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 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
30 (Actual)
8. Arms, Groups, and Interventions
Arm Title
AA4500 with investigator modeling and vacuum therapy
Arm Type
Active Comparator
Arm Description
AA4500 with investigator modeling and home use of the ErecAid® Esteem® Manual Vacuum Therapy System.
Arm Title
AA4500 without investigator modeling/with vacuum therapy
Arm Type
Active Comparator
Arm Description
AA4500 without investigator modeling but with home use of the ErecAid® Esteem® Manual Vacuum Therapy System.
Intervention Type
Biological
Intervention Name(s)
AA4500
Other Intervention Name(s)
Xiaflex, Xiapex, collagenase clostridium histolyticum
Intervention Type
Device
Intervention Name(s)
ErecAid® Esteem® Manual Vacuum Therapy System
Intervention Type
Procedure
Intervention Name(s)
Investigator Modeling
Primary Outcome Measure Information:
Title
Percent in improvement from baseline in penile curvature
Description
measurement of erect penis at day 42 (cycle 2), day 84 (cycle 3), day 126 (cycle 4), day 168 (follow up visit 1) and day 252 (follow up visit 2)
Time Frame
36 Weeks
Secondary Outcome Measure Information:
Title
Change in Peyronies disease bother
Description
Questionnaire at Day 168 (follow up 1) and day 252 (follow up 2)
Time Frame
36 Weeks
Title
Change in Peyronies disease physical symptoms
Description
measurement of erect penis at day 42 (cycle 2), day 84 (cycle 3), day 126 (cycle 4), day 168 (follow up visit 1) and day 252 (follow up visit 2)
Time Frame
Week 36
Title
Change in Peyronies disease psychological symptoms
Description
Questionnaire at Day 168 (follow up 1) and day 252 (follow up 2)
Time Frame
36 Weeks
Title
Change in penile plaque consistency
Description
Flaccid penile exam at day 42 (cycle 2), day 84 (cycle 3), day 126 (cycle 4), day 168 (follow up visit 1) and day 252 (follow up visit 2)
Time Frame
36 Weeks
Title
Change in penile length
Description
Flaccid penile exam at day 42 (cycle 2), day 84 (cycle 3), day 126 (cycle 4), day 168 (follow up visit 1) and day 252 (follow up visit 2)3), day 126 (cycle 4), day 168 (follow up visit 1) and day 252 (follow up visit 2)
Time Frame
36 Weeks
Title
Change in Peyronies disease penile pain
Description
examination for pain done on day 42 (cycle 2), day 84 (cycle 3), day 126 (cycle 4), day 168 (follow up visit 1) and day 252 (follow up visit 2)
Time Frame
36 Weeks
Title
A responder analysis based on subject global assessment
Description
Questionnaire at Day 168 (follow up 1) and day 252 (follow up 2)
Time Frame
36 Weeks
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Be a male ≥ 18 years of age
Have symptom(s) of Peyronie's disease and have evidence of stable disease as determined by the investigator
Have penile curvature of at least 30° in the dorsal, lateral, or dorsal/lateral plane at screening. It must be possible to delineate the single plane of maximal curvature for evaluation during the study
Be judged to be in good health, based upon the results of a medical history, physical examination, and laboratory profile
Voluntarily sign and date an informed consent agreement approved by the Independent Ethics Committee (IEC).
Be able to read, complete and understand the various rating instruments in English.
Exclusion Criteria:
Has a penile curvature of less than 30° or greater than 90° at the screening visit
Has any of the following conditions:
Chordee in the presence or absence of hypospadias
Thrombosis of the dorsal penile artery and/or vein
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 an active sexually transmitted disease
Known active hepatitis B or C
Known immune deficiency disease or be positive for human immunodeficiency virus (HIV)
Has a history of spontaneous priapism (ie, erection that lasts more than four hours)
Has previously undergone surgery for Peyronie's disease
Fails to have an erection which, in the opinion of the investigator, is sufficient to accurately measure the subject's penile deformity after administration of prostaglandin E1
Has a calcified plaque as evident by appropriate radiographic evaluation, penile ultrasound that would prevent proper injection of study medication. Non-contiguous stippling of calcium is acceptable for inclusion provided the calcium deposit does not interfere with the injection of AA4500 into the plaque
Has an isolated hourglass deformity of the penis
Has the plaque causing curvature of the penis located proximal to the base of the penis, so that the injection of the local anesthetic would interfere with the injection of AA4500 into the plaque
Has previously 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
Has received alternative medical therapies for Peyronie's disease administered by the oral (including, but not limited to, vitamin E [>500 U], 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 3 months before the first dose of study drug or plans to use any of these medical therapies at any time during the study
Has had extracorporeal shock wave therapy (ESWT) for the correction of Peyronie's disease within the 6-month period before screening or plans to have ESWT at any time during the study
Has 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 (except for that prescribed by protocol) at any time during the study
Has used a mechanical device to induce a passive erection within the 2-week period before screening or plans to use any of these devices (except for that prescribed by protocol) at any time during the study
Has significant erectile dysfunction that has failed to respond to oral treatment with phosphodiesterase type 5 (PDE5) inhibitors
Has a penile Duplex Doppler ultrasound evaluation at screening that shows compromised penile hemodynamics that in the opinion of the investigator is clinically significant
Has uncontrolled hypertension, as determined by the investigator
Has a known recent history of stroke, bleeding, or other significant medical condition, which in the investigator's opinion would make the subject unsuitable for enrollment in the study
Has sickle cell trait or disease, multiple myeloma, Hodgkin's lymphoma, and/or a blood dyscrasia that carries the risk for clotting or priapism
Has an impairment of the hand(s) that would prevent safe use of the vacuum pump, as determined by the investigator
Is unwilling or unable to cooperate with the requirements of the study including completion of all scheduled study visits
Has received an investigational drug or treatment within 30 days before the first dose of study drug
Has a known allergy to collagenase or any other excipient of AA4500
Has a known allergy to any concomitant medication required as per the protocol
Has a coagulation disorder
Is taking a medication for chronic anticoagulation (except for ≤ 150 mg aspirin daily)
Has received any collagenase treatments within 30 days of the first dose of study drug
Has, at any time, received AA4500 for the treatment of Peyronie's disease
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Neil Shusterman, MD
Organizational Affiliation
Endo
Official's Role
Study Director
Facility Information:
Facility Name
Hospital of St John and St Elizabeth
City
London
ZIP/Postal Code
NW8 9NH
Country
United Kingdom
12. IPD Sharing Statement
Citations:
PubMed Identifier
28974406
Citation
Ralph DJ, Abdel Raheem A, Liu G. Treatment of Peyronie's Disease With Collagenase Clostridium histolyticum and Vacuum Therapy: A Randomized, Open-Label Pilot Study. J Sex Med. 2017 Nov;14(11):1430-1437. doi: 10.1016/j.jsxm.2017.08.015. Epub 2017 Sep 30.
Results Reference
derived
Learn more about this trial
An Open-label Study to Assess the Safety and Effectiveness of AA4500 in Combination With the ErecAid® Esteem® Manual Vacuum Therapy System in Treating Men With Peyronie's Disease
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