Safety and Tolerability of TAR-302-5018 in Subjects With Neurogenic Detrusor Overactivity Resulting From Spinal Cord Injury
Primary Purpose
Neurogenic Detrusor Overactivity
Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Trospium-Releasing Intravesical System (TAR-302-5018)
Sponsored by
About this trial
This is an interventional treatment trial for Neurogenic Detrusor Overactivity
Eligibility Criteria
Inclusion Criteria
- Diagnosis of traumatic or nontraumatic suprasacral SCI for longer than 6 months and a documented history of NDO.
- Age ≥ 18 years.
Demonstrated competence in and currently uses intermittent catheterization (IC) to empty the bladder (minimum of 4 IC events/day).
- No indwelling catheter permitted
- Caregiver may perform IC
- Subject must be willing to maintain an established IC frequency throughout the study
- History of non-stress-based urinary incontinence.
Exclusion Criteria
- Participation in another drug or device study within 60 days prior to the screening visit.
- Previous urologic surgery that either decreases outlet resistance (transurethral prostatectomy, urethral stent, sphincterotomy) or changes native bladder anatomy (bladder augmentation).
- Presence of significant renal dysfunction at screening (Glomerular Filtration Rate < 30 mL/min).
- Presence of significant polyuria of any cause at screening (urine output > 4,000 mL/day).
- History of pelvic radiation.
- History of either bladder cancer or bladder pathology that the investigator deems unfit for study inclusion.
- Active malignancies within 12 months with the exception of those with a negligible risk of metastasis or death treated with expected curative outcome.
- Symptomatic autonomic dysreflexia requiring ongoing treatment.
- In the opinion of the investigator, the subject has a history of significant stress urinary incontinence.
- Subjects with active bladder stones or history of bladder stones < 6 months prior to study entry.
- History of recurrent symptomatic UTIs (> 6 per 1 year).
- Subjects with either untreated urinary retention or gastric retention or uncontrolled narrow-angle glaucoma.
- Subjects with known hypersensitivity to trospium or chemically-related drugs.
- Subjects with known hypersensitivity to nitinol or silicone.
- Subjects actively taking oral trospium. If previously used and discontinued, these medications must have been stopped for >2 weeks.
- The addition of a new or a change in dose to a current medication for the treatment of OAB (i.e. anticholinergics, beta-3 adrenergic agonists, antispasmodics, antidepressants, or hormones) within 30 days prior to signing the Informed Consent Form (ICF). A current dose must continue through the final study visit. If previously used and discontinued, these medications must have been stopped for > 2 weeks prior to Day 0.
- Intravesical onabotulinum toxin use within the last 9 months prior to the screening visit.
- Intravesical anticholinergic medications within the last 30 days prior to the screening visit.
- History of non-medication based therapy (i.e. Interstim therapy) for the treatment of OAB. History of non-invasive neuromodulation (i.e. Percutaneous Tibial Nerve Stimulation (PTNS)) is allowed if discontinued at least 8 weeks prior to Study Day 0.
- Female subject who is pregnant (as verified by urine test at time of screening) or lactating or of childbearing potential and not using acceptable methods of contraception.
- Subject has a medical condition that may cause noncompliance with the study protocol.
- Subject refuses to provide written informed consent.
- Subject will be unable or unwilling to complete the questionnaires, diaries, or attend all protocol mandated study visits.
- Presence of any bladder or urethral anatomic feature that in the opinion of the investigator may prevent the safe placement, indwelling use or removal of TAR-302-5018.
- History or presence of any significant cardiovascular, pulmonary, hepatic, renal, gastrointestinal, gynecological, endocrine, immunological, dermatological, neurological or psychiatric disease or disorder that, in the opinion of the investigator, contraindicates participation.
History of any of the following within 3 months prior to Screening Visit:
- Major illness/major surgery (requiring hospitalization), including pelvic, lower back surgery or procedure unrelated to bladder cancer; most outpatient procedures are not exclusionary
- Renal or ureteral stone disease or instrumentation
- Childbirth
- Difficulty providing blood samples.
- Other unspecified reasons that, in the opinion of the investigator or TARIS, make the subject unsuitable for enrollment.
Sites / Locations
- Michigan Institute of Urology
- Carolinas HealthCare System
- Urology of Virginia
- Virginia Mason
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
TAR-302-5018
Arm Description
Trospium-Releasing Intravesical System (TAR-302-5018) is placed into the bladder through an inserter on Study Day 0 and is removed on Study Day 42. TAR-302-5018 releases trospium gradually during the 42 day indwelling time.
Outcomes
Primary Outcome Measures
Safety of TAR-302-5018: Safety will be assessed throughout the study based on reported AEs
Safety will be assessed throughout the study based on reported AEs, investigational product events (IPEs), physical examinations (PEs), vital signs, clinical laboratory tests, scheduled cystoscopic examinations, bladder ultrasounds, bladder post-void residual volume (PVR), and the use of concomitant medications.
Secondary Outcome Measures
Tolerability of TAR-302-5018
Tolerability will be determined by the proportion of subjects who require TAR-302-5018 removal prior to the planned removal on Day 42 due to meeting any of the Subject Stopping Safety Criteria or other drug or device constituent related adverse event.
Peak Plasma Concentration (Cmax)
Plasma will be evaluated for trospium levels on Study Days 0, 3, 7, 14, 28, 42, and 49.
Peak Urine Concentration (Cmax)
Urine will be evaluated for trospium levels on Study Days 0, 3, 7, 14, 28, 42, and 49.
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Instillation Volume
Instillation volume at first sensation (mL)
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Vesical Pressure
Vesical pressure at first sensation (cmH2O)
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Instillation Volume
Instillation volume at first desire to urinate (mL)
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Vesical Pressure
Vesical pressure at first desire to urinate (cmH2O)
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Instillation Volume
Instillation volume at maximal desire to urinate (mL)
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Vesical Pressure
Vesical pressure at maximal desire to urinate (cmH2O)
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Instillation Volume
Instillation volume at maximum capacity (mL)
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Detrusor Pressure
Detrusor pressure at maximum capacity (cmH2O)
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Bladder Compliance
Bladder compliance (mL/cmH2O)
Preliminary Urodynamic Efficacy: Involuntary Bladder Contractions - Instillation Volume
Instillation Volume (mL)
Preliminary Urodynamic Efficacy: Involuntary Bladder Contractions - Vesical Pressure
Vesical pressure (cmH2O)
Preliminary Urodynamic Efficacy: Involuntary Bladder Contractions - Detrusor Pressure
Detrusor pressure (cmH2O)
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Peak Flow
Peak flow (mL/s)
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Mean Flow
Mean flow (mL/s)
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Detrusor Pressure
Detrusor pressure at the peak flow (cmH2O)
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Total Voided Volume
Total voided volume (mL)
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Post Void Residual Volume
Post void residual volume (mL)
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT03168828
Brief Title
Safety and Tolerability of TAR-302-5018 in Subjects With Neurogenic Detrusor Overactivity Resulting From Spinal Cord Injury
Official Title
A Prospective, Multi-center, Open-label Study of Trospium Delivered Intravesically by TAR-302-5018 to Spinal Cord Injury Subjects With Neurogenic Detrusor Overactivity (NDO)
Study Type
Interventional
2. Study Status
Record Verification Date
January 2020
Overall Recruitment Status
Completed
Study Start Date
April 24, 2017 (Actual)
Primary Completion Date
July 26, 2018 (Actual)
Study Completion Date
July 26, 2018 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Taris Biomedical LLC
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
5. Study Description
Brief Summary
The purpose of this study is to determine if TAR-302-5018, an investigational drug-delivery system, is safe and tolerable in patients with neurogenic detrusor overactivity (NDO) resulting from spinal cord injury (SCI).
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neurogenic Detrusor Overactivity
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
7 (Actual)
8. Arms, Groups, and Interventions
Arm Title
TAR-302-5018
Arm Type
Experimental
Arm Description
Trospium-Releasing Intravesical System (TAR-302-5018) is placed into the bladder through an inserter on Study Day 0 and is removed on Study Day 42. TAR-302-5018 releases trospium gradually during the 42 day indwelling time.
Intervention Type
Drug
Intervention Name(s)
Trospium-Releasing Intravesical System (TAR-302-5018)
Intervention Description
TAR-302-5018 is a passive, nonresorbable trospium-releasing intravesical system whose primary mode of action is the controlled release of trospium into the bladder over a 42-day period.
Primary Outcome Measure Information:
Title
Safety of TAR-302-5018: Safety will be assessed throughout the study based on reported AEs
Description
Safety will be assessed throughout the study based on reported AEs, investigational product events (IPEs), physical examinations (PEs), vital signs, clinical laboratory tests, scheduled cystoscopic examinations, bladder ultrasounds, bladder post-void residual volume (PVR), and the use of concomitant medications.
Time Frame
Safety will be assessed from the signing of the informed consent form through Study Day 49 (+ 7 days) for a total of up to 77 days.
Secondary Outcome Measure Information:
Title
Tolerability of TAR-302-5018
Description
Tolerability will be determined by the proportion of subjects who require TAR-302-5018 removal prior to the planned removal on Day 42 due to meeting any of the Subject Stopping Safety Criteria or other drug or device constituent related adverse event.
Time Frame
Tolerability will be assessed during the 42-day indwelling period unless removed due to lack of tolerability in advance of the Day 42 scheduled removal.
Title
Peak Plasma Concentration (Cmax)
Description
Plasma will be evaluated for trospium levels on Study Days 0, 3, 7, 14, 28, 42, and 49.
Time Frame
Seven time-points across 49 days (Day 0 through Day 49).
Title
Peak Urine Concentration (Cmax)
Description
Urine will be evaluated for trospium levels on Study Days 0, 3, 7, 14, 28, 42, and 49.
Time Frame
Seven time-points across 49 days (Day 0 through Day 49).
Title
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Instillation Volume
Description
Instillation volume at first sensation (mL)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Vesical Pressure
Description
Vesical pressure at first sensation (cmH2O)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Instillation Volume
Description
Instillation volume at first desire to urinate (mL)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Vesical Pressure
Description
Vesical pressure at first desire to urinate (cmH2O)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Instillation Volume
Description
Instillation volume at maximal desire to urinate (mL)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Vesical Pressure
Description
Vesical pressure at maximal desire to urinate (cmH2O)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Instillation Volume
Description
Instillation volume at maximum capacity (mL)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Detrusor Pressure
Description
Detrusor pressure at maximum capacity (cmH2O)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Bladder Compliance
Description
Bladder compliance (mL/cmH2O)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Involuntary Bladder Contractions - Instillation Volume
Description
Instillation Volume (mL)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Involuntary Bladder Contractions - Vesical Pressure
Description
Vesical pressure (cmH2O)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Involuntary Bladder Contractions - Detrusor Pressure
Description
Detrusor pressure (cmH2O)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Peak Flow
Description
Peak flow (mL/s)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Mean Flow
Description
Mean flow (mL/s)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Detrusor Pressure
Description
Detrusor pressure at the peak flow (cmH2O)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Total Voided Volume
Description
Total voided volume (mL)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Title
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Post Void Residual Volume
Description
Post void residual volume (mL)
Time Frame
Day 0, Day 14 (+/- 1 day), Day 42
Other Pre-specified Outcome Measures:
Title
The Change in Quality of Life as assessed by Qualiveen Surveys
Description
Evidence of improvement in QoL assessed at Study Days 14 (± 1 day) and 42 and compared to Study Day 0 (baseline) as assessed by the following instrument.
Time Frame
Three time-points across 42 days (Study Day 0 to Study Day 42).
10. Eligibility
Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria
Diagnosis of traumatic or nontraumatic suprasacral SCI for longer than 6 months and a documented history of NDO.
Age ≥ 18 years.
Demonstrated competence in and currently uses intermittent catheterization (IC) to empty the bladder (minimum of 4 IC events/day).
No indwelling catheter permitted
Caregiver may perform IC
Subject must be willing to maintain an established IC frequency throughout the study
History of non-stress-based urinary incontinence.
Exclusion Criteria
Participation in another drug or device study within 60 days prior to the screening visit.
Previous urologic surgery that either decreases outlet resistance (transurethral prostatectomy, urethral stent, sphincterotomy) or changes native bladder anatomy (bladder augmentation).
Presence of significant renal dysfunction at screening (Glomerular Filtration Rate < 30 mL/min).
Presence of significant polyuria of any cause at screening (urine output > 4,000 mL/day).
History of pelvic radiation.
History of either bladder cancer or bladder pathology that the investigator deems unfit for study inclusion.
Active malignancies within 12 months with the exception of those with a negligible risk of metastasis or death treated with expected curative outcome.
Symptomatic autonomic dysreflexia requiring ongoing treatment.
In the opinion of the investigator, the subject has a history of significant stress urinary incontinence.
Subjects with active bladder stones or history of bladder stones < 6 months prior to study entry.
History of recurrent symptomatic UTIs (> 6 per 1 year).
Subjects with either untreated urinary retention or gastric retention or uncontrolled narrow-angle glaucoma.
Subjects with known hypersensitivity to trospium or chemically-related drugs.
Subjects with known hypersensitivity to nitinol or silicone.
Subjects actively taking oral trospium. If previously used and discontinued, these medications must have been stopped for >2 weeks.
The addition of a new or a change in dose to a current medication for the treatment of OAB (i.e. anticholinergics, beta-3 adrenergic agonists, antispasmodics, antidepressants, or hormones) within 30 days prior to signing the Informed Consent Form (ICF). A current dose must continue through the final study visit. If previously used and discontinued, these medications must have been stopped for > 2 weeks prior to Day 0.
Intravesical onabotulinum toxin use within the last 9 months prior to the screening visit.
Intravesical anticholinergic medications within the last 30 days prior to the screening visit.
History of non-medication based therapy (i.e. Interstim therapy) for the treatment of OAB. History of non-invasive neuromodulation (i.e. Percutaneous Tibial Nerve Stimulation (PTNS)) is allowed if discontinued at least 8 weeks prior to Study Day 0.
Female subject who is pregnant (as verified by urine test at time of screening) or lactating or of childbearing potential and not using acceptable methods of contraception.
Subject has a medical condition that may cause noncompliance with the study protocol.
Subject refuses to provide written informed consent.
Subject will be unable or unwilling to complete the questionnaires, diaries, or attend all protocol mandated study visits.
Presence of any bladder or urethral anatomic feature that in the opinion of the investigator may prevent the safe placement, indwelling use or removal of TAR-302-5018.
History or presence of any significant cardiovascular, pulmonary, hepatic, renal, gastrointestinal, gynecological, endocrine, immunological, dermatological, neurological or psychiatric disease or disorder that, in the opinion of the investigator, contraindicates participation.
History of any of the following within 3 months prior to Screening Visit:
Major illness/major surgery (requiring hospitalization), including pelvic, lower back surgery or procedure unrelated to bladder cancer; most outpatient procedures are not exclusionary
Renal or ureteral stone disease or instrumentation
Childbirth
Difficulty providing blood samples.
Other unspecified reasons that, in the opinion of the investigator or TARIS, make the subject unsuitable for enrollment.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Michael Kennelly, MD
Organizational Affiliation
Wake Forest University Health Sciences
Official's Role
Principal Investigator
Facility Information:
Facility Name
Michigan Institute of Urology
City
Troy
State/Province
Michigan
ZIP/Postal Code
48084
Country
United States
Facility Name
Carolinas HealthCare System
City
Charlotte
State/Province
North Carolina
ZIP/Postal Code
28207
Country
United States
Facility Name
Urology of Virginia
City
Virginia Beach
State/Province
Virginia
ZIP/Postal Code
23462
Country
United States
Facility Name
Virginia Mason
City
Seattle
State/Province
Washington
ZIP/Postal Code
98101
Country
United States
12. IPD Sharing Statement
Learn more about this trial
Safety and Tolerability of TAR-302-5018 in Subjects With Neurogenic Detrusor Overactivity Resulting From Spinal Cord Injury
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