Doppler-Guided Uterine Artery Occlusion (DUAO) Device for Fibroid Related Bleeding (DUAO)
Primary Purpose
Menorrhagia, Uterine Fibroids
Status
Terminated
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Doppler-Guided Uterine Artery Occlusion Device (DUAO)
Sponsored by
About this trial
This is an interventional treatment trial for Menorrhagia focused on measuring Menorrhagia associated with Uterine Fibroids
Eligibility Criteria
Inclusion Criteria:
- 25 to 50 years of age;
- PBLAC score of 150 or greater;
- Completed child-bearing;
- Normal Pap smear within 12 months;
- Cervix suitable for tenaculum placement as determined by pelvic exam;
- At least one uterine fibroid of 3 cm diameter or greater with a prevailing pathology (e.g., as opposed to adenomyosis) of fibroids determined through ultrasound;
- Willing to maintain use or non-use of hormonal contraception from 3 months pre-study throughout the 12-month follow-up period;
- Willing to maintain use or non-use of anti-fibrinolytic agents from 3 months pre-study throughout the 12-month follow-up period;
- Able to tolerate the required prolonged supine position during treatment (approximately 6 hours);
- Willing and able to provide informed consent and to follow study-related requirements;
Exclusion Criteria:
- Pregnancy (as confirmed immediately prior to procedure)
- Fibroid diameter greater than 8.0 cm determined through transvaginal ultrasound; [or if 2 dimensions are measured, total dimension greater than 16 cm; or if the 3 dimensions (length, height, width) are measured, total dimension greater than 24 cm];
- Presence of a pedunculated fibroid determined by ultrasound; hysteroscopy, or saline infused sonography;
- Hydronephrosis as determined by radiologist interpretation on renal ultrasound pre-procedurally;
- Menopausal;
- Clinical history of any thromboembolic disease;
- Blood urine nitrogen (BUN) greater than 20 mg/dL and/or serum creatinine greater than 1.2 mg/dL unresolved with change in diet or hydration; · One or more lower uterine segment fibroids determined through pelvic exam;
- History of gynecologic malignancy, atypical endometrial hyperplasia, or pelvic inflammatory disease;
- Abnormal endometrial biopsy within the last 6 months prior to procedure;
- Pelvic mass outside the uterus suggesting other disease processes;
- Any current acute or chronic systemic infection or localized pelvic infection, including an unresolved urinary tract infection;
- Using GnRH agonist or mifepristone within 6-months prior to the start of the study;
- An intrauterine device (IUD) in place;
- Using anticoagulation therapy (except OTC treatments (e.g. aspirin)), or have an underlying bleeding disorder;
- Unsuitable for MRI examination, if within study subgroup to undergo MRI evaluation (e.g. severe claustrophobia, non-MRI-compatible implanted metalloid devices);
- Prior endometrial ablation, uterine artery embolization, or uterine artery ligation;
- Poor procedural candidate due to medical conditions as determined by the investigator (e.g. anesthesia class, renal insufficiency, heart disease);
- Grade 1 for 3D Color Doppler or no flow observed for cystoscopy on ureter flow assessment if applicable.
Sites / Locations
- Women's Health Research
- Holy Cross Medical Group
- University Women's Care - Wayne State University
- Minnesota Gynecology and Surgery
- St. Luke's Hospital
- North Carolina Children's & Adults' Clinical Research Foundation
- Complete Healthcare for Women
- Hahnemann University Hospital - Drexel University School of Med.
- Matlock Ob/Gyn
- St. Joseph's Health Care
- Hospital Universitario
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
DUAO Device
Arm Description
Doppler-guided uterine artery occlusion device (Single-arm study)
Outcomes
Primary Outcome Measures
No Surgical Re-intervention
Number of participants without any subsequent surgical procedure intended to manage fibroid symptoms performed. Potential procedures included surgical hysterectomy or dilatation and curettage (D&C) for treatment of menorrhagia; uterine artery embolization (UAE) or laparoscopic uterine artery occlusion; endometrial resection or ablation; myomectomy or myolysis.
Improvement in Pictorial Blood Loss Assessment Chart (PBLAC) Score
Number of participants with a 50% or greater reduction in PBLAC score from baseline at 12 mo and a PBLAC score of less than 250. PBLAC is a simple validated semiquantitative method of measuring total menstrual blood loss using a pictorial representation of blood loss, where higher scores indicate more blood loss. This hybrid endpoint combined the reduction in PBLAC score with the total PBLAC score.
Secondary Outcome Measures
Mean Improvement in Health Related Quality of Life (HRQOL) Scores
Participants categorized as "better" in the total UFS-QOL questionnaire, indicating an overall improvement in health-related quality of life. On this scale, higher scores are indicative of better quality of life, with a maximum(best)score of 100 and a minimum (worst)score of 0. "Better" was defined as a change of +12 or more from baseline at 12 mo.
Maintenance of Menses
Number of participants with continuation of menstrual cycles without interruption for three consecutive months
Procedural Satisfaction
Number of participants with responses of either "satisfied" or "very satisfied" on a qualitative survey that ranged from "very dissatisfied" (worst) to "very satisfied" (best)
Decrease in Fibroid Bulk
Number of participants with a minimum 15% decrease in fibroid bulk based on independent magnetic resonance imaging (MRI) review from baseline at 12 mo.
Note: As per protocol, MRIs were planned only for subjects 1 - 40, 81 - 120, and 161-200.
Mean Improvement in Uterine Fibroid Symptom Quality of Life (UFS-QOL) Symptom Severity Scores
Number of participants categorized as "better" in the UFS-QOL sympton severity questionnaire, indicating an overall improvement in fibroid related symptoms. On this scale, higher scores are indicative of increasing symptom distress, with a maximum(worst)score of 100 and a minimum (best)score of 0. "Better" was defined as a change of -11 or less from baseline at 12 mo.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT00496080
Brief Title
Doppler-Guided Uterine Artery Occlusion (DUAO) Device for Fibroid Related Bleeding
Acronym
DUAO
Official Title
A Pivotal Study of Doppler Guided Uterine Artery Occlusion as Treatment for the Reduction of Fibroid Associated Bleeding
Study Type
Interventional
2. Study Status
Record Verification Date
September 2012
Overall Recruitment Status
Terminated
Why Stopped
Trial terminated early due to results from a similar study.
Study Start Date
June 2007 (undefined)
Primary Completion Date
September 2010 (Actual)
Study Completion Date
October 2010 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ethicon, Inc.
4. Oversight
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The objective of this study is to evaluate the safety and effectiveness of Doppler guided uterine artery occlusion (D-UAO) for the reduction of fibroid associated bleeding.
Detailed Description
The GYNECARE GYNOCCLUDE D-UAO Instruments are single-use disposable instruments consisting of a GYNECARE GYNOCCLUDE Uterine Stabilizer, a GYNECARE GYNOCCLUDEM Introducer Sheath, a GYNECARE GYNOCCLUDE Doppler Clamp, and a GYNECARE GYNOCCLUDE Coupler.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Menorrhagia, Uterine Fibroids
Keywords
Menorrhagia associated with Uterine Fibroids
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
87 (Actual)
8. Arms, Groups, and Interventions
Arm Title
DUAO Device
Arm Type
Experimental
Arm Description
Doppler-guided uterine artery occlusion device (Single-arm study)
Intervention Type
Device
Intervention Name(s)
Doppler-Guided Uterine Artery Occlusion Device (DUAO)
Other Intervention Name(s)
floSTAT
Intervention Description
Investigational transvaginal clamp inserted one time for 6 hours.
Primary Outcome Measure Information:
Title
No Surgical Re-intervention
Description
Number of participants without any subsequent surgical procedure intended to manage fibroid symptoms performed. Potential procedures included surgical hysterectomy or dilatation and curettage (D&C) for treatment of menorrhagia; uterine artery embolization (UAE) or laparoscopic uterine artery occlusion; endometrial resection or ablation; myomectomy or myolysis.
Time Frame
Study completion
Title
Improvement in Pictorial Blood Loss Assessment Chart (PBLAC) Score
Description
Number of participants with a 50% or greater reduction in PBLAC score from baseline at 12 mo and a PBLAC score of less than 250. PBLAC is a simple validated semiquantitative method of measuring total menstrual blood loss using a pictorial representation of blood loss, where higher scores indicate more blood loss. This hybrid endpoint combined the reduction in PBLAC score with the total PBLAC score.
Time Frame
From baseline to 12 months
Secondary Outcome Measure Information:
Title
Mean Improvement in Health Related Quality of Life (HRQOL) Scores
Description
Participants categorized as "better" in the total UFS-QOL questionnaire, indicating an overall improvement in health-related quality of life. On this scale, higher scores are indicative of better quality of life, with a maximum(best)score of 100 and a minimum (worst)score of 0. "Better" was defined as a change of +12 or more from baseline at 12 mo.
Time Frame
From baseline to 12 months
Title
Maintenance of Menses
Description
Number of participants with continuation of menstrual cycles without interruption for three consecutive months
Time Frame
12 months
Title
Procedural Satisfaction
Description
Number of participants with responses of either "satisfied" or "very satisfied" on a qualitative survey that ranged from "very dissatisfied" (worst) to "very satisfied" (best)
Time Frame
12 months
Title
Decrease in Fibroid Bulk
Description
Number of participants with a minimum 15% decrease in fibroid bulk based on independent magnetic resonance imaging (MRI) review from baseline at 12 mo.
Note: As per protocol, MRIs were planned only for subjects 1 - 40, 81 - 120, and 161-200.
Time Frame
From baseline to 12-months
Title
Mean Improvement in Uterine Fibroid Symptom Quality of Life (UFS-QOL) Symptom Severity Scores
Description
Number of participants categorized as "better" in the UFS-QOL sympton severity questionnaire, indicating an overall improvement in fibroid related symptoms. On this scale, higher scores are indicative of increasing symptom distress, with a maximum(worst)score of 100 and a minimum (best)score of 0. "Better" was defined as a change of -11 or less from baseline at 12 mo.
Time Frame
From baseline to 12 months
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
25 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
25 to 50 years of age;
PBLAC score of 150 or greater;
Completed child-bearing;
Normal Pap smear within 12 months;
Cervix suitable for tenaculum placement as determined by pelvic exam;
At least one uterine fibroid of 3 cm diameter or greater with a prevailing pathology (e.g., as opposed to adenomyosis) of fibroids determined through ultrasound;
Willing to maintain use or non-use of hormonal contraception from 3 months pre-study throughout the 12-month follow-up period;
Willing to maintain use or non-use of anti-fibrinolytic agents from 3 months pre-study throughout the 12-month follow-up period;
Able to tolerate the required prolonged supine position during treatment (approximately 6 hours);
Willing and able to provide informed consent and to follow study-related requirements;
Exclusion Criteria:
Pregnancy (as confirmed immediately prior to procedure)
Fibroid diameter greater than 8.0 cm determined through transvaginal ultrasound; [or if 2 dimensions are measured, total dimension greater than 16 cm; or if the 3 dimensions (length, height, width) are measured, total dimension greater than 24 cm];
Presence of a pedunculated fibroid determined by ultrasound; hysteroscopy, or saline infused sonography;
Hydronephrosis as determined by radiologist interpretation on renal ultrasound pre-procedurally;
Menopausal;
Clinical history of any thromboembolic disease;
Blood urine nitrogen (BUN) greater than 20 mg/dL and/or serum creatinine greater than 1.2 mg/dL unresolved with change in diet or hydration; · One or more lower uterine segment fibroids determined through pelvic exam;
History of gynecologic malignancy, atypical endometrial hyperplasia, or pelvic inflammatory disease;
Abnormal endometrial biopsy within the last 6 months prior to procedure;
Pelvic mass outside the uterus suggesting other disease processes;
Any current acute or chronic systemic infection or localized pelvic infection, including an unresolved urinary tract infection;
Using GnRH agonist or mifepristone within 6-months prior to the start of the study;
An intrauterine device (IUD) in place;
Using anticoagulation therapy (except OTC treatments (e.g. aspirin)), or have an underlying bleeding disorder;
Unsuitable for MRI examination, if within study subgroup to undergo MRI evaluation (e.g. severe claustrophobia, non-MRI-compatible implanted metalloid devices);
Prior endometrial ablation, uterine artery embolization, or uterine artery ligation;
Poor procedural candidate due to medical conditions as determined by the investigator (e.g. anesthesia class, renal insufficiency, heart disease);
Grade 1 for 3D Color Doppler or no flow observed for cystoscopy on ureter flow assessment if applicable.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Piet Hinoul, M.D.
Organizational Affiliation
Ethicon, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Women's Health Research
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85015-2110
Country
United States
Facility Name
Holy Cross Medical Group
City
Fort Lauderdale
State/Province
Florida
ZIP/Postal Code
33308
Country
United States
Facility Name
University Women's Care - Wayne State University
City
Southfield
State/Province
Michigan
ZIP/Postal Code
48034
Country
United States
Facility Name
Minnesota Gynecology and Surgery
City
Edina
State/Province
Minnesota
ZIP/Postal Code
55435
Country
United States
Facility Name
St. Luke's Hospital
City
Chesterfield
State/Province
Missouri
ZIP/Postal Code
63017
Country
United States
Facility Name
North Carolina Children's & Adults' Clinical Research Foundation
City
Chapel Hill
State/Province
North Carolina
ZIP/Postal Code
27514
Country
United States
Facility Name
Complete Healthcare for Women
City
Columbus
State/Province
Ohio
ZIP/Postal Code
43231
Country
United States
Facility Name
Hahnemann University Hospital - Drexel University School of Med.
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19102
Country
United States
Facility Name
Matlock Ob/Gyn
City
Arlington
State/Province
Texas
ZIP/Postal Code
76014
Country
United States
Facility Name
St. Joseph's Health Care
City
London
State/Province
Ontario
ZIP/Postal Code
N6A 4V2
Country
Canada
Facility Name
Hospital Universitario
City
Monterrey
State/Province
Nuevo Leon
ZIP/Postal Code
64460
Country
Mexico
12. IPD Sharing Statement
Learn more about this trial
Doppler-Guided Uterine Artery Occlusion (DUAO) Device for Fibroid Related Bleeding
We'll reach out to this number within 24 hrs