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Engage 24: Evaluation of the Safety and Effectiveness of URG101 in Subjects With Interstitial Cystitis/Bladder Pain Syndrome

Primary Purpose

Interstitial Cystitis, Bladder Pain Syndrome

Status
Terminated
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
URG101
Placebo
Lidocaine
Heparin
Sponsored by
Urigen
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Interstitial Cystitis

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

Subjects diagnosed with interstitial cystitis/bladder pain syndrome must meet all of the following criteria to participate in the study:

  1. Have provided written informed consent to participate in this trial
  2. Be male or female, ≥ 18 years of age
  3. Have moderate-to-severe symptoms of bladder pain of bladder origin for at least 9 months prior to the study
  4. May or may not have received a cystoscopy in association with their diagnosis of interstitial cystitis/bladder pain syndrome prior to or at time of screening
  5. Have a score of ≥ 15 and < 30 on the PUF questionnaire, completed at screening
  6. A minimum score of 5 is required on the VAS
  7. Have been using a stable dose of hormone therapy for ≥ 3 months, if female and currently taking hormone therapy

Exclusion Criteria:

  1. Pregnant or breastfeeding. For females of child bearing potential and males, if sexually active, must be willing to commit to an acceptable method of birth control for the duration of the study.
  2. Have a known hypersensitivity to heparin or lidocaine
  3. Have used any local anesthetic by any route within 24 hours prior to study drug administration, or used a lidocaine patch within 14 days prior to study drug administration
  4. Have used a tricyclic antidepressant or a gamma-Aminobutyric acid (GABA) analogue (gabapentin or pregabalin) unless taking the medication for ≥ 3 weeks. The stable dose of gabapentin may not exceed 1,200 mg per day, and the stable dose of pregabalin may not exceed 150 mg per day.
  5. Have used any pain medication within 6 hours prior to study drug administration
  6. Have used narcotics or medical marijuana ≤ 3 weeks prior to study entry (generic names: fentanyl, hydrocodone, hydromorphone, levorphanol, medical marijuana, methadone, morphine, oxycodone, propoxyphene, tramadol). Subjects who have received codeine within this time period may be admitted if the use is not chronic, and not within 6 hours of enrollment, such that they are not at risk for GI or opiate withdrawal symptoms that in the opinion of the investigator would impact the subject's study participation due to their ability to follow the study protocol or bias study results.
  7. Have used prohibited drugs as determined by self-report, positive urine drug screen, or in the opinion of the investigator be under the influence of drugs affecting mentation precluding their ability to follow the study protocol or bias study results
  8. Have a known clinically significant abnormal laboratory test value defined by the investigator
  9. Have a neurogenic bladder or other disorder that, in the opinion of the investigator, may cause neurogenic bladder (including Parkinson's disease, multiple sclerosis, epilepsy, myasthenia gravis, movement disorders, spinal cord damage)
  10. Have pain or a pain disorder that, in the opinion of the investigator, would make it difficult to discriminate pelvic pain of bladder origin from the other pain
  11. Have severe depression, bipolar disorder, schizophrenia, anxiety, attention deficit disorder, obsessive compulsive disorder, or other major central nervous system disorder
  12. Have history of arrhythmias, conduction disturbances, or cardiac disease, or any coexisting medical condition that, in the opinion of the investigator, may be significant or interfere with study procedures or interpretation of study results
  13. Had bladder instillation therapy within 7 days prior to study entry or had a prior bladder instillation with heparin and lidocaine and did not respond
  14. Had dilatation (hydrodistention) of bladder within 3 months of study entry
  15. Evidence or suspected presence of cancer detected during cystoscopy prior to or at time of initial screening.
  16. Has received any investigational drug or device within 30 days prior to screening
  17. Is currently enrolled in another investigational drug or device study
  18. Is unwilling or unable to abide by the requirements of the study
  19. Have an actively bleeding lesion or area in the bladder as detected by dipstick urinalysis and investigator assessment, immediately prior to randomization
  20. Have had any of the following: bacterial, chemical (including ketamine and cyclophosphamide) or radiation cystitis; gynecological, urological or rectal cancer; current chemotherapy; tuberculous cystitis; urinary schistosomiasis; bladder or uretal calculi; vaginitis or genital herpes; urethral diverticulum or bladder fistulae.

Sites / Locations

  • IC Study, LLC
  • University of California San Diego
  • Georgia Urology
  • The Urogynecology Center
  • Rutgers Women's Health Clinic
  • The Arthur Smith Institue for Urology- North Shore Long Island Jewish Health System
  • Wake Forest University Health Sciences
  • MetroHealth System, Center for Advanced Gynecology
  • Medical University of South Carolina
  • Sanford Research
  • Urology of Virginia, PLLC

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Placebo Comparator

Experimental

Experimental

Arm Label

URG101

Placebo

Lidocaine

Heparin

Arm Description

A single 15 mL dose of URG101,a mix of buffered Lidocaine (200 mg) and Heparin (50,000 IU), delivered to the bladder via catheter.

A single 15 mL dose of placebo delivered to the bladder via catheter.

A single 15 mL dose of buffered Lidocaine (200 mg) delivered to the bladder via catheter.

A single 15 mL dose of buffered Heparin (50,000 IU) delivered to the bladder.

Outcomes

Primary Outcome Measures

Change in bladder pain differences from baseline as determined by using the Visual Analog Scale (VAS)
The primary objective is to evaluate the change in bladder pain intensity differences from baseline to either 12 hours or 24 hours after administration of URG101 compared with the administration of lidocaine alone, heparin alone, and placebo as determined by using the Visual Analog Scale (VAS).

Secondary Outcome Measures

Change in urgency from baseline as determined using the VAS
Evaluate the change in urgency intensity differences from baseline to 12 or 24 hours after administration of URG101 compared to lidocaine alone, heparin alone, and placebo using the VAS.
The relationship of plasma lidocaine concentrations at 1 hour after study drug administration to bladder pain and urgency
Evaluate the relationship of plasma lidocaine concentrations at 1 hour after study drug administration to bladder pain and urgency at 1 hour, and from baseline to 12 and 24 hours after treatment with URG101 compared to lidocaine alone, heparin alone, and placebo.
Safety and tolerability of study medication (Adverse events)
Adverse events reported after treatment with URG101 compared to lidocaine alone, heparin alone, and placebo.

Full Information

First Posted
October 28, 2015
Last Updated
August 19, 2020
Sponsor
Urigen
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1. Study Identification

Unique Protocol Identification Number
NCT02591199
Brief Title
Engage 24: Evaluation of the Safety and Effectiveness of URG101 in Subjects With Interstitial Cystitis/Bladder Pain Syndrome
Official Title
A Phase 2a, Randomized, Double-Blind, Placebo-Controlled Multi-Center Single Dose Study to Evaluate the Safety and Effectiveness of URG101 Compared With the Individual Components Lidocaine and Heparin in Subjects With Interstitial Cystitis/Bladder Pain Syndrome
Study Type
Interventional

2. Study Status

Record Verification Date
August 2020
Overall Recruitment Status
Terminated
Why Stopped
Prematurely terminated based on interim study analysis
Study Start Date
September 2015 (undefined)
Primary Completion Date
May 14, 2018 (Actual)
Study Completion Date
June 18, 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Urigen

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to determine if the combination product (URG101) is safe and effective versus its individual components (Heparin Sodium and Lidocaine Hydrochloride) for the treatment of Interstitial Cystitis/Bladder Pain Syndrome. The study is randomized and double-blinded such that neither the subject nor doctor will know which drug or placebo is received.
Detailed Description
This is a Phase 2a, randomized, double-blind, placebo controlled, multicenter, single-dose, pharmacokinetic study designed to determine the efficacy and safety of the combination product (URG101) compared with its individual components (Heparin Sodium and Lidocaine Hydrochloride). Eligible subjects exhibiting moderate to severe symptoms of bladder pain associated with their diagnosis of interstitial cystitis/bladder pain syndrome who have signed informed consent, will be screened and provisionally enrolled for intravesical treatment. On the day of study drug administration subjects will be randomized (2:1:2:1; URG101:placebo:lidocaine:heparin) and will receive a single administration of one of four intravesical treatments in a blinded fashion, based on random assignment: URG101 (buffered lidocaine-heparin) Placebo (phosphate buffer) Lidocaine hydrocholoride buffered alone Heparin sodium buffered alone Efficacy and safety assessments will be completed for 24 hours after study drug administration. End of Study Follow-up will be completed by telephone 48 to 72 hours after study drug administration.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Interstitial Cystitis, Bladder Pain Syndrome

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
92 (Actual)

8. Arms, Groups, and Interventions

Arm Title
URG101
Arm Type
Experimental
Arm Description
A single 15 mL dose of URG101,a mix of buffered Lidocaine (200 mg) and Heparin (50,000 IU), delivered to the bladder via catheter.
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
A single 15 mL dose of placebo delivered to the bladder via catheter.
Arm Title
Lidocaine
Arm Type
Experimental
Arm Description
A single 15 mL dose of buffered Lidocaine (200 mg) delivered to the bladder via catheter.
Arm Title
Heparin
Arm Type
Experimental
Arm Description
A single 15 mL dose of buffered Heparin (50,000 IU) delivered to the bladder.
Intervention Type
Drug
Intervention Name(s)
URG101
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Type
Drug
Intervention Name(s)
Lidocaine
Intervention Type
Drug
Intervention Name(s)
Heparin
Primary Outcome Measure Information:
Title
Change in bladder pain differences from baseline as determined by using the Visual Analog Scale (VAS)
Description
The primary objective is to evaluate the change in bladder pain intensity differences from baseline to either 12 hours or 24 hours after administration of URG101 compared with the administration of lidocaine alone, heparin alone, and placebo as determined by using the Visual Analog Scale (VAS).
Time Frame
24 hours
Secondary Outcome Measure Information:
Title
Change in urgency from baseline as determined using the VAS
Description
Evaluate the change in urgency intensity differences from baseline to 12 or 24 hours after administration of URG101 compared to lidocaine alone, heparin alone, and placebo using the VAS.
Time Frame
24 hours
Title
The relationship of plasma lidocaine concentrations at 1 hour after study drug administration to bladder pain and urgency
Description
Evaluate the relationship of plasma lidocaine concentrations at 1 hour after study drug administration to bladder pain and urgency at 1 hour, and from baseline to 12 and 24 hours after treatment with URG101 compared to lidocaine alone, heparin alone, and placebo.
Time Frame
24 hours
Title
Safety and tolerability of study medication (Adverse events)
Description
Adverse events reported after treatment with URG101 compared to lidocaine alone, heparin alone, and placebo.
Time Frame
Up to 72 hours

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Subjects diagnosed with interstitial cystitis/bladder pain syndrome must meet all of the following criteria to participate in the study: Have provided written informed consent to participate in this trial Be male or female, ≥ 18 years of age Have moderate-to-severe symptoms of bladder pain of bladder origin for at least 9 months prior to the study May or may not have received a cystoscopy in association with their diagnosis of interstitial cystitis/bladder pain syndrome prior to or at time of screening Have a score of ≥ 15 and < 30 on the PUF questionnaire, completed at screening A minimum score of 5 is required on the VAS Have been using a stable dose of hormone therapy for ≥ 3 months, if female and currently taking hormone therapy Exclusion Criteria: Pregnant or breastfeeding. For females of child bearing potential and males, if sexually active, must be willing to commit to an acceptable method of birth control for the duration of the study. Have a known hypersensitivity to heparin or lidocaine Have used any local anesthetic by any route within 24 hours prior to study drug administration, or used a lidocaine patch within 14 days prior to study drug administration Have used a tricyclic antidepressant or a gamma-Aminobutyric acid (GABA) analogue (gabapentin or pregabalin) unless taking the medication for ≥ 3 weeks. The stable dose of gabapentin may not exceed 1,200 mg per day, and the stable dose of pregabalin may not exceed 150 mg per day. Have used any pain medication within 6 hours prior to study drug administration Have used narcotics or medical marijuana ≤ 3 weeks prior to study entry (generic names: fentanyl, hydrocodone, hydromorphone, levorphanol, medical marijuana, methadone, morphine, oxycodone, propoxyphene, tramadol). Subjects who have received codeine within this time period may be admitted if the use is not chronic, and not within 6 hours of enrollment, such that they are not at risk for GI or opiate withdrawal symptoms that in the opinion of the investigator would impact the subject's study participation due to their ability to follow the study protocol or bias study results. Have used prohibited drugs as determined by self-report, positive urine drug screen, or in the opinion of the investigator be under the influence of drugs affecting mentation precluding their ability to follow the study protocol or bias study results Have a known clinically significant abnormal laboratory test value defined by the investigator Have a neurogenic bladder or other disorder that, in the opinion of the investigator, may cause neurogenic bladder (including Parkinson's disease, multiple sclerosis, epilepsy, myasthenia gravis, movement disorders, spinal cord damage) Have pain or a pain disorder that, in the opinion of the investigator, would make it difficult to discriminate pelvic pain of bladder origin from the other pain Have severe depression, bipolar disorder, schizophrenia, anxiety, attention deficit disorder, obsessive compulsive disorder, or other major central nervous system disorder Have history of arrhythmias, conduction disturbances, or cardiac disease, or any coexisting medical condition that, in the opinion of the investigator, may be significant or interfere with study procedures or interpretation of study results Had bladder instillation therapy within 7 days prior to study entry or had a prior bladder instillation with heparin and lidocaine and did not respond Had dilatation (hydrodistention) of bladder within 3 months of study entry Evidence or suspected presence of cancer detected during cystoscopy prior to or at time of initial screening. Has received any investigational drug or device within 30 days prior to screening Is currently enrolled in another investigational drug or device study Is unwilling or unable to abide by the requirements of the study Have an actively bleeding lesion or area in the bladder as detected by dipstick urinalysis and investigator assessment, immediately prior to randomization Have had any of the following: bacterial, chemical (including ketamine and cyclophosphamide) or radiation cystitis; gynecological, urological or rectal cancer; current chemotherapy; tuberculous cystitis; urinary schistosomiasis; bladder or uretal calculi; vaginitis or genital herpes; urethral diverticulum or bladder fistulae.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
C. Lowell Parsons, MD
Organizational Affiliation
Urigen
Official's Role
Study Chair
Facility Information:
Facility Name
IC Study, LLC
City
Escondido
State/Province
California
ZIP/Postal Code
92025
Country
United States
Facility Name
University of California San Diego
City
San Diego
State/Province
California
ZIP/Postal Code
92103
Country
United States
Facility Name
Georgia Urology
City
Cartersville
State/Province
Georgia
ZIP/Postal Code
30120
Country
United States
Facility Name
The Urogynecology Center
City
Overland Park
State/Province
Kansas
ZIP/Postal Code
66209
Country
United States
Facility Name
Rutgers Women's Health Clinic
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08901
Country
United States
Facility Name
The Arthur Smith Institue for Urology- North Shore Long Island Jewish Health System
City
Lake Success
State/Province
New York
ZIP/Postal Code
11042
Country
United States
Facility Name
Wake Forest University Health Sciences
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
MetroHealth System, Center for Advanced Gynecology
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44109
Country
United States
Facility Name
Medical University of South Carolina
City
Charleston
State/Province
South Carolina
ZIP/Postal Code
29425
Country
United States
Facility Name
Sanford Research
City
Sioux Falls
State/Province
South Dakota
ZIP/Postal Code
57105
Country
United States
Facility Name
Urology of Virginia, PLLC
City
Virginia Beach
State/Province
Virginia
ZIP/Postal Code
23462
Country
United States

12. IPD Sharing Statement

Links:
URL
http://www.urigen.com/
Description
Urigen N.A., Inc. homepage

Learn more about this trial

Engage 24: Evaluation of the Safety and Effectiveness of URG101 in Subjects With Interstitial Cystitis/Bladder Pain Syndrome

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