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IUB SEAD RED (Revolutionary Endometrial Ablation Device Study) (HMB)

Primary Purpose

Heavy Menstrual Bleeding

Status
Not yet recruiting
Phase
Not Applicable
Locations
Israel
Study Type
Interventional
Intervention
IUB SEAD
Sponsored by
Ocon Medical Ltd.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Heavy Menstrual Bleeding

Eligibility Criteria

40 Years - 50 Years (Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria: Female subject age 40 to 50 years, inclusive Suffering from the symptom of heavy menstrual bleeding (HMB) from benign causes with no definable organic cause and are candidates for endometrial ablation or surgical treatment. PBAC score of >150 - an average of 2 consecutive screening scores prior to study treatment Are thought to be ovulatory with cyclic predictable onset of menses with a cycle length of 24-38 days. Have either a normal appearing endometrial cavity as assessed by hysteroscopy performed within 90 days of study treatment, or one that is distorted by a FIGO Type 2 submucous leiomyoma ≤3 cm in mean diameter. Have endometrial sampling with normal histology within 6 months of the study procedure. Premenopausal status confirmed by FSH level measurement at screening (FSH < 40 IU/L). FSH level measurement will be repeated in case of a borderline result Screening hemoglobin levels >9.0 g/dL Uterine sound measurement of 6.5-12 cm (external os to internal fundus) Negative serum pregnancy test at the Screening visit and on the day of SEAD™ treatment women whose sexual activity places them at risk for pregnancy must agree to use an effective, non-hormonal, non-intrauterine method of contraception throughout the course of the study. For this study, acceptable effective methods of contraception are considered to be those listed below: Barrier method, i.e., (a) condom (male or female) with spermicide or (b) diaphragm with spermicide or Vasectomy (partner), or Abstinence, if in line with the preferred and usual lifestyle of the subject [where abstinence is defined as refraining from heterosexual intercourse] Subject is able to understand and sign a written informed consent form Subject is willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures The subject demonstrates an understanding of how to record menstrual blood loss using a menstrual pictogram Exclusion Criteria: Pregnant women or those who desire to conceive at any time in the future An endometrial cavity with any of the following: congenital malformation of (eg septate uterus), endometrial polyp >8 mm in largest dimension, FIGO Type 0 or 1 leiomyomas of any diameter or Type 2 leiomyomas > 3 cm in mean diameter; intrauterine adhesions/ synechiae that distort the endometrial cavity sufficient to impair deployment of the SEAD device. Underwent prior uterine surgery that interrupts the integrity of the uterine wall (e.g., transmural abdominal (laparoscopic or laparotomic) or hysteroscopic myomectomy and/or metroplasty during last 3 months prior to screening, classical Cesarean section, or endometrial ablation Have an abnormal endometrial biopsy that suggests either anovulation or a risk for the development of endometrial cancer (i.e., benign hyperplasia, endometrial hyperplasia with atypia, endometrial intraepithelial neoplasia, endometrial cancer) Have a documented clinical history of titanium allergy or hypersensitivity to any component of IUB™SEAD™. Suffers from active endometritis, active pelvic inflammatory disease (PID) or active sexually transmitted disease (STD) Suffers from active infection of the genitals, vagina, cervix, or uterus Presence of bacteremia, sepsis, or other active systemic infection Known/suspected abdominal, pelvic, or gynecological malignancy within the past 5 years Known clotting defects or bleeding disorders Currently using anticoagulant treatment Subjects with abnormal Papanicolaou (Pap) test or atypical squamous cells of undetermined significance (ASCUS) with positive high-risk human papilloma virus (HPV) test result within the appropriate screen timeframe, and prior to SEAD™ treatment. Alternatively, a colposcopy performed prior to SEAD™ treatment, that showed evidence of dysplasia requiring treatment. In case treatment was performed > 6 months prior to enrollment and follow-up was done with no evidence of disease by clinical evaluation, the subject is eligible. Suffers from clinically significant adenomyosis indicated by subject complaints or imaging Presence of an implantable contraceptive device, unless subject agrees to have the device removed immediately on screening, and prior to PBLAC assessment Post-partum ≤ 6-months Currently participating in or considering participation in a research study of an investigational drug or device that would begin during the course of this investigational study Any general health or mental, or other situation or condition which, in the opinion of the Investigator, could present an increased risk for the subject or impact the subject's ability to comply with protocol requirements. Has a polyp that was not removed before day of treatment

Sites / Locations

  • Shamir medical center

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment

Arm Description

IUB SEAD procedure

Outcomes

Primary Outcome Measures

Safety: Incidence and characteristics of device and/or procedure related adverse events (AEs)
occurring during the 6-months following SEAD™ device treatment
Efficacy: Change in bleeding volume
measured by Pictorial Blood Loss Assessment Chart (PBAC) at 6 months post-treatment compared to baseline.

Secondary Outcome Measures

Change from baseline quality of life (QoL)
as assessed using the MIQ questionnaire at 6, 12, 24- and 36-months post-treatment.
Change in bleeding volume
measured by Pictorial Blood Loss Assessment Chart (PBAC) at 12, 24- and 36-months post treatment.

Full Information

First Posted
October 24, 2022
Last Updated
October 31, 2022
Sponsor
Ocon Medical Ltd.
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1. Study Identification

Unique Protocol Identification Number
NCT05606146
Brief Title
IUB SEAD RED (Revolutionary Endometrial Ablation Device Study)
Acronym
HMB
Official Title
Phase IIc (Protocol 55P127): Addition of up to 10 Women to Explore Silver Systemic Absorption as a Continuation Study to: Phase IIb (Protocol 55P140)
Study Type
Interventional

2. Study Status

Record Verification Date
October 2022
Overall Recruitment Status
Not yet recruiting
Study Start Date
December 2022 (Anticipated)
Primary Completion Date
March 2024 (Anticipated)
Study Completion Date
July 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ocon Medical Ltd.

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
One of the AUB symptoms, heavy menstrual bleeding (HMB), can lead to iron deficiency and iron deficiency anemia and in acute and severe cases, can necessitate emergency medical care. This study's focus is on the symptom of HMB which has a number of benign causes. The investigative device, the IUB SEAD™, is a novel spherical endometrial ablation device developed to allow for simple, office-based chemical EA to treat benign causes of the symptom of HMB. The suggested procedure is expected to be simpler than the currently available EA methods and yet should still reduce the need for a hysterectomy.
Detailed Description
Chronic abnormal uterine bleeding (AUB), involving menstrual bleeding of abnormal quantity, duration, frequency, or regularity is experienced by 10-50% of women of reproductive age, adversely impacts quality of life, and can have substantial adverse economic impacts on patients, and healthcare systems. One of the AUB symptoms, heavy menstrual bleeding (HMB), can lead to iron deficiency and iron deficiency anemia and in acute and severe cases, can necessitate emergency medical care. This study's focus is on the symptom of HMB which has a number of benign causes. While pharmacologic treatment options exist, they are not always effective, and they are frequently associated with both side effects and ongoing cost of care. Consequently, some women desire more definitive options. Endometrial ablation (EA) is a minimally invasive approach designed to manage a number of the causes of HMB and can be performed under direct intrauterine vision with resectoscopic instruments or with a non-resectoscopic approach (non-resectoscopic endometrial ablation or NREA). For NREA, one of a number of specially designed device is inserted into the endometrial cavity to deliver thermal, cryogenic or radiofrequency electrical energy in an attempt to destroy the uterine lining or endometrium. In some jurisdictions, NREA has become an accepted office-based procedure, but is still usually performed in an institutional setting, is associated with risks associated with the procedure, anesthesia, and subsequent infertility, and has a failure rate that averages about 26%. These devices are typically expensive and require training for the surgeon and the ancillary support staff. The investigative device, the IUB SEAD™, is a novel spherical endometrial ablation device developed to allow for simple, office-based chemical EA to treat benign causes of the symptom of HMB. The suggested procedure is expected to be simpler than the currently available EA methods and yet should still reduce the need for a hysterectomy. This study will evaluate an additional exploratory endpoint in order to evaluate if there are detectable levels of silver in blood following SEAD treatment. SEAD treatment is performed locally by intrauterine administration for a duration of 30 minutes, during which the silver nitrate beads gradually dissolve. Upon dissolution the silver ions act on the mucus layer of the endometrium by binding to proteins and causing their denaturation, resulting in the formation of an eschar. The effect is local, and the bound silver is no longer active therefore it is unlikely that 100% of the silver dose will be available for absorption.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Heavy Menstrual Bleeding

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Model Description
Endometrium ablation with the IUB SEAD device
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment
Arm Type
Experimental
Arm Description
IUB SEAD procedure
Intervention Type
Device
Intervention Name(s)
IUB SEAD
Intervention Description
The investigative device, the IUB SEAD™, is a novel spherical endometrial ablation device developed to allow for simple, office-based chemical EA to treat benign causes of the symptom of HMB
Primary Outcome Measure Information:
Title
Safety: Incidence and characteristics of device and/or procedure related adverse events (AEs)
Description
occurring during the 6-months following SEAD™ device treatment
Time Frame
6 months
Title
Efficacy: Change in bleeding volume
Description
measured by Pictorial Blood Loss Assessment Chart (PBAC) at 6 months post-treatment compared to baseline.
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Change from baseline quality of life (QoL)
Description
as assessed using the MIQ questionnaire at 6, 12, 24- and 36-months post-treatment.
Time Frame
36 months
Title
Change in bleeding volume
Description
measured by Pictorial Blood Loss Assessment Chart (PBAC) at 12, 24- and 36-months post treatment.
Time Frame
36 months
Other Pre-specified Outcome Measures:
Title
SEAD levels in blood at baseline
Description
(prior to treatment) and at 1, 2 hours following treatment (post insertion), and at 1 day, 7 days, and 3 months following treatment.
Time Frame
3 months

10. Eligibility

Sex
Female
Gender Based
Yes
Gender Eligibility Description
Gender having a uterus
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
50 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Female subject age 40 to 50 years, inclusive Suffering from the symptom of heavy menstrual bleeding (HMB) from benign causes with no definable organic cause and are candidates for endometrial ablation or surgical treatment. PBAC score of >150 - an average of 2 consecutive screening scores prior to study treatment Are thought to be ovulatory with cyclic predictable onset of menses with a cycle length of 24-38 days. Have either a normal appearing endometrial cavity as assessed by hysteroscopy performed within 90 days of study treatment, or one that is distorted by a FIGO Type 2 submucous leiomyoma ≤3 cm in mean diameter. Have endometrial sampling with normal histology within 6 months of the study procedure. Premenopausal status confirmed by FSH level measurement at screening (FSH < 40 IU/L). FSH level measurement will be repeated in case of a borderline result Screening hemoglobin levels >9.0 g/dL Uterine sound measurement of 6.5-12 cm (external os to internal fundus) Negative serum pregnancy test at the Screening visit and on the day of SEAD™ treatment women whose sexual activity places them at risk for pregnancy must agree to use an effective, non-hormonal, non-intrauterine method of contraception throughout the course of the study. For this study, acceptable effective methods of contraception are considered to be those listed below: Barrier method, i.e., (a) condom (male or female) with spermicide or (b) diaphragm with spermicide or Vasectomy (partner), or Abstinence, if in line with the preferred and usual lifestyle of the subject [where abstinence is defined as refraining from heterosexual intercourse] Subject is able to understand and sign a written informed consent form Subject is willing and able to comply with scheduled visits, treatment plan, laboratory tests, and other study procedures The subject demonstrates an understanding of how to record menstrual blood loss using a menstrual pictogram Exclusion Criteria: Pregnant women or those who desire to conceive at any time in the future An endometrial cavity with any of the following: congenital malformation of (eg septate uterus), endometrial polyp >8 mm in largest dimension, FIGO Type 0 or 1 leiomyomas of any diameter or Type 2 leiomyomas > 3 cm in mean diameter; intrauterine adhesions/ synechiae that distort the endometrial cavity sufficient to impair deployment of the SEAD device. Underwent prior uterine surgery that interrupts the integrity of the uterine wall (e.g., transmural abdominal (laparoscopic or laparotomic) or hysteroscopic myomectomy and/or metroplasty during last 3 months prior to screening, classical Cesarean section, or endometrial ablation Have an abnormal endometrial biopsy that suggests either anovulation or a risk for the development of endometrial cancer (i.e., benign hyperplasia, endometrial hyperplasia with atypia, endometrial intraepithelial neoplasia, endometrial cancer) Have a documented clinical history of titanium allergy or hypersensitivity to any component of IUB™SEAD™. Suffers from active endometritis, active pelvic inflammatory disease (PID) or active sexually transmitted disease (STD) Suffers from active infection of the genitals, vagina, cervix, or uterus Presence of bacteremia, sepsis, or other active systemic infection Known/suspected abdominal, pelvic, or gynecological malignancy within the past 5 years Known clotting defects or bleeding disorders Currently using anticoagulant treatment Subjects with abnormal Papanicolaou (Pap) test or atypical squamous cells of undetermined significance (ASCUS) with positive high-risk human papilloma virus (HPV) test result within the appropriate screen timeframe, and prior to SEAD™ treatment. Alternatively, a colposcopy performed prior to SEAD™ treatment, that showed evidence of dysplasia requiring treatment. In case treatment was performed > 6 months prior to enrollment and follow-up was done with no evidence of disease by clinical evaluation, the subject is eligible. Suffers from clinically significant adenomyosis indicated by subject complaints or imaging Presence of an implantable contraceptive device, unless subject agrees to have the device removed immediately on screening, and prior to PBLAC assessment Post-partum ≤ 6-months Currently participating in or considering participation in a research study of an investigational drug or device that would begin during the course of this investigational study Any general health or mental, or other situation or condition which, in the opinion of the Investigator, could present an increased risk for the subject or impact the subject's ability to comply with protocol requirements. Has a polyp that was not removed before day of treatment
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Noam Smorjick, MD
Phone
089772512
Email
nsmorgik@shamir.gov.il
First Name & Middle Initial & Last Name or Official Title & Degree
Sergio Haimovich, Md
Phone
072-215-0105
Email
sergio@oconmed.com
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Noam Smorjick, MD
Organizational Affiliation
Shamir medical center ,Rishon LeZion
Official's Role
Principal Investigator
Facility Information:
Facility Name
Shamir medical center
City
Rishon LeZion
Country
Israel
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Noam Smorjick, MD

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

IUB SEAD RED (Revolutionary Endometrial Ablation Device Study)

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