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Muscle Progenitor Cell Therapy for Urinary Incontinence

Primary Purpose

Urinary Incontinence

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
Autologous Muscle Progenitor Cells
Sponsored by
Wake Forest University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Urinary Incontinence focused on measuring urinary incontinence, muscle progenitor cells, MPCs

Eligibility Criteria

18 Years - 75 Years (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria:

  • Adult female patients who are not pregnant or lactating/breast-feeding and must be either not sexually active, surgically sterilized, or must be practicing an effective method of birth control as determined by the investigator (e.g., oral contraceptives, double barrier methods, hormonal injectable or implanted contraceptives, tubal ligation, or partner with vasectomy)
  • Patients between the ages of 18 and 75 years
  • Patients with positive diagnosis of urinary incontinence due to sphincter insufficiency caused by acquired (e.g., stress urinary incontinence) and/or congenital (bilateral ectopic ureters with incompetent bladder neck; or female epispadias with or without bladder exstrophy) conditions.
  • Patients with cystometric capacity of bladder > 100 ml
  • Patients with normal renal function
  • Patients with a history of primary incontinence

Exclusion Criteria:

  • Patients with a history of hypercontractile bladder, non-compliant bladder, hydronephrosis or neurogenic bladder
  • Patients with an active urinary tract infection as evidenced by positive urine culture
  • Patients who are taking medication that affect urination (e.g. medically necessary, stable drugs) such as prescription drugs, over-the-counter drugs, or dietary supplements, including herbal supplements and those taken with teas
  • Patients requiring concomitant use of or treatment with immunosuppressive agents
  • Patients with a history of systemic conditions, including but not limited to HIV, diabetes and chronic liver disease (including Hepatitis B or C), that the Investigator believes may jeopardize the safety of the patient to participate in the study
  • Patients with evidence or diagnosis of any primary muscle disease or coagulation disorder (including concomitant anti-coagulation therapy at enrollment)
  • Patients who have been treated with any other investigational drug or participated in any investigational study within 30 days prior to enrollment in this study
  • Patients with urinary incontinence other than the categories being investigated
  • Patients with significant (>grade 2) pelvic organ prolapse (e.g., cystocele, rectocele)
  • Patients with vaginal prolapse beyond introitus
  • Patients with neurological disorders (e.g., multiple sclerosis, Parkinson's disease)
  • Patients with abnormal bladder capacity (i.e., less than 100 cc)
  • Patients with abnormal urologic conditions, including post-void residual, urethral stricture and bladder neck contracture, spastic bladder, vesicoureteral reflux, bladder stones, bladder tumors, hydronephrosis, other renal impairment

Sites / Locations

  • Wake Forest Urology Clinic
  • Wake Forest Institute for Regenerative Medicine (WFIRM)

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Autologous Muscle Progenitor Cells

Arm Description

Autologous MPCs, administered via a single, direct injection into the bladder neck sphincter region

Outcomes

Primary Outcome Measures

Incidence of treatment-related serious adverse events and the incidence of protocol defined treatment or procedure related adverse events
the subject/biopsy/treatment site will be monitored for signs of bleeding, infection, continued pain, prolonged hospitalization

Secondary Outcome Measures

change in Incontinence Assessment by pad test
Subjects will undergo 1 hour and 24 hour pad tests (pads are weighed)at baseline which are compared to the tests post-injection treatment
change in Number of incontinence episodes and pads used per day
through Voiding diaries, the number of incontinence episodes and pads used per day are compared to baseline
change in Urogenital distress and quality of life
subjects will complete the Urinary Incontinence and Quality of Life questionnaires and the baseline results will be compared to the 3, 6 and 12 months post injection results.

Full Information

First Posted
August 27, 2013
Last Updated
January 8, 2019
Sponsor
Wake Forest University
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1. Study Identification

Unique Protocol Identification Number
NCT01953315
Brief Title
Muscle Progenitor Cell Therapy for Urinary Incontinence
Official Title
A Phase 1 Pilot Safety and Feasibility Study of Muscle Progenitor Cell (MPC) Therapy for Urinary Incontinence
Study Type
Interventional

2. Study Status

Record Verification Date
January 2018
Overall Recruitment Status
Completed
Study Start Date
January 2014 (undefined)
Primary Completion Date
January 2018 (Actual)
Study Completion Date
January 2018 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Wake Forest University

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This study is designed to evaluate the safety of muscle progenitor cells (MPCs) for the treatment of urinary incontinence due to incompetent outlet (bladder neck/urethra).
Detailed Description
Eligible subjects with a diagnosis of urinary incontinence who give consent to take part will undergo a biopsy of the muscle from the inner thigh under anesthesia. The muscle sample will be cultured and expanded for approximately 6 weeks. The product, composed of autologous, ex vivo-expanded muscle progenitor cells (MPCs) in suspension, will be delivered via targeted injection into the bladder neck sphincter region using either an endoscopic needle via a cystoscope or periurethral injection under ultrasound guidance. All subjects will be followed at 1 week, 6 weeks, 3 months, 6 months and 12 months post-injection.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Urinary Incontinence
Keywords
urinary incontinence, muscle progenitor cells, MPCs

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
10 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Autologous Muscle Progenitor Cells
Arm Type
Experimental
Arm Description
Autologous MPCs, administered via a single, direct injection into the bladder neck sphincter region
Intervention Type
Biological
Intervention Name(s)
Autologous Muscle Progenitor Cells
Other Intervention Name(s)
MPCs
Intervention Description
Autologous MPCs, administered via a single, direct injection into the bladder neck sphincter region
Primary Outcome Measure Information:
Title
Incidence of treatment-related serious adverse events and the incidence of protocol defined treatment or procedure related adverse events
Description
the subject/biopsy/treatment site will be monitored for signs of bleeding, infection, continued pain, prolonged hospitalization
Time Frame
12 months
Secondary Outcome Measure Information:
Title
change in Incontinence Assessment by pad test
Description
Subjects will undergo 1 hour and 24 hour pad tests (pads are weighed)at baseline which are compared to the tests post-injection treatment
Time Frame
baseline, 3, 6, and 12 months post-injection
Title
change in Number of incontinence episodes and pads used per day
Description
through Voiding diaries, the number of incontinence episodes and pads used per day are compared to baseline
Time Frame
baseline, 3, 6 and 12 months post-injection treatment
Title
change in Urogenital distress and quality of life
Description
subjects will complete the Urinary Incontinence and Quality of Life questionnaires and the baseline results will be compared to the 3, 6 and 12 months post injection results.
Time Frame
baseline, 3, 6 and 12 months post-injection treatment

10. Eligibility

Sex
Female
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult female patients who are not pregnant or lactating/breast-feeding and must be either not sexually active, surgically sterilized, or must be practicing an effective method of birth control as determined by the investigator (e.g., oral contraceptives, double barrier methods, hormonal injectable or implanted contraceptives, tubal ligation, or partner with vasectomy) Patients between the ages of 18 and 75 years Patients with positive diagnosis of urinary incontinence due to sphincter insufficiency caused by acquired (e.g., stress urinary incontinence) and/or congenital (bilateral ectopic ureters with incompetent bladder neck; or female epispadias with or without bladder exstrophy) conditions. Patients with cystometric capacity of bladder > 100 ml Patients with normal renal function Patients with a history of primary incontinence Exclusion Criteria: Patients with a history of hypercontractile bladder, non-compliant bladder, hydronephrosis or neurogenic bladder Patients with an active urinary tract infection as evidenced by positive urine culture Patients who are taking medication that affect urination (e.g. medically necessary, stable drugs) such as prescription drugs, over-the-counter drugs, or dietary supplements, including herbal supplements and those taken with teas Patients requiring concomitant use of or treatment with immunosuppressive agents Patients with a history of systemic conditions, including but not limited to HIV, diabetes and chronic liver disease (including Hepatitis B or C), that the Investigator believes may jeopardize the safety of the patient to participate in the study Patients with evidence or diagnosis of any primary muscle disease or coagulation disorder (including concomitant anti-coagulation therapy at enrollment) Patients who have been treated with any other investigational drug or participated in any investigational study within 30 days prior to enrollment in this study Patients with urinary incontinence other than the categories being investigated Patients with significant (>grade 2) pelvic organ prolapse (e.g., cystocele, rectocele) Patients with vaginal prolapse beyond introitus Patients with neurological disorders (e.g., multiple sclerosis, Parkinson's disease) Patients with abnormal bladder capacity (i.e., less than 100 cc) Patients with abnormal urologic conditions, including post-void residual, urethral stricture and bladder neck contracture, spastic bladder, vesicoureteral reflux, bladder stones, bladder tumors, hydronephrosis, other renal impairment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Gopal Badlani, MD
Organizational Affiliation
Wake Forest School of Medicine, Dept. of Urology
Official's Role
Principal Investigator
Facility Information:
Facility Name
Wake Forest Urology Clinic
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27103
Country
United States
Facility Name
Wake Forest Institute for Regenerative Medicine (WFIRM)
City
Winston-Salem
State/Province
North Carolina
ZIP/Postal Code
27157
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Muscle Progenitor Cell Therapy for Urinary Incontinence

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