Stress Urinary Incontinence Study to Assess Safety and Efficacy of Muvon's Muscle Precursor Cell Therapy (SUISSE MPC2)
Primary Purpose
Female Stress Urinary Incontinence
Status
Recruiting
Phase
Phase 2
Locations
Switzerland
Study Type
Interventional
Intervention
autologous muscle precursor cells
Sponsored by
About this trial
This is an interventional treatment trial for Female Stress Urinary Incontinence focused on measuring SUI, Incontinence, rhabdomyosphincter, urine, Stress Incontinence, LUTS, lower urinary tract
Eligibility Criteria
Inclusion Criteria:
- Predominant clinical diagnosis of SUI
- Stress incontinence ≥ grade I for at least 6 months
- Patient has at least once been treated with, and failed prior conservative treatments
- Patient had no improvement of SUI symptoms for at least 6 months before enrollment
- Patients with a certain amount of leaks or /and a predefined pad weight at screening
- Candidate for a surgical treatment
- Negative blood test: Human immunodeficiency virus (HIV 1/2), Hepatitis B HBsAg, Anti HBc, Hepatitis C, Anti-HCV-Ab and Syphilis
- Negative laboratory or blood test, and medical examination to eliminate risk of sexually transmitted diseases (STD) per investigators' discretion
- Competent to comprehend, sign, and date informed consent form before any study-specific procedure is performed
- Able to communicate well with the Investigator, and to understand and comply with the requirements of the study including answering the required questionnaires
Exclusion Criteria:
- History of anti-incontinence surgery or prolapse surgery.
- Prolapse
- Diagnosed Hypermobile Urethra
Previous diagnosis of any of the following conditions, disorders, or diseases of the urinary tract:
- Clinically significant cystocele or rectocele
- Ureteric bladder, urethral or rectal fistula
- Uncorrected congenital abnormality leading to urinary incontinence
- Interstitial cystitis
- Urinary urgency that results in leakage (as a predominant symptom)
- Adult enuresis
- Urodynamically proven detrusor instability or detrusor sphincter dyssynergia (DSD)
- Sensory urgency defined as first sensation of bladder fill (urge to void) of <100 ml
- No sensation at any time during the simple filling cystometry procedure
- Known urethral Stenosis (ureterocystoscopy) or urethral diverticulum
- History of cancer (< 5 year of remission) or history of pelvic radiotherapy
- Immunosuppressed patients
- Women who are pregnant or become pregnant during the course of the study, breast feeding or <12 months postpartum
- Untreated symptomatic urinary tract infection
- Fever (as defined by ≥ 38,5°C, axillar measurement), any infectious disease, cold or flu within the last 7 days
- Unstable severe systemic disease including uncontrolled hypertension, unstable angina, or myocardial infarction, severe coagulation disorders, bleeding diathesis, emboli, thrombophlebitis, infectious diseases, poor wound healing, and poorly controlled diabetes mellitus within 6 months before enrolment
- Known allergy/intolerance to at least one of the active ingredients or excipients of the investigational products
- Known allergy/intolerance to Penicillin or Streptomycin.
- Known genetically determined or acquired muscular disease, known neurological disorder (Parkinson's disease, multiple sclerosis, spina bifida, medullary traumatism, Creutzfeldt-Jakob disease).
- Medication regimen including estrogens, anti-estrogens or diuretics where dose and/or frequency has not been stable for at least the past 12 weeks or is anticipated to change during the course of the study.
- Chronic use of defined drugs and not stopped prior to inclusion into or including the study. Selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI), alpha-receptor antagonists/agonists, beta-3-receptor agonists or anticholinergic/-muscarinic drugs.
- Have any clinically significant coexisting condition or symptoms that, in the opinion of the investigator, would put the safety of the participant at risk.
- Any organic or psychiatric disorder that, in the opinion of the investigator, might prevent the subject from completing the study or interfere with the interpretation of the study results.
- Medication known to affect lower urinary tract function.
- Patients having any electrical device inside their body (such as a cochlear implant, TENS stimulator (for pain), vagal nerve stimulator, brain stimulator, gastric pacemaker, bladder stimulator, or an implanted mechanical pump (such an insulin pump or pain pump).
- Patients having a cardiac pacemaker or defibrillator implant.
- Patients with Starr-Edwards artificial heart valve.
- Patients that suffer from claustrophobia.
Sites / Locations
- University Hospital ZurichRecruiting
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Experimental
Arm Label
Low dose
High dose
Arm Description
Already human tested low dose from phase I study
First in human dose used for efficacy reasons during phase II
Outcomes
Primary Outcome Measures
Change of SUI episode frequency
Assessment in episode change measured using a bladder diary, from baseline to 6 months after injection.
Secondary Outcome Measures
Incidence of (S)AEs
AEs related to obtaining biopsy, injection procedure and MPCs, including surgical injury, scars, urinary tract infection, inflammation, pelvic pain, prolonged urinary retention, voiding dysfunction, de novo urge incontinence, haematuria, aberrant tissue formation.
Measured from Visit 2 (biopsy) to End of Study.
Number of patients with any clinical significant findings
Number of patients with any clinically significant findings based on physical examination, standard haematology, clinical chemistry and urinalysis profiles, blood pressure (BP), pulse and adverse events recordings at baseline, 1 month, 3 months and 6 months post-implantation.
Change in 24 hour pad weight
Change in pad weight based on using regular pad tests, from baseline to 6 months after injection.
Full Information
NCT ID
NCT05534269
First Posted
August 23, 2022
Last Updated
October 19, 2023
Sponsor
University of Zurich
Collaborators
GCP-Service International Ltd. & Co. KG
1. Study Identification
Unique Protocol Identification Number
NCT05534269
Brief Title
Stress Urinary Incontinence Study to Assess Safety and Efficacy of Muvon's Muscle Precursor Cell Therapy
Acronym
SUISSE MPC2
Official Title
Stress Urinary Incontinence Study to Assess Safety and Efficacy of Muvon's Muscle Precursor Cell Therapy
Study Type
Interventional
2. Study Status
Record Verification Date
October 2023
Overall Recruitment Status
Recruiting
Study Start Date
October 17, 2022 (Actual)
Primary Completion Date
November 2024 (Anticipated)
Study Completion Date
November 2025 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Zurich
Collaborators
GCP-Service International Ltd. & Co. KG
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
The aim of the SUISSE MPC 2 study is to treat stress urinary incontinence in adult women.
Detailed Description
Stress urinary incontinence is the loss of small amounts of urine associated with coughing, laughing, sneezing, exercising or other movements that increase pressure on the abdomen and therefore increasing the pressure on the bladder.
The goal of the SUISSE MPC2 study is to treat SUI in women using their own autologous muscle precursor cells. To guarantee enough outcome data, a sufficient number of patients will be enrolled to complete the study with 70 patients.
The study will last approximately 8-9 months per patient. Each patient's baseline measurements serve as comparison for the treated measurements.
Patients will participate in the study for up to approximately 8 to 9 months, including a baseline visit for screening, a visit to obtain a muscle biopsy up to 12 weeks later, an injection of MPCs up to 5 weeks later, and follow-up visits after 1, 3 and 6 months post injection. The injection is performed with ultrasound guidance using an endocavity ultrasound probe mounted on an Injection Device specifically designed for the clinical trial.
All patients will be treated with one of the two doses of MPCs, assigned according to the study's randomization method.
Half of the participating patients will receive the cell therapy that was previously studied in the completed phase I study. The other half of the participants will receive a higher dose of the cell therapy to investigate the effects of dose increase. Both groups of patients will be additionally monitored by medical examinations performed by clinicians to ensure the safety of the treatment.
Furthermore, separate to the Principal Investigator, safety events will be reported to and investigated by the independent Data Safety Monitoring Board consisting of independent physicians and experts in the field. Data regarding the functionality and safety of the Injection Device will also be collected.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Female Stress Urinary Incontinence
Keywords
SUI, Incontinence, rhabdomyosphincter, urine, Stress Incontinence, LUTS, lower urinary tract
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
Low dose and High dose evaluation
Masking
Participant
Masking Description
Neither patient nor sponsor will know which patient gets which dose
Allocation
Randomized
Enrollment
70 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Low dose
Arm Type
Experimental
Arm Description
Already human tested low dose from phase I study
Arm Title
High dose
Arm Type
Experimental
Arm Description
First in human dose used for efficacy reasons during phase II
Intervention Type
Biological
Intervention Name(s)
autologous muscle precursor cells
Intervention Description
Patients own Muscle Precursor Cells are isolated and injected into the rhabdomyosphincter
Primary Outcome Measure Information:
Title
Change of SUI episode frequency
Description
Assessment in episode change measured using a bladder diary, from baseline to 6 months after injection.
Time Frame
8-9 months
Secondary Outcome Measure Information:
Title
Incidence of (S)AEs
Description
AEs related to obtaining biopsy, injection procedure and MPCs, including surgical injury, scars, urinary tract infection, inflammation, pelvic pain, prolonged urinary retention, voiding dysfunction, de novo urge incontinence, haematuria, aberrant tissue formation.
Measured from Visit 2 (biopsy) to End of Study.
Time Frame
6-8 months
Title
Number of patients with any clinical significant findings
Description
Number of patients with any clinically significant findings based on physical examination, standard haematology, clinical chemistry and urinalysis profiles, blood pressure (BP), pulse and adverse events recordings at baseline, 1 month, 3 months and 6 months post-implantation.
Time Frame
8-9 months
Title
Change in 24 hour pad weight
Description
Change in pad weight based on using regular pad tests, from baseline to 6 months after injection.
Time Frame
8-9 months
Other Pre-specified Outcome Measures:
Title
Change in total leakage episodes
Description
Response rate at 6 months, defined as percentage of patients with at least 50% change in number of stress leaks
Time Frame
8-9 months
Title
Questionnaire ICIQ-UI SF (International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form )
Description
Change in score from baseline to 6 months. Containing 1 scale ranging from 0 (not at all) to 10 (serious) measuring the impairment caused by urine leakage in everyday life.
Time Frame
8-9 months
Title
Questionnaire ICIQLUTSqol (International Consultation on Incontinence Questionnaire Lower Urinary Tract Symptoms quality of Life)
Description
Change in score from baseline to 6 months. This questionnaire contains 21 questions to measure the impact of urinary incontinence on quality of life with particular reference to social effects. Each question is accompanied by a scale to capture the subjective restriction concerning the respective topic. These scales range from 0 (not at all) to 10 (very much).
Time Frame
8-9 months
Title
Questionnaire VAS (Visual analogue scale)
Description
Change score for degree of suffering, quality of life overall and subjective health status from baseline to 6 months. Scales ranging from 0 to 10. For Quality of life and health status from 0 "very bad" to 10 "very well". The degree of suffering from 0 (low) to 10 (high).
Time Frame
8-9 months
Title
Urethral pressure profile
Description
It measures the changes in the bladder pressure (in cm/H2O) required to urinate and the flow rate (in ml/s) a given pressure generates between baseline and 6 months after injection.
Time Frame
8-9 months
Title
Urodynamic cystometric test
Description
It measures the change of how much urine (in mL) the bladder can hold, between baseline and 6 months after injection.
Time Frame
8-9 months
Title
Urodynamic cystometric test
Description
It measures the change how much pressure builds up inside the bladder (in cm/H2O) as it stores urine, between baseline and 6 months after injection.
Time Frame
8-9 months
Title
Urodynamic cystometric test
Description
It measures the change how full the bladder is (in mL) when the urge to urinate occurs, between baseline and 6 months after injection.
Time Frame
8-9 months
Title
Urodynamic leak point pressure measurement
Description
It measures the changes of pressure (in cm/H2O) at the point of leakage between baseline and 6 months after injection.
Time Frame
8-9 months
Title
% of subjects with successful injection
Description
at day of implantation
Time Frame
1 day
Title
MRI evaluation: Increase of sphincter diameter and (S)AEs
Description
MRI examinations of the rhabdomyosphincter at baseline visit and after ca. 6 months after the MPC injection at the end of the study. This means approximately 8-9 months after the baseline visit.
During the MRI we will measure the increase in sphincter diameter as well as looking for potential aberrant tissue formation and necrosis. The outcome will be reportet via MRI-pictures and data measurement provided by a Radiologist via the internal hospital system.
Time Frame
8-9 months
Title
PGI-I Questionnaire
Description
Response to Patient Global Impression of Improvement Questionnaire, ca. 6 months after MPC injection at end of study visit.
Time Frame
8-9 months
Title
Device deficiency, ADEs and SADEs related to the Injection Device
Description
Device deficiencies and Adverse Device Events and Serious Adverse Device Events regarding the Injection Device used during the MPC injection step.
Time Frame
6-8 months
Title
1 hour pad test
Description
Reduction in weight of standardized 1 hour pad test; From visit 3 (injection) to end of study visit. The pad test will be performed at the clinic under supervision of a member of the study personnel.
Time Frame
6-8 months
10. Eligibility
Sex
Female
Gender Based
Yes
Gender Eligibility Description
Participant has to have a female rhabdomyosphincter and urinary tract, independent from self-representation of gender identity.
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Predominant clinical diagnosis of SUI
Stress incontinence ≥ grade I for at least 6 months
Patient has at least once been treated with, and failed prior conservative treatments
Patient had no improvement of SUI symptoms for at least 6 months before enrollment
Patients with a certain amount of leaks or /and a predefined pad weight at screening
Candidate for a surgical treatment
Negative blood test: Human immunodeficiency virus (HIV 1/2), Hepatitis B HBsAg, Anti HBc, Hepatitis C, Anti-HCV-Ab and Syphilis
Negative laboratory or blood test, and medical examination to eliminate risk of sexually transmitted diseases (STD) per investigators' discretion
Competent to comprehend, sign, and date informed consent form before any study-specific procedure is performed
Able to communicate well with the Investigator, and to understand and comply with the requirements of the study including answering the required questionnaires
Exclusion Criteria:
History of anti-incontinence surgery or prolapse surgery.
Prolapse
Diagnosed Hypermobile Urethra
Previous diagnosis of any of the following conditions, disorders, or diseases of the urinary tract:
Clinically significant cystocele or rectocele
Ureteric bladder, urethral or rectal fistula
Uncorrected congenital abnormality leading to urinary incontinence
Interstitial cystitis
Urinary urgency that results in leakage (as a predominant symptom)
Adult enuresis
Urodynamically proven detrusor instability or detrusor sphincter dyssynergia (DSD)
Sensory urgency defined as first sensation of bladder fill (urge to void) of <100 ml
No sensation at any time during the simple filling cystometry procedure
Known urethral Stenosis (ureterocystoscopy) or urethral diverticulum
History of cancer (< 5 year of remission) or history of pelvic radiotherapy
Immunosuppressed patients
Women who are pregnant or become pregnant during the course of the study, breast feeding or <12 months postpartum
Untreated symptomatic urinary tract infection
Fever (as defined by ≥ 38,5°C, axillar measurement), any infectious disease, cold or flu within the last 7 days
Unstable severe systemic disease including uncontrolled hypertension, unstable angina, or myocardial infarction, severe coagulation disorders, bleeding diathesis, emboli, thrombophlebitis, infectious diseases, poor wound healing, and poorly controlled diabetes mellitus within 6 months before enrolment
Known allergy/intolerance to at least one of the active ingredients or excipients of the investigational products
Known allergy/intolerance to Penicillin or Streptomycin.
Known genetically determined or acquired muscular disease, known neurological disorder (Parkinson's disease, multiple sclerosis, spina bifida, medullary traumatism, Creutzfeldt-Jakob disease).
Medication regimen including estrogens, anti-estrogens or diuretics where dose and/or frequency has not been stable for at least the past 12 weeks or is anticipated to change during the course of the study.
Chronic use of defined drugs and not stopped prior to inclusion into or including the study. Selective serotonin and norepinephrine reuptake inhibitor antidepressant (SSNRI), alpha-receptor antagonists/agonists, beta-3-receptor agonists or anticholinergic/-muscarinic drugs.
Have any clinically significant coexisting condition or symptoms that, in the opinion of the investigator, would put the safety of the participant at risk.
Any organic or psychiatric disorder that, in the opinion of the investigator, might prevent the subject from completing the study or interfere with the interpretation of the study results.
Medication known to affect lower urinary tract function.
Patients having any electrical device inside their body (such as a cochlear implant, TENS stimulator (for pain), vagal nerve stimulator, brain stimulator, gastric pacemaker, bladder stimulator, or an implanted mechanical pump (such an insulin pump or pain pump).
Patients having a cardiac pacemaker or defibrillator implant.
Patients with Starr-Edwards artificial heart valve.
Patients that suffer from claustrophobia.
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Markus Veit
Phone
+41442551223
Email
markus.veit@usz.ch
First Name & Middle Initial & Last Name or Official Title & Degree
Florian Schmid, MD / PhD
Phone
+4144255440
Email
florian.schmid@usz.ch
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Florian Schmid, MD / PhD
Organizational Affiliation
University of Zurich
Official's Role
Principal Investigator
Facility Information:
Facility Name
University Hospital Zurich
City
Zurich
ZIP/Postal Code
8091
Country
Switzerland
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Markus Veit
Phone
+41 44 255 12 23
Email
markus.veit@usz.ch
12. IPD Sharing Statement
Plan to Share IPD
No
Links:
URL
http://www.muvon-trials.com
Description
Website for Phase II Study
Learn more about this trial
Stress Urinary Incontinence Study to Assess Safety and Efficacy of Muvon's Muscle Precursor Cell Therapy
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