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Testopel ® vs. Generic Testosterone Pellets.

Primary Purpose

Hypogonadism

Status
Completed
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Testopel 75mg Drug Implant
Testopel 100mg Drug Implant
Testopel 200mg Drug Implant
Sponsored by
University of Miami
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Hypogonadism focused on measuring Low T, Low Testosterone

Eligibility Criteria

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

Inclusion Criteria:

  • Voluntarily sign and date the study consent form(s), which have been approved by an Institutional Review Board (IRB). Written consent must be obtained prior to the initiation of any study procedures.
  • Male between 18 and 75 years of age.
  • Documented diagnosis of primary hypogonadism (congenital or acquired) or hypogonadotropic hypogonadism (congenital or acquired).
  • Serum total testosterone < 300 ng/dL on 2 measurements
  • Naïve to androgen replacement or has discontinued current treatment and completed a washout of 4 weeks following androgen treatment.
  • Judged to be in good general health as determined by the principal investigator based upon the results of a medical history, physical examination, vital signs, laboratory profile and a 12-lead electrocardiogram (ECG).

Exclusion Criteria:

  • History of significant sensitivity or allergy to androgens, or product excipients.
  • Clinically significant findings in the pre-study examinations including abnormal breast examination requiring follow-up, abnormal ECG.
  • Abnormal prostate digital rectal examination (DRE) with palpable nodule(s) or International Prostate Symptom Score (I-PSS) score > 19 points.
  • Body mass index (BMI) ≥ 40 kg/m2.
  • Clinically significant abnormal laboratory value, in the opinion of the investigator, in serum chemistry, hematology, or urinalysis including but not limited to:

    1. Baseline hemoglobin > 16 g/dL
    2. Hematocrit < 35% or > 50%
    3. PSA > 4 ng/mL
  • History of seizures or convulsions, including febrile, alcohol or drug withdrawal seizures.
  • History of any clinically significant illness, infection, or surgical procedure within 4 weeks prior to study drug administration.
  • History of stroke or myocardial infarction within the past 5 years.
  • History of, or current or suspected, prostate or breast cancer.
  • History of diagnosed, severe, untreated, obstructive sleep apnea.
  • History of abuse of alcohol or any drug substance in the opinion of the investigator within the previous 2 years.
  • Donation or loss of 550 mL or more blood volume (including plasmapheresis) or receipt of a transfusion of any blood product within 12 weeks prior to the start of treatment.
  • Inadequate venous access for collection of serial blood samples required for pharmacokinetic profiles.
  • Receipt of any investigational product within 4 weeks or within 5 half-lives prior to the start of treatment.
  • Inability to understand and provide written informed consent for the study.

Sites / Locations

  • University of Miami, Department of Urology

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Active Comparator

Arm Label

Testopel 75mg Group

Compounded testosterone pellets 100mg Group

Compounded Testosterone pellets 200mg Group

Arm Description

Participants in this group will receive a one-time subcutaneous testosterone insertion of 10 x 75 mg pellets of Testopel for a total of 750 mg Testopel.

Participants in this group will receive a one-time subcutaneous testosterone insertion of 8 x 100 mg compounded testosterone for a total of 800 mg compounded testosterone.

Participants in this group will receive a one-time subcutaneous testosterone insertion of 4 x 200 mg compounded testosterone for a total of 800 mg compounded testosterone.

Outcomes

Primary Outcome Measures

Change in Testosterone (T) Levels
Changes in serum Testosterone levels are assessed in ng/dL

Secondary Outcome Measures

Change in Hematocrit (Hct) Levels.
Changes in serum Hct levels are assessed in %.
Change in PSA Levels
Change in serum Prostate Specific Antigen (PSA) levels are assessed in ng/mL.
Change in Estradiol Levels
Change in serum estradiol levels are assessed in pg/mL.

Full Information

First Posted
August 11, 2020
Last Updated
July 20, 2023
Sponsor
University of Miami
Collaborators
Empower Research Inc
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1. Study Identification

Unique Protocol Identification Number
NCT04523480
Brief Title
Testopel ® vs. Generic Testosterone Pellets.
Official Title
Randomized Control Trial of Long Acting Subcutaneous Testosterone Pellets for Hypogonadism: Testopel ® vs. Generic Testosterone Pellets.
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Completed
Study Start Date
March 12, 2020 (Actual)
Primary Completion Date
December 20, 2022 (Actual)
Study Completion Date
December 20, 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Miami
Collaborators
Empower Research Inc

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to evaluate changes in vascular parameters in subjects receiving Testopel 75mg (one time) versus subjects receiving Compounded Testosterone pellets 100mg (one time) versus subjects receiving Compounded Testosterone pellets 200mg (one time) to participant with clinical hypogonadism.
Detailed Description
Hypogonadism, or low testosterone (Low T), is the deficiency in producing testosterone by the testes. Testosterone pellets is a long-acting formulation of Testosterone Replacement Therapy (TRT) that is delivered subcutaneously to men diagnosed with low T. Advantages to subcutaneous testosterone pellets include ease of delivery and decreased risk of the medication being transfer upon skin contact to woman or children. Long acting testosterone replacement Implantation of six to ≥10 testosterone pellets (450 to ≥750 mg) increased total testosterone into the therapeutic range at 1 month post-implantation and sustained therapeutic levels (>300) for 4-6 months. Participants will be randomly assigned to 1 of 3 study groups. In one of the groups the treatment will include implantation of Testopel ® 750mg (10 pellets with 75mg pellet) one time, in the second group, treatment will include compounded subcutaneous testosterone 800mg (8 pellets with 100mg pellet) one time and in the third group, treatment will include compounded subcutaneous testosterone 800mg (4 pellets with 200mg pellet) one time. The treatment takes approximately 30 minutes and will include: Clean and numb the insertion site with lidocaine at 1%, followed by small incision in the skin, implantation of pellets into subdermal fat layer and sealing the incision with Steri-strip. This is the current standard of care of Testopel insertion and same procedure will be followed with both compounded and commercial pellets.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Hypogonadism
Keywords
Low T, Low Testosterone

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
75 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Testopel 75mg Group
Arm Type
Experimental
Arm Description
Participants in this group will receive a one-time subcutaneous testosterone insertion of 10 x 75 mg pellets of Testopel for a total of 750 mg Testopel.
Arm Title
Compounded testosterone pellets 100mg Group
Arm Type
Active Comparator
Arm Description
Participants in this group will receive a one-time subcutaneous testosterone insertion of 8 x 100 mg compounded testosterone for a total of 800 mg compounded testosterone.
Arm Title
Compounded Testosterone pellets 200mg Group
Arm Type
Active Comparator
Arm Description
Participants in this group will receive a one-time subcutaneous testosterone insertion of 4 x 200 mg compounded testosterone for a total of 800 mg compounded testosterone.
Intervention Type
Drug
Intervention Name(s)
Testopel 75mg Drug Implant
Intervention Description
75 mg Testosterone pellets administered subcutaneously.
Intervention Type
Drug
Intervention Name(s)
Testopel 100mg Drug Implant
Intervention Description
100 mg Testosterone pellets administered subcutaneously.
Intervention Type
Drug
Intervention Name(s)
Testopel 200mg Drug Implant
Intervention Description
200 mg Testosterone pellets administered subcutaneously.
Primary Outcome Measure Information:
Title
Change in Testosterone (T) Levels
Description
Changes in serum Testosterone levels are assessed in ng/dL
Time Frame
Baseline, 2 months, 4 months, and 6 months
Secondary Outcome Measure Information:
Title
Change in Hematocrit (Hct) Levels.
Description
Changes in serum Hct levels are assessed in %.
Time Frame
Baseline, 2 months, 4 months, and 6 months
Title
Change in PSA Levels
Description
Change in serum Prostate Specific Antigen (PSA) levels are assessed in ng/mL.
Time Frame
Baseline, 2 months, 4 months, and 6 months
Title
Change in Estradiol Levels
Description
Change in serum estradiol levels are assessed in pg/mL.
Time Frame
Baseline, 2 months, 4 months, and 6 months

10. Eligibility

Sex
Male
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Voluntarily sign and date the study consent form(s), which have been approved by an Institutional Review Board (IRB). Written consent must be obtained prior to the initiation of any study procedures. Male between 18 and 75 years of age. Documented diagnosis of primary hypogonadism (congenital or acquired) or hypogonadotropic hypogonadism (congenital or acquired). Serum total testosterone < 300 ng/dL on 2 measurements Naïve to androgen replacement or has discontinued current treatment and completed a washout of 4 weeks following androgen treatment. Judged to be in good general health as determined by the principal investigator based upon the results of a medical history, physical examination, vital signs, laboratory profile and a 12-lead electrocardiogram (ECG). Exclusion Criteria: History of significant sensitivity or allergy to androgens, or product excipients. Clinically significant findings in the pre-study examinations including abnormal breast examination requiring follow-up, abnormal ECG. Abnormal prostate digital rectal examination (DRE) with palpable nodule(s) or International Prostate Symptom Score (I-PSS) score > 19 points. Body mass index (BMI) ≥ 40 kg/m2. Clinically significant abnormal laboratory value, in the opinion of the investigator, in serum chemistry, hematology, or urinalysis including but not limited to: Baseline hemoglobin > 16 g/dL Hematocrit < 35% or > 50% prostate-specific antigen (PSA) > 4 ng/mL History of seizures or convulsions, including febrile, alcohol or drug withdrawal seizures. History of any clinically significant illness, infection, or surgical procedure within 4 weeks prior to study drug administration. History of stroke or myocardial infarction within the past 5 years. History of, or current or suspected, prostate or breast cancer. History of diagnosed, severe, untreated, obstructive sleep apnea. History of abuse of alcohol or any drug substance in the opinion of the investigator within the previous 2 years. Donation or loss of 550 mL or more blood volume (including plasmapheresis) or receipt of a transfusion of any blood product within 12 weeks prior to the start of treatment. Inadequate venous access for collection of serial blood samples required for pharmacokinetic profiles. Receipt of any investigational product within 4 weeks or within 5 half-lives prior to the start of treatment. Inability to understand and provide written informed consent for the study.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Ranjith Ramasamy, MD
Organizational Affiliation
University of Miami
Official's Role
Principal Investigator
Facility Information:
Facility Name
University of Miami, Department of Urology
City
Miami
State/Province
Florida
ZIP/Postal Code
33136
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
Citations:
PubMed Identifier
24054931
Citation
Corona G, Rastrelli G, Maggi M. Diagnosis and treatment of late-onset hypogonadism: systematic review and meta-analysis of TRT outcomes. Best Pract Res Clin Endocrinol Metab. 2013 Aug;27(4):557-79. doi: 10.1016/j.beem.2013.05.002. Epub 2013 Jul 5.
Results Reference
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22319659
Citation
Walker WH. Testosterone signaling and the regulation of spermatogenesis. Spermatogenesis. 2011 Apr;1(2):116-120. doi: 10.4161/spmg.1.2.16956.
Results Reference
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PubMed Identifier
8954042
Citation
Katznelson L, Finkelstein JS, Schoenfeld DA, Rosenthal DI, Anderson EJ, Klibanski A. Increase in bone density and lean body mass during testosterone administration in men with acquired hypogonadism. J Clin Endocrinol Metab. 1996 Dec;81(12):4358-65. doi: 10.1210/jcem.81.12.8954042.
Results Reference
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PubMed Identifier
3544993
Citation
Finkelstein JS, Klibanski A, Neer RM, Greenspan SL, Rosenthal DI, Crowley WF Jr. Osteoporosis in men with idiopathic hypogonadotropic hypogonadism. Ann Intern Med. 1987 Mar;106(3):354-61. doi: 10.7326/0003-4819-106-3-.
Results Reference
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PubMed Identifier
9233903
Citation
Jockenhovel F, Vogel E, Reinhardt W, Reinwein D. Effects of various modes of androgen substitution therapy on erythropoiesis. Eur J Med Res. 1997 Jul 28;2(7):293-8.
Results Reference
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PubMed Identifier
7514512
Citation
Behre HM, Bohmeyer J, Nieschlag E. Prostate volume in testosterone-treated and untreated hypogonadal men in comparison to age-matched normal controls. Clin Endocrinol (Oxf). 1994 Mar;40(3):341-9. doi: 10.1111/j.1365-2265.1994.tb03929.x.
Results Reference
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PubMed Identifier
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Citation
Davidson JM, Camargo CA, Smith ER. Effects of androgen on sexual behavior in hypogonadal men. J Clin Endocrinol Metab. 1979 Jun;48(6):955-8. doi: 10.1210/jcem-48-6-955.
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PubMed Identifier
10946864
Citation
Snyder PJ, Peachey H, Berlin JA, Hannoush P, Haddad G, Dlewati A, Santanna J, Loh L, Lenrow DA, Holmes JH, Kapoor SC, Atkinson LE, Strom BL. Effects of testosterone replacement in hypogonadal men. J Clin Endocrinol Metab. 2000 Aug;85(8):2670-7. doi: 10.1210/jcem.85.8.6731.
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Citation
Baillargeon J, Urban RJ, Ottenbacher KJ, Pierson KS, Goodwin JS. Trends in androgen prescribing in the United States, 2001 to 2011. JAMA Intern Med. 2013 Aug 12;173(15):1465-6. doi: 10.1001/jamainternmed.2013.6895. No abstract available. Erratum In: JAMA Intern Med. 2013 Aug 12;173(15):1477.
Results Reference
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Citation
Ullah MI, Riche DM, Koch CA. Transdermal testosterone replacement therapy in men. Drug Des Devel Ther. 2014 Jan 9;8:101-12. doi: 10.2147/DDDT.S43475. eCollection 2014.
Results Reference
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Testopel ® vs. Generic Testosterone Pellets.

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