The Zenflow Spring System Safety and Performance Study (ZEST CAN)
Primary Purpose
Benign Prostatic Hyperplasia
Status
Recruiting
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
Zenflow Spring System
Sponsored by
About this trial
This is an interventional treatment trial for Benign Prostatic Hyperplasia
Eligibility Criteria
Inclusion Criteria:
- Patient is able and willing to comply with all the assessments of the study
- Patient or patient's legal representative has been informed of the nature of the study, agrees to participate and has signed the informed consent form
- ≥ 45 years of age
- Baseline IPSS score > 13
- Prostate volume 25 - 80 cc and prostatic urethral length between 2.5-4.5 cm measured within the past 90 days
- Failed, intolerant, or patient choice to not take a medication regimen for the treatment of LUTS
Exclusion Criteria:
- Obstructive intravesical median prostatic lobe which in the opinion of the operator would not benefit from treatment
- Urethral stricture, meatal stenosis, or bladder neck obstruction - either current, or recurrent requiring 2 or more dilations as reported in the patient's history
- Requiring self-catheterization to void.
- Baseline PSA > 10 ng/mL or confirmed or suspected prostate cancer
Any of the following, taken from a single uroflowmetry reading:
- Post-void residual volume (PVR) > 250 ml
- Peak urinary flow rate of > 15 ml/second
- < 125 ml urinary volume voided at baseline (pre-bladder urinary volume of ≥150 ml required)
- Other condition or disease that might cause urinary retention
- History of other diseases causing voiding dysfunction
- Concomitant Urinary Tract Infection (UTI) (subject can be enrolled following successful treatment of UTI and a clean urine test), or subjects who have a history of recurrent or chronic UTIs (defined as 2 or more UTIs in the past 12 months)
- Concomitant bladder stones
- Previous pelvic irradiation or radical pelvic surgery
- Previous prostate surgery, stent implantations, laser prostatectomy, hyperthermia or another invasive treatment to the prostate
- Chronic prostatitis, or recurring prostatitis within the past 12 months
- Known allergy to nickel
- Life expectancy less than 24 months
- Use of concomitant medications (e.g., anticholinergics, antispasmodics or tricyclic antidepressants) affecting bladder function
- Inability to stop taking anticoagulants and/or antiplatelets for at least 3 days prior to the procedure or coumadin for at least 5 days prior to the procedure (low dose aspirin therapy not prohibited).
- Taking 5-alpha-reductase inhibitors within 3 months of pre-treatment (baseline) evaluation
Taking one of the following within 2 weeks of pre-treatment (baseline) evaluation:
- alpha-blockers,
- imipramine,
- anticholinergics, or
- cholinergic medication gonadotropin releasing hormonal analogs
- Taking androgens, unless evidence of eugonadal state for at least 6 months.
Taking one of the following within 24 hours of pre-treatment (baseline) evaluation:
- phenylephrine, or
- pseudoephedrine
- Future fertility concerns
- Any concurrent medical condition or illness that might prevent study completion or would confound study results
Sites / Locations
- Toronto Western HospitalRecruiting
- Groupe Sante BrunswickRecruiting
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Treatment Group
Arm Description
Receives intervention with the Zenflow Spring System.
Outcomes
Primary Outcome Measures
Successful placement of the Zenflow Spring Implant
Number of successful deployments and procedural successes for the Zenflow System to implant the Spring device in the OR, or in an out-patient clinical setting as compared to total treatment attempts.
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH) using the International Prostate Symptom Score
At 3 months, achieve at least 30% mean improvement in International Prostate Symptom Score (IPSS) compared to baseline. The patient is asked to respond to 7 questions related to his urinary health using a rating scale of 0 to 5 where zero is excellent and 5 is the worst possible. The responses to the 7 questions are tallied for a total IPSS score.
Need for urinary catheterization
Achieve < 12% rate of extended post-operative urinary catheterization, defined as an occurrence of a subject requiring catheterization within the first 3 days as part of a postoperative management for inability to void, for greater than 7 days.
Incidence of procedure or device related serious adverse events
Achieve < 12% rate of device or procedure related SAEs through discharge and 30 days follow up.
Secondary Outcome Measures
Assessment of Sexual Health Assessment: Change in sexual health measured by change in the Sexual Health Inventory for Men (SHIM) questionnaire score
The patient selects the most appropriate response to 5 questions about his sexual health. Each response has an assigned value between 1 and 5. The numeric values are tallied for a total score.
Assessment of Pain, evaluated using a Visual Analog Score (VAS) of 1 to 10
Patient describes pain on a Visual Analog Scale (VAS). The scale is a line labeled 1 at the far left indicating minimal pain and 10 on the right, which is maximum pain.
Assessment of Adverse Events
Rate of adverse events related to the procedure or device.
Assessment of Clavien-Dindo events
Proportion of subjects with procedure or device related adverse events classified as Clavien-Dindo Grade 3 or higher or any event resulting in persistent disability evidenced through 3 months post treatment.
Assessment of PSA
Change in PSA from baseline through 12, 24, 36, 48, & 60 months post treatment.
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)
The patient is asked to respond to 7 questions related to his urinary health using a rating scale of 0 to 5 where zero is excellent and 5 is the worst possible. The responses to the 7 questions are tallied for a total score
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)
Improvement in flow of urine as measured by uroflowmetry machine.
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)
Incidence of increase in dosage or initiation of new medication to treat symptoms of BPH.
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)
Incidence of repeat treatment.
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04309695
Brief Title
The Zenflow Spring System Safety and Performance Study (ZEST CAN)
Official Title
The Zenflow Spring System Safety and Performance Study (ZEST CAN)
Study Type
Interventional
2. Study Status
Record Verification Date
August 2020
Overall Recruitment Status
Recruiting
Study Start Date
February 9, 2021 (Actual)
Primary Completion Date
December 1, 2025 (Anticipated)
Study Completion Date
January 1, 2026 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Zenflow, Inc.
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 objectives of the trial are to demonstrate the safety and performance of the Zenflow Spring System in relieving the symptoms of obstructive Benign Prostatic Hyperplasia (BPH).
Detailed Description
The purpose of the Zenflow Study (ZEST CAN) is to evaluate the safety, performance and effectiveness of the Zenflow Spring System for the treatment of Lower Urinary Tract Symptoms (LUTS) that arise due to bladder outlet obstruction (BOO), secondary to the presence of Benign Prostatic Hyperplasia (BPH). It is intended that the features of the Zenflow Spring will provide an effective office-based treatment and management therapy for BPH with little or no side effects.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Benign Prostatic Hyperplasia
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
40 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
Treatment Group
Arm Type
Experimental
Arm Description
Receives intervention with the Zenflow Spring System.
Intervention Type
Device
Intervention Name(s)
Zenflow Spring System
Intervention Description
The Zenflow Spring is a nitinol urethral implant for the treatment of Lower Urinary Tract Symptoms (LUTS) that arise due to bladder outlet obstruction (BOO), secondary to the presence of Benign Prostatic Hypertrophy (BPH). The device is intended to be a permanent implant however it may be removed if necessary.
Primary Outcome Measure Information:
Title
Successful placement of the Zenflow Spring Implant
Description
Number of successful deployments and procedural successes for the Zenflow System to implant the Spring device in the OR, or in an out-patient clinical setting as compared to total treatment attempts.
Time Frame
Day of discharge up to 7 days following device placement
Title
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH) using the International Prostate Symptom Score
Description
At 3 months, achieve at least 30% mean improvement in International Prostate Symptom Score (IPSS) compared to baseline. The patient is asked to respond to 7 questions related to his urinary health using a rating scale of 0 to 5 where zero is excellent and 5 is the worst possible. The responses to the 7 questions are tallied for a total IPSS score.
Time Frame
3 month
Title
Need for urinary catheterization
Description
Achieve < 12% rate of extended post-operative urinary catheterization, defined as an occurrence of a subject requiring catheterization within the first 3 days as part of a postoperative management for inability to void, for greater than 7 days.
Time Frame
7 days after the procedure
Title
Incidence of procedure or device related serious adverse events
Description
Achieve < 12% rate of device or procedure related SAEs through discharge and 30 days follow up.
Time Frame
30 days after the procedure
Secondary Outcome Measure Information:
Title
Assessment of Sexual Health Assessment: Change in sexual health measured by change in the Sexual Health Inventory for Men (SHIM) questionnaire score
Description
The patient selects the most appropriate response to 5 questions about his sexual health. Each response has an assigned value between 1 and 5. The numeric values are tallied for a total score.
Time Frame
Baseline, 3, 6, 12, 24, 36, 48, & 60 months
Title
Assessment of Pain, evaluated using a Visual Analog Score (VAS) of 1 to 10
Description
Patient describes pain on a Visual Analog Scale (VAS). The scale is a line labeled 1 at the far left indicating minimal pain and 10 on the right, which is maximum pain.
Time Frame
Baseline, interoperative (if conscious sedation used), immediately post-treatment, 2 weeks, 1 and 3 months
Title
Assessment of Adverse Events
Description
Rate of adverse events related to the procedure or device.
Time Frame
Up to 5 years
Title
Assessment of Clavien-Dindo events
Description
Proportion of subjects with procedure or device related adverse events classified as Clavien-Dindo Grade 3 or higher or any event resulting in persistent disability evidenced through 3 months post treatment.
Time Frame
Up to 5 years
Title
Assessment of PSA
Description
Change in PSA from baseline through 12, 24, 36, 48, & 60 months post treatment.
Time Frame
Up to 5 years
Title
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)
Description
The patient is asked to respond to 7 questions related to his urinary health using a rating scale of 0 to 5 where zero is excellent and 5 is the worst possible. The responses to the 7 questions are tallied for a total score
Time Frame
Baseline, 2 weeks, 1, 6, 12, 24, 36, 48, & 60 months
Title
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)
Description
Improvement in flow of urine as measured by uroflowmetry machine.
Time Frame
Baseline, 2 weeks, 1, 3, 6, 12, 24, 36, 48, & 60 months
Title
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)
Description
Incidence of increase in dosage or initiation of new medication to treat symptoms of BPH.
Time Frame
Up to 5 years
Title
Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)
Description
Incidence of repeat treatment.
Time Frame
24 to 60 months
10. Eligibility
Sex
Male
Minimum Age & Unit of Time
45 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Patient is able and willing to comply with all the assessments of the study
Patient or patient's legal representative has been informed of the nature of the study, agrees to participate and has signed the informed consent form
≥ 45 years of age
Baseline IPSS score > 13
Prostate volume 25 - 80 cc and prostatic urethral length between 2.5-4.5 cm measured within the past 90 days
Failed, intolerant, or patient choice to not take a medication regimen for the treatment of LUTS
Exclusion Criteria:
Obstructive intravesical median prostatic lobe which in the opinion of the operator would not benefit from treatment
Urethral stricture, meatal stenosis, or bladder neck obstruction - either current, or recurrent requiring 2 or more dilations as reported in the patient's history
Requiring self-catheterization to void.
Baseline PSA > 10 ng/mL or confirmed or suspected prostate cancer
Any of the following, taken from a single uroflowmetry reading:
Post-void residual volume (PVR) > 250 ml
Peak urinary flow rate of > 15 ml/second
< 125 ml urinary volume voided at baseline (pre-bladder urinary volume of ≥150 ml required)
Other condition or disease that might cause urinary retention
History of other diseases causing voiding dysfunction
Concomitant Urinary Tract Infection (UTI) (subject can be enrolled following successful treatment of UTI and a clean urine test), or subjects who have a history of recurrent or chronic UTIs (defined as 2 or more UTIs in the past 12 months)
Concomitant bladder stones
Previous pelvic irradiation or radical pelvic surgery
Previous prostate surgery, stent implantations, laser prostatectomy, hyperthermia or another invasive treatment to the prostate
Chronic prostatitis, or recurring prostatitis within the past 12 months
Known allergy to nickel
Life expectancy less than 24 months
Use of concomitant medications (e.g., anticholinergics, antispasmodics or tricyclic antidepressants) affecting bladder function
Inability to stop taking anticoagulants and/or antiplatelets for at least 3 days prior to the procedure or coumadin for at least 5 days prior to the procedure (low dose aspirin therapy not prohibited).
Taking 5-alpha-reductase inhibitors within 3 months of pre-treatment (baseline) evaluation
Taking one of the following within 2 weeks of pre-treatment (baseline) evaluation:
alpha-blockers,
imipramine,
anticholinergics, or
cholinergic medication gonadotropin releasing hormonal analogs
Taking androgens, unless evidence of eugonadal state for at least 6 months.
Taking one of the following within 24 hours of pre-treatment (baseline) evaluation:
phenylephrine, or
pseudoephedrine
Future fertility concerns
Any concurrent medical condition or illness that might prevent study completion or would confound study results
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Emily Hu
Phone
5109098237
Email
emily@zenflow.com
First Name & Middle Initial & Last Name or Official Title & Degree
Kevin MacDonald
Phone
415-609-9875
Email
kfmacdonald@zenflow.com
Facility Information:
Facility Name
Toronto Western Hospital
City
Toronto
State/Province
ONT
ZIP/Postal Code
M5T 2S8
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Iris Chan
Phone
416 603 5800
Ext
5033
Email
iris.chan2@uhn.ca
First Name & Middle Initial & Last Name & Degree
Dean Elterman, MD, MSc, FRCSC
Facility Name
Groupe Sante Brunswick
City
Pointe-Claire
State/Province
Quebec
ZIP/Postal Code
H9R 5K3
Country
Canada
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Michele Tisseur, RN
Phone
514-823-5018
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
The Zenflow Spring System Safety and Performance Study (ZEST CAN)
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