Botox for Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS)

A Prospective Pilot Study to Evaluate the Safety and Efficacy of Botox™ for the Treatment of Men Diagnosed With Chronic Prostatitis/Chronic Pelvic Pain Syndrome

The objective of this study is to evaluate the safety and efficacy of intraprostatic injection of Botox for the treatment of men diagnosed with chronic nonbacterial prostatitis/chronic pelvic pain syndrome (CP/CPPS).

Study Overview

• Status: Terminated
• Conditions: Chronic Pain Syndrome; Prostatitis
• Intervention / Treatment: Drug: Botox

Detailed Description

This is a prospective open label study examining the efficacy and safety of intraprostatic Botox . Men with a clinical diagnosis of chronic nonbacterial prostatitis/CPPS will be treated with intraprostatic Botox™ and followed for 12 weeks (primary efficacy analyses), and 24 weeks (long term follow-up) for responders.

It is proposed that a total of 40 males will be enrolled. There will be seven (7) research clinic visits and two phone contacts: Visit 1 (screening), Visit 2 (baseline/treatment), Visit 3 (2-week safety evaluation - clinic contact), Visit 4 (4-week safety evaluation - phone contact), Visit 5 (6-week interim efficacy/safety), Visit 6 (12-week primary endpoint evaluation), Visit 7 (14-week clinic follow up), Visit 8 (16 week phone contact) and Visit 9 (24-week clinic close out).

Outcome measures include Chronic Prostatitis Symptom Index (CPSI 0-35), NRS pain (0-10), Global Response Assessment (GRA) at 12 weeks. Safety to be monitored during the study.

• Study Type: Interventional
• Enrollment (Actual): 7
• Phase: Phase 1

Contacts and Locations

Study Locations

• Canada
  • Ontario
    • Kingston, Ontario, Canada, K7L 3J7
      • Centre for Advanced Urological Research

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 14 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

1. Participant has signed and dated the appropriate Informed Consent document.
2. Participant must be ≥ 18 years of age.
3. Participant has had a clinical diagnosis of chronic nonbacterial prostatitis (chronic pelvic pain syndrome) (CPPS) defined as symptoms of discomfort or pain in the perineal or pelvic region for at least the past 3 months without evidence of bacterial infection.
4. Participants must report ejaculatory pain and/or perineal discomfort.
5. Participants must have pain or discomfort localized to perineum or prostate during physical examination.
6. Participants must have an aggregate score of greater than or equal to 15 on the National Institutes of Health chronic prostatitis symptom index (NIH-CPSI).
7. Participant must have > 8 on the pain domain sub-score of the NIH-CPSI.
8. Participant must have had empiric treatment with 4 weeks fluoroquinolone, and subsequently failed the antibiotic therapy.

Exclusion Criteria:

1. Participant has a history of prostate, bladder or urethral cancer.
2. Participant has inflammatory bowel disease (such as Crohn's disease or ulcerative colitis, but not irritable bowel syndrome).
3. Participant has undergone pelvic radiation or systemic chemotherapy.
4. Participant has undergone intravesical chemotherapy.
5. Participant has been treated for unilateral orchialgia without pelvic symptoms.
6. Participant has a current urethral stricture and/or bladder stones.
7. Participant has a neurological disease or disorder affecting the bladder.
8. Participant has a neurological impairment or psychiatric disorder preventing his understanding of consent and his ability to comply with the protocol.
9. Participant has a documented UTI within the last 3 months.
10. Participant has evidence of facultative Gram negative or enterococcus with a value of ≥ 1000 CFU/ml in mid-stream urine (VB2).
11. Participant has had previous intraprostatic injection of Botox.
12. Participant currently enrolled in an investigational study.
13. Participant interested in future fertility/fathering children.
14. Participant with urinary retention (PVR >200cc).
15. Participant having had prostate surgery in the past 3 months.
16. Participant having had minimally invasive surgical therapy for BPH.
17. Participant with a cystostomy or nephrostomy.
18. Participant with penile or urinary sphincter implants.
19. Participant with previous rectal surgery, current rectal disease or peri-rectal inflammatory disorders except hemorrhoidectomy.
20. Participant with PSA >10 ng/ml(PSA range 4-10, biopsy at PI discretion (deferral).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Botox; 300 IU botox	Drug: Botox; 300 units; Other Names: Botulinem toxin

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
GRA	At 12 weeks there were no GRA responders. Study stopped because of futility.	12 weeks

Collaborators and Investigators

• Sponsor: Queen's University
• Collaborators: Allergan
• Investigators: Principal Investigator: J. Curtis Nickel, MD FRCSC, Queen's University

Study record dates

Study Major Dates

• Study Start: January 1, 2006
• Primary Completion (Actual): September 1, 2009
• Study Completion (Actual): December 1, 2009

Study Registration Dates

• First Submitted: September 12, 2007
• First Submitted That Met QC Criteria: September 12, 2007
• First Posted (Estimate): September 14, 2007

Study Record Updates

• Last Update Posted (Actual): March 25, 2019
• Last Update Submitted That Met QC Criteria: March 21, 2019
• Last Verified: March 1, 2019

More Information

Terms related to this study

• Keywords: Botox; prostatitis
• Additional Relevant MeSH Terms: Mental Disorders; Pathologic Processes; Pain; Neurologic Manifestations; Disease; Prostatic Diseases; Syndrome; Chronic Pain; Somatoform Disorders; Pelvic Pain; Prostatitis
• Other Study ID Numbers: BOTOX-CP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No