Research Evaluating an Investigational Medication for Erectile Dysfunction - Post-Prostatectomy

A Randomized, Double-Blind, Placebo-Controlled, Parallel Group, Multicenter Study of the Safety and Efficacy of Avanafil in the Treatment of Erectile Dysfunction Following Bilateral Nerve-Sparing Radical Prostatectomy

The objectives of this study are to evaluate the safety and efficacy of two doses of avanafil in the treatment of adult males for erectile dysfunction following bilateral nerve-sparing radical prostatectomy.

Study Overview

• Status: Completed
• Conditions: Erectile Dysfunction
• Intervention / Treatment: Drug: Placebo; Drug: Avanafil

• Study Type: Interventional
• Enrollment (Actual): 298
• Phase: Phase 3

Contacts and Locations

Study Locations

• United States
  • Arizona
    • Phoenix, Arizona, United States, 85050
      • Research Site
  • California
    • Laguna Hills, California, United States, 92653
      • Research Site
    • Los Angeles, California, United States, 90095
      • Research Site
    • Los Angeles, California, United States, 90073
      • Research Site
    • Sacramento, California, United States, 95817
      • Research Site
  • Colorado
    • Aurora, Colorado, United States, 80045
      • Research Site
    • Englewood, Colorado, United States, 80113
      • Research Site
    • Parker, Colorado, United States, 80134
      • Research Site
  • District of Columbia
    • Washington, District of Columbia, United States, 20006
      • Research Site
  • Florida
    • Jacksonville, Florida, United States, 32224
      • Research Site
    • Miami, Florida, United States, 33136
      • Research Site
    • Trinity, Florida, United States, 34655
      • Research Site
  • Illinois
    • Chicago, Illinois, United States, 60637
      • Research Site
    • Chicago, Illinois, United States, 60611
      • Research Site
    • Springfield, Illinois, United States, 62703
      • Research Site
  • Indiana
    • Indianapolis, Indiana, United States, 46202
      • Research Site
  • Louisiana
    • New Orleans, Louisiana, United States, 70112
      • Research Site
    • Shreveport, Louisiana, United States, 71106
      • Research Site
  • Maryland
    • Baltimore, Maryland, United States, 21287
      • Research Site
    • Towson, Maryland, United States, 21204
      • Research Site
  • Massachusetts
    • Brighton, Massachusetts, United States, 02135
      • Research Site
    • Burlington, Massachusetts, United States, 01805
      • Research Site
    • Jamaica Plain, Massachusetts, United States, 02130
      • Research Site
  • Michigan
    • Ann Arbor, Michigan, United States, 48109
      • Research Site
  • New Jersey
    • Hackensack, New Jersey, United States, 07601
      • Research Site
    • Lawrenceville, New Jersey, United States, 08648
      • Research Site
  • New York
    • Brooklyn, New York, United States, 11235
      • Research Site
    • Brooklyn, New York, United States, 11215
      • Research Site
    • Garden City, New York, United States, 11530
      • Research Site
    • Great Neck, New York, United States, 11021
      • Research Site
    • New York, New York, United States, 10016
      • Research Site
    • New York, New York, United States, 10065
      • Research Site
    • New York, New York, United States, 10029
      • Research Site
    • Poughkeepsie, New York, United States, 12601
      • Research Site
  • North Carolina
    • Durham, North Carolina, United States, 27710
      • Research Site
    • Greensboro, North Carolina, United States, 27403
      • Research Site
  • Ohio
    • Cincinnati, Ohio, United States, 45212
      • Research Site
    • Cleveland, Ohio, United States, 44195
      • Research Site
  • Pennsylvania
    • Bala Cynwyd, Pennsylvania, United States, 19004
      • Research Site
    • Philadelphia, Pennsylvania, United States, 19107
      • Research Site
    • Philadelphia, Pennsylvania, United States, 19111
      • Research Site
  • South Carolina
    • Myrtle Beach, South Carolina, United States, 29572
      • Research Site
    • Rock Hill, South Carolina, United States, 29732
      • Research Site
  • Tennessee
    • Nashville, Tennessee, United States, 37232
      • Research Site
  • Texas
    • Arlington, Texas, United States, 76017
      • Research Site
    • Houston, Texas, United States, 77030
      • Research Site
    • San Antonio, Texas, United States, 78229
      • Research Site
    • Temple, Texas, United States, 76508
      • Research Site
  • Virginia
    • Charlottesville,, Virginia, United States, 22908
      • Research Site
    • Fairfax, Virginia, United States, 22030
      • Research Site
    • Richmond, Virginia, United States, 23235
      • Research Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years to 70 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Male

Description

Inclusion Criteria:

• Adult males ≥ 18 years and ≤ 70 years;
• Have a history of erectile dysfunction of at least 6 months duration following bilateral nerve-sparing retropubic radical prostatectomy;
• Have a PSA level consistent with the absence of prostate cancer;
• Have a history of sexual potency prior to radical prostatectomy without requiring medical therapy;
• Be in a monogamous, heterosexual relationship with their current partner for at least 3 months;
• Provide written informed consent;
• Agree to make at least 4 attempts at intercourse per month;
• Agree not to use any other treatments for erectile dysfunction;
• Be willing and able to comply with all study requirements (including scheduled study visits, treatment plans, laboratory tests and other study procedures).

Exclusion Criteria

• Allergy or hypersensitivity to PDE5 inhibitors or any of the components of these drug products;
• History of dose-limiting AEs during prior treatment with a PDE5 inhibitor or discontinued use of a PDE5 inhibitor due to lack of efficacy at the highest tolerated dose;

• Concomitant use of one or more of the following medications:

  • Any nitrate, trazodone, itraconazole, ketoconazole, erythromycin, or cimetidine;
  • Other prescription or OTC drugs that are known to interfere with metabolism by the CYP 3A4 enzyme;
  • If receiving hormone replacement therapy (including thyroid supplementation), dose that has not been stable for at least 3 months;
  • If treated with an alpha blocker, dose that has not been stable for at least 14 days;
• Erectile dysfunction as a consequence of advanced neurologic disease, spinal cord injury, or diabetes;
• History of severe erectile dysfunction requiring medical therapy prior to bilateral nerve-sparing radical prostatectomy;
• History of previous pelvic surgery, brachytherapy, or cryotherapy of the prostate;
• Sexual partner who is under 18 years of age, pregnant, intends to become pregnant during the course of the study, is breastfeeding, has dyspareunia or other gynecologic conditions or other major medical conditions that would interfere with sexual activity or would have difficulty complying with study requirements;
• Uncontrolled hypertension;
• Hypotension;
• Orthostatic hypotension;
• Myocardial infarction, stroke, life-threatening arrhythmia or coronary revascularization within the past 6 months;
• Unstable angina, angina with sexual intercourse, or congestive heart failure > NYHA Class II;
• History or ECG evidence of any high-risk arrhythmia or clinically significant ECG;
• Hypertrophic, obstructive, or other clinically significant cardiomyopathy, moderate or severe cardiac valvular disease;
• Type 1 or type 2 diabetes, history of use of any antidiabetic medication;
• Clinically evident penile lesions, abrasions, anatomical deformities such as penile fibrosis, Peyronie's disease, penile implants, urinary tract or bladder infection, or sexually transmissible disease that the investigator deems to be clinically significant;
• Condition(s) predisposing to priapism, such as sickle cell disease , multiple myeloma, or leukemia;
• Any malignancy other than carcinoma of the prostate (except basal cell carcinoma or squamous cell carcinoma of the skin);
• Prior use of, or likely to require radiotherapy, chemotherapy, androgen deprivation therapy, cryotherapy, non-nerve-sparing surgery, and/or bladder or penile surgery during the study;
• Evidence of significant hepatic impairment;
• On dialysis, or history of renal transplantation;
• Untreated hypogonadism or low serum total testosterone;
• Abnormal laboratory value(s) judged to be clinically significant by the investigator;
• Positive STD screen (syphilis, gonorrhea, or chlamydia);
• Positive for HIV, HCV Ab, or HBsAg at screening;
• History or current drug, alcohol, or substance abuse;
• Positive urine drug screen;
• Positive breath alcohol test;
• Retinitis pigmentosa or nonarteritic anterior ischemic optic neuropathy;
• Use of any treatment or device for treatment of erectile dysfunction;
• Use of any other investigational medication or device for any indication within 30 days prior to enrollment or at any time during this study;
• Previous participation in any other investigational study of avanafil;
• Any history of bipolar disorder or psychosis, greater than one lifetime episode of major depression, current depression of moderate or greater severity or antidepressant use that has not been stable for at least 3 months;
• Involvement in the planning and conduct of the study on the part of subject or partner;
• Evidence of any clinically significant medical, psychiatric, social or other condition by history, physical examination or laboratory studies that, in the opinion of the investigator, would contraindicate the administration of study medications, affect compliance, interfere with study evaluations, limit study participation, contraindicate sexual activity or confound the interpretation of study results.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Placebo Comparator: Placebo	Drug: Placebo; One dose 30 minutes prior to initiation of sexual activity
Experimental: Avanafil 100 mg	Drug: Avanafil; One dose 30 minutes prior to initiation of sexual activity; Other Names: TA-1790; Stendra
Experimental: Avanafil 200 mg	Drug: Avanafil; One dose 30 minutes prior to initiation of sexual activity; Other Names: TA-1790; Stendra

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change in Percentage of Sexual Attempts in Which Subjects Are Able to Maintain an Erection of Sufficient Duration to Have Successful Intercourse	Data presented as mean change from baseline in the percentage of Yes responses to Sexual Encounter Profile (SEP) diary question 3 "Did your erection last long enough for you to have successful intercourse?"	Baseline, Week 12
The Change in Percentage of Sexual Attempts in Which Subjects Are Able to Insert the Penis Into the Partner's Vagina	Data presented as mean change from baseline in the percentage of Yes responses to Sexual Encounter Profile (SEP) diary question 2 "Were you able to insert your penis into your partner's vagina?"	Baseline, Week 12
Change in International Index of Erectile Function - Erectile Function Domain (IIEF-EF) Score	Questionnaire assesses subject's evaluation of erectile function over the previous 4-week period. Total scores from questions 1-5 & 15 range from 1 to 30. A higher score indicates better erectile function.	Baseline, End of Treatment (up to 12 weeks)

Collaborators and Investigators

• Sponsor: VIVUS LLC
• Investigators: Study Director: John Mulhall, MD, Memorial Sloan Kettering Cancer Center

Publications and helpful links

General Publications

• Mulhall JP, Burnett AL, Wang R, McVary KT, Moul JW, Bowden CH, DiDonato K, Shih W, Day WW. A phase 3, placebo controlled study of the safety and efficacy of avanafil for the treatment of erectile dysfunction after nerve sparing radical prostatectomy. J Urol. 2013 Jun;189(6):2229-36. doi: 10.1016/j.juro.2012.11.177. Epub 2012 Dec 3.

Study record dates

Study Major Dates

• Study Start: April 1, 2009
• Primary Completion (Actual): April 1, 2011
• Study Completion (Actual): April 1, 2011

Study Registration Dates

• First Submitted: May 5, 2009
• First Submitted That Met QC Criteria: May 6, 2009
• First Posted (Estimate): May 7, 2009

Study Record Updates

• Last Update Posted (Estimate): October 1, 2012
• Last Update Submitted That Met QC Criteria: September 14, 2012
• Last Verified: September 1, 2012

More Information

Terms related to this study

• Keywords: Erectile Dysfunction; E.D.
• Additional Relevant MeSH Terms: Mental Disorders; Sexual Dysfunctions, Psychological; Sexual Dysfunction, Physiological; Erectile Dysfunction
• Other Study ID Numbers: TA-303