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Safety and Tolerability of TAR-302-5018 in Subjects With Neurogenic Detrusor Overactivity Resulting From Spinal Cord Injury

10. januar 2020 opdateret af: Taris Biomedical LLC

A Prospective, Multi-center, Open-label Study of Trospium Delivered Intravesically by TAR-302-5018 to Spinal Cord Injury Subjects With Neurogenic Detrusor Overactivity (NDO)

The purpose of this study is to determine if TAR-302-5018, an investigational drug-delivery system, is safe and tolerable in patients with neurogenic detrusor overactivity (NDO) resulting from spinal cord injury (SCI).

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

7

Fase

  • Fase 1

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

    • Michigan
      • Troy, Michigan, Forenede Stater, 48084
        • Michigan Institute of Urology
    • North Carolina
      • Charlotte, North Carolina, Forenede Stater, 28207
        • Carolinas Healthcare System
    • Virginia
      • Virginia Beach, Virginia, Forenede Stater, 23462
        • Urology of Virginia
    • Washington
      • Seattle, Washington, Forenede Stater, 98101
        • Virginia Mason

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria

  1. Diagnosis of traumatic or nontraumatic suprasacral SCI for longer than 6 months and a documented history of NDO.
  2. Age ≥ 18 years.
  3. Demonstrated competence in and currently uses intermittent catheterization (IC) to empty the bladder (minimum of 4 IC events/day).

    • No indwelling catheter permitted
    • Caregiver may perform IC
    • Subject must be willing to maintain an established IC frequency throughout the study
  4. History of non-stress-based urinary incontinence.

Exclusion Criteria

  1. Participation in another drug or device study within 60 days prior to the screening visit.
  2. Previous urologic surgery that either decreases outlet resistance (transurethral prostatectomy, urethral stent, sphincterotomy) or changes native bladder anatomy (bladder augmentation).
  3. Presence of significant renal dysfunction at screening (Glomerular Filtration Rate < 30 mL/min).
  4. Presence of significant polyuria of any cause at screening (urine output > 4,000 mL/day).
  5. History of pelvic radiation.
  6. History of either bladder cancer or bladder pathology that the investigator deems unfit for study inclusion.
  7. Active malignancies within 12 months with the exception of those with a negligible risk of metastasis or death treated with expected curative outcome.
  8. Symptomatic autonomic dysreflexia requiring ongoing treatment.
  9. In the opinion of the investigator, the subject has a history of significant stress urinary incontinence.
  10. Subjects with active bladder stones or history of bladder stones < 6 months prior to study entry.
  11. History of recurrent symptomatic UTIs (> 6 per 1 year).
  12. Subjects with either untreated urinary retention or gastric retention or uncontrolled narrow-angle glaucoma.
  13. Subjects with known hypersensitivity to trospium or chemically-related drugs.
  14. Subjects with known hypersensitivity to nitinol or silicone.
  15. Subjects actively taking oral trospium. If previously used and discontinued, these medications must have been stopped for >2 weeks.
  16. The addition of a new or a change in dose to a current medication for the treatment of OAB (i.e. anticholinergics, beta-3 adrenergic agonists, antispasmodics, antidepressants, or hormones) within 30 days prior to signing the Informed Consent Form (ICF). A current dose must continue through the final study visit. If previously used and discontinued, these medications must have been stopped for > 2 weeks prior to Day 0.
  17. Intravesical onabotulinum toxin use within the last 9 months prior to the screening visit.
  18. Intravesical anticholinergic medications within the last 30 days prior to the screening visit.
  19. History of non-medication based therapy (i.e. Interstim therapy) for the treatment of OAB. History of non-invasive neuromodulation (i.e. Percutaneous Tibial Nerve Stimulation (PTNS)) is allowed if discontinued at least 8 weeks prior to Study Day 0.
  20. Female subject who is pregnant (as verified by urine test at time of screening) or lactating or of childbearing potential and not using acceptable methods of contraception.
  21. Subject has a medical condition that may cause noncompliance with the study protocol.
  22. Subject refuses to provide written informed consent.
  23. Subject will be unable or unwilling to complete the questionnaires, diaries, or attend all protocol mandated study visits.
  24. Presence of any bladder or urethral anatomic feature that in the opinion of the investigator may prevent the safe placement, indwelling use or removal of TAR-302-5018.
  25. History or presence of any significant cardiovascular, pulmonary, hepatic, renal, gastrointestinal, gynecological, endocrine, immunological, dermatological, neurological or psychiatric disease or disorder that, in the opinion of the investigator, contraindicates participation.
  26. History of any of the following within 3 months prior to Screening Visit:

    1. Major illness/major surgery (requiring hospitalization), including pelvic, lower back surgery or procedure unrelated to bladder cancer; most outpatient procedures are not exclusionary
    2. Renal or ureteral stone disease or instrumentation
    3. Childbirth
  27. Difficulty providing blood samples.
  28. Other unspecified reasons that, in the opinion of the investigator or TARIS, make the subject unsuitable for enrollment.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: TAR-302-5018
Trospium-Releasing Intravesical System (TAR-302-5018) is placed into the bladder through an inserter on Study Day 0 and is removed on Study Day 42. TAR-302-5018 releases trospium gradually during the 42 day indwelling time.
TAR-302-5018 er et passivt, ikke-resorberbart trospium-frigivende intravesikalt system, hvis primære virkemåde er den kontrollerede frigivelse af trospium til blæren over en 42-dages periode.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Safety of TAR-302-5018: Safety will be assessed throughout the study based on reported AEs
Tidsramme: Safety will be assessed from the signing of the informed consent form through Study Day 49 (+ 7 days) for a total of up to 77 days.
Safety will be assessed throughout the study based on reported AEs, investigational product events (IPEs), physical examinations (PEs), vital signs, clinical laboratory tests, scheduled cystoscopic examinations, bladder ultrasounds, bladder post-void residual volume (PVR), and the use of concomitant medications.
Safety will be assessed from the signing of the informed consent form through Study Day 49 (+ 7 days) for a total of up to 77 days.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Tolerability of TAR-302-5018
Tidsramme: Tolerability will be assessed during the 42-day indwelling period unless removed due to lack of tolerability in advance of the Day 42 scheduled removal.
Tolerability will be determined by the proportion of subjects who require TAR-302-5018 removal prior to the planned removal on Day 42 due to meeting any of the Subject Stopping Safety Criteria or other drug or device constituent related adverse event.
Tolerability will be assessed during the 42-day indwelling period unless removed due to lack of tolerability in advance of the Day 42 scheduled removal.
Peak Plasma Concentration (Cmax)
Tidsramme: Seven time-points across 49 days (Day 0 through Day 49).
Plasma will be evaluated for trospium levels on Study Days 0, 3, 7, 14, 28, 42, and 49.
Seven time-points across 49 days (Day 0 through Day 49).
Peak Urine Concentration (Cmax)
Tidsramme: Seven time-points across 49 days (Day 0 through Day 49).
Urine will be evaluated for trospium levels on Study Days 0, 3, 7, 14, 28, 42, and 49.
Seven time-points across 49 days (Day 0 through Day 49).
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Instillation Volume
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Instillation volume at first sensation (mL)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Vesical Pressure
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Vesical pressure at first sensation (cmH2O)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Instillation Volume
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Instillation volume at first desire to urinate (mL)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Vesical Pressure
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Vesical pressure at first desire to urinate (cmH2O)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Instillation Volume
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Instillation volume at maximal desire to urinate (mL)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Vesical Pressure
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Vesical pressure at maximal desire to urinate (cmH2O)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Instillation Volume
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Instillation volume at maximum capacity (mL)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Detrusor Pressure
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Detrusor pressure at maximum capacity (cmH2O)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Filling Phase - Bladder Compliance
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Bladder compliance (mL/cmH2O)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Involuntary Bladder Contractions - Instillation Volume
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Instillation Volume (mL)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Involuntary Bladder Contractions - Vesical Pressure
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Vesical pressure (cmH2O)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Involuntary Bladder Contractions - Detrusor Pressure
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Detrusor pressure (cmH2O)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Peak Flow
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Peak flow (mL/s)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Mean Flow
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Mean flow (mL/s)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Detrusor Pressure
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Detrusor pressure at the peak flow (cmH2O)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Total Voided Volume
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Total voided volume (mL)
Day 0, Day 14 (+/- 1 day), Day 42
Preliminary Urodynamic Efficacy: Vesical Voiding Phase - Post Void Residual Volume
Tidsramme: Day 0, Day 14 (+/- 1 day), Day 42
Post void residual volume (mL)
Day 0, Day 14 (+/- 1 day), Day 42

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
The Change in Quality of Life as assessed by Qualiveen Surveys
Tidsramme: Three time-points across 42 days (Study Day 0 to Study Day 42).
Evidence of improvement in QoL assessed at Study Days 14 (± 1 day) and 42 and compared to Study Day 0 (baseline) as assessed by the following instrument.
Three time-points across 42 days (Study Day 0 to Study Day 42).

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Ledende efterforsker: Michael Kennelly, MD, Wake Forest University Health Sciences

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

24. april 2017

Primær færdiggørelse (Faktiske)

26. juli 2018

Studieafslutning (Faktiske)

26. juli 2018

Datoer for studieregistrering

Først indsendt

6. april 2017

Først indsendt, der opfyldte QC-kriterier

24. maj 2017

Først opslået (Faktiske)

30. maj 2017

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. januar 2020

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

10. januar 2020

Sidst verificeret

1. januar 2020

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • TAR-302-101

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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Kliniske forsøg med Neurogen Detrusor Overaktivitet

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