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

10 de enero de 2020 actualizado por: 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).

Descripción general del estudio

Tipo de estudio

Intervencionista

Inscripción (Actual)

7

Fase

  • Fase 1

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

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

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

18 años y mayores (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

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.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: N / A
  • Modelo Intervencionista: Asignación de un solo grupo
  • Enmascaramiento: Ninguno (etiqueta abierta)

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: 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 es un sistema intravesical de liberación de trospio no reabsorbible pasivo cuyo principal modo de acción es la liberación controlada de trospio en la vejiga durante un período de 42 días.

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Safety of TAR-302-5018: Safety will be assessed throughout the study based on reported AEs
Periodo de tiempo: 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.

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Tolerability of TAR-302-5018
Periodo de tiempo: 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)
Periodo de tiempo: 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)
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: 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
Periodo de tiempo: Day 0, Day 14 (+/- 1 day), Day 42
Post void residual volume (mL)
Day 0, Day 14 (+/- 1 day), Day 42

Otras medidas de resultado

Medida de resultado
Medida Descripción
Periodo de tiempo
The Change in Quality of Life as assessed by Qualiveen Surveys
Periodo de tiempo: 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).

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Patrocinador

Investigadores

  • Investigador principal: Michael Kennelly, MD, Wake Forest University Health Sciences

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio (Actual)

24 de abril de 2017

Finalización primaria (Actual)

26 de julio de 2018

Finalización del estudio (Actual)

26 de julio de 2018

Fechas de registro del estudio

Enviado por primera vez

6 de abril de 2017

Primero enviado que cumplió con los criterios de control de calidad

24 de mayo de 2017

Publicado por primera vez (Actual)

30 de mayo de 2017

Actualizaciones de registros de estudio

Última actualización publicada (Actual)

13 de enero de 2020

Última actualización enviada que cumplió con los criterios de control de calidad

10 de enero de 2020

Última verificación

1 de enero de 2020

Más información

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

Ensayos clínicos sobre Hiperactividad del detrusor neurogénico

Ensayos clínicos sobre Sistema intravesical liberador de trospio (TAR-302-5018)

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