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

10 janvier 2020 mis à jour par: 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).

Aperçu de l'étude

Type d'étude

Interventionnel

Inscription (Réel)

7

Phase

  • La phase 1

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

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

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

18 ans et plus (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

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 d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: N / A
  • Modèle interventionnel: Affectation à un seul groupe
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Expérimental: 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.
Le TAR-302-5018 est un système intravésical passif et non résorbable libérant du trospium dont le principal mode d'action est la libération contrôlée de trospium dans la vessie sur une période de 42 jours.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Safety of TAR-302-5018: Safety will be assessed throughout the study based on reported AEs
Délai: 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.

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Tolerability of TAR-302-5018
Délai: 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)
Délai: 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)
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: 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
Délai: Day 0, Day 14 (+/- 1 day), Day 42
Post void residual volume (mL)
Day 0, Day 14 (+/- 1 day), Day 42

Autres mesures de résultats

Mesure des résultats
Description de la mesure
Délai
The Change in Quality of Life as assessed by Qualiveen Surveys
Délai: 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).

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Les enquêteurs

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

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

24 avril 2017

Achèvement primaire (Réel)

26 juillet 2018

Achèvement de l'étude (Réel)

26 juillet 2018

Dates d'inscription aux études

Première soumission

6 avril 2017

Première soumission répondant aux critères de contrôle qualité

24 mai 2017

Première publication (Réel)

30 mai 2017

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

13 janvier 2020

Dernière mise à jour soumise répondant aux critères de contrôle qualité

10 janvier 2020

Dernière vérification

1 janvier 2020

Plus d'information

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

Essais cliniques sur Système intravésical libérant du trospium (TAR-302-5018)

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