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To Establish the Safety and Effectiveness of the ALPFA GRAIL PFA System for Treating Symptomatic Benign Prostate Hyperplasia (BPH) Also Known as an Enlarged Prostate. (REBOUND)

10 novembre 2026 aggiornato da: ALPFA Medical

A Prospective Randomized Pivotal Trial of the ALPFA Medical Prostate Ablation System Compared With Cystoscopy in Men With Symptomatic Benign Prostatic Hyperplasia

The main goal of this study is to evaluate the ALPFA GRAIL™ Pulsed Field Ablation (PFA) System for treatment of enlarged prostate (BPH) symptoms. The study will involve up to 250 male participants who have urinary problems caused by BPH and whom are greater than 40 years of age in up to 30 investigational centers across the US,Canada and European Union.

Panoramica dello studio

Stato

Reclutamento

Condizioni

Intervento / Trattamento

Descrizione dettagliata

This study aims to test how safe and effective the ALPFA BPH PFA System is for treating men over age 40 who have urinary problems caused by an enlarged prostate (BPH).The study will involve up to 250 participants in up to 30 investigational centers across the US, Canada, and European Union.

Men who agree to join the study will have health checks before treatment. Those who meet the study eligibility criteria including medication washout requirements,will be placed by chance into one of two groups. Two out of three men will receive treatment with the ALPFA BPH PFA System. One out of three men will receive a sham procedure that looks like treatment but does not deliver treatment.Participants will be followed for longer term safety and effectiveness for a total of 5 years post treatment with the ALPFA GRAIL™ Pulsed Field Ablation (PFA) System.

Patients and site personnel administering follow-up assessments will be blinded to the randomized treatment through completion of the 3-month follow-up visit.

After 3 months, participants will be told which group they were in. Men who were in the sham group may choose to receive treatment with the ALPFA BPH PFA System. Men in the sham group who do not choose treatment by 6 months will no longer take part in the study.

All men who receive treatment will have follow-up visits at 2 weeks, 4 weeks, 3 months, 6 months, and 12 months. After that, they will be checked once a year for up to 5 years.

Tipo di studio

Interventistico

Iscrizione (Stimato)

250

Fase

  • Non applicabile

Contatti e Sedi

Questa sezione fornisce i recapiti di coloro che conducono lo studio e informazioni su dove viene condotto lo studio.

Contatto studio

Backup dei contatti dello studio

Luoghi di studio

    • Arizona
      • Mesa, Arizona, Stati Uniti, 85206
      • Sun City, Arizona, Stati Uniti, 85351
        • Reclutamento
        • Academic Urology & Urogynecology of Arizona
      • Tucson, Arizona, Stati Uniti, 85712
        • Non ancora reclutamento
        • Del Sol Research Management
    • California
      • Bakersfield, California, Stati Uniti, 93301
      • La Mesa, California, Stati Uniti, 91942
        • Reclutamento
        • San Diego Clinical Trials
        • Contatto:
          • Brian
      • Sacramento, California, Stati Uniti, 95823
    • Colorado
      • Lone Tree, Colorado, Stati Uniti, 80124
        • Reclutamento
        • Urology Associates - Lone Tree
        • Contatto:
        • Investigatore principale:
          • James Fagelson
    • Florida
      • Tampa, Florida, Stati Uniti, 33619
        • Reclutamento
        • Gulf Coast Clinical Trial Associates
        • Contatto:
          • Jodi
      • Winter Garden, Florida, Stati Uniti, 34788
        • Reclutamento
        • Avant Concierge Urology
        • Contatto:
        • Investigatore principale:
          • Sijo Parekattil
    • Idaho
      • Meridian, Idaho, Stati Uniti, 83642
        • Reclutamento
        • Capital Surgical Associates
        • Contatto:
        • Investigatore principale:
          • Austen Slade
    • Illinois
      • Lake Barrington, Illinois, Stati Uniti, 60010
        • Reclutamento
        • Comprehensive Urology
        • Contatto:
        • Investigatore principale:
          • Ning Wu
    • Louisiana
      • Lafayette, Louisiana, Stati Uniti, 70508
        • Reclutamento
        • Southern Urology
        • Contatto:
        • Investigatore principale:
          • Andre Broussard
    • Nebraska
      • Kearney, Nebraska, Stati Uniti, 68847
        • Reclutamento
        • Kearney Urology Center
        • Contatto:
          • Monique
    • New York
      • Plainview, New York, Stati Uniti, 11803
        • Reclutamento
        • The Smith Institute of Urology Northwell Health
        • Contatto:
          • Jennifer
    • Tennessee
    • Texas
      • Austin, Texas, Stati Uniti, 78705
      • San Antonio, Texas, Stati Uniti, 78240
        • Reclutamento
        • The Urology Place
        • Contatto:
        • Investigatore principale:
          • Naveen Kella
      • West Lake Hills, Texas, Stati Uniti, 78746
        • Reclutamento
        • Midtown Urology Associates
        • Contatto:
          • Andrew

Criteri di partecipazione

I ricercatori cercano persone che corrispondano a una certa descrizione, chiamata criteri di ammissibilità. Alcuni esempi di questi criteri sono le condizioni generali di salute di una persona o trattamenti precedenti.

Criteri di ammissibilità

Età idonea allo studio

45 anni e precedenti (Adulto, Adulto più anziano)

Accetta volontari sani

No

Sessi ammissibili allo studio

Maschio

Descrizione

Inclusion Criteria: Study subjects are required to meet all the following inclusion criteria to participate in this study as determined by the Investigator:

  1. ≥ 45 years of age on the day of enrollment.

  2. Symptomatic BPH meeting all of the following criteria determined within 30 days preceding enrollment and after fulfilling the concomitant medication washout period(s):

    1. Symptom Score: Baseline IPSS score ≥13
    2. Flow Rate: Uroflow test with a pre-void bladder volume ≥150 mL (confirmed by bladder scan),Single uroflow test with a minimum voided volume ≥ 125 mL and a Qmax ≥ 5 mL/sec and ≤ 15 mL/s
    3. Residual: ultrasound-determined PVR of ≤ 250 mL
  3. Prostate size 25-150 g, measured by transrectal ultrasound.

  4. Willing and able to provide consent and comply with study requirements.

Exclusion Criteria:Subjects will be excluded from the study if they meet any one of the following exclusion criteria, as determined by the Investigator:

  1. Medical conditions that would prevent participation in the study, interfere with assessment or therapy, significantly raise the risk of study participation, or confound data or its interpretation, including but not limited to:

    1. Cardiovascular:

      • History of clinically significant heart failure (NYHA III/IV)
      • Uncontrolled arrhythmia.
      • Stroke, TIA, myocardial infarction, unstable angina, percutaneous coronary intervention, or any cardiac surgery within 180 days of enrollment.
      • Uncontrolled hypertension (> 160 mmHg systolic or > 95 mmHg diastolic on repeat measurements)
    2. Renal: Serum creatinine > 2.0 mg/dL or any history of renal dialysis or renal transplant.

    3. Metabolic: Clinically uncontrolled diabetes mellitus or a baseline HbA1c ≥ 8.0%, or clinically significant liver disease.

    4. Non-urologic cancer: Active malignancy, or within 3 years of enrollment, a history of treated malignancy now in full remission, except basal cell or squamous cell carcinoma of the skin.

    5. Respiratory: Severe lung disease or respiratory illness requiring hospitalization.

    6. Immunosuppression: Known immunosuppression, including but not limited to AIDS, immunosuppressive medication, or current chemotherapy.

    7. Transplant: Solid organ or hematologic transplant or currently being evaluated for an organ transplant.

    8. Substance abuse: Active alcoholism or drug addiction.

    9. Sleep apnea: Known moderate to severe obstructive sleep apnea that is untreated or therapy non-compliant

  2. Urologic conditions that would prevent participation in the study, interfere with assessment or therapy, significantly raise the risk of study participation, or confound data or its interpretation, including but not limited to:

    1. Operative: Previous prostate surgery or interventional procedure, including but not limited to BPH surgery, radiation, laser, prostate arterial embolism, balloon dilatation, or hyperthermic treatment, or prostate biopsy within 40 days of the Index Procedure.
    2. Infection: Urinary tract infection (UTI) (105 CFU/mL) within 90 days of enrollment or >3 UTIs within the year prior to enrollment.
    3. Incontinence: History of urinary incontinence.
    4. Retention: Requires indwelling catheter or intermittent catheterization to void or had an episode of spontaneous urinary retention within 30 days of enrollment.
    5. Prostatitis: History of prostatitis or chronic pelvic pain syndrome (CPPS) within 2 years of enrollment.
    6. Cystolithiasis: Active bladder stones
    7. Neurogenic bladder: Neurogenic or atonic bladder or sphincter, including etiologies of uncontrolled diabetes, Parkinson's disease, multiple sclerosis, cerebrovascular accident, or polyneuropathy.
    8. Anatomic abnormality: Prior or current urethral stricture, meatal stenosis, bladder neck contracture, or other urologic anatomic abnormalities that would interfere with planned treatment or confound subsequent assessment.
    9. Implants: Any urinary tract implants including stents, sutures, penile implants, or artificial sphincters.
    10. Hematuria: Hematuria without a known contributing factor within 90 days of the Index Procedure.
  3. Bladder cancer: Actively being treated or suspected cancer of the bladder.

  4. Prostate cancer:

    1. Confirmed or history of prostate cancer
    2. Baseline PSA > 15 ng/mL within 30 days of enrollment
    3. If PSA is between 4.0 ng/mL and 15 ng/mL, prostate cancer must be ruled out with a negative biopsy or an MRI (≤PIRADS-3) within 12 months prior to enrollment.
  5. Prior pelvic or rectal interventions:

    1. Previous pelvic irradiation or radical pelvic surgery
    2. Previous rectal surgery (other than hemorrhoidectomy) or a history of rectal disease that may be impacted by Index Procedure.
  6. Peri-procedural anticoagulation: Unable to stop anti-platelet or anticoagulation treatment for the Index Procedure per site standard of care.

  7. Subjects who cannot or will not comply with the following washout medication requirements within the time period specified prior to enrollment:

    1. 24-Hours:

      • i. Taking phenylephrine or pseudoephedrine within 24 hours of the Baseline evaluation and Index Procedure.
    2. 1 Week:

      • i. Antihistamine, anticonvulsant, or antispasmodics medications within 1 week of enrollment unless documented on a stable (unchanged) dose for 180 days prior to enrollment.
    3. 2 Weeks:

      • i. Use of alpha blockers or daily dosage of PDE5 inhibitors (tadalafil [Cialis]) for BPH within 2 weeks prior to enrollment.
      • ii. Use of anticholinergics or beta-3 adrenergic receptor agonists (e.g., mirabegron, vibegron) within 2 weeks prior to enrollment, unless documented on a stable dose for 30 days prior to enrollment.
    4. 3 Months:

      • i. Taking estrogen, drugs producing androgen suppression, or androgens within 90 days prior to enrollment, unless documented on a stable dosage for at least 180 days prior to enrollment.
      • ii. Use of Type II 5-alpha reductase inhibitor medication (e.g., finasteride [Proscar, Propecia]) within 90 days of enrollment OR anticipated use within the first 12 months of follow-up.
    5. 6 Months:

      • i. Use of any Type I 5-alpha reductase inhibitor medication (e.g., dutasteride [Avodart]) within 180 days prior to enrollment OR anticipate use within the first 12 months of follow-up.
      • ii. Taking tricyclic antidepressants that are not on a stable dose for the 180 days prior to enrollment OR anticipate stopping or changing treatment in the first 12 months of follow-up.
  8. Subjects who wish to maintain their fertility.

  9. Current or anticipated enrollment in any other randomized or interventional clinical study (registry or retrospective studies permitted).

  10. Vulnerable populations, including individuals who are incarcerated or institutionalized.Any physical, psychological, or developmental impairment (e.g., developmental delay) that, in the investigator's opinion, would compromise the subject's ability to provide informed consent, comply with study procedures, or complete patient-reported outcome measures.

Piano di studio

Questa sezione fornisce i dettagli del piano di studio, compreso il modo in cui lo studio è progettato e ciò che lo studio sta misurando.

Come è strutturato lo studio?

Dettagli di progettazione

  • Scopo principale: Trattamento
  • Assegnazione: Randomizzato
  • Modello interventistico: Assegnazione incrociata
  • Mascheramento: Triplicare

Armi e interventi

Gruppo di partecipanti / Arm
Intervento / Trattamento
Comparatore attivo: Treatment Device

Men who join the study will first have a health check to see if they can take part. If they meet the study requirements and have stopped any restricted medications, they will be assigned by chance to a treatment group and treated with the ALPFA GRAIL™ Pulsed Field Ablation (PFA) System(Treatment) per their randomized assignment. Participants will then have follow-up visits with health checks as planned for this study

After the participant receives anesthesia, the Investigator will proceed with placement of the ALPFA GRAIL PFA Catheter into the prostate via a standard flexible cystoscope. Visualization of the prostatic urethra will determine the number of balloons that are exposed and inflated.

When the catheter has been properly positioned, the ALPFA GRAIL PFA Console will be activated and one PFA application will be delivered. The Investigator will assess if the catheter needs to be repositioned and additional ablation applications delivered, as necessary. Once ablation is complete, the catheter balloons will be deflated, and the catheter will be withdrawn from the urethra.

Participants will then have follow-up visits with health checks as planned for this study.

Comparatore fittizio: Control Device

Men who join the study will first have a health check to see if they can take part. If they meet the study requirements and have stopped any restricted medications, they will be assigned by chance to a control group and treated with sham flexible cystoscopy (Control) per their randomized assignment. Participants will then have follow-up visits with health checks as planned for this study

Participants will receive mock treatment with a flexible cystoscope with a working channel that is at least 6.9F in diameter. The cystoscope will be inserted and treatment script initiated. Once the script is completed, the cystoscope will be removed and procedural details captured on the relevant CRF.

Participants will then have follow-up visits with health checks as planned for this study.

Altro: Crossover Cohort

Control Arm (Sham) patients can receive treatment with the ALPFA GRAIL™ Pulsed Field Ablation (PFA) System after their 3-month follow-up assessments are completed, and participant symptom profile necessaites treatment and alll protocol defined enrollment criteria are met. The study visit follow-up schedule will restart and the subject will be followed for 60 months post ALPFA GRAIL™ Pulsed Field Ablation (PFA) System(Treatment)Unless treated with the ALPFA GRAIL™ Pulsed Field Ablation(PFA)System, the subject will be exited from the study once they have completed their 3-month follow-up visit.

After the participant receives anesthesia, the Investigator will proceed with placement of the ALPFA GRAIL PFA Catheter into the prostate via a standard flexible cystoscope. Visualization of the prostatic urethra will determine the number of balloons that are exposed and inflated.

When the catheter has been properly positioned, the ALPFA GRAIL PFA Console will be activated and one PFA application will be delivered. The Investigator will assess if the catheter needs to be repositioned and additional ablation applications delivered, as necessary. Once ablation is complete, the catheter balloons will be deflated, and the catheter will be withdrawn from the urethra.

Participants will then have follow-up visits with health checks as planned for this study.

Cosa sta misurando lo studio?

Misure di risultato primarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Safety-Incidence of Serious Device-or Procedure-Related Adverse Events (Composite Safety Endpoint)
Lasso di tempo: Through 12 months post-procedure

The primary safety endpoint is the proportion of participants experiencing one or more of the following serious device-related or procedure-related adverse event through 12 months post-procedure

Through 12 months post-procedure
Effectiveness-Change from Baseline in International Prostate Symptom Score (IPSS) at 3 Months.
Lasso di tempo: Baseline to 3 months post-procedure

The International Prostate Symptom Score (IPSS) is a 7-item questionnaire (score range 0-35) where higher scores indicate more severe symptoms. Success is defined as the Treatment group showing a 25% greater relative improvement in mean score compared to the Control group

Baseline to 3 months post-procedure
Effectiveness-Durability of Treatment Effect: Percent Change in International Prostate Symptom Score (IPSS) at 12 Months
Lasso di tempo: Baseline to 12 months post-procedure

This endpoint evaluates the long-term effectiveness of the ALPFA GRAIL PFA System. It is calculated as the mean percentage change in the total International Prostate Symptom Score (IPSS) score from the start of the study (baseline) to the 12-month follow-up for participants in the treatment group.

Baseline to 12 months post-procedure

Misure di risultato secondarie

Misura del risultato
Misura Descrizione
Lasso di tempo
Additional Study Goals
Lasso di tempo: 3 months

1.Comparison of Symptom Improvement (at 3 Months) Researchers will compare the average change in prostate symptoms between the group that received the study treatment and the control group. This helps show if the treatment provides more relief than the standard comparison.

3 months
Success Stories (Responder Rate)
Lasso di tempo: 3 months

2. Number of "Success Stories" (Responder Rate) The study will count how many participants had a meaningful improvement in their symptoms. A "responder" (a success) is defined as a person whose symptoms improved by at least 30% three months after the treatment.

3 months
Improvement in Urine Flow
Lasso di tempo: 3 months

3. Improvement in Urine Flow (Qmax) Researchers will measure the strength of the participant's urine flow. They will compare the average change in flow strength from the start of the study to three months later between the treatment group and the control group.

3 months

Collaboratori e investigatori

Qui è dove troverai le persone e le organizzazioni coinvolte in questo studio.

Sponsor

Investigatori

  • Investigatore principale: Dr. Bilal Chughtai, The Smith Institute of Urology/Northwell Health
  • Investigatore principale: Dr. Dean Elterman, University Health Network, Toronto

Studiare le date dei record

Queste date tengono traccia dell'avanzamento della registrazione dello studio e dell'invio dei risultati di sintesi a ClinicalTrials.gov. I record degli studi e i risultati riportati vengono esaminati dalla National Library of Medicine (NLM) per assicurarsi che soddisfino specifici standard di controllo della qualità prima di essere pubblicati sul sito Web pubblico.

Studia le date principali

Inizio studio (Effettivo)

28 ottobre 2026

Completamento primario (Stimato)

1 ottobre 2027

Completamento dello studio (Stimato)

1 dicembre 2032

Date di iscrizione allo studio

Primo inviato

27 aprile 2026

Primo inviato che soddisfa i criteri di controllo qualità

11 maggio 2026

Primo Inserito (Effettivo)

18 maggio 2026

Aggiornamenti dei record di studio

Ultimo aggiornamento pubblicato (Effettivo)

12 novembre 2026

Ultimo aggiornamento inviato che soddisfa i criteri QC

10 novembre 2026

Ultimo verificato

1 novembre 2026

Maggiori informazioni

Termini relativi a questo studio

Parole chiave

Altri numeri di identificazione dello studio

  • CS00004

Piano per i dati dei singoli partecipanti (IPD)

Hai intenzione di condividere i dati dei singoli partecipanti (IPD)?

NO

Informazioni su farmaci e dispositivi, documenti di studio

Studia un prodotto farmaceutico regolamentato dalla FDA degli Stati Uniti

No

Studia un dispositivo regolamentato dalla FDA degli Stati Uniti

Sì

Queste informazioni sono state recuperate direttamente dal sito web clinicaltrials.gov senza alcuna modifica. In caso di richieste di modifica, rimozione o aggiornamento dei dettagli dello studio, contattare register@clinicaltrials.gov. Non appena verrà implementata una modifica su clinicaltrials.gov, questa verrà aggiornata automaticamente anche sul nostro sito web .