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A Trial of Degarelix in Men With Lower Urinary Tract Symptoms (LUTS) Associated With Benign Prostatic Hyperplasia (BPH)

Phase 2
Completed
Conditions
Lower Urinary Tract Symptoms (LUTS)
Interventions
Registration Number
NCT00947882
Lead Sponsor
Ferring Pharmaceuticals
Brief Summary

A dose-finding, multi-centre, double-blind, randomised, parallel, placebo-controlled trial to investigate efficacy and safety of degarelix in men with lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH)

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
Male
Target Recruitment
404
Inclusion Criteria
  • Signed informed consent obtained before any trial-related activity is performed
  • Men, aged 50 or older
  • Clinical signs and symptoms of BPH for ≥6 months
  • Moderate to severe LUTS at screening, as defined by International Prostate Symptom Score (IPSS) ≥13
  • An IPSS QoL score of ≥3 at screening
  • Prostate specific antigen (PSA) at screening ≤10 ng/mL (responsibility of the Investigator to rule out prostate cancer when PSA is >4 ng/mL, except in the USA where patients with a PSA >4 and ≤10 ng/mL should undergo a prostatic biopsy or have a negative prostatic biopsy within 12 months prior to participation in the trial)
  • Maximum urinary flow (Qmax) ranging between 5 to 15 mL/second with a minimum voided volume >125 mL at screening
Exclusion Criteria
  • Post void residual volume (PVR) >250 mL

  • Stone in the bladder or urethra causing symptoms

  • Acute or chronic prostatitis

  • Interstitial cystitis / painful bladder syndrome

  • Acute or recurrent urinary tract infections

  • History of acute urinary retention (AUR)

  • Lower urinary tract instrumentation (including prostate biopsy) within 30 days of dosing at Visit 2

  • Clinical evidence of any of the following urinary tract conditions:

    1. Mullerian duct cysts
    2. Atonic, decompensated, or hypocontractile bladder
    3. Detrusor-sphincter dyssynergia (contraction of the detrusor without sphincter relaxation)
  • History of any of the following pelvic conditions:

    1. Pelvic surgery or any other pelvic procedure, including radical prostatectomy, pelvic surgery for removal of malignancy, or open lower colonic or rectal surgery
    2. Pelvic radiotherapy
    3. Any prior surgical procedure of the urinary tract, including minimally invasive LUTS/BPH therapies
    4. Lower tract malignancy or trauma
  • Clinically significant microscopic haematuria at screening

  • History of significant renal insufficiency, defined as receiving renal dialysis or having an estimated creatinine clearance <30 mL/minute at screening

  • Systolic blood pressure >180 or <90 mmHg or diastolic blood pressure >110 or <50 mmHg at screening or malignant hypertension

  • Any causes other than BPH, which may affect evaluation of symptoms of urine flow (e.g. neurogenic bladder, bladder neck contracture, urethral stricture, and bladder malignancy) as judged by the Investigator

  • Use of any prohibited therapies

  • Elevated liver function tests at screening:

    1. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) >2 times the upper limit of normal
    2. Total bilirubin >1.5 times the upper limit of normal
  • QTc interval on the screening ECG >450 ms, or a family history of long QT syndrome

  • Any clinically significant disorder (other than BPH) including, but not limited to, renal, haematological, gastrointestinal, endocrine, cardiac, neurological, or psychiatric disease, or any other condition, which may affect the patient's health or the outcome of the trial as judged by the Investigator

  • Diagnosed cancer within the last 5 years except for adequately managed basal cell carcinoma and squamous cell carcinoma of the skin

  • History of severe untreated asthma, anaphylactic reactions, or severe urticaria and/or angioedema

  • Mental incapacity or language barrier precluding adequate understanding or co-operation

  • History or current evidence of drug, alcohol, or substance abuse within 6 months prior to screening

  • Hypersensitivity towards any component of the investigational medicinal product (IMP)

  • Previous participation in any degarelix trial

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Degarelix 30 mgDegarelix 30 mg-
Degarelix 10 mgDegarelix 10 mg-
PlaceboPlacebo-
Degarelix 20 mgDegarelix 20 mg-
Primary Outcome Measures
NameTimeMethod
Mean Change in International Prostate Symptom Score (IPSS)From Baseline to Month 3 after Dosing

This outcome measure was used to assess the dose-response of the 3 degarelix dose groups in terms of severity of lower urinary tract symptoms (LUTS) and progress of the disease process, versus the placebo group. One treatment month equals 28 days.

The IPSS questionnaire is a tool commonly used to assess the severity of LUTS, and to monitor the progress of the symptoms during treatment. It contains 7 questions regarding incomplete emptying, frequency, intermittency, urgency, weak stream, straining, and nocturia. Each question is assigned a score of 0-5 (i.e. minimum total score is 0 and the maximum score is 35), where "0" corresponds to a response of "not at all" for the first six symptoms and "none" for nocturia, and "5" corresponds to a response of "almost always" for the first six symptoms and "5 times or more" for nocturia. The IPSS also includes a question to evaluate a patient's quality of life in relation to his urinary symptoms, which is not included in the total IPSS score.

Secondary Outcome Measures
NameTimeMethod
Mean Change in IPSSFrom Baseline to Month 4, Month 5 and Month 6 after Dosing

This secondary outcome measure was used to assess the maintained dose-response of the 3 degarelix dose groups in terms of severity of LUTS and progress of the disease process, versus the placebo group.

Mean Change in Maximum Urinary Flow (Qmax)From Baseline to Month 3 and Month 6 after Dosing

Urinary flow rate (mL/second) was measured using uroflowmetry performed according to the recommendation from the International Continence Society (ICS).

Mean Percentage Change in Total Prostate Volume (TPV)From Baseline to Month 3 and Month 6 after Dosing

TPV was measured directly by standardised trans-rectal ultrasound (TRUS).

Odds Ratio (as Compared to Placebo) of Treatment Response in IPSSAt Month 3, Month 4, Month 5 and Month 6 after Dosing

A 3-point reduction in IPSS score compared to baseline is defined as a clinically meaningful treatment response. Percentage of participants who met criteria for a clinically meaningful treatment response and odds ratios of treatment responses between each degarelix dose group and the placebo group are presented.

Trial Locations

Locations (47)

Urology Centers of Alabama, PC

🇺🇸

Homewood, Alabama, United States

Coastal Clinical Research Inc

🇺🇸

Mobile, Alabama, United States

California Professional Research

🇺🇸

Newport Beach, California, United States

Genitourinary Surgical Consultants

🇺🇸

Denver, Colorado, United States

Urology Associates , PC

🇺🇸

Englewood, Colorado, United States

South Florida Medical Research

🇺🇸

Aventura, Florida, United States

Winter Park Urology Associates

🇺🇸

Orlando, Florida, United States

Pinellas Urology Inc

🇺🇸

St Petersburg, Florida, United States

Florida Urology Partners

🇺🇸

Tampa, Florida, United States

Northwestern University

🇺🇸

Chicago, Illinois, United States

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Urology Centers of Alabama, PC
🇺🇸Homewood, Alabama, United States

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