The Safety and Effectiveness of AA4500 in Subjects With Peyronie's Disease

Phase 2

Completed

Conditions: Peyronie's Disease

Interventions: Biological: AA4500
Biological: Placebo

Registration Number: NCT00755222

Lead Sponsor: Endo Pharmaceuticals

Brief Summary: This study evaluated the safety and effectiveness of AA4500 in improving the impact of Peyronie's disease on quality of life and improving penile curvature in men with Peyronie's disease

Detailed Description: A Phase 2b randomized, double-blind, placebo-controlled study of AA4500 in the treatment of subjects with Peyronie's disease.

During the screening period, subjects had a physical examination including body weight and height, vital sign measurements, a 12-lead electrocardiogram (ECG), and clinical laboratory testing. Medical history, prior and concomitant medications, and demographic data were recorded.

Recruitment & Eligibility

Status: COMPLETED

Sex: Male

Target Recruitment: 147

Inclusion Criteria

Heterosexual male ≥ 18 years of age
In a stable relationship with a partner/spouse for at least 3 months before screening
Have a diagnosis of Peyronie's disease for at least 6 months before first dose of study drug
Have a penile curvature of at least 30° in the dorsal, lateral, or dorsal/lateral plane
Have functional difficulty related to Peyronie's disease (eg, difficulty with intromission or erectile dysfunction)
Be judged to be in good health based upon the results of medical history, physical examination and laboratory profile
Voluntarily sign an informed consent agreement approved by the Institutional Review Board/Independent Ethics Committee (IRB/IEC). The subject must have also signed an authorization form to allow disclosure of his protected health information. The protected health information authorization form and informed consent form may have been an integrated form or may have been separate forms, depending on the institution
Be able to complete and understand the various rating instruments

Exclusion Criteria

Have had an average of three successive blood pressure readings ≥ 160/100 mmHg during screening or the Day 1 assessments
Severe pain during penile palpation
Any of the following conditions:
- Chordee in the presence or absence of hypospadias
- Thrombosis of the dorsal penile artery
- Infiltration by a benign or malignant mass resulting in penile curvature
- Infiltration by an infectious agent, such as lymphogranuloma venereum
- Ventral curvature from any cause
- Presence of sexually transmitted disease
- Known Hepatitis B or C
- Known immune deficiency disease or be positive for human immunodeficiency virus (HIV)
Previously undergone surgery for Peyronie's disease
Penile curvature of less than 30° or greater than 90°
Failed to have a rigid erection after pharmacological stimulation with a vasoactive injection of Prostaglandin E1 10 to 20 µg, which, in the opinion of the investigator, was sufficient to accurately measure the subject's penile deformity
Had a calcified plaque as evident by appropriate radiographic evaluation, penile x-ray, or penile ultrasound. Non-contiguous stippling of calcium was acceptable for inclusion
Had an isolated hourglass deformity of the penis without curvature
Had the plaque causing curvature of the penis located proximal to the base of the penis, so that the injection of the local anesthetic would have interfered with the injection of AA4500 into the plaque
Received alternative medical therapies for Peyronie's disease administered by the intralesional route (including, but not limited to, steroids, verapamil, and the naturally occurring low molecular weight protein, interferon-α2b) within 3 months before the first dose of study drug or plans to use any of these medical therapies at any time during the study
Received alternative medical therapies for Peyronie's disease administered by the oral (including, but not limited to, vitamin E (>500IU), potassium aminobenzoate [Potaba], tamoxifen, colchicine, pentoxifylline, over-the-counter erectile dysfunction medications, or steroidal anti inflammatory drugs) or topical routes (including, but not limited to, verapamil applied as a cream) within 4 weeks before the first dose of study drug or plans to use any of these medical therapies at any time during the study
Used any mechanical type device for correction of Peyronie's disease within the 2-week period before screening or plans to use any these devices at any time during the study
Used a mechanical device to induce a passive erection within the 2-week period before screening or plans to use any of these devices at any time during the study
Significant erectile dysfunction that has failed to respond to oral treatment with phosphodiesterase type 5 (PDE5) inhibitors
Recent history of stroke, bleeding, or other medical condition, which in the investigator's opinion would make the subject unsuitable for enrollment in the study
Unwilling or unable to cooperate with the requirements of the study including completion of all scheduled study visits
Received an investigational drug or treatment within 30 days before the first dose of study drug
Allergy to collagenase or any other excipient of AA4500
Allergy to any concomitant medication required as per the protocol
Received anticoagulant medication (except for ≤ 165 mg aspirin daily or ≤ 800 mg of over-the-counter NSAIDS daily) during the 7 days before each dose of study drug
Received doxycycline or a tetracycline derivative during the 7 days before each dose of study drug or plans to use these drugs within 2 days after the injection of study drug
Received any collagenase treatments within 30 days of the first dose of study drug

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
AA4500	AA4500	Clostridial collagenase for injection
Placebo	Placebo	-

Primary Outcome Measures

Name	Time	Method
Change From Baseline in PDQ Intercourse Contraint	Baseline to Week 36 or LOCF	Peyronie's disease intercourse contraint Scale: 0-12 lower numbers reflect 'less intercourse contraint'; higher numbers reflect 'more intercourse constraint' Change from baseline equals Week 36 minus baseline. Negative change reflects improvement in the intercourse constraint scale.
Change From Baseline in PDQ Penile Pain	Baseline to Week 36 or LOCF	Peyronie's disease penile pain Scale: 0-40 lower numbers reflect 'less penile pain'; higher numbers reflect 'more penile pain' Change from baseline=Week 36 minus baseline. Negative change reflects improvement in the penile pain scale.
Change From Baseline in Penile Curvature	Baseline and Week 36 or last observation carried forward (LOCF)	Negative change reflects improvement in penile curvature
Change From Baseline in Peyronie's Disease Questionnaire (PDQ) Peyronie's Disease Symptom Bother	Baseline to Week 36 or LOCF	Peyronie's disease Symptom Bother Scale: 0-20 lower numbers reflect 'less symptom bother'; higher numbers reflect 'more symptom bother' Change from baseline equals Week 36 minus baseline. Negative change reflects improvement in the symptom bother scale.
Change From Baseline in PDQ Intercourse Discomfort	Baseline to Week 36 or LOCF	Peyronie's disease intercourse discomfort Scale: 0-15 lower numbers reflect 'less intercourse discomfort'; higher numbers reflect 'more intercourse discomfort' Change from baseline equals Week 36 minus baseline. Negative change reflects improvement in the intercourse discomfort scale.

Secondary Outcome Measures

Name	Time	Method

Trial Locations

Locations (12): Urology Associates Medical Group
🇺🇸
Burbank, California, United States
Urology Specialists Connecticut Clinical Research Center, LLC
🇺🇸
Middlebury, Connecticut, United States
The Urology Center, PC
🇺🇸
New Haven, Connecticut, United States
South Florida Medical Research
🇺🇸
Aventura, Florida, United States
Urology Specialists, SC
🇺🇸
Chicago, Illinois, United States
Northeast Indiana Research, LLC
🇺🇸
Fort Wayne, Indiana, United States
Metropolitan Urology, PSC
🇺🇸
Jeffersonville, Indiana, United States
Maimonides Medical Center Divison of Urology
🇺🇸
Brooklyn, New York, United States
University Urology Associates
🇺🇸
New York, New York, United States
Tristate Urologic Services
🇺🇸
Cincinnati, Ohio, United States
Baylor College of Medicine, Scott Department of Urology
🇺🇸
Houston, Texas, United States
Urology of Virginia (a division of Sentara Medical Group)
🇺🇸
Norfolk, Virginia, United States