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Urethral StricturePhase 2NCT02948842

Clostridium Histolyticum Collagenase Injection for Urethral Disease

A Phase 2 study testing Clostridium Histolyticum Collagenase and Saline in people with Urethral Stricture, run by University of South Florida at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The purpose of this study is to assess the efficacy of clostridium histolyticum collagenase (XIAFLEX®) in treating urethral strictures. Read more about this study

Who is it for?
Ages 18 years and older, men only
Conditions the study is for
Urethral Stricture
What is being tested?
Clostridium Histolyticum Collagenase and Saline
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
5 participants
Where
1 siteUnited States
Study dates
22 May 2020to 12 Apr 2023
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Males
  • Age ≥ 18 years
  • Failed prior proven conservative measures, including DVIU or balloon dilation of the stricture will be included in this study
  • Able and willing to undergo regular intervention as well as evaluation as described below will be included in the study
  • With a single stricture <2cm in size that can be identified on retrograde urethrogram or voiding cystourethrogram will be included in the study.
  • Must agree not to participate in a clinical study involving another investigational drug or device throughout the duration of this study
  • Must be competent to understand the information given in IRB approved ICF and must sign the form prior to the initiation of any study procedure

Who cannot join

  • Has not yet undergone proven non-invasive measures, including DVIU or balloon dilation.
  • Multiple strictures or a single stricture larger than 2cm in size, measured with retrograde urethrogram, voiding cystourethrogram, or urethral ultrasonography.
  • Corporal spongiosum tissues < 5 mm in depth at proposed injection site
  • Grade 5 spongiofibrosis
  • Age <18
  • Females
Show all 19Show fewer
  • Prior urethroplasty
  • Urethral fistula
  • History of penile cancer, prostate cancer, or urinary tract malignancy (bladder, urethral, ureteral, or kidney).
  • History of radiation (external or brachytherapy) to the pelvic organs, penis or groin.
  • History of autoimmune or inflammatory bowel disease
  • Contraindication to suprapubic tube placement
  • Pre-procedure PVR >250mL
  • Allergy or sensitivity to CHC
  • Bleeding disorder or anticoagulant use other than aspirin up to 150mg/day
  • Untreated urinary tract infection
  • Inability to perform intermittent self-catheterization
  • Participation in another clinical study or treatment with an investigational drug or device
  • Serious or active medical or psychiatric condition which, in the opinion of the Investigator, may interfere with treatment, assessment, or compliance with the protocol

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of South Florida - South Tampa Campus

    Tampa, Florida, 33606

Other trials in United States

About this study

Official title: Clostridium Histolyticum Collagenase Injection Treatment for Urethral Disease: a Prospective, Single-center, Open-label Study

The purpose of this study is to assess the efficacy of clostridium histolyticum collagenase (XIAFLEX®) in treating urethral strictures.

Read the detailed description

This is an open-label, pilot study to explore the efficacy of clostridium histolyticum collagenase (XIAFLEX®) in treating urethral strictures. Subjects will be followed for 2 years from the initial drug treatment.

Being tested
Clostridium Histolyticum Collagenase, Saline
Medical subject headings
Urethral Stricture

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Clostridium Histolyticum CollagenaseDrug

    Also called XIAFLEX®

    0.08ml of XIAFLEX® (0.58 mg of XIAFLEX® mixed with 0.39 mL of sterile diluent) in a single location within the stricture, chased by an additional 0.25 mL of reconstituted XIAFLEX® to allow for clearance of the original 0.08 mL of reconstituted XIAFLEX® from the transurethral syringe into the urethral stricture. This is based on 0.25 mL residual fluid that remains within the lumen of the injeTAK syringe. Thus, by adding the additional 0.25 mL of XIAFLEX® as a chase, we are expecting the original total of 0.08 mL of XIAFLEX® to be injected into the area of scarring.

  • SalineOther

    Also called Injectable normal saline

    0.08ml of injectable normal saline

Study groups in NCT02948842
Study groupRoleWhat they receive
Treatment GroupExperimentalPatients will undergo instillation of local anesthesia (20 mL of 2% urethral lidocaine jelly), the patient will undergo cystoscopy, transurethral injection (via a 70 cm 4.8 Fr flexible cystoscopic needle with a 23 gauge needle tip manufactured by Laborie®, Ontario, Canada) of 0.08ml of XIAFLEX® (0.58 mg of XIAFLEX® mixed with 0.39 mL of sterile diluent) in a single location within the stricture, chased by an additional 0.25 mL of reconstituted XIAFLEX® to allow for clearance of the original 0.08 mL of reconstituted XIAFLEX® from the transurethral syringe into the urethral stricture.
Receives: Drug: Clostridium Histolyticum Collagenase; Other: Saline

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Number of Subjects With Complication After Treatment

    Number of subjects with complication after treatment with clostridium histolyticum collagenase

    Measured: 84 days

Secondary outcomes (21)
  1. Number of Patients Needing Further Intervention for Treatment of Urethral Stricture

    Further intervention - defined as any medical or surgical intervention for treatment of urethral stricture.

    Measured: 2 years

  2. Number of Subjects With Recurrence of Urethral Stricture

    Number of subjects with recurrence of urethral stricture

    Measured: 2 years

  3. Change From Baseline and 6 Weeks: American Urology Association Questionnaire Scores

    The American Urology Association questionnaire score is totaled based on 7 questions. Each question asks the subject to rate their symptom on a 5-point scale from "Not at All" (0) to "Almost Always" (5). The total score is based on adding rating marked for each question. The total runs from 0 to 35 points with higher scores indicating more severe symptoms.

    Measured: 6 weeks

  4. Change From Baseline and 6 Months: American Urology Association Questionnaire Scores

    The American Urology Association questionnaire score is totaled based on 7 questions. Each question asks the subject to rate their symptom on a 5-point scale from "Not at All" (0) to "Almost Always" (5). The total score is based on adding rating marked for each question. The total runs from 0 to 35 points with higher scores indicating more severe symptoms.

    Measured: 6 months

  5. Change From Baseline and 9 Months: American Urology Association Questionnaire Scores

    The American Urology Association questionnaire score is totaled based on 7 questions. Each question asks the subject to rate their symptom on a 5-point scale from "Not at All" (0) to "Almost Always" (5). The total score is based on adding rating marked for each question. The total runs from 0 to 35 points with higher scores indicating more severe symptoms.

    Measured: 9 months

  6. Change From Baseline and 12 Months: American Urology Association Questionnaire Scores

    The American Urology Association questionnaire score is totaled based on 7 questions. Each question asks the subject to rate their symptom on a 5-point scale from "Not at All" (0) to "Almost Always" (5). The total score is based on adding rating marked for each question. The total runs from 0 to 35 points with higher scores indicating more severe symptoms.

    Measured: 12 months

  7. Change From Baseline and 2 Years: American Urology Association Questionnaire Scores

    The American Urology Association questionnaire score is totaled based on 7 questions. Each question asks the subject to rate their symptom on a 5-point scale from "Not at All" (0) to "Almost Always" (5). The total score is based on adding rating marked for each question. The total runs from 0 to 35 points with higher scores indicating more severe symptoms.

    Measured: 2 years

  8. Time to Urethral Stricture Recurrence

    Measured: 2 years

  9. Time to Additional Intervention for Urethral Stricture

    Measured: 2 years

  10. Change From Baseline and 6 Weeks: Obstructive Voiding Dysfunction (Uroflow)

    Obstructive voiding dysfunction defined as change in uroflow

    Measured: 6 weeks

  11. Change From Baseline and 6 Months: Obstructive Voiding Dysfunction (Uroflow)

    Obstructive voiding dysfunction defined as change in uroflow

    Measured: 6 months

  12. Change From Baseline and 9 Months: Obstructive Voiding Dysfunction (Uroflow)

    Obstructive voiding dysfunction defined as change in uroflow

    Measured: 9 months

  13. Change From Baseline and 12 Months: Obstructive Voiding Dysfunction (Uroflow)

    Obstructive voiding dysfunction defined as change in uroflow

    Measured: 12 months

  14. Change From Baseline and 18 Months: Obstructive Voiding Dysfunction (Uroflow)

    Obstructive voiding dysfunction defined as change in uroflow

    Measured: 18 months

  15. Change From Baseline and 2 Years: Obstructive Voiding Dysfunction (Uroflow)

    Obstructive voiding dysfunction defined as change in uroflow

    Measured: 2 years

  16. Change From Baseline and 6 Weeks: Obstructive Voiding Dysfunction (Post-void Residual Measurements)

    Obstructive voiding dysfunction defined as change in post-void residual measurements

    Measured: 6 weeks

  17. Change From Baseline and 6 Months: Obstructive Voiding Dysfunction (Post-void Residual Measurements)

    Obstructive voiding dysfunction defined as change in post-void residual measurements

    Measured: 6 months

  18. Change From Baseline and 9 Months: Obstructive Voiding Dysfunction (Post-void Residual Measurements)

    Obstructive voiding dysfunction defined as change in post-void residual measurements

    Measured: 9 months

  19. Change From Baseline and 12 Months: Obstructive Voiding Dysfunction (Post-void Residual Measurements)

    Obstructive voiding dysfunction defined as change in post-void residual measurements

    Measured: 12 months

  20. Change From Baseline and 18 Months: Obstructive Voiding Dysfunction (Post-void Residual Measurements)

    Obstructive voiding dysfunction defined as change in post-void residual measurements

    Measured: 18 months

  21. Change From Baseline and 2 Years: Obstructive Voiding Dysfunction (Post-void Residual Measurements)

    Obstructive voiding dysfunction defined as change in post-void residual measurements

    Measured: 2 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Oct 2016 (estimated)
  2. Study start22 May 2020
  3. Primary completion4 Mar 2023
  4. Study completion12 Apr 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
5 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT02948842
Sponsor's protocol ID
CHC
Status last verified
Oct 2023
First submitted
26 Oct 2016
Last updated
3 Nov 2023
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Publications

  • Santucci RA, Joyce GF, Wise M. Male urethral stricture disease. J Urol. 2007 May;177(5):1667-74. doi: 10.1016/j.juro.2007.01.041.

    PubMed 17437780
  • Chenoweth CE, Saint S. Urinary tract infections. Infect Dis Clin North Am. 2011 Mar;25(1):103-15. doi: 10.1016/j.idc.2010.11.005. Epub 2010 Dec 18.

    PubMed 21315996
  • Heyns CF, Steenkamp JW, De Kock ML, Whitaker P. Treatment of male urethral strictures: is repeated dilation or internal urethrotomy useful? J Urol. 1998 Aug;160(2):356-8. doi: 10.1016/s0022-5347(01)62894-5.

    PubMed 9679876
  • Hussain M, Greenwell TJ, Shah J, Mundy A. Long-term results of a self-expanding wallstent in the treatment of urethral stricture. BJU Int. 2004 Nov;94(7):1037-9. doi: 10.1111/j.1464-410X.2004.05100.x.

    PubMed 15541123
  • Zhang K, Qi E, Zhang Y, Sa Y, Fu Q. Efficacy and safety of local steroids for urethra strictures: a systematic review and meta-analysis. J Endourol. 2014 Aug;28(8):962-8. doi: 10.1089/end.2014.0090. Epub 2014 Jun 3.

    PubMed 24745607
  • Peak TC, Mitchell GC, Yafi FA, Hellstrom WJ. Role of collagenase clostridium histolyticum in Peyronie's disease. Biologics. 2015 Sep 29;9:107-16. doi: 10.2147/BTT.S65619. eCollection 2015.

    PubMed 26491251
  • Gelbard M, Goldstein I, Hellstrom WJ, McMahon CG, Smith T, Tursi J, Jones N, Kaufman GJ, Carson CC 3rd. Clinical efficacy, safety and tolerability of collagenase clostridium histolyticum for the treatment of peyronie disease in 2 large double-blind, randomized, placebo controlled phase 3 studies. J Urol. 2013 Jul;190(1):199-207. doi: 10.1016/j.juro.2013.01.087. Epub 2013 Jan 31.

    PubMed 23376148
  • Cavalcanti AG, Costa WS, Baskin LS, McAninch JA, Sampaio FJ. A morphometric analysis of bulbar urethral strictures. BJU Int. 2007 Aug;100(2):397-402. doi: 10.1111/j.1464-410X.2007.06904.x.

    PubMed 17617144
  • Sangkum P, Yafi FA, Kim H, Bouljihad M, Ranjan M, Datta A, Mandava SH, Sikka SC, Abdel-Mageed AB, Moparty K, Hellstrom WJ. Collagenase Clostridium histolyticum (Xiaflex) for the Treatment of Urethral Stricture Disease in a Rat Model of Urethral Fibrosis. Urology. 2015 Sep;86(3):647.e1-6. doi: 10.1016/j.urology.2015.06.013. Epub 2015 Jun 27.

    PubMed 26126692

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Clostridium Histolyticum Collagenase and Saline in people with Urethral Stricture, run by University of South Florida at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 19 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 3 Nov 2023. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 3 Nov 2023). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Number of Subjects With Complication After Treatment (time frame: 84 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT02948842, which also lists 9 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Nov 2023.

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