Patient case: 81-year-old male with Prostate cancer. Genetic variant: PTEN Inactivating. Other conditions: Hypertension, Depression.

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

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)


Eligibility: 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

Relevance to patient case: not relevant