Iltamiocel Compared to Placebo for Chronic Fecal Incontinence in Females With Obstetric Injury

Study Overview
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Brief Summary
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This study evaluates the efficacy and safety of a single injection of iltamiocel (300 x 10^6 cells) compared to a placebo in the reduction of fecal incontinence episode frequency in adult female participants with chronic fecal incontinence and a history of obstetric anal sphincter injury. Half of the participants will receive iltamiocel (injections with cells) and the other half will receive placebo.

Detailed Description
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Chronic fecal incontinence (FI) is the recurrent unintended passage of mucus and/or liquid or solid stool for at least 6 months. Iltamiocel is an investigational cell therapy product that involves a medical procedure in which a participant's own muscle cells are collected, processed, and then injected into the tissues of the external anal sphincter. This is a double-blind randomized study, which means neither the participant, nor the study doctor will know which treatment group the participant will be in. Participants who are randomly chosen to receive injection with placebo will have the option to receive an injection with their cells after completion of the blinded portion of their study participation (12 months).

Official Title
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A Two-stage, Randomized, Controlled Trial Comparing the Safety and Efficacy of Iltamiocel With Placebo in the Treatment of Female Participants With Chronic Fecal Incontinence and a History of Obstetric Anal Sphincter Injury (DigniFI)

Conditions
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Fecal Incontinence

Intervention / Treatment
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* Biological: Iltamiocel
* Other: Placebo


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Adult female ≥ 18 years of age who has primary symptoms of fecal incontinence (FI) for at least 12 months. History of obstetric anal sphincter injury (e.g., episiotomy, perineal tear). Failed conservative treatment (e.g., dietary modification, antidiarrheal medications, pelvic floor muscle training, biofeedback) for at least 6 months prior to enrollment. Has a Cleveland Clinic Florida Incontinence Score (CCFIS) ≥9 at Baseline. Must be willing and able to comply with the study procedures, be mentally competent and able to understand all study requirements, and must agree to read and sign the informed consent form prior to any study-related procedures. Exclusion Criteria: Has an implanted stimulation neuromodulation system (sacral or tibial) and symptoms are unstable as determined by the physician. Is pregnant or planning to become pregnant within the next 2 years. Has known rectal sensory dysfunction (e.g., hypersensitivity or hyposensitivity). Has an obstetric anal sphincter injury (e.g., episiotomy, perineal tear) within 1 year previous to study enrollment. Patient BMI ≥ 35. Has a history of cancer in the colorectal or pelvic organs within 5 years prior to study enrollment. Any cancer that has undergone treatment within the past 12 months. Has an established diagnosis of inflammatory bowel disease (Crohn's disease, ulcerative colitis) or current intestinal stoma. Has grade III/IV hemorrhoids. Has chronic diarrhea at the time of Screening. Has chronic constipation at the time of Screening. Has significant pelvic floor prolapse, significant genitourinary prolapse beyond the introitus, significant symptomatic rectocele, or evidence of significant rectal evacuation disorder leading to post-defecatory leakage.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Iltamiocel<br> | Biological: Iltamiocel<br>* Single external anal sphincter (EAS) injection of 300 x 10^6 cells.<br>|
| Placebo Comparator: Placebo<br> | Other: Placebo<br>* Placebo control is the vehicle solution used for the study product.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Changes in frequency of fecal incontinence episodes. |  | 12 Months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Obstetric Trauma, Obstetric Injury, Cell Therapy, Anal Incontinence, Rectal Diseases, Intestinal Diseases, Gastrointestinal Diseases, Bowel Incontinence