Clinical trial NCT01243411: A Study of AA4500 in Men With Peyronie's Disease
Official title: A Phase 3, Open-label Study of the Safety and Effectiveness of AA4500 Administered Twice Per Treatment Cycle for up to Four Treatment Cycles (2 x 4) in Men With Peyronie's Disease
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: PHASE3
Conditions: Peyronie's Disease
Keywords: Peyronie's Disease, penile plaque, penile curvature
Lead sponsor: Endo Pharmaceuticals
Sponsor class: INDUSTRY
First posted: 2010-11-18
Enrollment: 348
Sex: MALE
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: TREATMENT

Brief summary: This study is a Phase 3, open-label study of the safety and efficacy of AA4500 0.58 mg in subjects with Peyronie's disease. Subjects will be screened for study eligibility within 21 days before the initial injection of study drug in the first treatment cycle.

After up to four treatment cycles, each subject will be followed for additional safety and efficacy assessments on Days 168 (± 7 days) and 252 (± 7 days) (nominal weeks 24 and 36).

After the final injection of each treatment cycle, the investigator will model the plaque in an attempt to stretch or elongate the plaque. If the subject's penile curvature is reduced to \<15° after the first, second, or third cycle of injections or if the investigator determines further treatment is not clinically indicated (eg, adverse events; allergic reaction), subsequent treatment cycles will not be administered.

Approximately 300 subjects will be enrolled.


Eligibility criteria: Inclusion Criteria:

No subject should be enrolled until all eligibility criteria have been satisfied. Subjects who receive placebo in a previous Auxilium-sponsored study may enroll in this study provided they continue to meet the eligibility requirements. To qualify for the study a subject must:

1. Be a male and be ≥ 18 years of age
2. Be in a stable relationship with a female partner/spouse for at least 3 months before screening and be willing to have vaginal intercourse with that partner/spouse
3. Have symptom(s) of Peyronie's disease for at least 12 months before the first dose of study drug and have evidence of stable disease as determined by the investigator
4. Have penile curvature of at least 30° in the dorsal, lateral, or dorsal/lateral plane at screening. It must be possible to delineate the single plane of maximal curvature for evaluation during the study
5. Be judged to be in good health, based upon the results of a medical history, physical examination, and laboratory profile
6. Voluntarily sign and date an informed consent agreement approved by the Institutional Review Board/Independent Ethics Committee (IRB/IEC). The subject must also sign an authorization form to allow disclosure of his protected health information (PHI). The PHI authorization form and informed consent form may be an integrated form or may be separate forms depending on the institution
7. Be able to read, complete and understand the various rating instruments in English or the appropriate local language for the country in which the study is being performed.

   -

Exclusion Criteria:

A subject will be excluded from study participation if he:

1. Has a penile curvature of less than 30° or greater than 90° at the screening visit
2. Has any of the following conditions:

   * Chordee in the presence or absence of hypospadias
   * Thrombosis of the dorsal penile artery and/or vein
   * 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 an active sexually transmitted disease
   * Known active hepatitis B or C
   * Known immune deficiency disease or be positive for human immunodeficiency virus (HIV)
3. Has previously undergone surgery for Peyronie's disease
4. Fails to have an erection which in the opinion of the investigator is sufficient to accurately measure the subject's penile deformity after administration of prostaglandin E1 or trimix
5. Has a calcified plaque as evident by appropriate radiographic evaluation, penile x-ray or penile ultrasound that would prevent proper injection of study medication (penile ultrasound only in EU countries). Non-contiguous stippling of calcium is acceptable for inclusion provided the calcium deposit does not interfere with the injection of AA4500 into the plaque
6. Has an isolated hourglass deformity of the penis
7. Has the plaque causing curvature of the penis located proximal to the base of the penis, so that the injection of the local anesthetic would interfere with the injection of AA4500 into the plaque
8. Has previously 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
9. Has received alternative medical therapies for Peyronie's disease administered by the oral (including, but not limited to, vitamin E \[\> 500 U\], 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 3 months before the first dose of study drug or plans to use any of these medical therapies at any time during the study
10. Has had extracorporeal shock wave therapy (ESWT) for the correction of Peyronie's disease within the 6-month period before screening or plans to have ESWT at any time during the study
11. Has 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
12. Has 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
13. Has significant erectile dysfunction that has failed to respond to oral treatment with phosphodiesterase type 5 (PDE5) inhibitors
14. Has a penile Duplex Doppler ultrasound evaluation at screening that shows compromised penile hemodynamics that in the opinion of the investigator is clinically significant
15. Has uncontrolled hypertension, as determined by the investigator
16. Has a known recent history of stroke, bleeding, or other significant medical condition, which in the investigator's opinion would make the subject unsuitable for enrollment in the study
17. Is unwilling or unable to cooperate with the requirements of the study including completion of all scheduled study visits
18. Has received an investigational drug or treatment within 30 days before the first dose of study drug, except for subjects who receive one treatment cycle of AA4500 in Study AUX-CC-805
19. Has a known systemic allergy to collagenase or any other excipient of AA4500
20. Has a known allergy to any concomitant medication required as per the protocol
21. Has 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
22. Has received any collagenase treatments within 30 days of the first dose of study drug, except for subjects who receive one treatment cycle of AA4500 in Study AUX-CC-805
23. Has, at any time, received AA4500 for the treatment of Peyronie's disease, except for subjects who receive one treatment cycle of AA4500 in Study AUX-CC-805

Primary outcomes:
measure: Percentage Change From Baseline in Penile Curvature
timeFrame: Baseline and Week 36
measure: Change From Baseline in the Peyronie's Disease Bother Domain of the Peyronie's Disease Questionnaire (PDQ)
timeFrame: Baseline and Week 36
Secondary outcomes:
measure: Change From Baseline in the Severity of Peyronie's Disease Symptoms Domain of the PDQ
timeFrame: Baseline and Week 36
measure: Change From Baseline in the Penile Pain Domain of the PDQ in Subjects With Baseline Penile Pain Score ≥4
timeFrame: Baseline and Week 36
measure: A Responder Analysis Based on Subject Overall Global Assessment
timeFrame: Week 36
measure: Change in the Overall Satisfaction Domain of the International Index of Erectile Function (IIEF)
timeFrame: Baseline and Week 36
measure: Change From Baseline in Penile Plaque Consistency
timeFrame: Baseline and Week 36
measure: A Composite Responder Analysis Based on Change From Baseline in Penile Curvature and in the Peyronie's Disease Bother Score
timeFrame: Week 36
measure: Change From Baseline in Penile Length
timeFrame: Baseline and Week 36
Other outcomes:
Locations:
city: Burbank
country: United States
facility: Urology Associates Medical Group
state: California
city: Middlebury
country: United States
facility: Connecticut Clinical Research Center, LLC
state: Connecticut
city: New Haven
country: United States
facility: The Urology Center, P.C.
state: Connecticut
city: Aventura
country: United States
facility: South Florida Medical Research
state: Florida
city: Chicago
country: United States
facility: Urology Specialists, S.C.
state: Illinois
city: Fort Wayne
country: United States
facility: Northeast Indiana Research, LLC
state: Indiana
city: Jeffersonville
country: United States
facility: Metropolitan Urology, P.S.C.
state: Indiana
city: Brooklyn
country: United States
facility: Maimonides Medical Center, Division of Urology
state: New York
city: New York
country: United States
facility: University Urology Associates
state: New York
city: Cincinnati
country: United States
facility: Tristate Urologic Services PSC, Inc./ dba TUG Research
state: Ohio
city: Bala-Cynwyd
country: United States
facility: Urologic Consultants of SE PA
state: Pennsylvania
city: Norfolk
country: United States
facility: Urology of Virginia-Sentara Medical Group
state: Virginia
city: Richmond
country: United States
facility: Virginia Urology
state: Virginia
city: Aalborg
country: Denmark
facility: Aarhus Universitiy Hospital, Aalborg Sygehus
city: Frederiksberg
country: Denmark
facility: Frederiksberg Hospital
city: Frederikssund
country: Denmark
facility: Frederikssunds Hospital
city: Gentofte
country: Denmark
facility: Klinik for seksuelle dysfunktioner
city: Lyon
country: France
facility: Centre Hospitalier Edouar Herriot
city: Saint Genis Laval
country: France
facility: Hopital Henri Gabrielle
city: Freiburg
country: Germany
facility: Universitatsklinikum Freiburg, Abteilung Urologie
city: Hamburg
country: Germany
facility: Private Practice of Urology/Andrology
city: Marburg
country: Germany
facility: Uro-Onkologische Praxis Dr. von Keitz
city: Reutlingen
country: Germany
facility: Urologische Gemeinschaftspraxis Reutlingen
city: Tubingen
country: Germany
facility: Universitatsklinikum Tubingen
city: Naples
country: Italy
facility: University of Naples "Federico II"
city: Rome
country: Italy
facility: Universitiy Tor Vergatat of Rome
city: Takapuna
country: New Zealand
facility: Waitemata Urology Research North Shore Hospital
state: Auckland
city: Tauranga
country: New Zealand
facility: Tauranga Urology Research Ltd.
state: Bay of Plenty
city: Christchurch
country: New Zealand
facility: Primorus Clinical Trials Ltd.
state: Canterbury
city: Christchurch
country: New Zealand
facility: CURT Medical Trials Trust Board Inc.
state: Canterbury
city: Whangarei
country: New Zealand
facility: Cardinal Points Research Ltd.
state: Northland
city: Wellington South
country: New Zealand
facility: Wellington Urology Associates
state: Wellington
city: Barcelona
country: Spain
facility: Hospital Clinic de Barcelona
city: Madrid
country: Spain
facility: Hospital La Zarzuela
city: Goteborg
country: Sweden
facility: Specialistmottagningen i urologi
city: Karlshamn
country: Sweden
facility: Carlshamns Specialistklinik
city: Uppsala
country: Sweden
facility: Akademiska Sjukhuse
city: London
country: United Kingdom
facility: St. Peter's Andrology Centre
city: Sunderland
country: United Kingdom
facility: Sunderland Royal Hospital
Study officials:
affiliation: Auxilium Pharmaceuticals, Inc.
name: Gregory J. Kaufman, MD
role: STUDY_DIRECTOR
References:
citation: Levine LA, Cuzin B, Mark S, Gelbard MK, Jones NA, Liu G, Kaufman GJ, Tursi JP, Ralph DJ. Clinical safety and effectiveness of collagenase clostridium histolyticum injection in patients with Peyronie's disease: a phase 3 open-label study. J Sex Med. 2015 Jan;12(1):248-58. doi: 10.1111/jsm.12731. Epub 2014 Nov 12.