The Zenflow Spring System Safety, Performance and Effectiveness Study

Benign Prostatic Hyperplasia Clinical Trial

— ZEST2  

Official title:

The Zenflow Spring System Safety, Performance and Effectiveness Study (ZEST2)

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT03595735
• Other study ID #: CLIN-0043
• Status: Active, not recruiting
• Phase: N/A
• Start date: June 21, 2018
• Est. completion date: March 30, 2024

Study information

• Verified date: July 2021
• Source: Zenflow, Inc.
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

This is a clinical evaluation to assess the safety and performance of the Zenflow Spring System when used as intended to relieve symptoms of obstructive Benign Prostatic Hyperplasia (BPH).

Description:

A multi-center, prospective, single arm safety, performance, and effectiveness trial. The study will be conducted in two stages. Upon the successful completion of stage 1, the study will be expanded and continue to stage 2. Stage 1 will enroll subjects in the Intent to Treat (ITT) cohort. The purpose of stage 1 is to assess acute safety and performance of the Zenflow System at the time of the procedure, through discharge, 2 weeks and 1 month, in up to 10 subjects enrolled at up to 7 investigational sites, to determine continuation to stage 2. Upon successful completion of stage 1, the study will be expanded to stage 2 with sites added and continued enrollment in the ITT cohort. All subjects, including those enrolled in the stage 1 evaluation, will continue to be followed at all the designated follow-up time points for the full duration of the study (60 months). Whether or not the study continues to Stage 2, all enrolled subjects will be followed for the entire duration of the study (60 months), or until exited.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 40
• Est. completion date: March 30, 2024
• Est. primary completion date: December 30, 2020
• Accepts healthy volunteers: No
• Gender: Male
• Age group: 45 Years and older

Eligibility

Inclusion Criteria:

All subjects are required to meet the following inclusion criteria in order to be

considered eligible for participation in this trial:

1. = 45 years of age

2. Baseline IPSS score > 13, and a baseline Quality of Life (QoL) question score > 3

3. Prostate volume 25 - 80 cc by Trans Rectal Ultrasound (TRUS), measured within past 90 days and prostatic urethral length between 2.5-4.5 cm.

4. Failed or intolerant to medication regimen for the treatment of LUTS. Exclusion Criteria: Subjects will be excluded from participating in this trial if they meet any of the

following criteria:

1. Obstructive intravesical median prostatic lobe or high bladder neck

2. Urethral stricture, meatal stenosis, or bladder neck obstruction - either current, or recurrent requiring 2 or more dilatations

3. Baseline PSA > 10 ng/mL or confirmed or suspected prostate cancer

4. Elevated risk of prostate cancer

5. Post-void residual volume (PVR) > 250 ml

6. Peak urinary flow rate > 12 ml/second, with = 125 ml voided volume at baseline

7. History of chronic urinary retention

8. History of neurogenic bladder

9. Compromised renal function (e.g., serum creatinine > 1.8 mg/dl) due to bladder obstruction

10. Concomitant Urinary Tract Infection (UTI) (subject can be enrolled following successful treatment of UTI and a clean urine test)

11. Concomitant bladder stones

12. Confirmed or suspected bladder cancer

13. Previous pelvic irradiation or radical pelvic surgery

14. Previous prostate surgery, stent implantations, laser prostatectomy, hyperthermia or another invasive treatment to the prostate

15. Chronic prostatitis, or recurring prostatitis within the past 12 months

16. Serious concurrent medical conditions such as uncontrolled diabetes

17. Known allergy to nickel

18. Life expectancy less than 24 months

19. Use of concomitant medications (e.g., anticholinergics, antispasmodics or antidepressants) affecting bladder function

20. Patients taking coumadin 3 days or less prior to procedure and have INR value > 1.5 on day of procedure. ASA and clopidogrel must be ceased 7 days prior to the procedure

21. 5 alpha reductase inhibitors within 6 months of pre-treatment evaluation unless evidence of same drug dose for at least 6 months with a stable voiding pattern (the drug dose should not be altered or discontinued for entrance into or throughout the study)

22. alpha blockers within 2 weeks of pre-treatment evaluation unless evidence of same drug dose for at least 6 months with a stable voiding pattern (the drug dose should not be altered or discontinued for entrance into or throughout the study)

23. Future fertility concerns

24. Any severe illness that might prevent study completion or would confound study results

Related Conditions & MeSH terms

• Benign Prostatic Hyperplasia
• Hyperplasia
• Prostatic Hyperplasia

Intervention

Device:
• Zenflow Spring System
The Zenflow Spring System consists of the Spring Delivery System with Implant, Spring Scope, Camera Control Unit (CCU), Measurement Tool, and Spring Retrieval Tool.

Locations

Country	Name	City	State
Mexico	Centro de Urología Avanzada del Noreste (CUAN)	Monterrey	Nuevo León
Mexico	Hospital Universitario "Dr. José Eleuterio González"	Monterrey	Nuevo León
Mexico	Hospital Regional de Alta Especialidad de Ixtapaluca	Zoquiapan	Ciudad de Ixtapaluca

Sponsors (1)

Lead Sponsor	Collaborator
Zenflow, Inc.

Country where clinical trial is conducted

Mexico, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Successful placement of the Zenflow Spring Implant	Successful deployment and procedural success for the Zenflow System to implant the Spring device in the operating room or an out-patient clinical setting.	Day of discharge up to 7 days following device placement
Primary	Need for urinary catheterization	Rate of extended post-operative urinary catheterization	7 days after the procedure
Secondary	Incidence of procedure or device related serious adverse events	Assessment of any device or procedure related Serious Adverse Events (SAE)	Day of discharge up to 7 days following device placement
Secondary	Assessment of Pain	Patient describes pain on a Visual Analog Scale (VAS). The scale is a line labeled 1 at the far left indicating minimal pain and 10 on the right, which is maximum pain.	Baseline, 2 weeks, 1 month and 3 months
Secondary	Assessment of Adverse Events	Rate of adverse events related to the procedure or device.	Up to 2 years
Secondary	Assessment of Sexual Health: Change in sexual health measured by change in the Sexual Health Inventory for Men (SHIM) questionnaire score	The patient selects the most appropriate response to 5 questions about his sexual health. Each response has an assigned value between 1 and 5. The numeric values are tallied for a total score.	Baseline, 3, 6, 12, & 24 months
Secondary	Assessment of Sexual Health: Change in sexual health measured by change in ability to ejaculate using the Male Sexual Health Questionnaire - Ejaculatory domain (MSHQ-EjD)	The patient selects the most appropriate response to 4 questions about his sexual health specific to ejaculation. Each response has an assigned value between 0 and 5.	Baseline, 3, 6, 12, & 24 months
Secondary	Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH) by patient response to the International Prostate Symptom Score and Quality of Life Questionnaire (IPSS+QoL).	The patient is asked to respond to 7 questions related to his urinary health using a rating scale of 0 to 5 where is zero is excellent and 5 is the worst possible. The responses to the 7 questions are tallied for a total score. In addition the patient is asked 1 question related to his Quality of Life. The possible responses range from 0 to 6 where 0 is the best and 6 is the worst.	Baseline, 2 weeks, 1, 6, 12, 24 months
Secondary	Effectiveness of the Spring Implant in reducing symptoms of Benign Prostatic Hyperplasia (BPH)	Improvement in flow of urine	Baseline, 2 weeks, 1, 3, 6, 12, 24 months
Secondary	Repeat interventions to treat Benign Prostatic Hyperplasia (BPH)	Incidence of repeat invasive treatment for Lower Urinary Tract Symptoms (LUTS) or increase in dosage or initiation of new medication to treat symptoms of BPH.	Up to 2 years
Secondary	Increase or change in medications to treat Benign Prostatic Hyperplasia (BPH)	Incidence of increase in dosage, or initiation of new medication to treat symptoms of BPH.	Up to 2 years