A Study of AA4500 in Men With Peyronie's Disease

Peyronie's Disease Clinical Trial

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01243411
• Other study ID #: AUX-CC-802
• Status: Completed
• Phase: Phase 3
• First received: November 17, 2010
• Last updated: September 7, 2017
• Start date: November 2010
• Est. completion date: August 2012

Study information

• Verified date: September 2017
• Source: Endo Pharmaceuticals
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 348
• Est. completion date: August 2012
• Est. primary completion date: August 2012
• Accepts healthy volunteers: No
• Gender: Male
• Age group: 18 Years and older

Eligibility

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-a2b) 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

Related Conditions & MeSH terms

• Penile Induration
• Peyronie's Disease

Intervention

Biological:
• AA4500
2 injections separated by at least 24 hours but not more than 72 hours, repeated after 42 days (± 5 days) for up to 4 treatment cycles (ie, total of up to 8 injections per subject)

Locations

Country	Name	City	State
Denmark	Aarhus Universitiy Hospital, Aalborg Sygehus	Aalborg
Denmark	Frederiksberg Hospital	Frederiksberg
Denmark	Frederikssunds Hospital	Frederikssund
Denmark	Klinik for seksuelle dysfunktioner	Gentofte
France	Centre Hospitalier Edouar Herriot	Lyon
France	Hopital Henri Gabrielle	Saint Genis Laval
Germany	Universitatsklinikum Freiburg, Abteilung Urologie	Freiburg
Germany	Private Practice of Urology/Andrology	Hamburg
Germany	Uro-Onkologische Praxis Dr. von Keitz	Marburg
Germany	Urologische Gemeinschaftspraxis Reutlingen	Reutlingen
Germany	Universitatsklinikum Tubingen	Tubingen
Italy	University of Naples "Federico II"	Naples
Italy	Universitiy Tor Vergatat of Rome	Rome
New Zealand	CURT Medical Trials Trust Board Inc.	Christchurch	Canterbury
New Zealand	Primorus Clinical Trials Ltd.	Christchurch	Canterbury
New Zealand	Waitemata Urology Research North Shore Hospital	Takapuna	Auckland
New Zealand	Tauranga Urology Research Ltd.	Tauranga	Bay of Plenty
New Zealand	Wellington Urology Associates	Wellington South	Wellington
New Zealand	Cardinal Points Research Ltd.	Whangarei	Northland
Spain	Hospital Clinic de Barcelona	Barcelona
Spain	Hospital La Zarzuela	Madrid
Sweden	Specialistmottagningen i urologi	Goteborg
Sweden	Carlshamns Specialistklinik	Karlshamn
Sweden	Akademiska Sjukhuse	Uppsala
United Kingdom	St. Peter's Andrology Centre	London
United Kingdom	Sunderland Royal Hospital	Sunderland
United States	South Florida Medical Research	Aventura	Florida
United States	Urologic Consultants of SE PA	Bala-Cynwyd	Pennsylvania
United States	Maimonides Medical Center, Division of Urology	Brooklyn	New York
United States	Urology Associates Medical Group	Burbank	California
United States	Urology Specialists, S.C.	Chicago	Illinois
United States	Tristate Urologic Services PSC, Inc./ dba TUG Research	Cincinnati	Ohio
United States	Northeast Indiana Research, LLC	Fort Wayne	Indiana
United States	Metropolitan Urology, P.S.C.	Jeffersonville	Indiana
United States	Connecticut Clinical Research Center, LLC	Middlebury	Connecticut
United States	The Urology Center, P.C.	New Haven	Connecticut
United States	University Urology Associates	New York	New York
United States	Urology of Virginia-Sentara Medical Group	Norfolk	Virginia
United States	Virginia Urology	Richmond	Virginia

Sponsors (1)

Lead Sponsor	Collaborator
Endo Pharmaceuticals

Countries where clinical trial is conducted

United States,  Denmark,  France,  Germany,  Italy,  New Zealand,  Spain,  Sweden,  United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Percentage Change From Baseline in Penile Curvature	A negative value in the percentage change from baseline in penile curvature deformity (angle measured in degrees) indicates less curvature.	Baseline and Week 36
Primary	Change From Baseline in the Peyronie's Disease Bother Domain of the Peyronie's Disease Questionnaire (PDQ)	Peyronie's disease bother score range 0 (no issue or not at all bothered) to 4 (extremely bothered) on 4 questions; total score range 0 to 16. A decrease in the change from baseline total score in the Peyronie's disease bother domain of the PDQ is indicated by a negative number.	Baseline and Week 36
Secondary	Change From Baseline in the Severity of Peyronie's Disease Symptoms Domain of the PDQ	Peyronie's disease symptoms (physical and psychological) severity score range 0 (none) to 4 (very severe) on 6 questions; total score range 0 to 24. A decrease in the change from baseline total score in the Peyronie's disease symptoms domain of the PDQ is indicated by a negative number.	Baseline and Week 36
Secondary	Change From Baseline in the Penile Pain Domain of the PDQ in Subjects With Baseline Penile Pain Score =4	Penile pain scale range 0 (no pain) to 10 (extreme pain) on 3 questions; total score range 0 to 30. A decrease in the change from baseline total score in the penile pain domain of the PDQ is indicated by a negative number. Subjects were required to have a penile pain score of 4 or greater at baseline.	Baseline and Week 36
Secondary	A Responder Analysis Based on Subject Overall Global Assessment	Subject overall global assessment of Peyronie's disease score range -3 (much worse) to 3 (much improved). A score of 1 (improved in a small but important way), 2 (moderately improved), or 3 indicate a responder.	Week 36
Secondary	Change in the Overall Satisfaction Domain of the International Index of Erectile Function (IIEF)	Overall satisfaction domain of the IIEF score range 0 to 5 on 2 questions where higher scores indicate improved function or satisfaction; total score range 0 to 10.	Baseline and Week 36
Secondary	Change From Baseline in Penile Plaque Consistency	Penile plaque consistency score range 1 (non-palpable) to 5 (hard). A decrease in the change from baseline in penile plaque consistency is indicated by a negative number.	Baseline and Week 36
Secondary	A Composite Responder Analysis Based on Change From Baseline in Penile Curvature and in the Peyronie's Disease Bother Score	A composite responder is indicated by; a percent reduction from baseline in penile curvature greater than or equal to the threshold, and; a reduction from baseline in Peyronie's disease bother score greater than or equal to the threshold, or change in the overall sexual activity within the last 3 months to having vaginal intercourse from no vaginal intercourse at screening.	Week 36
Secondary	Change From Baseline in Penile Length	A negative value represents a reduction in measurement from baseline.	Baseline and Week 36