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CompletedNCT03372096Updated Feb 24, 2021Results posted

LC Bead LUMI for Prostatic Artery Embolization

An interventional study of Prostatic Artery Embolization in BPH, sponsored by University of North Carolina, Chapel Hill. Completed at 2 sites in United States. Open to male participants aged 40 Years and older. Per ClinicalTrials.gov, last updated 2021-02-24.

Sponsored by University of North Carolina, Chapel Hill · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
18
Allocation
Not applicable
Ages
40 Years and older
Sex
Male
01

Study summary

Purpose: The purpose of this pilot study is to determine preliminary estimates of the parameters related to the distribution of the study endpoints including: International Prostate Symptom Score (IPSS) and quality of life (QoL) score changes, Qmax (maximum urine flow rate) changes, post void residual volume (PVR) changes, percent prostate infarction and presence of non-target embolization.

Participants: 20 adult male subjects with benign hyperplasia will be enrolled in this study.

Procedures (methods): This will be a multisite, open label pilot study with a small population undergoing an investigational intervention (prostatic artery embolization) to determine initial safety and potential for efficacy as measured by improvement of lower urinary tract symptoms (LUTS) and decrease in prostate size.

Read the detailed description

This will be an open label pilot study with a small population undergoing an intervention to determine initial safety and potential for efficacy as measured by improvement of LUTS and decrease in prostate size

02

Conditions studied

  • BPH

Keywords

  • embolization
  • prostate
03

Who can participate

Ages eligible
40 Years and older
Sexes eligible
Male
Accepts healthy volunteers
No

Inclusion criteria

  1. Male
  2. Age > 40
  3. Prostate gland >50 grams as measured by pre-procedural CT angiogram (CTA)
  4. Have previously taken BPH medication for 6 months without desired improvement of LUTS or has started medication and stopped due to unwanted side effects
  5. Moderate to severe LUTS as defined by IPSS score >18
  6. Peak urine flow rate (Qmax) \<12 mL/sec
  7. Capable of giving informed consent
  8. Life expectancy greater than 1 year

Exclusion criteria

Exclusion Criteria

  1. Severe vascular disease
  2. Uncontrolled diabetes mellitus
  3. Immunosuppression
  4. Neurogenic bladder and/or sphincter abnormalities secondary to Parkinson's disease, multiple sclerosis, cerebral vascular accident, diabetes, etc.
  5. Complete urinary retention
  6. Impaired kidney function (serum creatinine level > 1.8 mg/dL or a glomerular filtration rate \< 60 as approximated using serum creatinine levels) unless anuric and on dialysis.
  7. Confirmed or suspected bladder cancer
  8. Urethral strictures, bladder neck contracture, or other potentially confounding bladder pathology
  9. Ongoing urogenital infection
  10. Previous pelvic radiation or radical pelvic surgery
  11. Confirmed or suspected malignancy of the prostate based on digital rectal exam (DRE), transrectal ultrasonography (TRUS) or prostate-specific antigen (PSA) (> 10 ng/mL or > 4.0 ng/mL and \< 10 ng/mL with free PSA \< 25% of total PSA without a negative biopsy).
  12. Uncorrectable coagulopathy including international normalized ratio (INR) > 1.5 or platelets \< 50,000
  13. Contrast hypersensitivity refractory to standard medications (antihistamines, steroids)
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
18 participants (actual)

Study arms

  • Experimental
    All patients

    Patients will receive the Prostatic Artery Embolization procedure.

    Device: Prostatic Artery Embolization

Interventions

  • DeviceProstatic Artery Embolization

    LC Bead LUMI is a spherical polyvinyl alcohol embolic particle that incorporates radiopaque moieties. Once a catheter has been fluoroscopically guided into the target vessel, the beads are then injected, causing obstruction at the arteriole level until the desired degree of embolization has occurred.

    Also known as: LC Bead LUMI

05

What researchers measure

Primary outcomes

  1. Mean Change in IPSS Score

    The International Prostate Symptom Score (IPSS) is an 8 item Likert questionnaire (7 symptom questions + 1 quality of life question) with scores ranging from 0 to 5, where 0 is less severe. IPSS is a written screening tool used to screen for, rapidly diagnose, track the symptoms of, and suggest management of the symptoms of the disease benign prostatic hyperplasia (BPH). Total scores are determined to be Mild (1-7), Moderate (8-19), or Severe (20-35).

    Time frame: Baseline and 6 months following PAE procedure

Secondary outcomes

  1. Mean Change in Quality of Life Scores

    The QoL question is a single question included with the IPSS related to the symptoms of the disease benign prostatic hyperplasia (BPH). Lower scores indicate a higher quality of life. The range of this scale is 0 to 5.

    Time frame: Baseline and 6 months following PAE procedure

  2. Mean Change in Urine Flow

    Urine flow will be measured to determine the maximum rate of urine flow (Qmax), which is measured in mL per second.

    Time frame: Baseline and 6 months following PAE Procedure

  3. Mean Change in Prostate Volume

    Change in the prostate volume measured in grams.

    Time frame: Baseline and 3 months following

  4. Percent of Prostate Infarcted

    Percentage of prostate infarcted will be determined using manual demarcation of non-enhancing areas within the prostate on serial axial slices of post contrast CT images. Segmentation software will then be employed to calculate the volume.

    Time frame: 6 months following PAE procedure

  5. Number of Participants That Have Non-Targeted Embolization Following the Prostatic Artery Embolization (PAE) Procedure

    Number of participants that have non-targeted embolization following the prostatic artery embolization (PAE) procedure. Non-target embolization will be determined by comparing non-contrast CT images from pre- and post-PAE scans or clinical symptoms. This will be a binary data point and not a calculation.

    Time frame: 3 months following PAE procedure

  6. Number of Participants That Have Minor Complications Following the Prostatic Artery Embolization (PAE) Procedure

    Number of participants that experience minor complications following the PAE procedure.

    Time frame: Up to 12 months following PAE procedure

  7. Mean Change in IIEF Score

    Change in sexual function as determined by an unchanged or improved score on the International Index of Erectile Function (IIEF) questionnaire. The International Index of Erectile Function is a 15 question tool that measures erectile function (30 max), orgasmic function (10 max), sexual desire (10 max), intercourse satisfaction (15 max), and overall satisfaction (10 max). The total maximum score is 75. Higher scores indicated higher levels of sexual function.

    Time frame: Baseline and 6 months following PAE procedure

06

Results

Posted Feb 5, 2021

Participant flow

Participant flow — Overall Study
MilestoneAll Patients
Started18
Received intervention10
Completed10
Not completed8
Withdrew: Study closed8

Outcome measures

PrimaryMean Change in IPSS Score

The International Prostate Symptom Score (IPSS) is an 8 item Likert questionnaire (7 symptom questions + 1 quality of life question) with scores ranging from 0 to 5, where 0 is less severe. IPSS is a written screening tool used to screen for, rapidly diagnose, track the symptoms of, and suggest management of the symptoms of the disease benign prostatic hyperplasia (BPH). Total scores are determined to be Mild (1-7), Moderate (8-19), or Severe (20-35).

Time frame:
Baseline and 6 months following PAE procedure
Reported as:
Mean · units on a scale
Mean Change in IPSS Score
units on a scalePatients With 6 Month Follow up
Mean Change in IPSS Score-11.4 ± 8.4
SecondaryMean Change in Quality of Life Scores

The QoL question is a single question included with the IPSS related to the symptoms of the disease benign prostatic hyperplasia (BPH). Lower scores indicate a higher quality of life. The range of this scale is 0 to 5.

Time frame:
Baseline and 6 months following PAE procedure
Reported as:
Mean · units on a scale
Mean Change in Quality of Life Scores
units on a scalePatients With 6 Month Follow up Data
Mean Change in Quality of Life Scores-2 ± 1.3
SecondaryMean Change in Urine Flow

Urine flow will be measured to determine the maximum rate of urine flow (Qmax), which is measured in mL per second.

Time frame:
Baseline and 6 months following PAE Procedure
Reported as:
Mean · mL/s
Mean Change in Urine Flow
mL/sAll Patients With 6 Month Uroflow Testing
Mean Change in Urine Flow3.3 ± 4.5
SecondaryMean Change in Prostate Volume

Change in the prostate volume measured in grams.

Time frame:
Baseline and 3 months following
Reported as:
Mean · grams
Mean Change in Prostate Volume
gramsAll Patients
Mean Change in Prostate Volume-20 ± 23.2
SecondaryPercent of Prostate Infarcted

Percentage of prostate infarcted will be determined using manual demarcation of non-enhancing areas within the prostate on serial axial slices of post contrast CT images. Segmentation software will then be employed to calculate the volume.

Time frame:
6 months following PAE procedure

No measurements were reported for this outcome.

SecondaryNumber of Participants That Have Non-Targeted Embolization Following the Prostatic Artery Embolization (PAE) Procedure

Number of participants that have non-targeted embolization following the prostatic artery embolization (PAE) procedure. Non-target embolization will be determined by comparing non-contrast CT images from pre- and post-PAE scans or clinical symptoms. This will be a binary data point and not a calculation.

Time frame:
3 months following PAE procedure
Reported as:
Count of participants · Participants
Number of Participants That Have Non-Targeted Embolization Following the Prostatic Artery Embolization (PAE) Procedure
ParticipantsAll Patients
Number of Participants That Have Non-Targeted Embolization Following the Prostatic Artery Embolization (PAE) Procedure8
SecondaryNumber of Participants That Have Minor Complications Following the Prostatic Artery Embolization (PAE) Procedure

Number of participants that experience minor complications following the PAE procedure.

Time frame:
Up to 12 months following PAE procedure
Reported as:
Count of participants · Participants
Number of Participants That Have Minor Complications Following the Prostatic Artery Embolization (PAE) Procedure
ParticipantsAll Patients
Number of Participants That Have Minor Complications Following the Prostatic Artery Embolization (PAE) Procedure8
SecondaryMean Change in IIEF Score

Change in sexual function as determined by an unchanged or improved score on the International Index of Erectile Function (IIEF) questionnaire. The International Index of Erectile Function is a 15 question tool that measures erectile function (30 max), orgasmic function (10 max), sexual desire (10 max), intercourse satisfaction (15 max), and overall satisfaction (10 max). The total maximum score is 75. Higher scores indicated higher levels of sexual function.

Time frame:
Baseline and 6 months following PAE procedure
Reported as:
Mean · units on a scale
Mean Change in IIEF Score
units on a scaleAll Patients
Mean Change in IIEF Score-1.1 ± 13.4

Adverse events

Collected over 1 year following PAE procedure. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
All Patients0/10 (0%)0/10 (0%)8/10 (80%)
Most frequent other events
Most frequent other events
EventAll Patients
brief penile pain and sensitivityRenal and urinary disorders3/10
brief rectalgia or anal painRenal and urinary disorders2/10
dysuriaRenal and urinary disorders2/10
temporary increased urgency to urinateRenal and urinary disorders2/10
increased frequencyRenal and urinary disorders1/10
penile ulcerationRenal and urinary disorders1/10
temporary hematuriaRenal and urinary disorders1/10
temporary urinary retentionRenal and urinary disorders1/10

Baseline characteristics

Age, Continuous
Age, Continuous(years)All Patients
Mean70 ± 6
Sex: Female, Male
Sex: Female, Male(Participants)All Patients
Female0
Male18
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)All Patients
Hispanic or Latino0
Not Hispanic or Latino18
Unknown or Not Reported0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)All Patients
American Indian or Alaska Native0
Asian1
Native Hawaiian or Other Pacific Islander0
Black or African American3
White14
More than one race0
Unknown or Not Reported0
Region of Enrollment
Region of Enrollment(Participants)All Patients
United States18
IPSS
IPSS(units on a scale)All Patients
Mean22.5 ± 4.2
IIEF
IIEF(units on a scale)All Patients
Mean46 ± 22
Quality of Life
Quality of Life(units on a scale)All Patients
Mean4.5 ± 0.7

1 further baseline measures are reported on the registry.

07

Study locations

2 sites
  • UNC Hospitals
    Chapel Hill, North Carolina 27599, United States
  • Vascular Institute of Virginia
    Woodbridge, Virginia 22193, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Jul 19, 2019

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT03372096
Lead sponsor
University of North Carolina, Chapel Hill
Collaborators
BTG International Inc.
Responsible party
Sponsor
First posted
Dec 13, 2017
Start date
Jul 13, 2018
Primary completion
Sep 3, 2020
Completion
Sep 3, 2020
Results posted
Feb 5, 2021
Last update
Feb 24, 2021

Study contacts

Ari Isaacson, MD
principal investigator · University of North Carolina, Chapel Hill

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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