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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/study/NCT03605745
Registration number
NCT03605745
Ethics application status
Date submitted
23/07/2018
Date registered
30/07/2018
Titles & IDs
Public title
Minimally Invasive Prostatic Vapor Ablation for the Treatment of BPH in Large Prostates (Rezum XL)
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Scientific title
Minimally Invasive Prostatic Vapor Ablation - Multicenter, Single Arm Study for the Treatment of BPH in Large Prostates (Rezum XL)
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Secondary ID [1]
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3034-001
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Universal Trial Number (UTN)
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Trial acronym
Rezum XL
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
BPH With Urinary Obstruction
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BPH
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BPH With Urinary Obstruction With Other Lower Urinary Tract Symptoms
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Condition category
Condition code
Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Treatment: Devices - Prostatic Vapor Ablation
Experimental: Treatment - Prostatic Vapor Ablation with Rezum
Treatment: Devices: Prostatic Vapor Ablation
Rezum uses the stored thermal energy in water vapor (steam) to treat the extra prostate tissue that is causing symptoms such as frequency, urgency, irregular flow, weak stream, straining and getting up at night to urinate.
Inside a hand-held device, radiofrequency energy is applied to a few drops of water to create vapor (steam). The water vapor is injected into the prostate tissue that is blocking the flow of urine from the bladder, where it immediately turns back to water, releasing the energy stored in the vapor into the cell membranes. At this point, the cells are gently and immediately damaged, causing cell death. Over time, the body absorbs the treated tissue through its natural healing response.
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Intervention code [1]
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Treatment: Devices
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Number of Participants With = 30% Improvement in Symptoms as Measured by the International Prostate Symptom Score (IPSS)
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Assessment method [1]
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The proportion of the intent-to-treat (ITT) analysis population that responds to the Rezum therapy is reported. A responder is defined as a subject who has an improvement in International Prostate Symptom Score (IPSS) \> 30% from baseline to 6 months post-therapy. IPSS scores range from 0 (no symptoms) to 35 (severe symptoms). Improvement in symptoms is shown by a reduction in score.
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Timepoint [1]
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6 Months
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Primary outcome [2]
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Number of Participants With Post Procedure Device Related Serious Complications
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Assessment method [2]
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Assess the composite rate of post procedure device related serious complications in treated subjects through 6 months follow-up.
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Timepoint [2]
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6 Months
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Secondary outcome [1]
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Number of Subjects With Device-related Retention Catheterizations
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Assessment method [1]
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This safety endpoint will be to characterize the rate of post procedure device-related serious retention catheterizations at 6 months.
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Timepoint [1]
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6 Month
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Secondary outcome [2]
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Change in Lower Urinary Tract Symptoms as Assessed by the Absolute Change in IPSS Score From Baseline to Follow-up
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Assessment method [2]
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The change in IPSS from baseline to each follow-up visit was determined. IPSS scores range from 0 (no symptoms) to 35 (severe symptoms). Improvement in symptoms is shown by a reduction in score.
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Timepoint [2]
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Baseline, 6 weeks, 3 months, 6 months, 1 year
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Eligibility
Key inclusion criteria
1. Male subjects = 50 years of age who have symptomatic BPH.
2. International Prostate Symptom Score (IPSS) score = 13.
3. Peak urinary flow rate (Qmax): = 5ml/sec to = 12 ml/sec with minimum voided volume of = 125 ml.
4. Post-void residual (PVR) =300 ml.
5. Prostate volume >80 cm3 to =150 cm3
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Minimum age
50
Years
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Maximum age
No limit
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
Urology:
1. Any prior invasive prostate intervention (e.g., "Radiofrequency" thermotherapy, balloon, microwave thermotherapy, "Prostatic Urethral Lift", "Transurethral Resection", or laser) or other surgical interventions of the prostate.
2. Undergone a prostate biopsy within 60 days prior to the scheduled treatment date or has an imminent need for surgery.
3. Verified acute bacterial prostatitis within last 12 months documented by culture.
4. Active or history of epididymitis within the past 3 months.
5. Urethral strictures, bladder neck contracture, unusual anatomy or muscle spasms that would prevent the introduction and use of the Rezum device.
6. Diagnosed bladder, urethral or ureteral stones or active stone passage in the past 6 months, provided that stones that are known to be in the kidney and have been stable for a period exceeding 3 months are permissible.
7. Subject interested in maintaining fertility.
8. Use of the following medications where the dose is not stable (stable dose defined as the same medication and dose in the last three months):
1. Beta-blockers;
2. Anticonvulsants;
3. Antispasmodics;
4. Antihistamines;
5. Alpha blockers for BPH and anticholinergics or cholinergics;
6. Type II, 5-alpha reductase inhibitor (e.g., finasteride (Proscar, Propecia));
7. Dual 5-alpha reductase inhibitor (e.g., dutasteride (Avodart));
8. Estrogen, drug-producing androgen suppression, or anabolic steroids;
9. PD5 Inhibitors (e.g., Viagra, Levitra or Cialis)
9. Subjects who have had an incidence of spontaneous urinary retention either treated with indwelling transurethral catheter or suprapubic catheter 6 months prior to baseline. A provoked episode now resolved is still admissible
10. Evidence of atonic neurogenic bladder evaluated by a baseline urodynamic assessment.
11. Visible hematuria with subject urine sample without a known contributing factor.
12. Presence of a penile implant or stent(s) in the urethra or prostate
13. Active urinary tract infection by culture within 7 days of treatment or two documented independent urinary tract infections of any type in the past 6 months.
Gastroenterology:
14. Previous pelvic irradiation or radical pelvic surgery.
15. Previous rectal surgery (other than hemorrhoidectomy) or known history of rectal disease.
Nephrology:
16. Compromised renal function defined as serum creatinine > 2.0 mg/dl.
17. Hydronephrosis (Grade 2 or higher).
Oncology:
18. Prostate cancer testing:
If PSA is > 2.5 ng/ml and = 10 ng/ml with free PSA <25%, prostate cancer for the subject must be/had been ruled out through a negative biopsy prior to enrollment
* Males 50-59 years - PSA is >2.5 ng/ml and =10 ng/ml with free PSA <25%,
* Males 60+ years - PSA is >4 ng/ml and =10 ng/ml, with free PSA <25%
19. History of confirmed malignancy or cancer of the prostate or bladder; however, high grade prostatic intraepithelial "PIN" is acceptable.
20. History of cancer in non-genitourinary system that is not considered cured (except basal cell or squamous cell carcinoma of the skin). A potential participant is considered cured if there has been no evidence of cancer within five years of enrollment.
Cardiology:
21. History of clinically significant congestive heart failure (i.e., NYHA Class III and IV).
22. Cardiac arrhythmias that are not controlled by medication and/or medical device.
23. An episode of unstable angina pectoris, a myocardial infarction, transient ischemic attack, or a cerebrovascular accident within the past six months.
Pulmonology:
24. History of significant respiratory disease where hospitalization for the disease is required.
Hematology:
25. Diagnosed or suspected bleeding disorder, or coagulopathies.
26. Use of antiplatelet or anticoagulant medication except low dose aspirin (<100mg/day) within 10 days prior to treatment.
Endocrinology:
27. History of diabetes not controlled by a stable dose of medication over the past three months, provided that patients with a hemoglobin A1c <8.0% are allowed.
Immunology:
28. History of immunosuppressive conditions (e.g., AIDS, post-transplant).
Neurology:
29. Any cognitive or psychiatric condition that interferes with or precludes direct and accurate communication with the study investigator regarding the study or affect the ability to complete the study quality of life questionnaires.
30. Diagnosed or suspected primary neurologic conditions such as multiple sclerosis or Parkinson's disease or other neurological diseases known to affect bladder function, sphincter function or poor detrusor muscle function (< 25% of accepted and established nomograms).
General:
31. Currently enrolled in any other pre-approval investigational study in the US (does not apply to long-term post-market studies unless these studies might clinically interfere with the current study endpoints (e.g., limit use of study-required medication, etc.).
32. Any significant medical history that would pose an unreasonable risk or make the subject unsuitable for the study.
33. Inability to provide a legally effective "Informed Consent Form" and/or comply with all the required follow-up requirements.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
NA
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
NA
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
19/06/2018
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
11/08/2020
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Sample size
Target
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Accrual to date
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Final
47
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Recruitment in Australia
Recruitment state(s)
NSW
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Recruitment hospital [1]
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Sydney Adventist Hospital/University of Sydney - Wahroonga
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Recruitment postcode(s) [1]
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2076 - Wahroonga
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Recruitment outside Australia
Country [1]
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United States of America
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State/province [1]
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Arizona
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United States of America
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State/province [2]
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Florida
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United States of America
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Indiana
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Country [4]
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United States of America
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State/province [4]
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Kansas
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Country [5]
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United States of America
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State/province [5]
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Maryland
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Country [6]
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United States of America
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State/province [6]
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Nebraska
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Country [7]
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United States of America
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State/province [7]
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New Jersey
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United States of America
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State/province [8]
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Texas
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Funding & Sponsors
Primary sponsor type
Commercial sector/industry
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Name
Boston Scientific Corporation
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Address
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Country
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Ethics approval
Ethics application status
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Summary
Brief summary
Prospective, multicenter, single arm clinical trial designed to evaluate the safety of the Rezum System in treating subjects with symptomatic BPH for prostate sizes \>80cm3 and =150 cm3.
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Trial website
https://clinicaltrials.gov/study/NCT03605745
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Henry Woo, MD
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Address
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Sydney Adventist Hospital
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
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Other Details
Attachment
Study protocol
Study Protocol and Statistical Analysis Plan
https://cdn.clinicaltrials.gov/large-docs/45/NCT03605745/Prot_SAP_000.pdf
Statistical analysis plan
Study Protocol and Statistical Analysis Plan
https://cdn.clinicaltrials.gov/large-docs/45/NCT03605745/Prot_SAP_000.pdf
Results publications and other study-related documents
No documents have been uploaded by study researchers.
Results are available at
https://clinicaltrials.gov/study/NCT03605745