Active, not recruiting
Not applicable
ROBUST III- Re-Establishing Flow Via Drug Coated Balloon For The Treatment Of Urethral Stricture Disease
Condition(s) studied
Urethral Stricture
Investigational drug(s) / intervention(s)
Optilume Drug Coated Balloon (DCB)Control Treatment
Optilume Drug Coated Balloon (DCB): The Optilume Drug Coated Balloon (DCB) is a guidewire compatible catheter with a tapered atraumatic tip. The distal end of the catheter has an inflatable balloon coated with a proprietary coating containing the drug paclitaxel that facilitates the drug's transfer to the urethral wall upon inflation.
Control Treatment: A control subject may be dilated with either a rod, uncoated balloon or DVIU until the desired result is reached, based on standard of care for the clinical site and treating physician
Study summary
ROBUST III is a prospective, multi-center, randomized controlled adaptive sample size clinical trial to establish the safety and effectiveness for the Optilume Stricture Drug Coated Balloon (DCB).
Eligibility
Inclusion Criteria:
1. Male subjects ≥ 18 years' old
2. Visual confirmation of stricture via cystoscopy or urethrogram
3. Single, tandem or diffuse anterior urethral stricture(s), less than or equal to 3.0 cm total length measured by retrograde urethrogram. (Stricture length is defined as the distance between the most distal edge of the stricture to the most proximal edge of the stricture).
4. Two or more prior dilation treatments of the same stricture, including DVIU (Direct Vision Internal Urethrotomy), but no prior urethroplasty.
5. Significant symptoms of stricture such as frequency of urination, dysuria, urgency, hematuria, slow flow, feeling of incomplete emptying, recurrent urinary tract infections (UTI's).
6. International Prostrate Symptoms Score (IPSS) score of 11 or higher (assumed to be "35" if suprapubic catheter is present)
7. Lumen diameter ≤ 12F by urethrogram
8. Qmax \<15 ml/sec (assumed to be "0" if suprapubic catheter is present)
9. Guidewire must be able to cross the lesion
Exclusion Criteria:
1. Subjects with diffuse stricture length, greater than 3.0 cm in total length. (Stricture length is defined as the distance between the most distal edge of the stricture to the most proximal edge of the stricture).
2. Subjects with a history of hypersensitivity reactions to TAXOL, on medication that may have negative interaction with paclitaxel, with solid tumors who have a baseline neutrophil counts of \<1500 cells/mm3 or subjects with AIDS-related Kaposi's sarcoma with baseline neutrophile counts of \<1000 cells/mm3.
3. Subjects who had an indwelling suprapubic catheter longer than three (3) months total prior to enrollment.
4. Previous urethroplasty within the anterior urethra
5. Stricture dilated or incised within the last six (6) weeks (urethral catheterization is not considered dilation)
6. Presence of local adverse factors, including abnormal prostate making catheterization difficult, urethral false passage or fistula.
7. Presence of signs of obstructive voiding symptoms not directly attributable to the stricture at the discretion of the physician
8. Diagnosis of untreated and unresolved BPH or BNC
9. Untreated stress urinary incontinence (SUI).
10. History of diagnosed radiation cystitis.
11. Diagnosis of carcinoma of the urethra, bladder or prostate within the last two (2) years
12. Active kidney, bladder, urethral or ureteral stone passage in the last six (6) weeks or concern of stone passage in the next 6 weeks at the discretion of the investigator.
13. Diagnosis of chronic renal failure and treatment with hemodialysis
14. New diagnosis of OAB (overactive bladder) within the last six (6) months
15. Use of alpha blockers, beta blockers, OAB (Overactive Bladder) medication, anticonvulsants (drugs that prevent or reduce the severity and frequency of seizures), and antispasmodics where the dose is not stable. (Stable dose is defined as having the same medication and dose in the last six months.)
16. Dependence on Botox (onabotulinumtoxinA) in urinary system
17. Presence of an artificial urinary sphincter, slings, or stent(s) in the urethra or prostate
18. Known neurogenic bladder, sphincter abnormalities, or poor detrusor muscle function
19. Diagnosed with Lichen Sclerosus, or stricture due to balanitis xerotica obliterans (BXO)
20. Previous hypospadias repair
21. History of cancer in non-genitourinary system which is not considered in complete remission (except basal cell or squamous cell carcinoma of the skin). A potential participant is considered in complete remission if there has been no evidence of cancer within two (2) years of enrollment
22. 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
23. Unwilling to use protected sex for thirty (30) days' post treatment
24. Unwilling to abstain or use protected sex for ninety (90) days post treatment if sexual partner is of child bearing potential.
25. Inability to provide Informed Consent Form (ICF) and/or comply with all the required follow-up requirements
26. Participation in other pre-market studies or treatment with an investigational drug or device. Long term follow up or post market study of an approved device is allowed.
27. Current active infection in the urinary system
28. Current uncontrolled diabetes (hemoglobin A1c \> 8.0%) or evidence of poor wound healing due to diabetes
29. 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.
30. Visible hematuria in subject's urine sample without known contributing factor
31. Invisible hematuria (or significant microscopic hematuria, i.e. hematuria of ≥ 3 RBC's/HPF) that may be caused by a clinically significant disease unless it is attributed to the urethral stricture disease or other causes which are benign and not requiring treatment.
Primary outcome measure(s)
- Percentage of Subjects Stricture Free — 6 months
The percentage of subjects deemed to be stricture free will be compared between arms. Stricture free subjects are those for which a 16F flexible cystoscope or 14F Foley catheter is able to be passed through the treated stricture without significant resistance.
- Safety: Rate of Major Device or Procedure Related Complications — 3 months
Rate of Major Device or Procedure Related complications
Trial sites (22)
| Facility | City | Region | Status |
| Academic Urology and Urogynecology of Arizona |
Phoenix |
Arizona |
|
| Arkansas Urology |
Little Rock |
Arkansas |
|
| Advanced Urology Institute |
Daytona Beach |
Florida |
|
| University of Iowa |
Iowa City |
Iowa |
|
| Chesapeake Urology Research |
Annapolis |
Maryland |
|
| Chesapeake Urology |
Hanover |
Maryland |
|
| University of Minnesota Department of Urology |
Minneapolis |
Minnesota |
|
| Mayo Clinic |
Rochester |
Minnesota |
|
| Minnesota Urology |
Woodbury |
Minnesota |
|
| Adult & Pediatric Urology, PC |
Omana |
Nebraska |
|
| New Jersey Urology |
Voorhees Township |
New Jersey |
|
| Western New York Urology Associates |
Cheektowaga |
New York |
|
| Columbia University Medical Center/New York-Presbyterian Hospital |
New York |
New York |
|
| Iris Cantor Men's Health Center |
New York |
New York |
|
| Integrated Medical Professionals OBP |
North Hills |
New York |
|
| Carolina Urology Partners |
Concord |
North Carolina |
|
| Oregon Urology Institute |
Springfield |
Oregon |
|
| UT Southwestern |
Dallas |
Texas |
|
| Urology San Antonio |
San Antonio |
Texas |
|
| Urology of Virginia |
Virginia Beach |
Virginia |
|
| University of Washington Harborview Medical Center |
Seattle |
Washington |
|
| Royal Victoria Hospital, Glen Site |
Montreal |
Quebec |
|
More Urotronic Inc. trials in the USA
Other trials for the same condition