4-aminopyridine Treatment for Nerve Injury

NCT ID: NCT03701581

Last Updated: 2025-12-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

PHASE2/PHASE3

Total Enrollment

70 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-06-05

Study Completion Date

2028-12-31

Brief Summary

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To evaluate the role of 4-aminopyridine (4-AP) on the course of recovery after peripheral nerve traction and/or crush injury. This study aims to test the hypothesis that 4-aminopyridine speeds the often slow and unpredictable recovery after peripheral nerve traction and/or crush injuries.

Detailed Description

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To evaluate the role of 4-AP on the recovery of nerve function we will be giving patients with prostate cancer who are undergoing robot assisted radical prostatectomy (RP) either 4-AP or placebo in the perioperative period. This population of patients was selected as nerve crush injury during RP is thought to contribute to erectile dysfunction and urinary continence post operatively.

Conditions

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Nerve Injury Prostate Cancer

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomized placebo-controlled trial of 4AP vs placebo for nerve injury
Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Group A: Investigational Treatment

* FDA-approved 10mg dalfampridine (generic Ampyra)
* Subjects will not take more than 2 tablets in a 24-hour period
* Subjects will take the tablets whole. They will not break, crush, chew, or dissolve tablets before swallowing.
* The subjects will be told that the medication is released slowly over time and if the tablet is broken, the medicine may be released too fast which can raise the chance of having a seizure.
* Study drug can be taken with or without food.
* If a dose is missed they should not make up the missed dose. They will be told not to take two doses at the same time but to take the next dose at the regular scheduled time.
* Subjects will be reminded not to take study drug together with other aminopyridine medications, including compounded 4-AP (sometimes called 4-aminopyridine or fampridine).

Group Type EXPERIMENTAL

4-Aminopyridine

Intervention Type DRUG

FDA-approved tablets.

Group B: Placebo

Subjects will receive an oral dose of placebo treatment the day after surgery, continuing daily for 2 months (60 days) following the same administration instructions as the investigational treatment. The placebo tablets will be manufactured by a licensed compounding pharmacy. The Investigational Drug Service at Banner University Medical Center will manage the placebos.

Group Type PLACEBO_COMPARATOR

Placebo

Intervention Type OTHER

Placebo will be tooled to look similar to the study drug.

Interventions

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4-Aminopyridine

FDA-approved tablets.

Intervention Type DRUG

Placebo

Placebo will be tooled to look similar to the study drug.

Intervention Type OTHER

Other Intervention Names

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4-AP Fampridine Dalfampridine

Eligibility Criteria

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Inclusion Criteria

* Male patients with organ-confined, non-metastatic prostate cancer (stages cT1c-T2c), planning to undergo Robotic-Assisted Laparoscopic Bilateral Nerve Sparing Radical Prostatectomy (NSRP)
* Prostate-Specific Antigen (PSA) levels less than 15 ng/ml (within the last 12 months), with biopsy-proven prostate cancer, for whom postoperative adjuvant therapy (e.g. radiation or androgen deprivation therapy) is not expected to be needed
* Ages 45-75
* An Abridged International Index of Erectile Function-Erectile Function (IIEF-5) score of greater than or equal to 17 at time of screening
* Has experienced at least 6 months of regular sexual activity and sexual activity during the 12 weeks prior to prostate biopsy or surgery
* Willingness to abstain from treatments for Erectile Dysfunction until 3 months after surgery
* Willingness to participate and able to provide informed consent

Exclusion Criteria

* Planned adjuvant therapy after NSRP based on specimen pathology and stage of prostate cancer (stage T3 or greater), positive lymph nodes or positive surgical margins
* Neo-adjuvant therapy prior to NSRP
* History of recurrent prostate cancer
* History of seizures, multiple sclerosis, stroke or any other diagnosed neurological disorder
* History of non-organ confined or metastatic prostate cancer (clinical Stages T3 or greater)
* History of known hypersensitivity to 4AP
* Patients with history of penile surgery other than circumcision or endoscopic urethral stricture surgery
* Renal impairment based on calculated GFR (GFR\<60 mL/min)
* Use of any other aminopyridine medications for any other indication
Minimum Eligible Age

45 Years

Maximum Eligible Age

75 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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John Elfar

OTHER

Sponsor Role lead

Responsible Party

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John Elfar

Tenured Professor, Chairman, Department of Orthopaedic Surgery

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Rashid Sayyid, MD

Role: PRINCIPAL_INVESTIGATOR

University of Arizona

John Elfar, MD

Role: STUDY_CHAIR

University of Arizona

Locations

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University of Arizona

Tucson, Arizona, United States

Site Status RECRUITING

University of Rochester

Rochester, New York, United States

Site Status TERMINATED

Countries

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United States

Central Contacts

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Andrea Horne

Role: CONTACT

520-626-6456

Facility Contacts

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John Elfar, MD

Role: primary

Carly J Deal

Role: backup

520-626-6456

References

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Ghazi A, Osinski TL, Feng C, Horne A, Elfar J. 4-Aminopyridine treatment for nerve injury resulting from radical retro-pubic prostatectomy: a single-center double-blind, randomized, placebo-controlled study. Trials. 2024 May 21;25(1):332. doi: 10.1186/s13063-024-08102-z.

Reference Type DERIVED
PMID: 38773595 (View on PubMed)

Other Identifiers

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00003869

Identifier Type: -

Identifier Source: org_study_id