Delayed Dose Collagenase Clostridium Histolyticum (CCH) Protocol for Men With Peyronie's Disease

NCT ID: NCT06649539

Last Updated: 2025-02-13

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

PHASE4

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-11

Study Completion Date

2029-10-31

Brief Summary

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Our team has previously demonstrated efficacy in performing a novel collagenase Clostridium histolyticum (CCH) injection protocol in men who previously failed to achieve a response to an initial 4 series of CCH.

The objective of the current study is to evaluate a protocol that incorporates limited in-office modeling for up to 4 series, followed by up to 2 additional salvage series to determine safety and efficacy compared to historical data.

Participants will receive up to 4 series of CCH injections using our previously published protocol, with mild in-office modeling. CCH injections are given on back-to back days, after which they are counseled to utilize Restorex and sildenafil daily, as instructed. Patients will undergo mild in-office modeling on day 2.

The sexual partners of study participants will also be invited to enroll in the study and will complete non-validated questionnaires detailing their level of support for the patient's treatment.

Detailed Description

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The current study would prospectively follow 40 men through the following treatment protocol:

* Men would receive 4 series of CCH injections according to the protocol below, which represents a modified version of our most recently published technique.13

* Medication administered on back-to-back days
* Total of 0.9 mg administered with each series, diluted to 0.8 mL
* Mild in-office modeling performed on treatment day 2 of each series
* Wraps performed ranging from 2-4 full-time and 2-4 part-time days to minimize bruising
* Sildenafil 25 mg nightly beginning treatment day 2 until 6 weeks after final injection of the final series.
* Restorex initiated beginning on post-injection day 3 or as soon as tolerated - 30 min daily, continuing until 6 weeks after final injection of the final series.
* Note that men may stop sooner if they are satisfied before completing the 4 series.
* If the patient is not satisfied with outcomes by the end of the 4th series, they would be permitted to enter the 'salvage' phase of the treatment protocol.

* This would be performed 9-12 months after the 4th series of injections.
* The technique would be similar to the one noted above with the exception of more aggressive in-office modeling as described in our prior publication and per our ongoing randomized trial.
* The men would receive up to two additional series per this protocol for a maximum number of cycles being 6 in total.

At the time of initial enrollment, partners of study participants will be invited to enroll in the study and will be administered non-validated questionnaires designed to assess the partner's overall support for the ongoing treatment protocol.

Assessments and study questionnaires will be administered at baseline, with the 1st injection of each series, 6 weeks after completing the 4th series of CCH injections, and 1 year after completion of the final series of CCH injections.

Conditions

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Peyronie Disease

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

prospective, single-blinded clinical trial
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Investigators will be blinded to baseline curvature measurements.

Study Groups

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Primary Cohort

Men would receive 4 series of CCH injections:

* Administered on back-to-back days
* 0.9 mg administered with each series, diluted to 0.8 mL
* Mild in-office modeling performed on treatment day 2 of each series
* Wraps applied 2-4 full-time and 2-4 part-time days
* Sildenafil 25 mg nightly and Restorex beginning treatment day 2 (sildenafil) or 3 (Restorex - 30 min/day) until 6 weeks after final injection of the final series.

Note that men may stop sooner if they are satisfied before completing the 4 series. If the patient is not satisfied with outcomes by the end of the 4th series, they would be permitted to enter the 'salvage' phase of the treatment protocol.

* Performed 9-12 months after the 4th series of injections.
* The technique would incorporate more aggressive, in-office modeling.
* Men would receive up to two additional series per this protocol.

Group Type EXPERIMENTAL

Collagenase Clostridium Histolyticum

Intervention Type DRUG

4 Series given to each participant, 6 weeks apart. Medication administered on back-to-back days. If failing to achieve an adequate response, men may receive up to 2 additional series 9-12 months after the 4th series.

Total of 0.9 mg administered with each series, diluted to 0.8 mL

RestoreX

Intervention Type DEVICE

Restorex initiated beginning on post-injection day 3 or as soon as tolerated - 30 min daily, continuing until 6 weeks after final injection of the final CCH series.

Sildenafil

Intervention Type DRUG

Men will be prescribed sildenafil 25 mg nightly beginning treatment day 2 until 6 weeks after final injection of the final series.

Interventions

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Collagenase Clostridium Histolyticum

4 Series given to each participant, 6 weeks apart. Medication administered on back-to-back days. If failing to achieve an adequate response, men may receive up to 2 additional series 9-12 months after the 4th series.

Total of 0.9 mg administered with each series, diluted to 0.8 mL

Intervention Type DRUG

RestoreX

Restorex initiated beginning on post-injection day 3 or as soon as tolerated - 30 min daily, continuing until 6 weeks after final injection of the final CCH series.

Intervention Type DEVICE

Sildenafil

Men will be prescribed sildenafil 25 mg nightly beginning treatment day 2 until 6 weeks after final injection of the final series.

Intervention Type DRUG

Other Intervention Names

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Xiaflex CCH Viagra

Eligibility Criteria

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Inclusion Criteria

* Men with Peyronie's Disease
* Older than 18 years old
* Curvature ≥30 degrees
* Ability to achieve an erection satisfactory for intercourse with or without phosphodiesterase-5 (PDE5) inhibitors
* The patient exhibits a palpable plaque consistent with Peyronie's Disease

Exclusion Criteria

* Prior surgical treatment on the penis (other than circumcision)
* Prior treatment with CCH injections
* Any contraindications to CCH - as determined by the PI
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Endo Pharmaceuticals

INDUSTRY

Sponsor Role collaborator

Charitable Union for the Research and Education of Peyronie's Disease

OTHER

Sponsor Role lead

Responsible Party

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Landon Trost

Principal Investigator, MD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Landon Trost, MD

Role: PRINCIPAL_INVESTIGATOR

Charitable Union for the Research and Education of Peyronie's Disease

Locations

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Male Fertility and Peyronie's Clinic

Orem, Utah, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Landon Trost, MD

Role: CONTACT

801-655-0015

Holli Burgon

Role: CONTACT

801-691-4714

Facility Contacts

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Landon Trost, MD

Role: primary

801-655-0015

Jesse Labbe, PhD

Role: backup

801-655-0015

References

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Nguyen HMT, Anaissie J, DeLay KJ, Yafi FA, Sikka SC, Hellstrom WJG. Safety and Efficacy of Collagenase Clostridium histolyticum in the Treatment of Acute-Phase Peyronie's Disease. J Sex Med. 2017 Oct;14(10):1220-1225. doi: 10.1016/j.jsxm.2017.08.008. Epub 2017 Sep 2.

Reference Type BACKGROUND
PMID: 28874331 (View on PubMed)

Larson H, Warner J, Savage J, Kohler T, Ziegelmann M, Trost L. Changes in Point of Maximal Curvature During Collagenase Clostridium Histolyticum Injections for Peyronie's Disease. Urology. 2024 Feb;184:122-127. doi: 10.1016/j.urology.2023.11.024. Epub 2023 Dec 6.

Reference Type BACKGROUND
PMID: 38061610 (View on PubMed)

Gelbard M, Lipshultz LI, Tursi J, Smith T, Kaufman G, Levine LA. Phase 2b study of the clinical efficacy and safety of collagenase Clostridium histolyticum in patients with Peyronie disease. J Urol. 2012 Jun;187(6):2268-74. doi: 10.1016/j.juro.2012.01.032. Epub 2012 Apr 13.

Reference Type BACKGROUND
PMID: 22503048 (View on PubMed)

Alom M, Sharma KL, Toussi A, Kohler T, Trost L. Efficacy of Combined Collagenase Clostridium histolyticum and RestoreX Penile Traction Therapy in Men with Peyronie's Disease. J Sex Med. 2019 Jun;16(6):891-900. doi: 10.1016/j.jsxm.2019.03.007. Epub 2019 Apr 5.

Reference Type BACKGROUND
PMID: 30956106 (View on PubMed)

Ziegelmann MJ, Viers BR, Montgomery BD, Westerman ME, Savage JB, Trost LW. Self-reported Clinical Meaningfulness Early in the Treatment Course Predicts Objective Outcomes in Men Undergoing Collagenase Clostridium histolyticum Injections for Peyronie Disease. Urology. 2017 Aug;106:107-112. doi: 10.1016/j.urology.2017.04.045. Epub 2017 May 5.

Reference Type BACKGROUND
PMID: 28483591 (View on PubMed)

Ziegelmann MJ, Viers BR, McAlvany KL, Bailey GC, Savage JB, Trost LW. Restoration of Penile Function and Patient Satisfaction with Intralesional Collagenase Clostridium Histolyticum Injection for Peyronie's Disease. J Urol. 2016 Apr;195(4 Pt 1):1051-6. doi: 10.1016/j.juro.2015.10.065. Epub 2015 Oct 23.

Reference Type BACKGROUND
PMID: 26476353 (View on PubMed)

Alom M, Meng Y, Sharma KL, Savage J, Kohler T, Trost L. Safety and Efficacy of Collagenase Clostridium Histolyticum in Peyronie's Disease Men With Ventral Curvatures. Urology. 2019 Jul;129:119-125. doi: 10.1016/j.urology.2019.01.055. Epub 2019 Mar 22.

Reference Type BACKGROUND
PMID: 30910455 (View on PubMed)

Other Identifiers

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CUREPD120

Identifier Type: -

Identifier Source: org_study_id

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