Early BOTOX After Spinal Cord Injury

NCT ID: NCT06793683

Last Updated: 2025-01-27

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

ENROLLING_BY_INVITATION

Clinical Phase

EARLY_PHASE1

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-07-27

Study Completion Date

2028-09-30

Brief Summary

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The investigators would like to improve our understanding of how early intervention with the use of bladder chemodenervation can preserve bladder function in those with a new SCI. Although detrimental cystometric and tissue changes are known to occur, often within 3 months after SCI, the investigators seek to document the time course of these changes and the range of severity of those changes in both those participants that receive prophylactic treatment and those who do not.

Detailed Description

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Conditions

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Spinal Cord Injuries

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The investigators hope to recruit 10 participants randomly assigned to 7 cases (those that will receive Botox bladder injections) and 3 controls (those that will receive placebo bladder injections).
Primary Study Purpose

PREVENTION

Blinding Strategy

SINGLE

Participants
Participants will be blinded during the study.

Study Groups

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Bladder Chemodenervation (Botox) Injection Procedure

BoNT-A (Botox) 200 U, will be injected into the detrusor (bladder wall muscle).

Group Type ACTIVE_COMPARATOR

Bladder chemodenervation (Botox)

Intervention Type DRUG

BoNT-A (Botox) 200 U will be injected into the detrusor (bladder wall muscle).

Bladder Sham (saline) Injection Procedure

Saline will be injected into the detrusor (bladder wall muscle).

Group Type SHAM_COMPARATOR

Bladder Sham (Saline) Injection Procedure

Intervention Type PROCEDURE

20mL placebo (saline only), will be injected into the detrusor (bladder wall muscle).

Interventions

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Bladder chemodenervation (Botox)

BoNT-A (Botox) 200 U will be injected into the detrusor (bladder wall muscle).

Intervention Type DRUG

Bladder Sham (Saline) Injection Procedure

20mL placebo (saline only), will be injected into the detrusor (bladder wall muscle).

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Male or female 18-65 years of age at time of SCI.
* English speaking
* Recent SCI (within 20 weeks of injury).
* Documentation of a spinal cord injury at T6 or higher, American Spinal Injury Association Impairment Scale (AIS) level A or B as designated on initial (72 hour) AIS exam.
* Ability for subject to comply with the requirements of the study.
* Written informed consent obtained from subject.

Exclusion Criteria

* Inability to return to research site (Harborview Medical Center) for follow-up studies after initial hospitalization.
* Acute (as part of concurrent hospitalization) or history of bladder surgery (urethral or prostate surgery acceptable) or injury.
* Inability to provide informed consent.
* Pregnant, breastfeeding, or unwilling to practice birth control during participation in the study.
* Incarcerated in a detention facility or in police custody.
* Presence of a condition or abnormality that in the opinion of the Investigator would compromise the safety of the patient or the quality of the data.
* Active medical problems precluding the safe conduct of urodynamics, bladder chemodenervation, bladder biopsy (e.g., evidence of active bladder infection, ruled out by urine culture prior to procedures)
* Known hypersensitivity to any botulinum toxin preparation or to any of the components in the formulation
* Cardiovascular instability
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Washington

OTHER

Sponsor Role lead

Responsible Party

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Claire Yang, MD

Professor: Department of Urology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Claire C Yang, MD

Role: PRINCIPAL_INVESTIGATOR

University of Washington

Locations

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Harborview Medical Center

Seattle, Washington, United States

Site Status

Countries

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United States

References

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Comperat E, Reitz A, Delcourt A, Capron F, Denys P, Chartier-Kastler E. Histologic features in the urinary bladder wall affected from neurogenic overactivity--a comparison of inflammation, oedema and fibrosis with and without injection of botulinum toxin type A. Eur Urol. 2006 Nov;50(5):1058-64. doi: 10.1016/j.eururo.2006.01.025. Epub 2006 Feb 6.

Reference Type BACKGROUND
PMID: 16517054 (View on PubMed)

Ginsberg D, Gousse A, Keppenne V, Sievert KD, Thompson C, Lam W, Brin MF, Jenkins B, Haag-Molkenteller C. Phase 3 efficacy and tolerability study of onabotulinumtoxinA for urinary incontinence from neurogenic detrusor overactivity. J Urol. 2012 Jun;187(6):2131-9. doi: 10.1016/j.juro.2012.01.125. Epub 2012 Apr 12.

Reference Type BACKGROUND
PMID: 22503020 (View on PubMed)

Ku JH, Choi WJ, Lee KY, Jung TY, Lee JK, Park WH, Shim HB. Complications of the upper urinary tract in patients with spinal cord injury: a long-term follow-up study. Urol Res. 2005 Dec;33(6):435-9. doi: 10.1007/s00240-005-0504-4. Epub 2005 Nov 30.

Reference Type BACKGROUND
PMID: 16317536 (View on PubMed)

Janzen J, Vuong PN, Bersch U, Michel D, Zaech GA. Bladder tissue biopsies in spinal cord injured patients: histopathologic aspects of 61 cases. Neurourol Urodyn. 1998;17(5):525-30. doi: 10.1002/(sici)1520-6777(1998)17:53.0.co;2-f.

Reference Type BACKGROUND
PMID: 9776015 (View on PubMed)

Bywater M, Tornic J, Mehnert U, Kessler TM. Detrusor Acontractility after Acute Spinal Cord Injury-Myth or Reality? J Urol. 2018 Jun;199(6):1565-1570. doi: 10.1016/j.juro.2018.01.046. Epub 2018 Jan 17.

Reference Type BACKGROUND
PMID: 29352989 (View on PubMed)

Rosier PFWM, Valdevenito JP, Smith P, Sinha S, Speich J, Gammie A; Members of the ICS Working Group PFS23. ICS-SUFU standard: Theory, terms, and recommendations for pressure-flow studies performance, analysis, and reporting. Part 1: Background theory and practice. Neurourol Urodyn. 2023 Nov;42(8):1590-1602. doi: 10.1002/nau.25192. Epub 2023 Apr 25.

Reference Type BACKGROUND
PMID: 37096828 (View on PubMed)

Welk B, Morrow S, Madarasz W, Baverstock R, Macnab J, Sequeira K. The validity and reliability of the neurogenic bladder symptom score. J Urol. 2014 Aug;192(2):452-7. doi: 10.1016/j.juro.2014.01.027. Epub 2014 Feb 8.

Reference Type BACKGROUND
PMID: 24518764 (View on PubMed)

Tang DH, Colayco D, Piercy J, Patel V, Globe D, Chancellor MB. Impact of urinary incontinence on health-related quality of life, daily activities, and healthcare resource utilization in patients with neurogenic detrusor overactivity. BMC Neurol. 2014 Apr 4;14:74. doi: 10.1186/1471-2377-14-74.

Reference Type BACKGROUND
PMID: 24708598 (View on PubMed)

Bushnell JY, Cates LN, Hyde JE, Hofstetter CP, Yang CC, Khaing ZZ. Early Detrusor Application of Botulinum Toxin A Results in Reduced Bladder Hypertrophy and Fibrosis after Spinal Cord Injury in a Rodent Model. Toxins (Basel). 2022 Nov 10;14(11):777. doi: 10.3390/toxins14110777.

Reference Type BACKGROUND
PMID: 36356027 (View on PubMed)

Other Identifiers

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STUDY00018758

Identifier Type: -

Identifier Source: org_study_id

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