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Benign Prostatic HyperplasiaPhase 4NCT03144596

The Effects of α-adrenergic Receptor Antagonists on Choroid and Pupil

A Phase 4 study testing Alfuzosin Hydrochloride 10 MG and Tamsulosin Hydrochloride 0.4 MG in people with Benign Prostatic Hyperplasia and Pupil Anomaly, run by Kocatepe University.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

It was aimed to evaluate and investigate the effects of tamsulosin hydrochloride, has preferential selectivity for the α1A receptor in the prostat versus the α1B receptor in the blood vessels, and alfuzosin hydrochloride on choroidal thickness (CT), pupil diameter sizes evaluated by using enhanced depth imaging… Read more about this study

Who is it for?
Ages 45 years and older, men only
What is being tested?
Alfuzosin Hydrochloride 10 MG and Tamsulosin Hydrochloride 0.4 MG
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
63 participants
Where
No sites listed yet
Study dates
29 Oct 2015to 19 Nov 2016
Phase
Phase 4
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 45 years and older
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Best corrected visual acuity (BCVA) ≥ 0.8
  • Diagnosis of BPH and initiation of alfuzosin hydrochloride or tamsulosin hydrochloride treatments
  • 45 years of age or older man

Who cannot join

  • Occluded angle by gonioscopy (grade 0, narrow angle, grade I, grade II)
  • Corneal scarring or cataract that prevents appearance of the fundus
  • Formation of macular or peripheral retinal pathologies or choroidopathy
  • Optic nerve pathologies such as optic neuropathy
  • Spherical refractive error ≥ ±6.00 D or cylinder refractive error ≥ ±3.00 D
  • Systemic diseases that may affect choroidal blood flow

About this study

Official title: The Effects of Systemic Alfuzosin and Tamsulosin Hydrochloride on Choroidal Thickness and Pupil Diameter Sizes in Cases With Benign Prostatic Hyperplasia

It was aimed to evaluate and investigate the effects of tamsulosin hydrochloride, has preferential selectivity for the α1A receptor in the prostat versus the α1B receptor in the blood vessels, and alfuzosin hydrochloride on choroidal thickness (CT), pupil diameter sizes evaluated by using enhanced depth imaging spectral-domain optical coherence tomography (EDI-OCT) and scheimpflug/placido photography-based topoghraphy system in this study.

63 men patients with newly diagnosis of benign prostatic hyperplasia were randomly assigned to either alfuzosin hydrochloride or to tamsulosin hydrochloride groups in this prospective, randomized, parallel-group clinical trial. Enhanced depth imaging spectral-domain optical coherence tomography, pupillography were obtained at baseline, 1st and 3rd month, and choroidal thicknesses and pupil diameter sizes were compared between the 2 groups.

Read the detailed description

The local authorized clinical trials ethics committee approved the study and this study was performed following the principles of the Declaration of Helsinki. Detailed information was given to patients about clinical applications and tests, and signed informed consent forms were also obtained from all patients. 32 right eyes of 32 men with diagnosis of BPH initiated on AH (Xatral®) (10 mg/day) and 31 right eyes of 31 men with diagnosis of BPH initiated on TH (Flomax®) (0.4 mg/day) were included in this self-controlled prospective clinical trial. Urologists in the urology clinic made diagnosis of BPH, and 63 men diagnosis of BPH were directed towards eye clinic. AH or TH treatments were randomly recommended for previously untreated patients with newly diagnosis of BPH by urologists. After providing information to patients about the disease and treatment, patients predicted to show adherence to treatment, were enrolled in the study.

Ophthalmological examinations were performed in all cases. Choroidal thicknesses (CTs) were measured under the fovea, 3 mm nasal to the fovea and 3 mm temporal to the fovea, and they were recorded as submacular (SCT), nasal (NCT) and temporal (TCT) choroidal thicknesses. CTs were measured and recorded by using EDI-OCT imaging (Cirrus HD 4000, Carl Zeis Meditec, CA, USA). Mesopic, scotopic and photopic pupil diameter sizes were measured and recorded by using Scheimpflug/Placido photography-based topography system in the pupillometer mode (Sirius, Italy). CTs, scotopic, mesopic and photopic pupil diameter sizes were measured and recorded at baseline, 1st and 3rd months.

Data obtained from cases were encoded and they were transferred to the computer program. SPSS 20.0 software (SPSS Inc., Chicago, IL, USA) was used for statistical evaluation. Data distribution was tested using Kolmogorov-Smirnov test. Baseline values and 1st, 3rd month values were compared by using the repeated measure of ANOVA in intra-group evaluation and independent samples t-test in inter-group evaluation, and the significance level of p-value was accepted as 0,05 (P ≤ 0, 05). Progressions were evaluated by using repeated measures analyses of variance-ANOVA (with the Bonferroni correction) and the correlation between parameters were evaluated by using bivariate (Pearson's) correlation analysis. Positive values and negative values were considered to be correlated in the same direction and opposite direction, respectively in correlation analysis. Correlation coefficient values r ≥ |± 0.3| were accepted as correlation; and the significance level of P value that was below 0,05 was evaluated as the significant correlation.

Being tested
Alfuzosin Hydrochloride 10 MG, Tamsulosin Hydrochloride 0.4 MG
Medical subject headings
Prostatic Hyperplasia, Pupil Disorders, Choroid Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Alfuzosin Hydrochloride 10 MGDrug

    Also called Xatral

    Alfuzosin hydrochloride Tablet

  • Tamsulosin Hydrochloride 0.4 MGDrug

    Also called Flomax

    Tamsulosin Hydrochloride Tablet

Study groups in NCT03144596
Study groupRoleWhat they receive
Alfuzosin HydrochlorideExperimentalAlfuzosin hydrochloride 10 mg tablet by mouth, every 24 hours for 3 months
Receives: Drug: Alfuzosin Hydrochloride 10 MG
Tamsulosin HydrochlorideActive comparatorTamsulosin hydrochloride 0.4 mg tablet by mouth, every 24 hours for 3 months
Receives: Drug: Tamsulosin Hydrochloride 0.4 MG

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from baseline choroidal thicknesses at 3 months

    Choroidal thicknesses (CTs) measurement under the fovea, 3 mm nasal to the fovea and 3 mm temporal to the fovea at baseline, 1st and 3rd month, and recording as submacular (SCT), nasal (NCT) and temporal (TCT) choroidal thicknesses.

    Measured: 1 month and 2 months

  2. Change from baseline pupil diameter sizes at 3 months

    Mesopic, scotopic and photopic pupil diameter sizes measurement at baseline, 1st and 3rd months

    Measured: 1 month and 2 months

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted9 May 2017
  2. Study start29 Oct 2015
  3. Primary completion3 Feb 2016
  4. Study completion19 Nov 2016

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 4
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
prospective, randomized, parallel-group clinical trial
Masking
None (open label)
Enrolment
63 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03144596
Sponsor's protocol ID
2011-KAEK-2 2015/342
Status last verified
May 2017
First submitted
2 May 2017
Last updated
9 May 2017
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Undecided

Publications

  • Berry SJ, Coffey DS, Walsh PC, Ewing LL. The development of human benign prostatic hyperplasia with age. J Urol. 1984 Sep;132(3):474-9. doi: 10.1016/s0022-5347(17)49698-4.

    PubMed 6206240
  • Yuan J, Liu Y, Yang Z, Qin X, Yang K, Mao C. The efficacy and safety of alpha-1 blockers for benign prostatic hyperplasia: an overview of 15 systematic reviews. Curr Med Res Opin. 2013 Mar;29(3):279-87. doi: 10.1185/03007995.2013.766594. Epub 2013 Jan 29.

    PubMed 23323875
  • McVary KT, Roehrborn CG, Avins AL, Barry MJ, Bruskewitz RC, Donnell RF, Foster HE Jr, Gonzalez CM, Kaplan SA, Penson DF, Ulchaker JC, Wei JT. Update on AUA guideline on the management of benign prostatic hyperplasia. J Urol. 2011 May;185(5):1793-803. doi: 10.1016/j.juro.2011.01.074. Epub 2011 Mar 21.

    PubMed 21420124
  • Filson CP, Hollingsworth JM, Clemens JQ, Wei JT. The efficacy and safety of combined therapy with alpha-blockers and anticholinergics for men with benign prostatic hyperplasia: a meta-analysis. J Urol. 2013 Dec;190(6):2153-60. doi: 10.1016/j.juro.2013.05.058. Epub 2013 May 30.

    PubMed 23727412
  • Osman NI, Chapple CR, Cruz F, Desgrandchamps F, Llorente C, Montorsi F. Silodosin : a new subtype selective alpha-1 antagonist for the treatment of lower urinary tract symptoms in patients with benign prostatic hyperplasia. Expert Opin Pharmacother. 2012 Oct;13(14):2085-96. doi: 10.1517/14656566.2012.714368. Epub 2012 Aug 28.

    PubMed 22924980
  • Oelke M, Gericke A, Michel MC. Cardiovascular and ocular safety of alpha1-adrenoceptor antagonists in the treatment of male lower urinary tract symptoms. Expert Opin Drug Saf. 2014 Sep;13(9):1187-97. doi: 10.1517/14740338.2014.936376. Epub 2014 Jul 29.

    PubMed 25073735
  • Hollingsworth JM, Wilt TJ. Lower urinary tract symptoms in men. BMJ. 2014 Aug 14;349:g4474. doi: 10.1136/bmj.g4474.

    PubMed 25125424
  • Schwinn DA, Michelotti GA. alpha1-adrenergic receptors in the lower urinary tract and vascular bed: potential role for the alpha1d subtype in filling symptoms and effects of ageing on vascular expression. BJU Int. 2000 Apr;85 Suppl 2:6-11. doi: 10.1046/j.1464-410x.2000.00061.x. No abstract available.

    PubMed 10781179
  • Hatano A, Takahashi H, Tamaki M, Komeyama T, Koizumi T, Takeda M. Pharmacological evidence of distinct alpha 1-adrenoceptor subtypes mediating the contraction of human prostatic urethra and peripheral artery. Br J Pharmacol. 1994 Nov;113(3):723-8. doi: 10.1111/j.1476-5381.1994.tb17053.x.

    PubMed 7858860
  • de Mey C. alpha(1)-blockers for BPH: are there differences? Eur Urol. 1999;36 Suppl 3:52-63. doi: 10.1159/000052349.

    PubMed 10559631
  • Dunn CJ, Matheson A, Faulds DM. Tamsulosin: a review of its pharmacology and therapeutic efficacy in the management of lower urinary tract symptoms. Drugs Aging. 2002;19(2):135-61. doi: 10.2165/00002512-200219020-00004.

    PubMed 11950378
  • Bird ST, Delaney JA, Brophy JM, Etminan M, Skeldon SC, Hartzema AG. Tamsulosin treatment for benign prostatic hyperplasia and risk of severe hypotension in men aged 40-85 years in the United States: risk window analyses using between and within patient methodology. BMJ. 2013 Nov 5;347:f6320. doi: 10.1136/bmj.f6320.

    PubMed 24192967
  • Chrischilles E, Rubenstein L, Chao J, Kreder KJ, Gilden D, Shah H. Initiation of nonselective alpha1-antagonist therapy and occurrence of hypotension-related adverse events among men with benign prostatic hyperplasia: a retrospective cohort study. Clin Ther. 2001 May;23(5):727-43. doi: 10.1016/s0149-2918(01)80022-9.

    PubMed 11394731
  • Chang DF, Campbell JR. Intraoperative floppy iris syndrome associated with tamsulosin. J Cataract Refract Surg. 2005 Apr;31(4):664-73. doi: 10.1016/j.jcrs.2005.02.027.

    PubMed 15899440
  • Abdel-Aziz S, Mamalis N. Intraoperative floppy iris syndrome. Curr Opin Ophthalmol. 2009 Jan;20(1):37-41. doi: 10.1097/ICU.0b013e32831bc0ad.

    PubMed 19077827

Questions about this trial

What is this clinical trial studying?

A Phase 4 study testing Alfuzosin Hydrochloride 10 MG and Tamsulosin Hydrochloride 0.4 MG in people with Benign Prostatic Hyperplasia and Pupil Anomaly, run by Kocatepe University.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 9 May 2017. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 4 studies take place after a treatment is approved, to learn more about its long-term benefits and risks in everyday use.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from baseline choroidal thicknesses at 3 months (time frame: 1 month and 2 months). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03144596, which also lists 26 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 9 May 2017.

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