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Benign Prostatic HyperplasiaBPH EFFICACYNCT06601179

Evaluating the Safety and Efficacy of the "HIFU" High-intensity Focused Ultrasound Treatment of Benign Prostatic Hyperplasia;

A study testing HIFU in people with Benign Prostatic Hyperplasia, run by EDAP TMS S.A. at 9 sites in France.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Prostate adenoma, also known as benign prostatic hypertrophy or hyperplasia (BPH), involves an increase in the size of the prostate, forming a benign tumor. It is the most common benign tumor in men, generally affecting those over 40 years old. Read more about this study

Who is it for?
Ages 50 to 85 years, men only
Conditions the study is for
Benign Prostatic Hyperplasia
What is being tested?
HIFU
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
100 participants
Where
9 sitesFrance
Study dates
23 Aug 2024to 31 Aug 2028
Phase
Interventional
Are there results?
Not yet: the study is under way

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 50 to 85 years
  • Men only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Men aged ≥ 50 to ≤ 85
  • Patient diagnosed with benign prostatic hyperplasia evaluated by:
  • Prostate volume ranging from 30 cc to 80 cc evaluated by MRI
  • Qmax < 15ml/s
  • IPSS ≥ 8
  • IPSS-QoL ≥ 3
  • IIEF-5 > 17
  • Patient for whom medical treatment failed (having been taken regularly for more than 12 weeks) OR patient with a contraindication to the initiation of medical treatment OR patient refusing medical treatment Patient whose prostate show no sign of cancerous lesion confirmed by MRI Patient capable of reading and understanding French or with a carer who speaks French and could help the patient understand the leaflet and the questionnaires Patient registered with a social security scheme Patient having given their free and informed consent to participate in the study

Who cannot join

  • Presence of a median lobe preventing the HIFU treatment to be delivered according to the investigator's judgment Prostate cancer confirmed or suspected History of surgical treatment of the prostate History of radiotherapy of the prostate History of bladder cancer History of urethral stricture Presence of a urinary tract fistula Urethral stricture or untreated bladder neck stenosis Untreated urinary lithiasis Neurological bladder or neurological bladder disease or any other neurological disease likely to affect the functioning of the bladder-sphincter system History of pelvic radiotherapy Patient with renal failure with GFR < 35ml/min Patient currently undergoing anticoagulant therapy (antivitamins K (AVK) and new oral anticoagulants (NOACs) for which the stop window cannot exceed 48H at the time of the HIFU procedure Contraindication to the surgical procedure, in particular anesthesia Contraindication to the pelvic MRI Patient with a rectal wall > 10mm
  • Contraindication to the HIFU treatment procedure:
  • Active urogenital infection (the infection must be treated before HIFU treatment)
  • Anal or rectal fibrosis, anal or rectal stenosis or any other abnormalities making it difficult to insert the Focal One® probe
  • Urinary tract or rectal fistula
  • Anatomic abnormalities of the rectum or rectal mucosa
Show all 12Show fewer
  • Presence of permanent radioactive implants in the rectal wall
  • Presence of prostatic calcification the location of which interferes with the HIFU treatment
  • Patient with an artificial sphincter, a penile prosthesis or intra-prostatic implant; for example, an endoprosthesis
  • Presence of an implant (stent, catheter) within 1cm of the treatment area
  • History of inflammatory bowel disease
  • Presence of metal stents or implants in the urethra Patient refusing to participate in the study Person under guardianship considered legally incapable of giving their informed consentPatient unable or refusing to complete the questionnaires Persons placed under judicial protection Subject participating in another study including an exclusion period that is still running at the time of pre-inclusion

Trial locations and contacts

9 sites in 1 country. Contact the study team or a site near you to ask about taking part.

9 sites in 1 country

France9 sites, 9 recruiting
  • Clinique Saint Vincent

    Besançon, 25000

    Vincent Bailly, Dr, +330381472111, docteur.bailly.urologie@gmail.com

    Vincent Bailly, Dr

    Not yet recruiting
  • Clinique Tivoli-Ducos

    Bordeaux, 33000

    Gilles Pasticier, Dr, +330556901121, gillespasticier@gmail.com

    Gilles Pasticier, Dr

    Not yet recruiting
  • Groupe Hospitalier Pellegrin

    Bordeaux, 33000

    Franck Bladou, Pr, +330557820370, franck.bladou@chu-bordeaux.fr

    Franck Bladou, Pr

    Not yet recruiting
  • CHU de Lille

    Lille, 59000

    Jonathan Olivier, Dr, +330320444173, jonathan.olivier@chu-lille.fr

    Jonathan Olivier, Dr

    Not yet recruiting
  • HCL_Hôpital Edouard Herriot

    Lyon, 69003

    Hakim Fassi-Fehri, Dr, +3304111140, hakim.fassi-fehri@chu-lyon.fr

    Hakim Fassi-Fehri, Dr

    Recruiting
  • CH Matigues

    Martigues, 13500

    Harry Toledano, Dr, +3304 42 43 20 11, Harry.TOLEDANO@ch-martigues.fr

    Harry Toledano, Dr

    Recruiting
  • Hôpital Foch

    Suresnes, 92150

    Tarek Ghoneim, Dr, +330146252834, t.ghoneim@hopital-foch.org

    Tarek Ghoneim, Dr

    Not yet recruiting
  • Clinique Saint Michel

    Toulon, 83100

    Stéphane Mallick, Dr, +3304 98 00 18 69, mallick@orange.fr

    Stéphane Mallick

    Not yet recruiting
  • Hôpitaux de Toulouse

    Toulouse, 31400

    Mathieu Roumiguié, Dr, +330561322748, roumiguie.m@chu-toulouse.fr

    Mathieu Roumiguié, Dr

    Not yet recruiting

Other trials in France

About this study

Official title: Phase 1-2 Dose-escalation Study, Evaluating the Safety and Efficacy of the "HIFU" High-intensity Focused Ultrasound Treatment of Benign Prostatic Hyperplasia After 3 Months, 6 Months, 12 Months, 18 Months and 36 Months.

Prostate adenoma, also known as benign prostatic hypertrophy or hyperplasia (BPH), involves an increase in the size of the prostate, forming a benign tumor. It is the most common benign tumor in men, generally affecting those over 40 years old. The risk of BPH is more than 50% in men aged 50 to 60 and rises to 90% in men by age 80.

This hyperplasia leads to altered urinary flow and bladder outlet obstruction, referred to as "lower urinary tract symptoms" or LUTS, which become more frequent with age. These symptoms are categorized as obstructive or irritative. In the early stages, men with BPH may have difficulty starting urination and may feel as if their bladder is not completely empty. As a result, they need to urinate more often, especially at night, a condition known as nocturia. Additionally, the volume and velocity of the urinary flow may decrease significantly, as evidenced by flow measurements, and residual urine discharge may occur at the end of urination.

Read more

High-intensity focused ultrasound (HIFU) is a medical technique that uses high-intensity ultrasonic waves to treat various medical conditions, including malignant and benign tumors, without the need for invasive surgery or ionizing radiation. HIFU generates heat between 80° to 95°C at the focal point, causing necrosis of the targeted area with pinpoint accuracy. In urology, HIFU is used to treat prostate cancer in a minimally invasive manner, with focused ultrasounds delivered endorectally using a transducer that targets the treatment area with real-time monitoring.

Exclusively targeted HIFU treatment has been suggested for BPH, where localized necrosis of the side lobes reduces the volume of the prostatic transition zone, alleviating compression of the prostatic urethra and improving urinary symptoms.

This new study was initiated to evaluate the safety and efficacy of HIFU for BPH treatment.

Being tested
HIFU
Medical subject headings
Prostatic Hyperplasia

What participants receive

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

  • HIFUDevice

    high-intensity focused ultrasound treatment of benign prostatic hyperplasia

Study groups in NCT06601179
Study groupRoleWhat they receive
HIFUExperimentalNot described
Receives: Device: HIFU

What is being measured

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

  1. Rate of adverse events

    Phase 1

    Presence of significant cavitation that may be associated with adverse effects. Repeated urethral involvement that could damage the urethra. Absence of serious adverse effects (Clavien-Dindo ≥ III) directly attributable to the HIFU treatment procedure at 3 months of follow-up.

    Based on these elements, the scientific committee will analyze the cause-and-effect relationship between the indicators observed during treatment and the adverse effects.

    Measured: 3 months

  2. Rate of patients with two of the following criteria ( Δ Qmax ≥ 50%, Δ IPSS ≥30%, Homogeneous necrosis observed on MRI)

    Phase 1

    Efficacy :

    Efficacy will be considered satisfactory if at least two of the following three conditions are met:

    Significant improvement in the maximum flow defined by Δ Qmax ≥ 50% of the initial flow or by a removal of the urinary catheter or supra-pubic catheter in included patients with urinary retention.

    Improvement in obstructive and irritative symptoms 3 months after treatment, defined by a reduction in the IPSS score defined by Δ IPSS ≥30% Homogeneous necrosis observed on MRI

    Measured: 3 months

  3. Rate of patients that meet the four evaluation criteria (Absence of AD Clavien-Dindo ≥ III + ΔQmax ≥ 50% + Δ IPSS ≥30% + IPSS-QoL score ≤2)

    Phase 2

    Efficacy of the treatment

    To validate phase 2, 80% of patients are expected to meet the four evaluation criteria below after 6 months.

    Evaluation of urinary symptoms, continence, the erectile function, postoperative complications using a composite "tetrafecta" score defined by 4 criteria:

    1. Absence of serious adverse effects relating to the HIFU procedure, Clavien-Dindo ≥ III after 6 months.
    2. Significant improvement in the maximum flow defined by ΔQmax ≥ 50% of the initial flow after 6 months, or by a removal of the urinary catheter after 3 months in included patients with urinary retention.
    3. Improvement in obstructive and irritative symptoms 6 months after treatment, defined by a reduction in the IPSS score defined by Δ IPSS ≥30%
    4. Improvement in quality of life 6 months after treatment defined by an IPSS-QoL score ≤2

    Measured: 6 months

Secondary outcomes (11)
  1. Rate of adverse events

    Treatment safety 1 month, 3 months, 6 months, 12 months, 18 months, 24 months and 36 months after treatment will be evaluated by:

    The rate of patients who experienced at least one adverse event with a Clavien-Dindo grade ≥ III The rate of patients with an SAE linked to the procedure The rate of patients with an SAE linked to the MD The rate of patients with unscheduled consultation and/or secondary re-hospitalization due to problems in connection with the procedure or the MD

    Measured: 36 months

  2. Rate of patients with a significant decrease of prostate size

    The impact of treatment on changes in prostate size will be evaluated by MRI and ultrasound 3 months, 6 months, 12 months after treatment.

    Measured: 36 months

  3. The impact of the HIFU treatment on the urinary flow

    The impact of the HIFU treatment on the urinary flow will be evaluated by measuring Q max 1 month, 3 months, 6 months, 12 months after treatment defined by:

    The rate of patient with ΔQmax ≥ 50% Rate of patients with removal of the urinary catheter after 3 months in included patients with urinary retention.

    The rate of patients with Qmax ≥ 15 ml/s

    Measured: 36 months

  4. Rate of patients with a significant decrease of RPM

    The impact of the HIFU treatment on bladder voiding will be evaluated by measuring RPM 1 month, 3 months, 6 months, 12 months after treatment, defined by:

    The rate of patients with RPM ≤ 150 ml The rate of patients with Δ RPM ≥50%

    Measured: 36 months

  5. The rate of patients with a significant improvment of obstructive and irritative symptoms of the lower urinary tract

    The effect of the treatment on the obstructive and irritative symptoms of the lower urinary tract will be evaluated using the IPSS score 1 month, 3 months, 6 months, 12 months, 24 months and 36 months after treatment, defined by:

    The rate of patients with Δ IPSS ≥30% The rate of patients with an IPSS score ≤ 7

    Measured: 36 months

  6. The rate of patients with a significant improvment of LUTS-related quality of life

    The evaluation of the impact of the HIFU treatment on LUTS-related quality of life 1 month, 3 months, 6 months, 12 months, 24 months and 36 months after treatment, defined by:

    The rate of patients with an IPSS-QoL score ≤ 2

    Measured: 36 months

  7. The rate of patients with an improvment in the erectile function

    The evaluation of the impact of treatment on the erectile function 1 month, 3 months, 6 months, 12 months and 36 months after treatment, defined by:

    The rate of patients with a Δ IIEF score ≤ 5

    Measured: 36 months

  8. The evaluation of the impact of treatment on the ejaculatory function

    The evaluation of the impact of treatment on the ejaculatory function 1 month, 3 months, 6 months, 12 months and 36 months after treatment, defined by:

    The rate of patients with a Δ MSHQ-EjD score < 25 The rate of patients with MSHQ-EJD <10 (no ejaculatory dysfunction or mild dysfunction) The rate of patients who say they suffer from retrograde ejaculation

    Measured: 36 months

  9. The rate of patients with a recurrence over the follow-up period up to 36 months

    The recurrence rate over the follow-up period up to 36 months will be evaluated by the number of patients with urinary retention who required catheterization or surgery for BPH.

    Measured: 36 months

  10. The cost related to the use of HIFU

    The estimation of costs related to the use of HIFU will be carried out by calculating the costs associated with consumables, the time of medical staff directly involved in the procedure, and the duration of hospitalization.

    Measured: 36 months

  11. Efficiency

    Efficiency will be estimated through the consideration of costs associated with HIFU treatment, follow-up costs, retreatments, and the duration of medical leave of absence.

    Measured: 36 months

Timeline

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

  1. First posted19 Sep 2024
  2. Study start23 Aug 2024
  3. Primary completion31 Aug 2028 (estimated)
  4. Study completion31 Aug 2028 (estimated)

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 N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Model description
Phase 1 aims to determine the minimum effective dose for BPH treatment. It will include 10 patients receiving 50% of the standard shooting power. If, after a 3-month follow-up, there are no serious adverse events (SAEs) and good efficacy, Phase 2 will begin. If Phase 1 results indicate that 50% power is insufficient, power levels will be increased by 10% increments (60%, 70%, 80%, 90%) with similar follow-up until the minimum effective dose is determined. Phase 2 aims to validate the effocacy of the minimum effective dose. It will include 90 new patients treated with the same 50% power. They will be monitored regularly after 1 and 3 months, every 6 months up to 24 months, and finally at 36 months.
Masking
None (open label)
Enrolment
100 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06601179
Sponsor's protocol ID
HIFU.F.23.02
Acronym
BPH EFFICACY
Status last verified
Oct 2024
First submitted
8 Jul 2024
Last updated
15 Oct 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing HIFU in people with Benign Prostatic Hyperplasia, run by EDAP TMS S.A. at 9 sites in France.

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 8 inclusion and 12 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: looking for participants now, as of the sponsor's last update on 15 Oct 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 9 sites in France. Whether a site is taking part right now should be confirmed with that site. See every site.

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.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Djamila BENNAT (33472153142, affaires-cliniques@edap-tms.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Rate of adverse events (time frame: 3 months). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 15 Oct 2024.

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