Title

Efficacy Study of Adalimumab to Treat Interstitial Cystitis
An Investigator Initiated, Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Efficacy of Humira® (Adalimumab) For The Treatment of Interstitial Cystitis(IC)
  • Phase

    Phase 3
  • Study Type

    Interventional
  • Intervention/Treatment

    adalimumab ...
  • Study Participants

    43
The purpose of this study is to evaluate an investigational treatment for interstitial cystitis. Interstitial cystitis is a chronic bladder disease that includes the following symptoms: Urinary frequency during the day,urinary frequency at night, urinary urgency and bladder discomfort relieved by voiding.

Presently, there is no cure for interstitial cystitis. The response to current treatments is poor. Patients with interstitial cystitis have a poorer quality of life. The cause of interstitial cystitis is unknown. This study is evaluating the drug Humira® (adalimumab) for improving the symptoms of patients with interstitial cystitis. Humira® is an injectable anti-inflammatory medication that has been available for use since December 31, 2002. Humira® has been FDA approved for the treatment of rheumatoid arthritis, psoriasis, ankylosing spondylitis, and Crohn's disease. These diseases have similar characteristics to interstitial cystitis. This study will evaluate an investigational use of Humira® for the treatment of interstitial cystitis.
Interstitial cystitis (IC) is a chronic disabling bladder syndrome characterized by urinary frequency, nocturia, urinary urgency, and pain with bladder filling-relieved by emptying. There is no cure for IC and the treatment options are suboptimal. Patients with IC report significant negative effects on their physical and mental quality of life. The etiology of IC is unknown. Certain aspects of IC suggest that autoimmunity may play a role in initiating or sustaining the chronic inflammatory response. Bladder biopsies of patients with IC demonstrate an increase number of mast cells. Mast cell activation with the release of tumor necrosis factor (TNF) may mediate this bladder inflammation. Humira® (adalimumab) is a medication that blocks the effect of TNF. Humira® (adalimumab) is FDA approved for the treatment of rheumatoid arthritis, psoriasis, ankylosing spondylitis, and Crohn's disease. These diseases are similar to IC. In this study, the hypothesis being tested is that Humira® (adalimumab) will show efficacy at reducing the symptoms of IC.
Study Started
Mar 31
2011
Primary Completion
Jun 30
2013
Study Completion
Jul 31
2013
Results Posted
Jul 16
2015
Estimate
Last Update
Jul 16
2015
Estimate

Drug Adalimumab

80 mg loading dose given subcutaneously followed by 40 mg dose given subcutaneously every two weeks over a twelve week period

  • Other names: Humira

Other inactive drug

80 mg loading dose given subcutaneously followed by 40 mg dose given subcutaneously every two weeks over a twelve week period

  • Other names: placebo

adalimumab Experimental

Adalimumab 80mg subcutaneous loading dose followed by 40 mg subcutaneous every 2 weeks for 12 weeks

Inactive drug Placebo Comparator

Placebo in identical syringe subcutaneous every 2 weeks for 12 weeks

Criteria

Inclusion Criteria:

Males or females ≥18 and ≤ 65 years of age previously diagnosed with Interstitial Cystitis
Currently have symptoms of urinary urgency, frequency or pain for more than 6 months
Urinating at least 7 times a day or having some urgency or pain (measured on linear analog scales)
Must be post-menopausal or surgically sterile or willing to use an adequate form of birth control
Not pregnant or lactating
Capable of voiding independently
Willing to provide informed consent to participate

Exclusion Criteria:

Have symptoms that are presently relieved on other medications for interstitial cystitis
Have absence of nocturia
Have symptoms that are relieved by antimicrobials or antibiotics.
Have a body mass index (BMI) of >39 kg/m2
Have uncontrolled hypertension
Have Type I or type 2 diabetes
Have active Hepatitis B, Hepatitis C, or Human Immunodeficiency Virus (HIV) infection, or who are known carriers (Hepatitis B) at Screening
Have a positive tuberculosis test at screening
Have had a urinary tract infection for 6 weeks
Have had bacterial cystitis in previous 3 months
Have had previous exposure to Humira® (adalimumab)
Have taken investigational medication within 30 days of screening
Have any other condition/disease which, in the opinion of the investigator, could compromise subject safety or confound the interpretation of study results
Are unable or unwilling to comply with protocol requirements

Summary

Inactive Drug

Adalimumab

All Events

Event Type Organ System Event Term Inactive Drug Adalimumab

O'Leary-Santa Interstitial Cystitis Symptom Index and Problem Index (OSPI) Score

Improvement in the O'Leary Sant Symptom and Problem Index from baseline to week 12 Total scores on a scale range: 0-36 (0, meaning no symptoms to 36, meaning the most severe symptoms)

Inactive Drug

Baseline

27.7
units on a scale (Mean)
Standard Deviation: 4.9

Week 12

19.6
units on a scale (Mean)
Standard Deviation: 10.7

Adalimumab

Baseline

27.8
units on a scale (Mean)
Standard Deviation: 3.9

Week 12

19.9
units on a scale (Mean)
Standard Deviation: 7.5

Interstitial Cystitis Symptom Index (ICSI)

Improvement in O'Leary Sant Interstitial Cystitis Symptom Index (ICSI) Total scores on a range scale: 0-20 (0, meaning no symptoms, to 20, meaning the most severe symptoms)

Inactive Drug

Baseline

14.2
units on a scale (Mean)
Standard Deviation: 3.1

Week 12

10.5
units on a scale (Mean)
Standard Deviation: 5.7

Adalimumab

Baseline

14.0
units on a scale (Mean)
Standard Deviation: 2.7

Week 12

10.0
units on a scale (Mean)
Standard Deviation: 4.2

Interstitial Cystitis Problem Index (ICPI)

Improvement in O'Leary Sant Interstitial Cystitis Problem Index (ICPI) Total scores on a scale: 0-16 (0, meaning no symptoms, to 16, meaning the most severe symptoms)

Inactive Drug

Baseline

13.5
units on a scale (Mean)
Standard Deviation: 2.2

Week 12

9.1
units on a scale (Mean)
Standard Deviation: 5.1

Adalimumab

Baseline

13.8
units on a scale (Mean)
Standard Deviation: 1.7

Week 12

9.9
units on a scale (Mean)
Standard Deviation: 3.6

Pelvic Pain Urgency/Frequency (PUF) Score

Pelvic Pain, Urgency/Frequency Symptom Scale Total scores on a scale range: 0-35 (0, meaning no symptoms, to 35, meaning the most severe symptoms)

Inactive Drug

Baseline

24.2
units on a scale (Mean)
Standard Deviation: 3.9

Week 12

17.3
units on a scale (Mean)
Standard Deviation: 8.7

Adalimumab

Baseline

24.6
units on a scale (Mean)
Standard Deviation: 4.1

Week 12

18.3
units on a scale (Mean)
Standard Deviation: 6.9

Global Response Assessment (GRA)

Percent(%) of patients who reported 50% or greater overall improvement in their condition. Score on a scale range (improvement 0%-100%)

Inactive Drug

50.0
percentage of participants

Adalimumab

53.0
percentage of participants

Total

43
Participants

Age, Continuous

45.9
years (Mean)
Standard Deviation: 13.7

Age, Categorical

Region of Enrollment

Sex: Female, Male

Overall Study

Inactive Drug

Adalimumab

Drop/Withdrawal Reasons

Inactive Drug

Adalimumab