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| ID | Type | Description | Link |
|---|---|---|---|
| R01DK083609 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) | NIH |
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The objective of this study is to evaluate inhibition of mast cells and the histamine 1 receptor (H1R) for treatment of chronic prostatitis (CP) and chronic pelvic pain syndrome (CPPS).
Chronic pelvic pain is a hallmark of patients with CPPS, a non-bacterial category of prostatitis that is a significant source of morbidity in men. The cause of CPPS is unknown and there is a lack of biomarkers for diagnosis of this syndrome. Research in animal models of CP/CPPS have pointed to a role for mast cells and their degranulation constituents including mast cell tryptase in the development of pelvic pain and lower urinary tract symptoms. This study aims to evaluate the ability of FDA approved and marketed drugs to inhibit the release of mast cell tryptase and to ameliorate symptoms in patients with CP/CPPS.
This is an open label study to evaluate the efficacy of Cromolyn Sodium Oral Solution and Cetirizine hydrochloride (tablet) in men with CP/CPPS to reduce mast cell tryptase levels in expressed prostatic fluids and to show improvement in symptoms of CP/CPPS. There is no control group for the study. The difference between pre- and post-treatment levels across individuals will be assessed.
The study will consist of 3 periods: the Screening Period (Days -7 to -1), the Treatment Period (Days 1 to 21), and the Follow-up Period (7 days) after the last dose at Day 21.
During screening, subjects will be admitted to the clinic, undergo specimen (Expressed prostatic secretions (EPS), urine and blood) collection and recording of their baseline questionnaire responses Subjects will provide a basic health history, including current general health, adverse events, medications or treatments within the past 5 years. A physical examination including vital heart rate, breathing rate, blood pressure, temperature, height, weight and body mass will be taken. Subsequently, EPS from eligible subjects will be collected by the clinical team and assayed for the levels of mast cell tryptase within 24 hours of sample collection at the screening visit. 20 subjects with elevated mast cell tryptase will be identified and will be eligible for receiving the study medication from the Investigational pharmacy at Northwestern University.
Eligible subjects will be required to take medication for days 1-21 (Week 1-3), record their symptom scores weekly using the NIH-CPSI, and record all safety related symptoms.
Subjects will return to the clinic after the completion of three weeks of treatment. Expressed prostatic secretions (EPS), blood as well as a voided bladder 1, 2 and 3 (VB1-3) urine specimens will be collected as at baseline and after the last dose at day 21 for evaluating mast cell tryptase levels. A review subject's general health, adverse events, and any medications that have changed since the last visit will be collected. Vital signs (heart rate, breathing rate, blood pressure, temperature, weight and BMI will be collected.
Treated subjects will be contacted by phone 7 days after treatment by the study coordinator to follow up on any study related adverse effects or changes in symptoms.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Treatment arm | Experimental | Treated arm with cromolyn sodium and cetirizine hydrochloride |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cromolyn Sodium | Drug | Mast cell stabilizer |
|
|
| Measure | Description | Time Frame |
|---|---|---|
| Mast cell tryptase levels in expressed prostatic secretions | Changes in Mast cell tryptase at the end of treatment compared to levels observed before administration of the study drug. | 3 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| NIH-CPSI score | Change in pelvic pain, urinary symptoms and quality of life after treatment | 3 weeks |
| AUA-SI score | Change in symptoms of lower urinary tract dysfunction after treatment |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Praveen Thumbikat, PhD | Northwestern University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Northwestern Medical Faculty Foundation | Chicago | Illinois | 60611 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 22341813 | Result | Done JD, Rudick CN, Quick ML, Schaeffer AJ, Thumbikat P. Role of mast cells in male chronic pelvic pain. J Urol. 2012 Apr;187(4):1473-82. doi: 10.1016/j.juro.2011.11.116. Epub 2012 Feb 17. | |
| 24686526 | Result | Murphy SF, Schaeffer AJ, Thumbikat P. Immune mediators of chronic pelvic pain syndrome. Nat Rev Urol. 2014 May;11(5):259-69. doi: 10.1038/nrurol.2014.63. Epub 2014 Apr 1. |
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| ID | Term |
|---|---|
| D011472 | Prostatitis |
| D059350 | Chronic Pain |
| D017699 | Pelvic Pain |
| ID | Term |
|---|---|
| D011469 | Prostatic Diseases |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
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| ID | Term |
|---|---|
| D004205 | Cromolyn Sodium |
| D017332 | Cetirizine |
| ID | Term |
|---|---|
| D002867 | Chromones |
| D001578 | Benzopyrans |
| D011714 | Pyrans |
| D006573 | Heterocyclic Compounds, 1-Ring |
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Comparison of mast cell tryptase levels and changes in symptom scores after treatment with cromolyn sodium and cetirizine hydrochloride
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| Cetirizine Hydrochloride | Drug | Histamine receptor antagonist |
|
|
| 3 weeks |
| 24726923 | Result | Roman K, Done JD, Schaeffer AJ, Murphy SF, Thumbikat P. Tryptase-PAR2 axis in experimental autoimmune prostatitis, a model for chronic pelvic pain syndrome. Pain. 2014 Jul;155(7):1328-1338. doi: 10.1016/j.pain.2014.04.009. Epub 2014 Apr 13. |
| D052801 |
| Male Urogenital Diseases |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D006571 |
| Heterocyclic Compounds |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006919 | Hydroxyzine |
| D010879 | Piperazines |