Actively Recruiting

Phase 2
Phase 3
Age: 45Years - 75Years
MALE
ID03701581

4-aminopyridine Treatment for Nerve Injury Resulting From Radical Retro-Pubic Prostatectomy

Led by John Elfar · Updated on 2025-12-17

70

Participants Needed

2

Research Sites

74 weeks

Total Duration

On this page

AI-Summary

What this Trial Is About

Researchers are studying the potential effects of 4-aminopyridine (4-AP) on recovery after peripheral nerve injuries caused by traction or crush. The study focuses on men with prostate cancer undergoing robot-assisted radical prostatectomy, as nerve injury during this surgery may lead to erectile dysfunction and urinary continence issues. This research aims to test whether 4-AP can speed up the often slow and unpredictable recovery process after such nerve injuries. Participants will receive either FDA-approved 10 mg 4-aminopyridine tablets or placebo tablets after surgery. The medication is taken orally, with a maximum of two tablets per 24 hours, and must be swallowed whole without breaking or crushing. The treatment period lasts for 60 days following surgery. The placebo is designed to look like the active drug, and participants will be reminded not to take other aminopyridine medications during the study. Throughout the study, participants will be monitored for changes in urinary incontinence and erectile function using standardized questionnaires every seven days for six months. They will also keep a daily drug diary for 90 days and complete sexual activity questionnaires regularly. The study includes follow-up for up to one year to assess recovery progress and safety. The total participation time involves regular assessments and monitoring after the surgery.

CONDITIONS

Brief Title

4-aminopyridine Treatment for Nerve Injury

Who Can Participate

Age: 45Years - 75Years
MALE

Eligibility Criteria

Eligible

You may qualify if you...

  • Male patients with organ-confined, non-metastatic prostate cancer (stages cT1c-T2c) planning robotic-assisted laparoscopic bilateral nerve sparing radical prostatectomy
  • Prostate-Specific Antigen (PSA) levels less than 15 ng/ml within the last 12 months
  • Biopsy-proven prostate cancer with no expected need for postoperative adjuvant therapy
  • Age between 45 and 75 years
  • Abridged International Index of Erectile Function-Erectile Function (IIEF-5) score of 17 or higher at screening
  • At least 6 months of regular sexual activity and sexual activity during the 12 weeks prior to prostate biopsy or surgery
  • Willingness to abstain from erectile dysfunction treatments until 3 months after surgery
  • Able and willing to provide informed consent
Not Eligible

You will not qualify if you...

  • Planned adjuvant therapy after surgery based on pathology or cancer stage (stage T3 or greater), positive lymph nodes, or positive surgical margins
  • Neo-adjuvant therapy before surgery
  • History of recurrent prostate cancer
  • History of seizures, multiple sclerosis, stroke, or other neurological disorders
  • History of non-organ confined or metastatic prostate cancer (stage T3 or greater)
  • Known allergy or hypersensitivity to 4-aminopyridine
  • History of penile surgery other than circumcision or endoscopic urethral stricture surgery
  • Renal impairment with calculated GFR less than 60 mL/min
  • Use of other aminopyridine medications for any indication

AI-Screening

AI-Powered Screening

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Your Study Journey

Screening

Duration - 2 to 4 weeks

Participants are screened for eligibility to participate in the trial.

Treatment

Duration - 2 months (60 days)

Participants receive either 4-aminopyridine or placebo daily starting the day after surgery, continuing for 2 months (60 days).

Daily dosing throughout treatment period

Follow-up

Duration - 6 months

Participants are monitored with questionnaires and assessments starting 7 days after surgery and continuing weekly for 6 months to evaluate recovery and symptoms.

Weekly visits for up to 6 months (up to 25 visits)

Trial Site Locations

Total: 2 locations

1

University of Arizona

Tucson, Arizona, United States, 85724

Actively Recruiting

2

University of Rochester

Rochester, New York, United States, 14602

Terminated

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Research Team

A

Andrea Horne

How is the study designed?

Study Type

INTERVENTIONAL

Masking

QUADRUPLE

Allocation

RANDOMIZED

Model

PARALLEL

Primary Purpose

TREATMENT

Number of Arms

2

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Published Research Related To This Trial

4-Aminopyridine treatment for nerve injury resulting from radical retro-pubic prostatectomy: a single-center double-blind, randomized, placebo-controlled study.

Ahmed Ghazi, Thomas L Osinski, Changyong Feng...

https://pubmed.ncbi.nlm.nih.gov/38773595