Study of Adalimumab Effects on Benign Prostatic Hyperplasia Symptoms and Prostate Inflammation in Men Aged 45 to 80
Led by Endeavor Health · Updated on 2024-11-21
70
Participants Needed
1
Research Sites
8 weeks
Total Duration
AI-Summary
What this Trial Is About
Researchers are evaluating the effects of a drug called adalimumab, which blocks tumor necrosis factor TNF, in men with benign prostatic hyperplasia BPH, a condition involving prostate enlargement and inflammation. The study aims to see if this anti-inflammatory treatment can relieve symptoms, reduce prostate size, and lower inflammation in men with BPH who do not have autoimmune diseases. Researchers also seek to identify genetic factors that might predict how patients respond to this therapy.
Participants will be randomly assigned to receive either adalimumab at a dose of 40 mg by subcutaneous injection every two weeks for a total of six doses or a placebo injection of saline on the same schedule. The study includes a treatment period of 12 weeks followed by monitoring to assess outcomes. The use of adalimumab in this context is investigational, as it is not approved for BPH but is commonly used for autoimmune diseases.
During the study, participants will complete symptom questionnaires, provide medical information, and undergo assessments including measurement of prostate volume, urinary flow rates, and inflammation markers. Researchers will monitor safety using a standardized grading system throughout the 24-week study period. The total study duration includes initial treatment, follow-up visits, and outcome evaluations to understand the drugs impact on BPH symptoms and prostate health.
CONDITIONS
Brief Title
Effects of TNF Blockade on Human BPH/LUTS
Research Team
M
Malgorzata Antoniak, Ph.D.
P
Pooja Talaty, MS MHA CCRP
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National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Collaborating Sponsor
How This Trial Compares With Other Options
This table compares participation in this trial with other options available for this condition. The information is drawn from published research and the trial’s study details and is provided for educational purposes only.
Factors
Adalimumab (Trial Arm)
Placebo (Trial Arm)
Current Medical Therapy (External Context)
What is it?
Adalimumab is a monoclonal antibody therapy targeting tumor necrosis factor (TNF), administered by subcutaneous injection every 2 weeks for six doses.
The placebo group receives matching injections without active medication, mimicking the adalimumab schedule.
Oral medical therapy with doxazosin (an alpha blocker) and/or finasteride (a 5-alpha reductase inhibitor) is established as a standard treatment for symptomatic BPH in this population.
Role in the trial
Active treatment arm: all participants receive adalimumab as anti-TNF therapy.
Control arm: participants receive placebo injections.
Not part of the trial; medical therapy is the current treatment offered in real-world care for eligible BPH patients.
Primary use or purpose
Studied to see if TNF blockade with adalimumab improves urinary symptoms and reduces prostatic inflammation in men with BPH.
Serves as a rigorously controlled comparison for symptom changes, safety, and inflammation in the absence of active anti-TNF treatment.
Used to relieve lower urinary tract symptoms and reduce risk of urinary retention or need for surgery in men with BPH.
How it is given/performed
Subcutaneous injection of 40mg adalimumab every two weeks for a total of 6 doses over 12 weeks.
Subcutaneous injections without active medication, given on the same schedule as adalimumab.
Oral tablets taken daily; doxazosin and finasteride are usually prescribed at guideline-recommended doses for ongoing symptom management.
Evidence maturity / published evidence
No published results yet for TNF blockade with adalimumab in BPH; the study is ongoing. Prior evidence for adalimumab in BPH is limited to preclinical models and rationale papers.
Placebo-controlled trials ensure rigorous assessment of treatment effects; the placebo arm itself does not improve symptoms beyond natural variability or expectation effects.
Long-term trials confirm significant symptom reduction and lower risk of acute urinary retention and surgery with doxazosin and/or finasteride in men with moderate/severe BPH.
Important limitations
Safety and effectiveness of adalimumab for BPH are not yet established; risks include infection and rare reported adverse reactions seen with anti-TNF drugs in other diseases. Study population excludes those with infection or immunosuppression.
Placebo does not provide symptom relief beyond expectation effects. Limited to study-specific role, and not used as a treatment outside clinical trials.
Alpha blockers and 5-alpha reductase inhibitors may cause low blood pressure, sexual dysfunction, or other side effects. Some patients may not respond or may experience adverse effects that require different management.
Disclaimer: This comparison is created with the help of artificial intelligence(AI) and may contain errors or missing information. It is not medical advice and does not mean one option is better or safer than another. Clinical trials are still being studied, and joining a trial is your choice. Please consult your healthcare professional before making any decisions.
Who Can Participate
Age: 45Years - 80Years
MALE
Eligibility Criteria
You may qualify if you...
Male sex
Age 45-80 years
Diagnosed by physician with benign prostatic hyperplasia (BPH)
Prostate volume 60 mL
International Prostate Symptom Score (IPSS) 8
Able and willing to complete questionnaires
Able and willing to provide informed consent
Able to read, write, and speak in English
No prior treatment with TNF inhibitors such as adalimumab, etanercept, infliximab, certolizumab, or golimumab
No plans to move from study area in the next 6 months
You will not qualify if you...
Female sex or intersex
Age less than 45 or greater than 80 years
Being a prisoner or detainee
Urinary retention requiring catheterization
Gross hematuria
Contraindication to adalimumab treatment (e.g., active infection, tuberculosis, hepatitis B, fungal infection, lymphoma, leukemia, other malignancy, congestive heart failure, hematologic abnormalities, allergy to adalimumab or components, anti-drug antibodies)
Pelvic or endoscopic genitourinary surgery within past 6 months (excluding diagnostic cystoscopy)
History of pelvic or lower urinary tract malignancy including prostate cancer; history of pelvic radiation therapy
Ongoing symptomatic urethral stricture
Current chemotherapy or other cancer therapy
Severe neurological or psychiatric disorders preventing participation (e.g., bipolar disorder, psychotic disorder, Alzheimer's disease)
Current moderate or severe substance use disorder
Your Study Journey
Screening
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Treatment
Duration - Approximately 12 weeks
Participants receive adalimumab or placebo injections every 2 weeks to evaluate effects on BPH symptoms and inflammation.
6 visits every 2 weeks (in-person injections)
Follow-up
Duration - Up to 12 weeks after treatment completion (through Week 24)
Participants are monitored for safety and symptom changes after the treatment period ends.
Visits for assessments up to Week 24
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
BASIC_SCIENCE
Number of Arms
2
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