This is a Phase 2a, single-dose, double-blind, placebo-controlled, 2-way crossover study in men with ED. A single 2 gram dose of SST-6006 topical cream 5% w/w (formulated to deliver 100 mg of sildenafil) or a topical placebo cream will be applied to the penile shaft and glans. There are 4 study phases: the Initial Patient Screening Phase (Visit 1, an Off Site 4-Week Run-in Period and Visit 2), the Final Patient Screening Phase (Visit 3), the SST-6006/Placebo Double-Blind Dosing Phase (Visits 4-5), and the Follow-up Phase. Primary outcomes will be be evaluated at Weeks 7 and 8 of the study
Initial Patient Eligibility: Visit 1 (Day 1) After the patient provides written informed consent, the initial screening procedures will be performed. Patients who meet all eligibility criteria will be instructed on completion of the SEP Diary, the need for a one week washout of any ED medications before starting the Off-Site 4-Week Run-In Period and that the use of any ED medications will be prohibited throughout the entire 4-week duration and up until the completion of Visit 5. Site staff will contact patients by phone between 4 and 7 days following Visit 1 (on Days 4- 7) to communicate eligibility (met laboratory parameters and the one week washout) to participate in the Off-Site 4-Week Run-In Period. Site staff will also schedule the Topical Placebo RigiScan Qualification Visit (Visit 2) to be within two days of completion of the 4-Week Run-In Period for eligible patients. Ineligible patients will be instructed to discard their SEP Diary and will be discontinued from further study participation Off-Site 4-Week Run-In Period (Day 8-35) Eligible patients will participate in an Off-Site 4-Week Run-In Period during which time they will attempt intercourse a minimum of 4 times. Use of any ED medications will be prohibited throughout the entire 4-week duration and up until the completion of Visit 5. Patients will be asked to maintain a Sexual Encounter Profile (SEP) diary during the 4-Week Run-In Period to be completed after each intercourse attempt. Topical Placebo RigiScan Qualification: Visit 2 (Day 36 \[+ 2 days\]) Patients who successfully complete the 4-Week Run-In will be instructed to complete the IIEF questionnaire at the beginning of Visit 2. Eligible patients must have documented mild-moderate ED as demonstrated by a score of 11-21 in the International Index of Erectile Function (IIEF) Erectile Function domain of the IIEF questionnaire. Eligible patients will then complete a single-blind (patient) 60 minute plethysmography procedure using placebo cream to familiarize patients with the plethysmography device (i.e. RigiScan) and evaluate the placebo response with Visual Sexual Stimulation (VSS). Patients who demonstrate a topical placebo response (i.e. achieve an erection of ≥ 60% rigidity at the base of the penis for a cumulative duration of \> 4 minutes) will be ineligible for further study participation. Any patients with an adverse dermatologic reaction to the placebo cream will be excluded from further participation in the study but will be followed until normalization of symptoms. Safety data for all patients, regardless of continued eligibility, will be included in the database as patients will have been exposed to IP (placebo cream only) during this visit. There will be a 7 (± 1) day washout period between Visits 2 and 3. Oral Sildenafil RigiScan Qualification: Visit 3 (Day 43 \[± 2 days\]) Patients who meet the eligibility criteria will then complete the Oral Sildenafil RigiScan Qualification visit, consisting of a single-blind (patient) plethysmography procedure with 60 minutes of VSS to evaluate the patient's response to oral sildenafil. Patients who do not respond to oral sildenafil (i.e., do not achieve ≥ 60% rigidity at the base of the penis for a cumulative duration of \>15 minutes and an EHS Score of 3 or 4) will be excluded from further study participation. There will be a 7 (± 1) day washout period between Visit 3 and Visit 4 (i.e., the first visit in the SST-6006/Placebo Double-Blind Dosing Phase). SST-6006/Placebo Double-Blind Dosing Phase: Visits 4 \& 5 (Days 50 and 57 \[± 2 days\]) Eligible patients will be randomized to a sequence of dosing (i.e., placebo cream then SST-6006 or SST-6006 then placebo cream). The SST-6006/Placebo Double-Blind Dosing Phase will consist of two plethysmography procedures with 60 minutes of VSS. One will evaluate the patient's response to SST-6006 and the other will evaluate the patient's response to placebo cream. Patients will be instructed to complete a 4-Point Erection Hardness Scale (EHS) immediately following completion of the plethysmography procedure at each visit. There will be a 7 (± 1) day wash-out between Visit 4 and Visit 5.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
33
Patients will be instructed to apply pre-weighed SST-6006 to the non-erect penile skin area at the time of dosing. Patients will then massage the cream into the penile shaft and glans for a maximum of 3 minutes.
Patients will be instructed to apply the pre-weighed placebo cream to the non-erect penile skin area at the time of dosing. Patients will then massage the cream into the penile shaft and glans for a maximum of 3 minutes.
During each dosing period, penile plethysmography will be utilized to evaluate efficacy of SST-6006 verses placebo cream. Each plethysmography session will be approximately 75 minutes.This includes a 15 minute 'baseline' period where patients are told to remain in the flaccid state and 60 minutes during which time patients will watch a series of erotic videos.
San Diego Sexual Medicine
San Diego, California, United States
Tulane Medical Center
New Orleans, Louisiana, United States
Manhattan Medical Research
New York, New York, United States
Cumulative duration of ≥ 60% rigidity at the base of the penis during 60 minutes of VSS (SST-6006 compared to placebo cream)
Time frame: 60 minutes
Percentage of patients reporting occurrence of at least one Grade 3 or Grade 4 erection as defined by the EHS (refer to Appendix B) (SST-6006 compared to placebo cream)
Time frame: 60 minutes
Adverse Events
Time frame: From first application of cream (Week 5) through follow-up phone call (Week 9)
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