This pilot study evaluates the safety and tolerability of a single injection of collagenase enzyme directly into a uterine fibroid in subjects already selected for hysterectomy or myomectomy. Fibroids contain excessive amounts of collagen and it is possible that digestion of collagen may be beneficial in reducing pain and bleeding associated with fibroids. Three subjects will be injected with saline only to evaluate the safety and effectiveness of the injection method. Additional subjects will then be injected with increasing doses of study drug.
Collagenase enzyme breaks down collagen and has shown efficacy in clinical trials for a number of diseases for which there is an accumulation of collagen. It is possible that lysis of collagen may reduce the collagen content of fibroids thus decreasing the size of fibroids, and possibly reducing the stiffness of fibroids. This may result in reducing the symptoms of pain and bleeding associated with fibroids. In this study three subjects will be injected with saline only followed immediately by hysterectomy in order to evaluate the safety and effectiveness of the injection method. Twelve subjects will receive a single injection of study drug as follows: three subjects will receive a set dose of collagenase enzyme followed by hysterectomy or myomectomy 24-96 hours later (Group 1) to evaluate safety of the injection of study drug. Nine subjects will then receive increasing doses of collagenase enzyme followed by hysterectomy or myomectomy 60-90 days later (Group 2).
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
15
Johns Hopkins Hospital
Baltimore, Maryland, United States
Number of participants with treatment-related adverse events following a single injection of EN3835 into a fibroid
Assessed by number of subjects with uterine injury or peritoneal irritation determined post hysterectomy
Time frame: Through hysterectomy or myomectomy (average = 60-90 days post injection)
Change in symptoms of pain and bleeding and quality of life
Determined by standardized questionnaires for menstrual distress, quality of life and sexual activity; McGill Pain Questionnaire
Time frame: Throughout the study prior to hysterectomy or myomectomy(avg 60-90 days post injection study drug)
Reduction in size of treated fibroids- Group 2
Size of fibroid to be determined post hysterectomy or myomectomy
Time frame: 60-90 days post injection study drug
Increased rate of apoptosis of treated fibroids -Group 2
Specimens to be taken post hysterectomy or myomectomy and evaluated by TUNEL staining
Time frame: 60-90 days post injection study drug
Reduction in collagen content of treated fibroids-Group 2
Specimens to be taken post hysterectomy or myomectomy and by tested histology stains
Time frame: 60-90 days post injection study drug
Reduction in stiffness of treated fibroid-Group 2
Specimens to be taken post hysterectomy or myomectomy and tested via rheometry
Time frame: 60-90 days post injection study drug
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.