Iltamiocel Autologous Cell Therapy for the Treatment of Female Stress Urinary Incontinence: A Double‐Blind, Randomized, Stratified, Placebo‐Controlled Trial

• Published in: Neurourology and urodynamics 2024-11, Vol.43 (8), p.2290-2299
• Main Authors: Kaufman, Melissa R., Goldman, Howard B., Chermansky, Christopher J., Dmochowski, Roger, Kennelly, Michael J., Peters, Kenneth M., Quiroz, Lieschen H., Bennett, Jason B., Thomas, Sherry, Marguet, Charles G., Benson, Kevin D., Lee, Una J., Sokol, Eric R., Wolter, Christopher E., Katz, Daniel M., Tarnay, Christopher M., Antosh, Danielle, Heit, Michael H., Rehme, Christian, Karram, Mickey, Snyder, Scott, Canestrari, Emanuele, Jankowski, Ron J., Chancellor, Michael B.
• Format: Article
• Language: English
• Subjects: autologous myoblasts; Cell therapy; Females; Patients; Placebos; Population studies; regenerative medicine; skeletal muscle cells; stress urinary incontinence; Surgery; Urinary incontinence
• ISSN: 0733-2467; 1520-6777; 1520-6777
• DOI: 10.1002/nau.25588

ABSTRACT Aims This study aimed to determine the efficacy and safety of iltamiocel investigational autologous muscle cell therapy in females with stress urinary incontinence (SUI). Methods Adult females were randomized 2:1 to iltamiocel (150 × 106 cells) or placebo and stratified by severity and prior SUI surgery. The primary objective was efficacy based on the frequency of stress incontinence episodes (SIE) recorded in a 3‐day diary at 12 months posttreatment. After 12 months, placebo participants could elect to receive open‐label iltamiocel. Efficacy and safety analyses were performed using all patients as treated populations. Results The study enrolled 311 patients, 297 were randomized to either iltamiocel (n = 199) or placebo (n = 98). Of the 295 participants that completed 12 months blinded follow‐up, the proportion achieving the primary endpoint of ≥ 50% SIE reduction was not statistically different between treatment groups (52% vs. 53.6%; p = 0.798). A significantly greater proportion of iltamiocel participants in the prior SUI surgery stratum group achieved ≥ 75% SIE reduction compared with placebo, (40% vs. 16%; p = 0.037). Treatment response was maintained at 24 months in 78.4% and 64.9% of iltamiocel participants who achieved ≥ 50% and ≥ 75% SIE reduction, respectively, at Month 12. Adverse events related to the treatment were reported in 19 (9.5%) iltamiocel participants and 6 (6.1%) placebo participants. Conclusion The study did not meet its primary endpoint however, iltamiocel cell therapy is safe and may be ideally suited to female patients who have undergone prior surgery for SUI. Additional study in this group of patients with high unmet medical needs is warranted. Trial Registration ClinicalTrials.gov identifier: NCT01893138; EudraCT number: 2014‐002919‐41.