Ignite Creation Date:
2024-05-06 @ 6:07 PM
Last Modification Date:
2024-10-26 @ 2:42 PM
Study NCT ID:
NCT05551949
Status:
ACTIVE_NOT_RECRUITING
Last Update Posted:
2023-10-19
First Post:
2022-09-20
Brief Title:
Preventing Recurrent UTI With Vaginal Estrogen
Sponsor:
Johns Hopkins University
Organization:
Johns Hopkins University
Study Overview
Official Title:
Mechanisms of Successful Vaginal Estrogen Prophylaxis for Postmenopausal Women With Recurrent Urinary Tract Infections Urogenital Microbiota and Host Immune Responses
Status:
ACTIVE_NOT_RECRUITING
Status Verified Date:
2024-10
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
PRUVE
Brief Summary:
Among postmenopausal women who suffer from recurrent urinary tract infections UTI vaginal estrogen therapy prevents UTI recurrences for 50 of sufferers This research will investigate why some women benefit but others do not focusing on a the effects of vaginal estrogen therapy on the bacteria that inhabit the vagina and bladder b its influence on immune responses in both compartments and c the extent to which those changes are critical to successful UTI prevention The findings will be a first step in the development of more effective strategies to prevent UTI one of the most common and costly benign urologic conditions
Detailed Description:
Recurrent urinary tract infections rUTI are a significant problem among older women 13 of female Medicare beneficiaries experience at least one UTI annually and 40 of these develop chronic recurrent UTI Although UTIs are significantly reduced by vaginal estrogen therapy VET 50 of those using VET continue to experience UTI recurrences It is unknown why some women benefit from VET while others do not This application focuses on interrogating two mechanisms likely to be central to the effectiveness of VET The first is the urogenital microbiota an increase in vaginal lactobacilli is the purported mechanism by which VET reduces rUTI Important and unanswered questions include how VET influences specific Lactobacillus spp whether changes to specific Lactobacillus spp are the key to successful prophylaxis and how VET affects the urinary microbiota A second mechanism addressed by this application is the host vaginal and urinary immune response Estrogen appears to influence localized urogenital immune responses including Th17 and Th1 versus Th2 pathway signaling Animal studies suggest that these compartmentalized immune responses play a critical role in UTI susceptibility but human data are lacking This application will address these unanswered questions Postmenopausal women with rUTI will be treated with VET Samples collected before and after VET will characterize vaginal and urinary microbiota soluble mediators of inflammation in both compartments and vaginal D-lactic acid Aims 1 and 2 of this proposal will investigate the impact of VET on the urogenital microbiota and urogenital immune responses respectively Aim 3 will characterize the urogenital environments of participants who continue to experience rUTI during VET versus those who remain UTI-free The accomplishment of these aims will provide pilot data for a larger and more definitive clinical trial These proposed studies are a key step toward the investigators goals of identifying biomarkers that reliably predict a successful response to rUTI prophylaxis and ascertaining the biological conditions required for successful UTI prevention Ultimately an understanding of the mechanisms of rUTI prevention will allow the development of novel and effective prevention strategies for postmenopausal women suffering from rUTI
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
True
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
True
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| R01DK130856 | NIH | None | httpsreporternihgovquickSearchR01DK130856 |