Full Text View
Tabular View
No Study Results Posted
Related Studies
The FIRSTT: Comparing MRgFUS(MR-guided Focused Ultrasound) Versus UAE (Uterine Artery Embolization)for Uterine Fibroids.
This study is currently recruiting participants.
Verified March 2012 by Mayo Clinic

First Received on October 13, 2009.   Last Updated on March 12, 2012   History of Changes
Sponsor: Mayo Clinic
Collaborator: Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Information provided by: Mayo Clinic
ClinicalTrials.gov Identifier: NCT00995878
  Purpose

The primary goal of this study is to compare the safety and effectiveness of two standard fibroid treatments: MRI guided ultrasound surgery (MRgFUS) and uterine artery embolization (UAE). Both treatments are approved by the Food and Drug Administration (FDA) for women who do not plan to become pregnant.

A second goal of this study is to better understand which symptoms bother women with fibroids the most. Understanding and addressing the symptoms of clinically-significant uterine fibroids is important in order to optimize treatment outcomes and control health care costs.

Women who are eligible to participate in the study, are randomized to one of two treatment arms (UAE or MRgFUS). Women in both arms will receive treatment but will not be able to choose which treatment she will receive.

A comprehensive assessment of symptoms-including experienced pain- will take place at baseline, 6 weeks, and at 6, 12, 24, and 36 months following treatment with UAE and MRgFUS.


Condition Intervention Phase
Symptomatic Uterine Leiomyomas
Fibroid
Myomas
 Procedure: Focused ultrasound (MRgFUS)
Procedure: Uterine artery embolization (UAE)
 Phase 4

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
Official Title: The FIRSTT Study: Comparing Focused Ultrasound and Uterine Artery Embolization for Uterine Fibroids

Resource links provided by NLM:

MedlinePlus related topics: Ultrasound
U.S. FDA Resources

Further study details as provided by Mayo Clinic:

Primary Outcome Measures:
  • Symptomatic outcomes measured by validated instruments [ Time Frame: At baseline, 6 weeks and 6, 12, 24, and 36 months following treatment. ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Adverse events following treatment [ Time Frame: At baseline, 6 weeks and 6, 12, 24 and 36 months following treatment. ] [ Designated as safety issue: Yes ]
  • Biologic predictors of outcome [ Time Frame: Blood sample is obtained at baseline and at 24 and 36 months following treatment ] [ Designated as safety issue: No ]

Estimated Enrollment: 180
Study Start Date: October 2009
Estimated Study Completion Date: December 2015
Estimated Primary Completion Date: December 2015 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Active Comparator: Focused Ultrasound (MRgFUS) Procedure: Focused ultrasound (MRgFUS)
MRgFUS treatment will take place in a MRI machine and powerful ultrasound waves go through the abdominal wall to destroy the fibroid or fibroids. No incision is made during this treatment and light sedation is required. There are certain fibroids that may not be treated with this technique and there is no treatment of normal uterine tissue.ough the abdominal wall to destroy the fibroid.
Other Name: ExAblate 2000
Active Comparator: Uterine Artery Embolization (UAE) Procedure: Uterine artery embolization (UAE)
UAE treatment takes place on a regular x-ray machine. A small incision is made where the leg meets the trunk and a small tube is used to use very small pellets to block off the blood supply to the entire uterus. Sedation is used. Most fibroids are treated with this technique and normal uterine tissue is also affected.
Other Names:
  • Uterine Fibroid Embolization
  • UFE

Detailed Description:

Uterine fibroids affect up to 70 to 80% of women and about 30% of women are symptomatic. Over 200,000 hysterectomies are performed each year for uterine fibroids in the USA. The direct health care costs attributable to uterine fibroids exceed $2.1 billion annually. Fibroids are reported to cause a number of symptoms including heavy or prolonged menstrual bleeding, pelvic pressure, pain with menses and bowel and bladder dysfunction. However, fibroid symptomatology is incompletely understood. Understanding and addressing the myomas pain are important in optimizing treatment outcomes and controlling health care costs from a societal perspective. This study proposes to comprehensively assess the changes in pelvic pain and other symptomatic outcomes following treatment with uterine artery embolization (UAE) and magnetic Resonance guided focused ultrasound surgery (MRgFUS).

Clinical and scientific significance of the studies is high. The understanding of initiation of the uterine leiomyomas pain will potentially lead to improved treatment of this disorder.

  Eligibility

Ages Eligible for Study:   25 Years and older
Genders Eligible for Study:   Female
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  1. Women able to give informed consent and willing and able to attend all study visits
  2. Premenopausal women at least 25 years of age
  3. No evidence of High Grade SIL by pap smears or HPV testing within institutional guidelines.

Exclusion Criteria:

  1. Women actively trying for pregnancy or currently pregnant
  2. Uterine size > 20 weeks
  3. Prior myomectomy, UAE, or MRgFUS. Previous hysteroscopic or laparoscopic myomectomy for the removal of only pedunculated leiomyomas (as described in #17, below) will be allowed and evaluated on an individual basis to determine eligibility for treatment.
  4. More than 6 fibroids > than 3 centimeters in maximal diameter
  5. Allergy to either gadolinium or iodinated contrast
  6. Implanted metallic device prohibiting MRI
  7. Severe claustrophobia
  8. BMI which prohibits subject from fitting in MRI device
  9. Severe abdominal scarring precluding safe MRgFUS treatment
  10. Active pelvic infection
  11. Intrauterine contraceptive device in place at the time of treatment
  12. Current use of GnRH agonists or antagonists
  13. Unstable medical conditions requiring additional monitoring during the procedure
  14. Bleeding diathesis requiring medical treatment
  15. Imaging suggestive of malignant disease of uterus, ovary, or cervix
  16. Imaging suggestive of only adenomyosis
  17. Pedunculated submucosal or subserosal myoma with a stalk less than 25% of the maximal fibroid diameter
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00995878

Contacts
Contact: Lisa G. Peterson, RN 507-266-4813 mayofibroids@mayo.edu

Locations
United States, Minnesota
Mayo Clinic Recruiting
Rochester, Minnesota, United States, 55905
Contact: Lisa G. Peterson, RN     507-266-4813     mayofibroids@mayo.edu    
United States, North Carolina
Duke University Health System Recruiting
Durham, North Carolina, United States, 27705
Contact: Jessica Y Houlihan, BA     919-668-2340     Jessica.Houlihan@duke.edu    
Contact: Stacy Murray, BA, CPT     919-681-4556     murra046@mc.duke.edu    
Principal Investigator: Phyllis Leppert, M.D., Ph.D            
Sub-Investigator: Michael Miller, M.D.            
Sponsors and Collaborators
Mayo Clinic
Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)
Investigators
Principal Investigator: Elizabeth A. Stewart, M.D. Mayo Clinic
  More Information

Additional Information:
National Institute of Child Health and Human Development  This link exits the ClinicalTrials.gov site
Mayo Clinic Uterine Fibroids Information  This link exits the ClinicalTrials.gov site
Radiology Society of North America Information on UFE  This link exits the ClinicalTrials.gov site
Focused Ultrasound Foundation on MRgFUS  This link exits the ClinicalTrials.gov site
Mayo Clinic Uterine Fibroid Facebook page sharing educational information related to fibroids.  This link exits the ClinicalTrials.gov site

No publications provided by Mayo Clinic

Additional publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Bouwsma EV, Hesley GK, Woodrum DA, Weaver AL, Leppert PC, Peterson LG, Stewart EA. Comparing focused ultrasound and uterine artery embolization for uterine fibroids-rationale and design of the Fibroid Interventions: reducing symptoms today and tomorrow (FIRSTT) trial. Fertil Steril. 2011 Sep;96(3):704-10. Epub 2011 Jul 27.

Responsible Party: Elizabeth A. Stewart, M.D., Mayo Clinic
ClinicalTrials.gov Identifier: NCT00995878     History of Changes
Other Study ID Numbers: 09-005095, 1RC1HD063312-01
Study First Received: October 13, 2009
Last Updated: March 12, 2012
Health Authority: United States: Institutional Review Board

Keywords provided by Mayo Clinic:
Uterine fibroids
Uterine leiomyomas
Uterine Artery Embolization
UAE
 UFE
Magnetic resonance guided focused ultrasound
MRgFUS
Pelvic pain

Additional relevant MeSH terms:
Leiomyoma
Myofibroma
Myoma
Neoplasms, Muscle Tissue
Neoplasms, Connective and Soft Tissue
 Neoplasms by Histologic Type
Neoplasms
Neoplasms, Connective Tissue
Connective Tissue Diseases

ClinicalTrials.gov processed this record on May 23, 2012



Contact Help Desk
Lister Hill National Center for Biomedical Communications,  U.S. National Library of Medicine,
U.S. National Institutes of Health,  U.S. Department of Health & Human Services,
USA.gov,  Copyright,  Privacy,  Accessibility,  Freedom of Information Act

U.S. National Institutes of Health U.S. National Library of Medicine U.S. Department of Health & Human Services