Phase 3
N=2,174
A Trial Comparing Combination Treatment (Solifenacin Plus Mirabegron) With One Treatment Alone (Solifenacin)
Urinary Bladder Diseases · Urinary Bladder Overactive · Urologic Diseases
Bottom Line
View on ClinicalTrials.gov: NCT01908829 ↗Enrolled (actual)
2,174
Serious AEs
1.8%
Results posted
Oct 2017
Primary outcome: Primary: Change From Baseline to End of Treatment (EoT) in Mean Number of Incontinence Episodes Per 24 Hours — -1.8; -1.53; -1.67 incontinence episodes — p==0.001
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- mirabegron 25 mg (Drug); mirabegron 50 mg (Drug); solifenacin 5 mg (Drug); solifenacin 10 mg (Drug); mirabegron 25 mg matching placebo (Drug); mirabegron 50 mg matching placebo (Drug); solifenacin 5 mg matching placebo (Drug); solifenacin 10 mg matching placebo (Drug)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Astellas Pharma Europe Ltd.
- Primary completion
- Nov 2014
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Change From Baseline to End of Treatment (EoT) in Mean Number of Incontinence Episodes Per 24 Hours |
-1.8; -1.53; -1.67 | =0.001 sig |
| SECONDARY Change From Baseline to Weeks 4, 8 & 12 in Mean Number of Incontinence Episodes Per 24 Hours |
-1.24; -0.91; -1.12; -1.68; -1.29; -1.49 | <0.001 sig |
| SECONDARY Change From Baseline in Mean Number of Micturitions Per 24 Hours |
-0.95; -0.69; -0.79; -1.36; -0.94; -1.00 | =0.010 sig |
| SECONDARY Number of Incontinence Episodes Reported During the 3-Day Diary |
5.81; 6.68; 6.41; 4.55; 5.43; 5.28 | =0.005 sig |
| SECONDARY Change From Baseline in Mean Volume Voided (MVV) Per Micturition |
15.06; 11.20; 14.99; 25.21; 14.02; 21.08 | <0.078 |
| SECONDARY Change From Baseline to EoT in Corrected Micturition Frequency (CMF) |
-0.96; -0.52; -0.71 | =0.003 sig |
| SECONDARY Change From Baseline in Mean Number of Urgency Incontinence (UI) Episodes Per 24 Hours |
-1.26; -0.91; -1.14; -1.70; -1.25; -1.45 | <0.001 sig |
| SECONDARY Number of UI Episodes Reported During the 3-Day Diary |
4.96; 5.86; 5.50; 3.55; 4.76; 4.50 | =0.003 sig |
| SECONDARY Change From Baseline in Mean Number of Urgency Episodes (Grade 3 and/or 4) Per 24 Hours |
-1.84; -1.39; -1.74; -2.64; -2.00; -2.29 | =0.001 sig |
| SECONDARY Change From Baseline in Mean Number of Pads Per 24 Hours |
-1.12; -0.86; -1.04; -1.50; -1.17; -1.36 | =0.008 sig |
| SECONDARY Number of Pads Used During the 3-Day Diary |
4.80; 5.69; 5.41; 3.64; 4.71; 4.50 | =0.545 |
| SECONDARY Change From Baseline in Mean Number of Nocturia Episodes |
-0.28; -0.27; -0.29; -0.37; -0.35; -0.37 | =0.836 |
| SECONDARY Number of Nocturia Episodes Reported Over 3-Day Diary |
3.63; 3.59; 3.58; 3.33; 3.35; 3.32 | =0.993 |
| SECONDARY Number of Participants With Change From Baseline to EoT in Euroqol European Quality of Life-5 Dimensions (EQ-5D) Subscale Score: Mobility |
409; 370; 374; 33; 35; 36 | — |
| SECONDARY Number of Participants With Change From Baseline to EoT in EQ-5D Subscale Score: Self-care |
548; 541; 548; 28; 26; 25 | — |
| SECONDARY Number of Participants With Change From Baseline to EoT in EQ-5D Subscale Score: Usual Activities |
397; 384; 379; 38; 30; 42 | — |
| SECONDARY Number of Participants With Change From Baseline to EoT in EQ-5D Subscale Score: Pain/Discomfort |
299; 290; 283; 45; 62; 51 | — |
| SECONDARY Number of Participants With Change From Baseline to EoT in EQ-5D Subscale Score: Anxiety/Depression |
322; 300; 307; 43; 39; 43 | — |
| SECONDARY Change From Baseline in Overactive Bladder Symptom (OAB-q) Symptom Bother Score |
-16.68; -13.79; -15.82; -22.86; -18.36; -19.34 | =0.002 sig |
| SECONDARY Change From Baseline in OAB-q Health-Related Quality of Life (HRQL) Total Score |
12.95; 11.03; 12.44; 17.58; 15.26; 14.60 | =0.021 sig |
| SECONDARY Change From Baseline in OAB-q HRQL Subscale Score: Coping |
15.17; 12.27; 14.25; 20.82; 17.47; 16.87 | =0.003 sig |
| SECONDARY Change From Baseline in OAB-q HRQL Subscale Score: Concern |
13.79; 11.85; 13.82; 18.87; 16.36; 15.88 | =0.044 sig |
| SECONDARY Change From Baseline in OAB-q HRQL Subscale Score: Sleep |
11.58; 11.04; 11.16; 16.18; 14.57; 13.72 | =0.575 |
| SECONDARY Change From Baseline in OAB-q HRQL Subscale Score: Social Interaction |
9.58; 7.85; 8.95; 11.93; 10.84; 10.16 | =0.037 sig |
| SECONDARY Change From Baseline in Treatment Satisfaction - Visual Analogue Scale (TS-VAS) Score |
1.2; 0.8; 1.1; 1.5; 1.2; 1.3 | <0.001 sig |
| SECONDARY Change From Baseline in Patient Perception Bladder Control (PPBC) Score |
-0.9; -0.6; -0.7; -1.2; -1.0; -1.0 | <0.001 sig |
| SECONDARY Number of Participants in Each Category of Patient and Clinician Global Impression of Change Scales (PGIC and CGIC) |
227; 152; 171; 257; 264; 284 | — |
| SECONDARY Percentage of Participants With at Least a 50% Decrease From Baseline in Mean Number of Incontinence Episodes Per 24 Hours |
52.5; 43.3; 49.0; 66.9; 57.6; 61.8 | <0.001 sig |
| SECONDARY Percentage of Participants With Zero Incontinence Episodes Postbaseline |
23.5; 20.0; 22.1; 40.4; 31.6; 34.3 | =0.119 |
| SECONDARY Percentage of Participants With a Mean of at Least 8 Micturitions Per 24 Hours at Baseline and Less Than 8 Micturitions Per 24 Hours Postbaseline |
21.0; 18.7; 20.2; 28.1; 22.4; 26.3 | =0.305 |
| SECONDARY Percentage of Participants With at Least a 10-Point Improvement From Baseline in OAB-q Symptom Bother Score |
67.9; 58.2; 61.9; 77.2; 66.4; 69.1 | =0.001 sig |
| SECONDARY Percentage of Participants With at Least a 10-Point Improvement From Baseline in HRQL Total Score |
52.6; 44.5; 48.1; 63.6; 54.8; 53.8 | =0.003 sig |
| SECONDARY Percentage of Participants With at Least a 1-Point Improvement From Baseline in PPBC |
61.1; 52.1; 56.3; 70.1; 62.1; 64.6 | =0.003 sig |
| SECONDARY Percentage of Participants With Major (at Least 2-Point) Improvement From Baseline in PPBC |
26.6; 21.6; 21.6; 39.5; 31.5; 31.8 | =0.065 |
| SECONDARY Number of Participants With Adverse Events (AEs) |
260; 241; 283; 141; 125; 161 | — |
| SECONDARY Change From Baseline in Post Void Residual (PVR) Volume |
1.545; 2.821; 7.308; 2.245; 1.117; 7.232 | — |
Summary
The purpose of this study was to see if adding a new type of medication recently approved to treat overactive bladder (mirabegron) to an antimuscarinic treatment (solifenacin) would be more effective in controlling incontinence than when using the antimuscarinic treatment alone.
Eligibility Criteria
Inclusion Criteria
- Main Inclusion at Screening:
- Subject has symptoms of OAB (urinary frequency and urgency with urgency incontinence) for >= 3 months prior to the screening visit
- Subject is willing and able to complete the micturition diary and questionnaires correctly, including collection and measurement of urine output for 3 days prior to each visit;
- Subject has symptoms of "wet" OAB (urinary frequency and urgency with incontinence or mixed incontinence with predominant urgency incontinence), and reports an average of at least 2 incontinence episodes per day.
- Main Inclusion at Run-in (Visit 2):
- Subject experiences on average at least 1 episode of urgency (grade 3 or 4) with or without incontinence per 24-hour period during the 3-day micturition diary period.
- Subject experiences on average at least 2 incontinence episodes per 24-hour period during the 3-day micturition diary period.
- Subject experiences on average at least 8 micturitions (excluding incontinence episodes) per 24-hour period during the 3-day micturition diary period.
- Main Inclusion at Randomization (Visit 3):
- Subject experiences at least 1 incontinence episode during the 3-day micturition diary period and wishes to increase their treatment for OAB symptoms.
Exclusion Criteria
- Main Exclusion at Screening:
- Subject in the opinion of the investigator has clinically significant Bladder Outlet Obstruction (BOO).
- Subject has significant Post-void residual (PVR) volume (PVR > 150 ml).
- Subject has significant stress incontinence or mixed stress/urgency incontinence where stress is the predominant factor as determined by the investigator
- Subject has an indwelling catheter or practices intermittent self catheterization.
- Subject has evidence of a UTI.
- Subject has chronic inflammation such as interstitial cystitis, bladder stones, previous pelvic radiation therapy, or previous or current malignant disease of the pelvic organs
- Subject has moderate to severe hepatic impairment
- Subject has severe renal impairment or End Stage Renal disease
- Subject has a clinically significant abnormal Electrocardiogram (ECG)
- Subject has a concurrent malignancy or history of cancer (except noninvasive skin cancer) within the last 5 years prior to screening.
- Subject has a QTcF interval > 450 ms for males or > 470 ms for females or is at risk of QT prolongation (e.g., family history of long QT syndrome, hypokalaemia).
- Subject has received intravesical treatment in the past 12 months with e.g., botulinum toxin, resiniferatoxin, capsaicin.
- Subject has severe uncontrolled hypertension, which is defined as a sitting average systolic blood pressure ≥ 180 mmHg and/or average diastolic blood pressure ≥ 110 mmHg.
- Main Exclusion at Randomization (visit 3):
- Subject has achieved 100% continence from Visit 2 to Visit 3 (no incontinence episodes are recorded in the 3 day diary administered for 3 days prior to Visit 3).
- Subject does not desire an increase in study medication.
- Subject has an average total daily urine volume > 3000ml as recorded in the micturition diary.
- Subject has severe uncontrolled hypertension, which is defined as a sitting average systolic blood pressure ≥ 180 mmHg and/or average diastolic blood pressure ≥ 110 mmHg.
- Subject has a clinically significant abnormal ECG
Data sourced from ClinicalTrials.gov (NCT01908829). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.