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A Phase 4 Study to Evaluate the Efficacy, Safety, and Tolerability of Mirabegron in Male Subjects With Overactive Bladder (OAB) Symptoms, While Taking the Alpha Blocker for Benign Prostatic Hypertrophy (BPH)

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ClinicalTrials.gov Identifier: NCT02656173
Recruitment Status : Completed
First Posted : January 14, 2016
Results First Posted : September 18, 2018
Last Update Posted : April 9, 2019
Sponsor:
Collaborator:
Astellas Pharma Singapore Pte. Ltd.
Information provided by (Responsible Party):
Astellas Pharma Inc

Brief Summary:
The primary objective of the study was to investigate the efficacy of mirabegron versus placebo in male patients with OAB symptoms while taking the alpha blocker, tamsulosin, for BPH.

Condition or disease Intervention/treatment Phase
Overactive Bladder Drug: Mirabegron Drug: Placebo Drug: Tamsulosin Phase 4

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 568 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary Purpose: Treatment
Official Title: A Phase 4, Double-blind, Randomized, Placebo-controlled Multicenter Study to Evaluate the Efficacy and Safety of Mirabegron in Japanese and Korean Male Patients With Overactive Bladder Under Treatment With the α-Blocker Tamsulosin for Benign Prostatic Hyperplasia
Actual Study Start Date : January 25, 2016
Actual Primary Completion Date : July 21, 2017
Actual Study Completion Date : July 21, 2017

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Mirabegron 50 mg
Participants who received mirabegron 50 mg once a day along with tamsulosin 0.2 mg for 12 weeks
Drug: Mirabegron
Oral tablet
Other Name: YM178

Drug: Tamsulosin
Oral tablet

Experimental: Placebo
Participants who received matching placebo once a day along with tamsulosin 0.2 mg for 12 weeks.
Drug: Placebo
Oral tablet

Drug: Tamsulosin
Oral tablet




Primary Outcome Measures :
  1. Change From Baseline to End of Treatment (EoT) in Mean Number of Micturitions Per 24 Hours [ Time Frame: Baseline and EoT (up to 12 weeks) ]
    A micturition was defined as any voluntary micturition (excluding incontinence only episodes). The mean number of micturitions per 24 hours was calculated from data recorded by participants on a 3-day micturition diary before each visit.

  2. Change From Baseline to Weeks 4, 8, 12 in Mean Number of Micturitions Per 24 Hours [ Time Frame: Baseline and week 4, 8 and 12 ]
    A micturition was defined as any voluntary micturition (excluding incontinence only episodes). The mean number of micturitions per 24 hours was calculated from data recorded by participants on a 3-day micturition diary before each visit.


Secondary Outcome Measures :
  1. Change From Baseline to EoT in Mean Number of Urgency Episodes Per 24 Hours [ Time Frame: Baseline and EoT (up to 12 weeks) ]
    An urgency episode was defined as a complaint of a sudden, compelling desire to pass urine, which is difficult to defer. The mean number of urgency episodes per 24 hours was calculated from data recorded by participants on a 3-day micturition diary before each visit.

  2. Change From Baseline to EoT in Mean Number of Urgency Incontinence Episodes Per 24 Hours [ Time Frame: Baseline and EoT (up to 12 weeks) ]
    An urgency incontinence episode was defined as any episode when both urgency and incontinence occurred concurrently. The mean number of urgency incontinence episodes per 24 hours was calculated from data recorded by participants on a 3-day micturition diary before each visit.

  3. Change From Baseline to EoT in Mean Number of Incontinence Episodes Per 24 Hours [ Time Frame: Baseline and EoT (up to 12 weeks) ]
    An incontinence episode was defined as the complaint of any involuntary leakage of urine. The mean number of incontinence episodes per 24 hours was calculated from data recorded by participants on a 3-day micturition diary before each visit.

  4. Change From Baseline to EoT in Mean Number of Nocturia Episodes [ Time Frame: Baseline and EoT (up to 12 weeks) ]
    A nocturia episode was defined as a micturition episode initiated between night time. Night time was defined as the period between sleep onset time and the wake-up time the following day (micturitions at the same time as the wake-up time were excluded). The mean number of nocturia episodes per 24 hours was calculated from data recorded by participants on a 3-day micturition diary before each visit.

  5. Change From Baseline to EoT in Mean Volume Voided Per Micturition [ Time Frame: Baseline and EoT (up to 12 weeks) ]
    The mean volume voided per micturition was calculated from data recorded by participants on a 3-day micturition diary before each visit.

  6. Change From Baseline to EoT in Total Overactive Bladder Symptom Score (OABSS) [ Time Frame: Baseline and EoT (up to 12 weeks) ]
    The OABSS is a 4-item questionnaire that assesses urinary frequency. Total score was the sum total of the score of each item (ranges: 0-15). Negative change means improvement.

  7. Change From Baseline to EoT in OABSS Subscale Scores [ Time Frame: Baseline and EoT (up to 12 weeks) ]
    Each OABSS subscale score was based on each question in the questionnaire: Daytime Frequency ("How many times do you typically urinate from waking in the morning until sleeping at night?" where scores range from 0-2), Nighttime Frequency ("How many times do you typically wake up to urinate from sleeping at night until waking in the morning?" where scores range from 0-3), Urgency ("How often do you have a sudden desire to urinate, which is difficult to defer?" where scores range from 0-5), Urgency Incontinence ("How often do you leak urine because you cannot defer the sudden desire to urinate?" where scores range from 0-5). A higher score is indicative of worse condition and a negative change from baseline indicates an improvement.

  8. Change From Baseline to EoT in Total International Prostate Symptom Score (IPSS) [ Time Frame: Baseline and EoT (up to 12 weeks) ]
    The IPSS included an 7-item questionnaire that assesses urinary frequency and incomplete voiding along with a QoL assessment. Total IPSS score was the sum total of the score (range: 0-35) of each item (Questions 1-7). Negative change means improvement.

  9. Change From Baseline to EoT in IPSS Subscale Scores [ Time Frame: Baseline and EoT (up to 12 weeks) ]
    IPSS subscale scores was calculated by following each formula. Storage subscale was derived as sum of scores for questions 2, 4, and 7 (range: 1-15). Voiding subscale-1 was derived as sum of scores for questions 3, 5, and 6 (range: 1-15). Voiding subscale-2 was derived as sum of voiding subscale-1 and the score for question 1 (range: 1-20). Individual scores and IPSS Quality of Life (QoL) score was the score of each item (range: 1-6) (Questions 1-7 and QoL item). A higher score is indicative of worse condition and a negative change from baseline indicates an improvement.

  10. Change From Baseline to EoT in Symptom Bother as Assessed by the Overactive Bladder Questionnaire (OAB-q) [ Time Frame: Baseline and EoT (up to 12 weeks) ]

    The OAB-q was a 33-item questionnaire, which consisted of an 8-item symptom bother scale and 25 health-related QoL items that form 4 subscales (coping, concern, sleep, and social interaction) and a total health-related QoL score.

    Symptom Bother was derived as sum of scores for questions 1-8 (range: 0-100). Higher Symptom Bother is indicative of greater symptom bother.


  11. Change From Baseline to EoT in Total Health-Related QoL (HRQoL) Scores as Assessed by the OAB-q [ Time Frame: Baseline and EoT (up to 12 weeks) ]

    The OAB-q was a 33-item questionnaire, which consisted of an 8-item symptom bother scale and 25 health-related QoL items that form 4 subscales (coping, concern, sleep, and social interaction) and a total health-related QoL score.

    Total HRQL score was derived as sum of HRQL subscale scores (range: 25-150). Higher total HRQL score is indicative of better HRQL.


  12. Number of Participants With Adverse Events [ Time Frame: From first dose of study drug up to Week 12 ]
    Treatment-emergent adverse events (TEAE) was defined as an adverse event (AE) with onset during the double-blind treatment period or an AE with onset during the screening period with worsening severity during the double-blind treatment period. The investigator assessed the severity of AEs as follows: Mild: No disruption of normal daily activities; Moderate: Affected normal daily activities; Severe: Inability to perform daily activities. A drug-related TEAE was a TEAE with at least a possible relationship to the study drug as assessed by the investigator. Serious TEAE was an AE considered serious.

  13. Change From Baseline to EoT in Postvoid Residual (PVR) Volume [ Time Frame: Baseline and EoT (up to 12 weeks) ]
    PVR was measured by ultrasonography.

  14. Change From Baseline to EoT in Maximum Urine Flow Rate (Qmax) [ Time Frame: Baseline and EoT (up to 12 weeks) ]
    Urine flow rate was volume voided per micturition (voided volume) divided by time for the micturition (flow time).



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   40 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

at Visit 1 (Screening):

  • Patient had been under treatment with tamsulosin 0.2mg for at least 4 weeks before the start of the Screening period.
  • Patient with a history of an average of at least 2 episodes of urgency per 24 hours and an average of 8 or more micturitions per 24 hours during the last 3 days before the start of the Screening period (verified by interview).
  • Patient who had no wish to have children in the future (Unique to Japan).
  • Male subjects and their female spouses/partners who were of childbearing potential must be using highly effective contraception consisting of two forms of birth control (at least one of which must be a barrier method), starting at Screening, continuing throughout the study period, and for 28 days after the final study drug administration.
  • Subject must not donate sperm, starting at Screening, continuing throughout the study period, and for 28 days after the final study drug administration.
  • Patient was willing and able to complete the micturition diary and questionnaires correctly.
  • Subject agreed not to participate in another interventional study while receiving treatment in this study.

at Visit 2 (Baseline):

  • Subject with an average of at least 2 episodes of urgency per 24 hours and an average of 8 or more micturitions per 24 hours based on a 3-day micturition diary from the Screening period.

Exclusion Criteria:

at Visit 1 (Screening):

  • Patient with suspected symptoms of OAB, with onset only transient (e.g., drug-induced, psychogenic).
  • Patient with PVR urine volume >100 mL or Q max <5 mL/sec.
  • Patient with prostate-specific antigen (PSA) ≥4 ng/mL.
  • Patient with neurogenic bladder (e.g., spinal-cord lesions or other damage that will clearly affect urination; multiple sclerosis; Parkinson's disease) or a history of surgery that caused damage to the pelvic plexus.
  • Patient with urethral stricture or bladder-neck stenosis.
  • Patient with diabetic neuropathy complications.
  • Patient who had undergone a surgical procedure, previous pelvic radiation therapy, or hyperthermia therapy that may affect urinary tract function.
  • Patient with significant stress incontinence or postsurgical prostate incontinence, as determined by the Investigator.
  • Patient with an indwelling catheter or practices intermittent self-catheterization.
  • Patient with 3 or more episodes of recurrent urinary tract infection (UTI) within the last 6 months.
  • Patient with a UTI; prostatitis; chronic inflammation, such as interstitial cystitis; urinary calculus; or previous or current malignant disease of the pelvic organs.
  • Patient with a concurrent malignancy or history of any malignancy (within the past 5 years), except for non-metastatic basal-cell or squamous-cell carcinoma of the skin that had been treated successfully.
  • Patient with serious heart disease, liver disease, kidney disease, immunological disease, lung disease.
  • Patient who had received intravesical injection within the last 12 months with botulinum toxin, resiniferatoxin, or capsaicin.
  • Patient who had received electrostimulation therapy for OAB.
  • Patient who had received a bladder training program or pelvic floor exercises <28 days prior to the start of the Screening period.
  • Patient with postural hypotension or syncope, hypokalemia, or closed-angle glaucoma.
  • Patient with evidence of QT prolongation on electrocardiogram (ECG), defined as QTcF >450 msec.
  • Patient with severe uncontrolled hypertension, defined as sitting systolic blood pressure (SBP) >180 mmHg and/or diastolic blood pressure (DBP) >110 mmHg.
  • Patient with a clinically significant ECG abnormality, as determined by the Investigator.
  • Patient who had severe renal impairment, defined as an estimated glomerular filtration rate of <29 mL/min/1.73m2; end-stage renal disease; or is undergoing dialysis.
  • Patient with aspartate transaminase (AST) or alanine transaminase (ALT) >2 times the upper limit of normal (ULN), or gamma-glutamyl transferase (γ-GT) >3 times the ULN and considered clinically significant by the Investigator.
  • Patient with moderate or severe hepatic impairment, defined as Child-Pugh Class B or C.
  • Patient with hypersensitivity to any of the components of mirabegron, other beta-adrenergic receptor (β-AR) agonists, or any of the inactive ingredients.
  • Patient with ongoing alcohol and/or drug abuse.
  • Patient with or a history of mood disorder, neurotic disorder, or schizophrenia.
  • Patient with dementia, cognitive dysfunction, or clinically significant cerebrovascular disorder.
  • Patient who had been treated with an experimental device <84 days or received an investigational agent <84 days prior to the start of the Screening period.
  • Patient had used any prohibited concomitant medication <28 days (but, <1 year for 5α-reductase inhibitors) before the start of the Screening period.
  • Patient with any clinically significant condition, which in the opinion of the Investigator, made the subject unsuitable for study participation.
  • Patient who was involved in the conduct of the study as an employee of the Astellas group, a third party associated with the study, or the study site team.

at Visit 2 (Baseline):

  • Subject fulfills any exclusion criteria of Visit 1 at Visit 2.
  • Subject was noncompliant during the 4 week tamsulosin Screening period, defined as taking less than 80% or greater than 120% of prescribed dose of study medication.
  • Subject had an average total daily urine volume >3000 mL, as recorded in the 3-day micturition diary.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02656173


  Show 58 Study Locations
Sponsors and Collaborators
Astellas Pharma Inc
Astellas Pharma Singapore Pte. Ltd.
Investigators
Layout table for investigator information
Study Director: Medical Director Astellas Pharma Inc
  Study Documents (Full-Text)

Documents provided by Astellas Pharma Inc:
Statistical Analysis Plan  [PDF] November 14, 2017
Study Protocol  [PDF] May 10, 2016


Additional Information:
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Responsible Party: Astellas Pharma Inc
ClinicalTrials.gov Identifier: NCT02656173     History of Changes
Other Study ID Numbers: 178-MA-3016
First Posted: January 14, 2016    Key Record Dates
Results First Posted: September 18, 2018
Last Update Posted: April 9, 2019
Last Verified: March 2019
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Yes
Plan Description: Access to anonymized individual participant level data collected during the trial, in addition to study-related supporting documentation, is planned for trials conducted with approved product indications and formulations, as well as compounds terminated during development. Conditions and exceptions are described under the Sponsor Specific Details for Astellas on www.clinicalstudydatarequest.com.
Supporting Materials: Study Protocol
Statistical Analysis Plan (SAP)
Clinical Study Report (CSR)
Time Frame: Access to participant level data is offered to researchers after publication of the primary manuscript (if applicable) and is available as long as Astellas has legal authority to provide the data.
Access Criteria: Researchers must submit a proposal to conduct a scientifically relevant analysis of the study data. The research proposal is reviewed by an Independent Research Panel. If the proposal is approved, access to the study data is provided in a secure data sharing environment after receipt of a signed Data Sharing Agreement.
URL: https://www.clinicalstudydatarequest.com/

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Product Manufactured in and Exported from the U.S.: Yes

Keywords provided by Astellas Pharma Inc:
Tamsulosin
Overactive bladder
Benign prostatic hypertrophy
Mirabegron

Additional relevant MeSH terms:
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Urinary Bladder, Overactive
Prostatic Hyperplasia
Hypertrophy
Urinary Bladder Diseases
Urologic Diseases
Lower Urinary Tract Symptoms
Urological Manifestations
Signs and Symptoms
Prostatic Diseases
Genital Diseases, Male
Pathological Conditions, Anatomical
Tamsulosin
Mirabegron
Adrenergic alpha-1 Receptor Antagonists
Adrenergic alpha-Antagonists
Adrenergic Antagonists
Adrenergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action
Physiological Effects of Drugs
Urological Agents
Adrenergic beta-3 Receptor Agonists
Adrenergic beta-Agonists
Adrenergic Agonists