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A Study of Fesoterodine and Oxybutynin on Cognitive Function in Mild Cognitive Impairment

Primary Purpose

Overactive Bladder, Mild Cognitive Impairment

Status
Completed
Phase
Phase 2
Locations
Canada
Study Type
Interventional
Intervention
fesoterodine 4mg
Oxybutynin
placebo
fesoterodine 8mg
Sponsored by
University of Alberta
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional other trial for Overactive Bladder focused on measuring crossover study, placebo controlled, double blind, overactive bladder

Eligibility Criteria

75 Years - undefined (Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. The subject is either male or female and ≥ 75 years of age.
  2. The subject has OAB as determined by ICS criteria
  3. The subject has mild cognitive impairment as determined by NIA criteria
  4. The subject is competent to give informed consent and perform the tasks associated with the study
  5. The subject has a body mass index (BMI) between 18.0 to 30.0 kg/m2 inclusive.
  6. Written informed consent has been obtained.
  7. The subject is available to complete the study.
  8. At training visits (visit 2): the subject has performed at or above the minimum level on at least one occasion for each individual task measure in cognitive function test training.

Exclusion Criteria:

  1. The subject does not have OAB.
  2. The subject has either dementia or moderate to severe cognitive impairment at screening.
  3. The subject has probable clinical depression as determined by Geriatric Depression Scale (GDS) short form >5 at screening.
  4. Subjects taking any cognitive enhancers (cholinesterase inhibitors or memantine).
  5. The subject has a history of allergy to the study drug(s), to any component of the dosage form or any other allergy, which, in the opinion of the Investigator, contraindicates their participation.
  6. The subject has any clinically significant abnormal heart rate or blood pressure measurements, at the screening visit, which, in the opinion of the Investigator, prevent safe participation in the study. (dBP< 60mmHg or > 90mmHg, sBP < 95mmHg or > 160mmHg or HR < 40bpm or > 100bpm).
  7. Subjects with known history of urinary retention, severe gastrointestinal obstruction (including paralytic ileus or intestinal atony) or severe gastrointestinal conditions (including toxic megacolon or ulcerative colitis), myasthenia gravis, uncontrolled narrow angle glaucoma or shallow interior chamber or subjects deemed to be at risk for these conditions.
  8. Subjects undergoing haemodialysis or who have severe renal impairment.
  9. Subjects with severe hepatic impairment, defined as Child-Pugh grade IV.
  10. Subjects taking potent CYP 3A4 inhibitors which would, under normal circumstances, require adjustment of the dose of the test drugs.
  11. Subject has taken prescribed medication within 14 days prior to the first study day or over-the-counter medicine (including vitamins and herbal remedies) within 48 hours prior to the first study day, which in the opinion of the Investigator, will interfere with the study procedures or compromise safety.
  12. Subject has an average weekly alcohol intake of greater than 21 units (male) or 14 units (female) within the 90 days prior to the study. 1 unit is 270cc of beer, 40cc of spirits or 125cc of wine.
  13. History of smoking more than 10 cigarettes (or the equivalent amount of tobacco) per day within the 90 days prior to the study.
  14. Subject has participated in any clinical study within the last 90 days.
  15. Any clinically significant abnormality following Investigator review of the pre study physical examination.
  16. Any clinical condition, which, in the opinion of the Investigator, would not allow safe completion of the study.
  17. Any subjects who, in the opinion of the investigator, may find it difficult to adhere to the provisions of treatment and observation specified in the protocol.

Sites / Locations

  • Division of Geriatric Medicine, Clinical Sciences Building, University of Alberta Hosp

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Active Comparator

Placebo Comparator

Arm Label

Fesoterodine 4mg daily

Fesoterodine 8mg

oxybutynin

placebo capsule

Arm Description

fesoterodine 4mg oral

Fesoterodine 8mg in form of 2, 4mg tablets

oxybutynin immediate release, encapsulated 2, 5mg capsules daily

placebo capsule, 2 per day

Outcomes

Primary Outcome Measures

continuity of attention
Continuity of Attention: Accuracy of responding in Choice Reaction Time task Percent Target Detection in Digit Vigilance task False Alarms in Digit Vigilance task

Secondary Outcome Measures

cognitive function
includes the following domains of cognition power of attention, quality of working memory, quality of episodic secondary memory, speed of memory Montreal Cognitive assessment score

Full Information

First Posted
September 11, 2014
Last Updated
February 18, 2020
Sponsor
University of Alberta
Collaborators
Pfizer
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1. Study Identification

Unique Protocol Identification Number
NCT02240459
Brief Title
A Study of Fesoterodine and Oxybutynin on Cognitive Function in Mild Cognitive Impairment
Official Title
A Double Blind, Randomized Four Way Cross Over Study to Compare the Effect of Fesoterodine 4mg and 8mg Once Daily and Oxybutynin 5mg Twice Daily After Steady State Dosing Versus Placebo on Cognitive Function in Subjects With Overactive Bladder, Over the Age of 75 Years With Mild Cognitive Impairment
Study Type
Interventional

2. Study Status

Record Verification Date
February 2020
Overall Recruitment Status
Completed
Study Start Date
August 2016 (undefined)
Primary Completion Date
January 31, 2020 (Actual)
Study Completion Date
January 31, 2020 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
University of Alberta
Collaborators
Pfizer

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to assess the effects of fesoterodine at 4mg and 8mg doses versus a placebo and oxybutynin 5mg bid versus placebo on cognitive abilities in older people with overactive bladder and mild cognitive impairment.
Detailed Description
This is a randomized placebo controlled, blinded four way cross over trial of the effect of medications used to treat overactive bladder on the cognition of older men and women with mild cognitive impairment. Each treatment phase is a week, with a weeks washout period before starting the next treatment. Cognitive testing is by way of a validated computer assisted battery of tests

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Overactive Bladder, Mild Cognitive Impairment
Keywords
crossover study, placebo controlled, double blind, overactive bladder

7. Study Design

Primary Purpose
Other
Study Phase
Phase 2
Interventional Study Model
Crossover Assignment
Masking
ParticipantCare ProviderInvestigatorOutcomes Assessor
Allocation
Randomized
Enrollment
47 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Fesoterodine 4mg daily
Arm Type
Experimental
Arm Description
fesoterodine 4mg oral
Arm Title
Fesoterodine 8mg
Arm Type
Experimental
Arm Description
Fesoterodine 8mg in form of 2, 4mg tablets
Arm Title
oxybutynin
Arm Type
Active Comparator
Arm Description
oxybutynin immediate release, encapsulated 2, 5mg capsules daily
Arm Title
placebo capsule
Arm Type
Placebo Comparator
Arm Description
placebo capsule, 2 per day
Intervention Type
Drug
Intervention Name(s)
fesoterodine 4mg
Other Intervention Name(s)
Toviaz
Intervention Description
7 days therapy followed by seven days washout. Each 4mg tablet is taken in the morning
Intervention Type
Drug
Intervention Name(s)
Oxybutynin
Other Intervention Name(s)
ditropan
Intervention Description
5mg IR oxybutynin taken bid, encapsulated into a form indistinguishable from placebo
Intervention Type
Drug
Intervention Name(s)
placebo
Other Intervention Name(s)
placebo capsule
Intervention Description
placebo capsule, one twice daily, and 2 placebo fesoterodine tablets taken each morning for masking and comparator purposes
Intervention Type
Drug
Intervention Name(s)
fesoterodine 8mg
Other Intervention Name(s)
Toviaz 8mg
Intervention Description
2, 4mg fesoterodine capsules taken together in the morning
Primary Outcome Measure Information:
Title
continuity of attention
Description
Continuity of Attention: Accuracy of responding in Choice Reaction Time task Percent Target Detection in Digit Vigilance task False Alarms in Digit Vigilance task
Time Frame
1 and 4h post dose
Secondary Outcome Measure Information:
Title
cognitive function
Description
includes the following domains of cognition power of attention, quality of working memory, quality of episodic secondary memory, speed of memory Montreal Cognitive assessment score
Time Frame
1 and 4h post last dose of study drug

10. Eligibility

Sex
All
Minimum Age & Unit of Time
75 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: The subject is either male or female and ≥ 75 years of age. The subject has OAB as determined by ICS criteria The subject has mild cognitive impairment as determined by NIA criteria The subject is competent to give informed consent and perform the tasks associated with the study The subject has a body mass index (BMI) between 18.0 to 30.0 kg/m2 inclusive. Written informed consent has been obtained. The subject is available to complete the study. At training visits (visit 2): the subject has performed at or above the minimum level on at least one occasion for each individual task measure in cognitive function test training. Exclusion Criteria: The subject does not have OAB. The subject has either dementia or moderate to severe cognitive impairment at screening. The subject has probable clinical depression as determined by Geriatric Depression Scale (GDS) short form >5 at screening. Subjects taking any cognitive enhancers (cholinesterase inhibitors or memantine). The subject has a history of allergy to the study drug(s), to any component of the dosage form or any other allergy, which, in the opinion of the Investigator, contraindicates their participation. The subject has any clinically significant abnormal heart rate or blood pressure measurements, at the screening visit, which, in the opinion of the Investigator, prevent safe participation in the study. (dBP< 60mmHg or > 90mmHg, sBP < 95mmHg or > 160mmHg or HR < 40bpm or > 100bpm). Subjects with known history of urinary retention, severe gastrointestinal obstruction (including paralytic ileus or intestinal atony) or severe gastrointestinal conditions (including toxic megacolon or ulcerative colitis), myasthenia gravis, uncontrolled narrow angle glaucoma or shallow interior chamber or subjects deemed to be at risk for these conditions. Subjects undergoing haemodialysis or who have severe renal impairment. Subjects with severe hepatic impairment, defined as Child-Pugh grade IV. Subjects taking potent CYP 3A4 inhibitors which would, under normal circumstances, require adjustment of the dose of the test drugs. Subject has taken prescribed medication within 14 days prior to the first study day or over-the-counter medicine (including vitamins and herbal remedies) within 48 hours prior to the first study day, which in the opinion of the Investigator, will interfere with the study procedures or compromise safety. Subject has an average weekly alcohol intake of greater than 21 units (male) or 14 units (female) within the 90 days prior to the study. 1 unit is 270cc of beer, 40cc of spirits or 125cc of wine. History of smoking more than 10 cigarettes (or the equivalent amount of tobacco) per day within the 90 days prior to the study. Subject has participated in any clinical study within the last 90 days. Any clinically significant abnormality following Investigator review of the pre study physical examination. Any clinical condition, which, in the opinion of the Investigator, would not allow safe completion of the study. Any subjects who, in the opinion of the investigator, may find it difficult to adhere to the provisions of treatment and observation specified in the protocol.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Adrian S Wagg, MD
Organizational Affiliation
University of Alberta
Official's Role
Principal Investigator
Facility Information:
Facility Name
Division of Geriatric Medicine, Clinical Sciences Building, University of Alberta Hosp
City
Edmonton
State/Province
Alberta
ZIP/Postal Code
T6G 2P4
Country
Canada

12. IPD Sharing Statement

Citations:
PubMed Identifier
23332882
Citation
Wagg A, Dale M, Tretter R, Stow B, Compion G. Randomised, multicentre, placebo-controlled, double-blind crossover study investigating the effect of solifenacin and oxybutynin in elderly people with mild cognitive impairment: the SENIOR study. Eur Urol. 2013 Jul;64(1):74-81. doi: 10.1016/j.eururo.2013.01.002. Epub 2013 Jan 11.
Results Reference
background
PubMed Identifier
19747069
Citation
Wesnes KA, Edgar C, Tretter RN, Bolodeoku J. Exploratory pilot study assessing the risk of cognitive impairment or sedation in the elderly following single doses of solifenacin 10 mg. Expert Opin Drug Saf. 2009 Nov;8(6):615-26. doi: 10.1517/14740330903260790.
Results Reference
background

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A Study of Fesoterodine and Oxybutynin on Cognitive Function in Mild Cognitive Impairment

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