Mirabegron and Urinary Urgency Incontinence
Primary Purpose
Overactive Bladder
Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Mirabegron
Sponsored by
About this trial
This is an interventional treatment trial for Overactive Bladder focused on measuring Urinary Urgency Incontinence, Mirabegron, Myrbetriq, Betmiga
Eligibility Criteria
Inclusion Criteria:
- Bothersome idiopathic (non-neurologic) urgency urinary incontinence (UUI) who recall ≥ 5 urgency predominant urinary incontinence episodes in the prior week (urgency urinary incontinence or mixed urinary incontinence-urgency predominant)
- No contraindications to taking mirabegron
- Patients on current OAB therapy will undergo a two-week drug washout period prior to baseline assessment
Exclusion Criteria:
- Neurologic disease known to affect the lower urinary tract
- Systemic immunologic deficiency
- Current urinary tract infection (UTI) (based on dipstick assessment) or recurrent culture-proven UTIs
- History or current pelvic malignancy or radiation
- Untreated symptomatic pelvic organ prolapse (POP) > POP-Q Stage II
- A contraindication to receiving mirabegron
- Women of childbearing potential who are pregnant or nursing or intend to become pregnant during the study, or who are not practicing a reliable method of contraception
- Must not have taken any antibiotics in the 4 weeks prior to enrollment
Sites / Locations
- Loyola University Medical Center
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Mirabegron
Arm Description
Participants received mirabegron (Myrbetriq) daily for 12 weeks
Outcomes
Primary Outcome Measures
Response to Therapy
Response to therapy was measured using the Patient Perception of Bladder Control (PPBC) questionnaire which measures patients' perceived bladder condition on a 6-point ordinal scale ranging from 1 (no problems at all) to 6 (many severe problems). Women reporting a PPBC score of 4 or 5 by week 12 responded to therapy. Women reporting a PPBC score of 1, 2, or 3 by week 12 did not respond to therapy.
Secondary Outcome Measures
Change in Overactive Bladder Questionnaire (OAB-q) Health Related Quality of Life (HRQL)
The Overactive Bladder Questionnaire (OAB-q) Health Related Quality of Life (HRQL) score is a measure of patients' bladder symptom severity. It ranges from 25 to 150 where higher scores indicate greater quality of life.
Change in Urinary Distress Inventory (UDI)
The Urinary Distress Inventory is a 29-item questionnaire that asks patients to report how bothered they are by symptoms of urinary urgency on a scale from 1 (not at all) to 4 (quite a bit). The total score ranges from 0 to 300 where higher scores indicate worsening symptom severity.
Change in Pelvic Organ Prolapse Distress Inventory (POPDI) Score
The Pelvic Organ Prolapse Distress Inventory (POPDI) is a 16-item questionnaire that asks patients to report how bothered they are by symptoms of urinary urgency on a scale from 1 (not at all) to 4 (quite a bit). The total score ranges from 0 to 300 where higher scores indicate worsening symptom severity.
Change in Colo-Rectal-Anal Distress Inventory (CRADI)
The Colo-Rectal-Anal Distress Inventory (CRADI) is a 17-item questionnaire that asks patients to report how bothered they are by symptoms of urinary urgency on a scale from 1 (not at all) to 4 (quite a bit). The total score ranges from 0 to 400 where higher scores indicate worsening symptom severity.
Full Information
NCT ID
NCT02495389
First Posted
July 9, 2015
Last Updated
October 30, 2020
Sponsor
Loyola University
Collaborators
Astellas Pharma US, Inc.
1. Study Identification
Unique Protocol Identification Number
NCT02495389
Brief Title
Mirabegron and Urinary Urgency Incontinence
Official Title
Mirabegron and Urinary Urgency Incontinence: The Clinical Response and the Female Urinary Microbiome
Study Type
Interventional
2. Study Status
Record Verification Date
October 2020
Overall Recruitment Status
Completed
Study Start Date
January 28, 2015 (Actual)
Primary Completion Date
January 29, 2019 (Actual)
Study Completion Date
January 29, 2019 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Loyola University
Collaborators
Astellas Pharma US, Inc.
4. Oversight
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.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This study is for women diagnosed with urinary urgency incontinence (UUI) or overactive bladder (OAB). Some patients continue to have symptoms even while taking medication for OAB. The purpose of this study is to estimate the number of women who respond to a medication called mirabegron and estimate change in symptom severity over 12 weeks of therapy. A secondary goal is to correlate the female urinary microbiome (FUM) with response to treatment and change in symptom severity over 12 weeks of therapy.
Detailed Description
Mirabegron is an FDA-approved medication for urgency incontinence. Evaluation of mirabegron's influence on clinical symptoms may need to take into account the effect of the female urinary microbiome (FUM) on a patient's response to treatment. Compared to asymptomatic patients, several bacterial species are more common in patients with overactive bladder.
Currently, physicians have limited ability to personalize a patient's urinary urgency incontinence treatment and, consequently, the prescribed medication may provide minimal symptom relief. Since the FUM can be assessed prior to treatment, this study proposes to determine if baseline FUM assessment can provide insight into future symptom relief with mirabegron treatment.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Overactive Bladder
Keywords
Urinary Urgency Incontinence, Mirabegron, Myrbetriq, Betmiga
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Model Description
All patients receive mirabegron daily for 12 weeks
Masking
None (Open Label)
Masking Description
There is no masking scheme
Allocation
N/A
Enrollment
84 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Mirabegron
Arm Type
Experimental
Arm Description
Participants received mirabegron (Myrbetriq) daily for 12 weeks
Intervention Type
Drug
Intervention Name(s)
Mirabegron
Other Intervention Name(s)
Myrbetriq, Betmiga
Intervention Description
Mirabegron is a medication for the treatment of overactive bladder. It was developed by Astellas Pharma and was approved by the United States Food and Drug Administration (FDA) in July 2012.
Primary Outcome Measure Information:
Title
Response to Therapy
Description
Response to therapy was measured using the Patient Perception of Bladder Control (PPBC) questionnaire which measures patients' perceived bladder condition on a 6-point ordinal scale ranging from 1 (no problems at all) to 6 (many severe problems). Women reporting a PPBC score of 4 or 5 by week 12 responded to therapy. Women reporting a PPBC score of 1, 2, or 3 by week 12 did not respond to therapy.
Time Frame
12 weeks
Secondary Outcome Measure Information:
Title
Change in Overactive Bladder Questionnaire (OAB-q) Health Related Quality of Life (HRQL)
Description
The Overactive Bladder Questionnaire (OAB-q) Health Related Quality of Life (HRQL) score is a measure of patients' bladder symptom severity. It ranges from 25 to 150 where higher scores indicate greater quality of life.
Time Frame
12 weeks
Title
Change in Urinary Distress Inventory (UDI)
Description
The Urinary Distress Inventory is a 29-item questionnaire that asks patients to report how bothered they are by symptoms of urinary urgency on a scale from 1 (not at all) to 4 (quite a bit). The total score ranges from 0 to 300 where higher scores indicate worsening symptom severity.
Time Frame
12 weeks
Title
Change in Pelvic Organ Prolapse Distress Inventory (POPDI) Score
Description
The Pelvic Organ Prolapse Distress Inventory (POPDI) is a 16-item questionnaire that asks patients to report how bothered they are by symptoms of urinary urgency on a scale from 1 (not at all) to 4 (quite a bit). The total score ranges from 0 to 300 where higher scores indicate worsening symptom severity.
Time Frame
12 weeks
Title
Change in Colo-Rectal-Anal Distress Inventory (CRADI)
Description
The Colo-Rectal-Anal Distress Inventory (CRADI) is a 17-item questionnaire that asks patients to report how bothered they are by symptoms of urinary urgency on a scale from 1 (not at all) to 4 (quite a bit). The total score ranges from 0 to 400 where higher scores indicate worsening symptom severity.
Time Frame
12 weeks
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Bothersome idiopathic (non-neurologic) urgency urinary incontinence (UUI) who recall ≥ 5 urgency predominant urinary incontinence episodes in the prior week (urgency urinary incontinence or mixed urinary incontinence-urgency predominant)
No contraindications to taking mirabegron
Patients on current OAB therapy will undergo a two-week drug washout period prior to baseline assessment
Exclusion Criteria:
Neurologic disease known to affect the lower urinary tract
Systemic immunologic deficiency
Current urinary tract infection (UTI) (based on dipstick assessment) or recurrent culture-proven UTIs
History or current pelvic malignancy or radiation
Untreated symptomatic pelvic organ prolapse (POP) > POP-Q Stage II
A contraindication to receiving mirabegron
Women of childbearing potential who are pregnant or nursing or intend to become pregnant during the study, or who are not practicing a reliable method of contraception
Must not have taken any antibiotics in the 4 weeks prior to enrollment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Alan Wolfe, PhD
Organizational Affiliation
Loyola Univerity Medical Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Loyola University Medical Center
City
Maywood
State/Province
Illinois
ZIP/Postal Code
60153
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
IPD Sharing Plan Description
There is no plan to make individual participant data (IPD) available to other researchers.
Citations:
PubMed Identifier
21344495
Citation
Barber MD, Chen Z, Lukacz E, Markland A, Wai C, Brubaker L, Nygaard I, Weidner A, Janz NK, Spino C. Further validation of the short form versions of the Pelvic Floor Distress Inventory (PFDI) and Pelvic Floor Impact Questionnaire (PFIQ). Neurourol Urodyn. 2011 Apr;30(4):541-6. doi: 10.1002/nau.20934. Epub 2011 Feb 22.
Results Reference
background
PubMed Identifier
24515544
Citation
Brubaker L, Nager CW, Richter HE, Visco A, Nygaard I, Barber MD, Schaffer J, Meikle S, Wallace D, Shibata N, Wolfe AJ. Urinary bacteria in adult women with urgency urinary incontinence. Int Urogynecol J. 2014 Sep;25(9):1179-84. doi: 10.1007/s00192-013-2325-2. Epub 2014 Feb 11.
Results Reference
background
PubMed Identifier
24127366
Citation
Chapple CR, Cardozo L, Nitti VW, Siddiqui E, Michel MC. Mirabegron in overactive bladder: a review of efficacy, safety, and tolerability. Neurourol Urodyn. 2014 Jan;33(1):17-30. doi: 10.1002/nau.22505. Epub 2013 Oct 11.
Results Reference
background
PubMed Identifier
24458878
Citation
Chapple CR, Nitti VW, Khullar V, Wyndaele JJ, Herschorn S, van Kerrebroeck P, Blauwet MB, Siddiqui E. Onset of action of the beta3-adrenoceptor agonist, mirabegron, in Phase II and III clinical trials in patients with overactive bladder. World J Urol. 2014 Dec;32(6):1565-72. doi: 10.1007/s00345-014-1244-2. Epub 2014 Jan 24.
Results Reference
background
PubMed Identifier
12206577
Citation
Coyne K, Revicki D, Hunt T, Corey R, Stewart W, Bentkover J, Kurth H, Abrams P. Psychometric validation of an overactive bladder symptom and health-related quality of life questionnaire: the OAB-q. Qual Life Res. 2002 Sep;11(6):563-74. doi: 10.1023/a:1016370925601.
Results Reference
background
PubMed Identifier
16460875
Citation
Coyne KS, Matza LS, Kopp Z, Abrams P. The validation of the patient perception of bladder condition (PPBC): a single-item global measure for patients with overactive bladder. Eur Urol. 2006 Jun;49(6):1079-86. doi: 10.1016/j.eururo.2006.01.007. Epub 2006 Jan 24.
Results Reference
background
PubMed Identifier
20025017
Citation
de Boer TA, Salvatore S, Cardozo L, Chapple C, Kelleher C, van Kerrebroeck P, Kirby MG, Koelbl H, Espuna-Pons M, Milsom I, Tubaro A, Wagg A, Vierhout ME. Pelvic organ prolapse and overactive bladder. Neurourol Urodyn. 2010;29(1):30-9. doi: 10.1002/nau.20858.
Results Reference
background
PubMed Identifier
22929533
Citation
Fouts DE, Pieper R, Szpakowski S, Pohl H, Knoblach S, Suh MJ, Huang ST, Ljungberg I, Sprague BM, Lucas SK, Torralba M, Nelson KE, Groah SL. Integrated next-generation sequencing of 16S rDNA and metaproteomics differentiate the healthy urine microbiome from asymptomatic bacteriuria in neuropathic bladder associated with spinal cord injury. J Transl Med. 2012 Aug 28;10:174. doi: 10.1186/1479-5876-10-174.
Results Reference
background
PubMed Identifier
19937315
Citation
Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Int Urogynecol J. 2010 Jan;21(1):5-26. doi: 10.1007/s00192-009-0976-9. Epub 2009 Nov 25.
Results Reference
background
PubMed Identifier
19941278
Citation
Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN; International Urogynecological Association; International Continence Society. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4-20. doi: 10.1002/nau.20798.
Results Reference
background
PubMed Identifier
24371246
Citation
Hilt EE, McKinley K, Pearce MM, Rosenfeld AB, Zilliox MJ, Mueller ER, Brubaker L, Gai X, Wolfe AJ, Schreckenberger PC. Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder. J Clin Microbiol. 2014 Mar;52(3):871-6. doi: 10.1128/JCM.02876-13. Epub 2013 Dec 26.
Results Reference
background
PubMed Identifier
21231991
Citation
Irwin DE, Kopp ZS, Agatep B, Milsom I, Abrams P. Worldwide prevalence estimates of lower urinary tract symptoms, overactive bladder, urinary incontinence and bladder outlet obstruction. BJU Int. 2011 Oct;108(7):1132-8. doi: 10.1111/j.1464-410X.2010.09993.x. Epub 2011 Jan 13.
Results Reference
background
PubMed Identifier
16813908
Citation
Kenton K, Fitzgerald MP, Brubaker L. What is a clinician to do-believe the patient or her urinary diary? J Urol. 2006 Aug;176(2):633-5; discussion 635. doi: 10.1016/j.juro.2006.03.069.
Results Reference
background
PubMed Identifier
23596238
Citation
Khasriya R, Sathiananthamoorthy S, Ismail S, Kelsey M, Wilson M, Rohn JL, Malone-Lee J. Spectrum of bacterial colonization associated with urothelial cells from patients with chronic lower urinary tract symptoms. J Clin Microbiol. 2013 Jul;51(7):2054-62. doi: 10.1128/JCM.03314-12. Epub 2013 Apr 17.
Results Reference
background
PubMed Identifier
21850507
Citation
Lowenstein L, Rickey L, Kenton K, Fitzgerald MP, Brubaker L, Tulke M, Fordham J, Mueller ER. Reliability and responsiveness of the Urgency Severity and Life Impact Questionnaire (USIQ). Int Urogynecol J. 2012 Feb;23(2):193-6. doi: 10.1007/s00192-011-1531-z. Epub 2011 Aug 18.
Results Reference
background
PubMed Identifier
19588154
Citation
Michel MC, Chapple CR. Basic mechanisms of urgency: roles and benefits of pharmacotherapy. World J Urol. 2009 Dec;27(6):705-9. doi: 10.1007/s00345-009-0446-5.
Results Reference
background
PubMed Identifier
12493346
Citation
Mostwin JL. Pathophysiology: the varieties of bladder overactivity. Urology. 2002 Nov;60(5 Suppl 1):22-6; discussion 27. doi: 10.1016/s0090-4295(02)01788-0.
Results Reference
background
PubMed Identifier
25006228
Citation
Pearce MM, Hilt EE, Rosenfeld AB, Zilliox MJ, Thomas-White K, Fok C, Kliethermes S, Schreckenberger PC, Brubaker L, Gai X, Wolfe AJ. The female urinary microbiome: a comparison of women with and without urgency urinary incontinence. mBio. 2014 Jul 8;5(4):e01283-14. doi: 10.1128/mBio.01283-14.
Results Reference
background
PubMed Identifier
20803179
Citation
Sajadi KP, Vasavada SP. Overactive bladder after sling surgery. Curr Urol Rep. 2010 Nov;11(6):366-71. doi: 10.1007/s11934-010-0136-2.
Results Reference
background
PubMed Identifier
22047020
Citation
Siddiqui H, Nederbragt AJ, Lagesen K, Jeansson SL, Jakobsen KS. Assessing diversity of the female urine microbiota by high throughput sequencing of 16S rDNA amplicons. BMC Microbiol. 2011 Nov 2;11:244. doi: 10.1186/1471-2180-11-244.
Results Reference
background
PubMed Identifier
9243034
Citation
Smith HS, Hughes JP, Hooton TM, Roberts P, Scholes D, Stergachis A, Stapleton A, Stamm WE. Antecedent antimicrobial use increases the risk of uncomplicated cystitis in young women. Clin Infect Dis. 1997 Jul;25(1):63-8. doi: 10.1086/514502.
Results Reference
background
PubMed Identifier
23189940
Citation
Tincello DG, Owen RK, Slack MC, Abrams KR. Validation of the Patient Global Impression scales for use in detrusor overactivity: secondary analysis of the RELAX study. BJOG. 2013 Jan;120(2):212-216. doi: 10.1111/1471-0528.12069. Epub 2012 Nov 27.
Results Reference
background
PubMed Identifier
22278835
Citation
Wolfe AJ, Toh E, Shibata N, Rong R, Kenton K, Fitzgerald M, Mueller ER, Schreckenberger P, Dong Q, Nelson DE, Brubaker L. Evidence of uncultivated bacteria in the adult female bladder. J Clin Microbiol. 2012 Apr;50(4):1376-83. doi: 10.1128/JCM.05852-11. Epub 2012 Jan 25.
Results Reference
background
PubMed Identifier
35412069
Citation
Halverson T, Mueller ER, Brubaker L, Wolfe AJ. Symptom improvement with mirabegron treatment is associated with urobiome changes in adult women. Int Urogynecol J. 2022 May;33(5):1319-1328. doi: 10.1007/s00192-022-05190-w. Epub 2022 Apr 12.
Results Reference
derived
Learn more about this trial
Mirabegron and Urinary Urgency Incontinence
We'll reach out to this number within 24 hrs