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Treatment of REfractory Overactive BLadder With the AXonics Sacral Neuromodulation System (RELAX-OAB) (RELAX-OAB)

Primary Purpose

Overactive Bladder

Status
Completed
Phase
Not Applicable
Locations
International
Study Type
Interventional
Intervention
Axonics Sacral Neuromodulation (SNM) System
Sponsored by
Axonics Modulation Technologies, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Overactive Bladder focused on measuring OAB

Eligibility Criteria

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

Inclusion Criteria:

  • Diagnosis of OAB as demonstrated on a 3-day voiding diary defined as ≥ 8 voids/day, and/or a minimum of 2 involuntary leaking episodes in a 72-hour period
  • Positive motor response on at least two implanted electrodes during intraoperative test
  • Failed, or are not a candidate for more conservative treatment (e.g., pelvic floor training, biofeedback, behavioral modification, oral pharmacotherapy)
  • No changes to current regimen of medications that affect bladder function for at least 4 weeks prior to beginning the baseline voiding diary
  • Willing and capable of providing informed consent
  • Capable of participating in all testing associated with this clinical investigation

Exclusion Criteria:

  • Primary stress incontinence or mixed incontinence where the stress component overrides the urgency component
  • Current urinary tract mechanical obstruction such as benign prostatic enlargement or urethral stricture
  • Interstitial cystitis or bladder pain syndrome as defined by either AUA or EAU guidelines
  • History of any pelvic cancer
  • Any significant medical condition that is likely to interfere with study procedures, device operation, or likely to confound evaluation of study endpoints
  • Any psychiatric or personality disorder at the discretion of the study physician
  • PHQ-9 Patient Depression Score ≥ 10
  • Current symptomatic urinary tract infection (UTI) or more than 3 UTIs in past year
  • Any neurological condition that may interfere with normal bladder function, including stroke, multiple sclerosis, Parkinson's disease, clinically significant peripheral neuropathy, or spinal cord injury (e.g., paraplegia)
  • Severe or uncontrolled diabetes (A1C > 8, documented in the last 3 months) or diabetes with peripheral nerve involvement
  • Treatment of urinary symptoms with botulinum toxin therapy in the past 12 months
  • Treatment of urinary symptoms with tibial nerve stimulation in the past 3 months
  • Previously implanted with a sacral neuromodulation device or participated in a sacral neuromodulation trial
  • Subject with a documented history of allergic response to titanium, zirconia, polyurethane, epoxy, or silicone
  • Knowledge of planned MRIs, diathermy, or high output ultrasonic exposure
  • Any other active implanted devices including neurostimulators (e.g., cochlear implant, pacemaker) and/or drug delivery pumps, whether turned on or off
  • Passive implants (e.g., prostheses) are allowed, but no implanted metal should be at the Neurostimulator implant site
  • A female who is breastfeeding or of child-bearing potential with a positive urine pregnancy test or not using adequate contraception
  • Participation in a current clinical trial or within the preceding 30 days

Sites / Locations

  • UZ Leuven
  • Hospices Civils de Lyon
  • Chu De Nantes - Hôtel-Dieu
  • Maastricht University Medical Center
  • Erasmus Medical Center
  • University College London Hospital

Arms of the Study

Arm 1

Arm Type

Other

Arm Label

Axonics SNM System

Arm Description

Axonics SNM Therapy for urinary control is indicated for the treatment of urinary retention and the symptoms of overactive bladder, including urinary urge incontinence and significant symptoms of urgency-frequency alone or in combination, in patients who have failed or could not tolerate more conservative treatments.

Outcomes

Primary Outcome Measures

Mean change in ICIQ-OABqol HRQL Total Score compared to baseline.
A disease-specific quality of life questionnaire. The ICIQ-OABqol is a psychometrically robust patient-completed questionnaire evaluating quality of life (QoL) in patients with overactive bladder for use in research and clinical practice across the world. The ICIQ-OABqol is the OAB-q adapted for use within the ICIQ structure and provides a detailed and robust measure to assess the impact of overactive bladder on quality of life. It is an ideal research tool as it explores in detail the impact on patients' lives of overactive bladder. The Third International Consultation on Incontinence recommended that all randomised trials evaluating treatments for incontinence use high quality questionnaires, in particular the ICIQ, to assess impact on patient outcome and facilitate comparisons. The ICIQ-OABqol provides a robust measure for this purpose.

Secondary Outcome Measures

Rate of serious adverse device effects (SADEs)
Rate of adverse device effects (ADEs)
Rate of adverse procedure effects (APEs)
Rate of serious adverse events (SAEs)
Rate of adverse events (AEs)
Device performance metrics
Data recorded from the patient's devices (Device Readings)
Average leaks per day (3-day voiding diary)
Average voids per day (3-day voiding diary)
Percent of subjects with successful treatment
Defined as either 1) a 50% improvement in the number of average leaks or the number of voids per day or 2) a return to a normal number of voids per day (<8 voids)
SF-12
General quality of life questionnaire
EQ-5D
Questionnaire assessing general quality of life
ICIQ-UI Short Form
Quality of life questionnaire assessing urinary incontinence
ICIQ-OABqol
Quality of life questionnaire assessing over active bladder
I-QOL
Quality of life questionnaire assessing urinary incontinence
Patient satisfaction with treatment
Questionnaire in scale format assessing treatment-specific satisfaction
Healthcare utilization
Questionnaire about subject's medical treatment

Full Information

First Posted
December 1, 2015
Last Updated
August 15, 2022
Sponsor
Axonics Modulation Technologies, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT02620410
Brief Title
Treatment of REfractory Overactive BLadder With the AXonics Sacral Neuromodulation System (RELAX-OAB)
Acronym
RELAX-OAB
Official Title
Treatment of REfractory Overactive BLadder With the AXonics Sacral Neuromodulation System (RELAX-OAB)
Study Type
Interventional

2. Study Status

Record Verification Date
August 2022
Overall Recruitment Status
Completed
Study Start Date
June 2016 (Actual)
Primary Completion Date
June 2017 (Actual)
Study Completion Date
January 2022 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Axonics Modulation Technologies, Inc.

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The RELAX-OAB (Treatment of REfractory Overactive BLadder with the AXonics Sacral Neuromodulation System) is a post-market clinical follow-up (PMCF) study designed to confirm the performance of the Axonics Sacral Neuromodulation (SNM) System as an aid in the treatment of the symptoms of overactive bladder (OAB) as well as capturing patient satisfaction and quality of life data.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Overactive Bladder
Keywords
OAB

7. Study Design

Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
51 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Axonics SNM System
Arm Type
Other
Arm Description
Axonics SNM Therapy for urinary control is indicated for the treatment of urinary retention and the symptoms of overactive bladder, including urinary urge incontinence and significant symptoms of urgency-frequency alone or in combination, in patients who have failed or could not tolerate more conservative treatments.
Intervention Type
Device
Intervention Name(s)
Axonics Sacral Neuromodulation (SNM) System
Other Intervention Name(s)
Axonics SNM System
Intervention Description
The implantable components of the Axonics Sacral Neuromodulation (SNM) System consist of an IPG and tined lead. Additional components include a clinician programmer, surgical tool kit, recharging kit, and patient remote control.
Primary Outcome Measure Information:
Title
Mean change in ICIQ-OABqol HRQL Total Score compared to baseline.
Description
A disease-specific quality of life questionnaire. The ICIQ-OABqol is a psychometrically robust patient-completed questionnaire evaluating quality of life (QoL) in patients with overactive bladder for use in research and clinical practice across the world. The ICIQ-OABqol is the OAB-q adapted for use within the ICIQ structure and provides a detailed and robust measure to assess the impact of overactive bladder on quality of life. It is an ideal research tool as it explores in detail the impact on patients' lives of overactive bladder. The Third International Consultation on Incontinence recommended that all randomised trials evaluating treatments for incontinence use high quality questionnaires, in particular the ICIQ, to assess impact on patient outcome and facilitate comparisons. The ICIQ-OABqol provides a robust measure for this purpose.
Time Frame
3 Months
Secondary Outcome Measure Information:
Title
Rate of serious adverse device effects (SADEs)
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
Rate of adverse device effects (ADEs)
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
Rate of adverse procedure effects (APEs)
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
Rate of serious adverse events (SAEs)
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
Rate of adverse events (AEs)
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
Device performance metrics
Description
Data recorded from the patient's devices (Device Readings)
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
Average leaks per day (3-day voiding diary)
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
Average voids per day (3-day voiding diary)
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
Percent of subjects with successful treatment
Description
Defined as either 1) a 50% improvement in the number of average leaks or the number of voids per day or 2) a return to a normal number of voids per day (<8 voids)
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
SF-12
Description
General quality of life questionnaire
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
EQ-5D
Description
Questionnaire assessing general quality of life
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
ICIQ-UI Short Form
Description
Quality of life questionnaire assessing urinary incontinence
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
ICIQ-OABqol
Description
Quality of life questionnaire assessing over active bladder
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
I-QOL
Description
Quality of life questionnaire assessing urinary incontinence
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
Patient satisfaction with treatment
Description
Questionnaire in scale format assessing treatment-specific satisfaction
Time Frame
3 Months, 1 Year, 2 Year post-implantation
Title
Healthcare utilization
Description
Questionnaire about subject's medical treatment
Time Frame
3 Months, 1 Year, 2 Year post-implantation

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Diagnosis of OAB as demonstrated on a 3-day voiding diary defined as ≥ 8 voids/day, and/or a minimum of 2 involuntary leaking episodes in a 72-hour period Positive motor response on at least two implanted electrodes during intraoperative test Failed, or are not a candidate for more conservative treatment (e.g., pelvic floor training, biofeedback, behavioral modification, oral pharmacotherapy) No changes to current regimen of medications that affect bladder function for at least 4 weeks prior to beginning the baseline voiding diary Willing and capable of providing informed consent Capable of participating in all testing associated with this clinical investigation Exclusion Criteria: Primary stress incontinence or mixed incontinence where the stress component overrides the urgency component Current urinary tract mechanical obstruction such as benign prostatic enlargement or urethral stricture Interstitial cystitis or bladder pain syndrome as defined by either AUA or EAU guidelines History of any pelvic cancer Any significant medical condition that is likely to interfere with study procedures, device operation, or likely to confound evaluation of study endpoints Any psychiatric or personality disorder at the discretion of the study physician PHQ-9 Patient Depression Score ≥ 10 Current symptomatic urinary tract infection (UTI) or more than 3 UTIs in past year Any neurological condition that may interfere with normal bladder function, including stroke, multiple sclerosis, Parkinson's disease, clinically significant peripheral neuropathy, or spinal cord injury (e.g., paraplegia) Severe or uncontrolled diabetes (A1C > 8, documented in the last 3 months) or diabetes with peripheral nerve involvement Treatment of urinary symptoms with botulinum toxin therapy in the past 12 months Treatment of urinary symptoms with tibial nerve stimulation in the past 3 months Previously implanted with a sacral neuromodulation device or participated in a sacral neuromodulation trial Subject with a documented history of allergic response to titanium, zirconia, polyurethane, epoxy, or silicone Knowledge of planned MRIs, diathermy, or high output ultrasonic exposure Any other active implanted devices including neurostimulators (e.g., cochlear implant, pacemaker) and/or drug delivery pumps, whether turned on or off Passive implants (e.g., prostheses) are allowed, but no implanted metal should be at the Neurostimulator implant site A female who is breastfeeding or of child-bearing potential with a positive urine pregnancy test or not using adequate contraception Participation in a current clinical trial or within the preceding 30 days
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sohier Elneil, MRCOG, PhD
Organizational Affiliation
University College London Hospital & National Hospital for Neurology & Neurosurgery
Official's Role
Principal Investigator
Facility Information:
Facility Name
UZ Leuven
City
Leuven
Country
Belgium
Facility Name
Hospices Civils de Lyon
City
Lyon
Country
France
Facility Name
Chu De Nantes - Hôtel-Dieu
City
Nantes
Country
France
Facility Name
Maastricht University Medical Center
City
Maastricht
Country
Netherlands
Facility Name
Erasmus Medical Center
City
Rotterdam
Country
Netherlands
Facility Name
University College London Hospital
City
London
Country
United Kingdom

12. IPD Sharing Statement

Learn more about this trial

Treatment of REfractory Overactive BLadder With the AXonics Sacral Neuromodulation System (RELAX-OAB)

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